Transcript Pediatric Drug Therapy

Chapter 5
Drug Therapy for
Pediatric Clients
Pediatric Drug Therapy


Approximately 75% of all prescription
drugs in the U.S. lack full approval by the
FDA because most drugs are not studied
on children.
Studying the effects of drugs in children
is a problem.
5-2
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Absorption




Gastric acid (hydrochloric acid)
secretion in infants
Choosing the intramuscular injection
site
Topical drug absorption
Intravenous drug administration
5-3
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Distribution
Dependent upon the amount of water
and/or fat present in the child, as well
as plasma affinity of the drug and
protein-binding activity



Water-soluble drugs effectively utilized
Protein binding capacity is less
5-4
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Metabolism


Difficult to predict
Maternal drug history is important
5-5
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Excretion
Kidney maturation



Excretion increases as the kidney matures
Drug toxicity decreases as the kidney
matures
5-6
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Pediatric Drug Sensitivity
Central nervous system drugs


Barbiturates and morphine


Depressant effects are exaggerated
Lowering body temperature

Acetaminophen
•

Becomes toxic easily with large doses
Salicylates
•
Do not give to children under the age of 12.
5-7
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Pediatric Dosages
Determined by using a nomogram


Nomograms are generally accurate after
the attainment of mature liver and kidney
function.
5-8
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Rights to Follow
Allow adequate time for drug
administration.
Gain the child’s trust.





Never lie to the child.
Consider the child’s developmental
level.
Prevent choking.
5-9
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Administration Methods

Liquid medications are administered
using an infant dropper, syringe without
a needle, or a small spoon
5 - 10
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Parenteral Medications
Explain the procedure to the child and to
the parents.
Use additional materials such as:







Booklets
Coloring books
Puppets
Dolls
IV setup with colored water
5 - 11
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Painful Procedures





Allow the parents to stay.
Painful procedures should be done in a
separate room designated as the “owie”
room.
Use a firm positive manner.
Assemble equipment first.
Maintain the child’s safety.
5 - 12
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Intramuscular Injections
Vastus lateralis is the preferred site for
children under the age of 3.
Ventrogluteal site is the preferred site
for children over the age of 3.



5 - 13
The child should be walking.
(continues)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
(continued)
5 - 14
Anterior view of the location of the vastus
lateralis muscle in a young child.
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Final Step in Administering Drugs
Evaluate drug action
Remember





Children are vulnerable.
Be kind and patient.
Enjoy the children; you will receive more
than you give.
5 - 15
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.