The pediatric cardiology pharmacopoeia

Keeping up with a rapidly growing list of medications has always been a breathtaking and, at times, impossible task to master. Contrary to common belief, the enormity of keeping abreast with the more recently developed medications is not a modern phenomenon resulting from the great technological advances of the past few years, but an ongoing struggle spanning the latter half of this century. It appears that there are more drugs to use than to know how, when, or what to do with them. This sentiment was expressed in 1973 by the editors of Martindale's The Extra Pharmacopoeia, twenty-sixth edition [3]: "The unprecedented rate at which our knowledge of medicine and pharmacy is advancing makes it a formidable challenge to provide within a single volume an up-to-date source of basic information on the properties and uses of the many drugs in current use." In this article, a review of the medications currently used in the management of children with heart diseases is presented. The medications have been collected in groups based upon their pharmacological actions: Antiarrhythmic, antihypertensive, diuretics, sedatives and miscellaneous agents. Within each group the agents are listed alphabetically using chemical names. We attempted to include as many drugs as thought to be of relevance to the team of health practitioners involved in the care of children with cardiac problems. Various routes of administration are presented, some of which have been infrequently described in the pediatric literature, such as continuous infusion of diuretic agents [22]. The dosing ranges were adopted from many sources [1, 5, 8, 9, 17-19, 22, 23, 26], and we sought to include the widest ranges of dosages published. All dosages listed in Table 1 are quantitated per dose and not per day. This approach was adopted as it reduces calculations and the potential for medication errors.