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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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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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Manipulating prednisolone tablets for paediatric adjustments - dose accuracy and precision.

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

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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.