Drug Therapy for Pediatric Clients Chapter 5. Copyright 2007 Thomson Delmar Learning, a division of...

Drug Therapy for Pediatric Clients

Chapter 5

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

5 - 2

Pediatric Drug Therapy

Approximately 75% of all prescription drugs in the U.S. lack full approval by the FDA because most drugs are not studied on children.

Studying the effects of drugs in children is a problem.


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Absorption

Gastric acid (hydrochloric acid) secretion in infants

Choosing the intramuscular injection site

Topical drug absorption Intravenous drug administration


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Distribution

Dependent upon the amount of water and/or fat present in the child, as well as plasma affinity of the drug and protein-binding activity

Water-soluble drugs effectively utilized Protein binding capacity is less


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Metabolism

Difficult to predict Maternal drug history is important


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Excretion

Kidney maturation Excretion increases as the kidney matures Drug toxicity decreases as the kidney

matures


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Pediatric Drug Sensitivity

Central nervous system drugs Barbiturates and morphine

Depressant effects are exaggerated Lowering body temperature

Acetaminophen• Becomes toxic easily with large doses

Salicylates • Do not give to children under the age of 12.


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Pediatric Dosages

Determined by using a nomogram Nomograms are generally accurate after

the attainment of mature liver and kidney function.


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Rights to Follow

Allow adequate time for drug administration.

Gain the child’s trust. Never lie to the child.

Consider the child’s developmental level.

Prevent choking.


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Administration Methods

Liquid medications are administered using an infant dropper, syringe without a needle, or a small spoon


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Parenteral Medications

Explain the procedure to the child and to the parents.

Use additional materials such as: Booklets Coloring books Puppets Dolls IV setup with colored water


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Painful Procedures

Allow the parents to stay. Painful procedures should be done in a

separate room designated as the “owie” room.

Use a firm positive manner. Assemble equipment first. Maintain the child’s safety.


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Intramuscular Injections

Vastus lateralis is the preferred site for children under the age of 3.

Ventrogluteal site is the preferred site for children over the age of 3.

The child should be walking.

(continues)


5 - 14

Anterior view of the location of the vastus lateralis muscle in a young

child.

(continued)


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Final Step in Administering Drugs

Evaluate drug action Remember

Children are vulnerable. Be kind and patient. Enjoy the children; you will receive more

than you give.

Drug Therapy for Pediatric Clients Chapter 5. Copyright 2007 Thomson Delmar Learning, a division of...

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