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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Intravenous (IV) infusion is often utilized when continuous and controlled drug delivery is necessary, such as during surgery or in the treatment of chronic diseases. This method offers numerous advantages, including immediate drug action, precise control over dosage, and bypassing the first-pass metabolism.
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PAEDIATRIC STANDARDISED CONCENTRATION INFUSIONS - A NATIONAL SOLUTION.

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Cross-site collaboration successfully expanded a paediatric drug library for standardised concentration infusions (SCIs). This initiative enhances resource use and aims to reduce medication errors across multiple healthcare sites.

Keywords:
AbstractOral

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Area of Science:

  • Pediatric critical care
  • Medication safety
  • Health informatics

Background:

  • Implementation of paediatric standardised concentration infusions (SCIs) and smart pump technology has been slow in Europe.
  • Multidisciplinary collaboration, particularly pharmacy input and smart pump drug libraries, are crucial but often limiting factors.
  • Previous success in developing a paediatric drug library at a single tertiary children's hospital prompted expansion.

Purpose of the Study:

  • To develop and implement a paediatric drug library for standardised concentration infusions across multiple healthcare sites.
  • To overcome barriers to widespread adoption of SCIs and smart pump technology.
  • To facilitate multisite adoption of a standardised drug library, including paediatric acute transport services.

Main Methods:

  • Established a cross-site multidisciplinary collaborative working group with representation from pharmacy, intensivists, nursing, and clinical engineering.
  • Utilized a database for tracking amendments and expansions to an existing SCI drug library.
  • Resolved inter-site practice differences through consensus, omission, or 'hiding' of drug lines, and established legally binding agreements.

Main Results:

  • Successfully amended and extended the original drug library to create a new master drug file through cross-site collaboration.
  • Developed and disseminated individual site versions of the library and supporting documentation.
  • Created and agreed upon a change control management plan for ongoing library maintenance.

Conclusions:

  • Cross-site collaboration is feasible and effective in supporting the implementation of standardised concentration infusions.
  • Standardising practices across sites optimizes human and financial resources.
  • The initiative has the potential to reduce medication errors during patient and staff transfers between sites.