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Perioperative Pharmacologic Considerations in the Care of Children with Medical Complexity

Leanne Svoboda1, Zarema Muratova2, Dimitrios A Savva3

  • 1Pediatrics, Department of Pharmacy, New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA.

Pediatric Clinics of North America
|April 22, 2026
PubMed

Insights

Managing medications for children with medical complexity (CMC) requires careful consideration of unique physiological factors, polypharmacy, and safety. Optimizing care involves addressing health literacy and coordinating interventions for better outcomes.

Area of Science:

  • Pediatric pharmacology
  • Complex care management

Background:

  • Children with medical complexity (CMC) present unique challenges in medication management.
  • Polypharmacy and specific physiological characteristics complicate treatment regimens.

Purpose of the Study:

  • To outline key considerations for optimizing medication management in CMC.
  • To highlight strategies for improving safety and efficacy of pharmacotherapy in this population.

Main Methods:

  • Review of pharmacokinetic and pharmacogenomic factors relevant to CMC.
  • Discussion of medication safety practices, including reconciliation and interaction monitoring.
  • Emphasis on patient and caregiver health literacy and communication.

Main Results:

  • Pharmacokinetic and pharmacogenomic variations significantly impact drug response in CMC.
  • Medication reconciliation and drug-drug interaction assessment are critical for safety.
  • Addressing health literacy and communication enhances care adherence and outcomes.

Conclusions:

  • A nuanced, multidisciplinary approach is essential for effective medication management in CMC.
  • Interventions like sedation weaning and coordinated care planning improve quality of life.
  • Tailored strategies considering individual patient needs are paramount for this vulnerable group.

Keywords:
Health literacyMedication safetyPharmacotherapy

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