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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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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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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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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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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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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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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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Dosage Regimen Designs: Nomograms and Tabulations01:23

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Nomograms and tabulations are vital tools used by clinicians to design accurate and individualized dosage regimens. These instruments provide a straightforward method for adjusting dosages based on individual patient characteristics, including age, weight, and physiological condition. The foundation of a drug's nomogram is population pharmacokinetic data collected and analyzed using specific models. This data simplifies complex equations, presenting them diagrammatically or tabularly for easy...
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Updated: Mar 21, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
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Manipulating prednisolone tablets for paediatric adjustments - dose accuracy and precision.

Randi Maria Hamre Svendsen1,2, Ellen Hagesaether3, Sarah Maud Fischer1

  • 1Oslo Hospital Pharmay, Hospital Pharmacy Enterprise, Oslo, Norway.

European Journal of Hospital Pharmacy : Science and Practice
|March 19, 2026
PubMed
Summary

Manipulating prednisolone tablets for pediatric dosing can be inaccurate. Pharmacy compounded suspensions offer higher accuracy for precise prednisolone administration when needed.

Keywords:
Chemistry, PharmaceuticalDrug CompoundingPATIENT SAFETYPEDIATRICSPHARMACY SERVICE, HOSPITAL

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Area of Science:

  • Pharmaceutical Sciences
  • Pediatric Pharmacology

Background:

  • Prednisolone is a crucial medication for adults and children.
  • Tablet manipulation is common in pediatrics to achieve accurate dosing and ease administration.

Purpose of the Study:

  • To assess the dose accuracy of manipulated prednisolone tablets.
  • To compare tablet manipulation techniques with compounded suspensions for pediatric dosing.

Main Methods:

  • Ultra-high-performance liquid chromatography (UHPLC) was used to quantify prednisolone in tablet fragments and suspensions.
  • Tested 2.5 mg and 5 mg tablets from different manufacturers and a 1 mg/mL compounded suspension.
  • Evaluated accuracy and precision of splitting tablets into halves/quarters and dispersing fragments.

Main Results:

  • Tablet splitting into halves and quarters yielded accuracy within ±15%.
  • Dispersing fragments in oral syringes resulted in an average 6% prednisolone loss, with stability up to 6 hours.
  • Pharmacy compounded suspensions demonstrated superior accuracy (±10%) and precision compared to manipulated tablets.

Conclusions:

  • Splitting prednisolone tablets into halves or quarters provides clinically acceptable accuracy for general use.
  • For precise dose tapering or when higher accuracy is critical, pharmacy compounded suspensions are recommended.
  • Compounded suspensions ensure greater accuracy and precision for specific pediatric prednisolone administration needs.