1. Pediatric Pharmacology Overview
Elizabeth Allen NR, MSN

2. Learning Objectives
Nursing Considerations for Safe Preparation and Administration of Pediatric Medications
Locate reconstitution and dilution instructions in mobile drug reference guide (Skyscape or drug book)
Verify correct drug, appropriateness for clinical situation, lab values needing review and monitoring parameters
Complete the necessary calculations to ensure safe dosage
Pounds to kilograms, safe dosage range in milligrams per dose (may need to convert mg/kg/day to mg per dose)
Reconstitute antibiotic medication according to manufacturers guidelines
Dilute medication for administration according to manufacturers guidelines and as appropriate for the weight of the child
Determine how the medication will be delivered and administer medication in the laboratory setting via IV push, piggy back or syringe pump (if syringe pump available)
Assessing effectiveness of medication

3. Pediatric Pharmacology
Pediatric patients are not “little adults”
Body surface area
Absorption
Immature organ systems
Increased body surface area. Increased integumentary absorption, ___________. Immature organ systems, like kidneys. Less efficient filtering at <2 years. Liver also less efficient at drug breakdown

4. Pediatric Pharmacology
Medications given based on weight in kg
Know exact weight for pediatric patient and each medication is calculated for dose
Look up:
Pediatric dosing
May depend on condition
Mg/kg/day in divided doses, maximum dose
Adverse Effects
Mechanism of Action
Administration & Reconstitution
Monitoring

5. Pediatric Pharmacology
Medication Order
Medication
Dose
Route
Time
Parameters (ex. Severe pain, >7)
Safety checks at: time of order, in pharmacy (verifying the order and preparing the medication) and by nurse prior to giving a medication

6. Pediatric Pharmacology
ATI Resources
Med Math
D(Desired dose) X V (Vehicle-tab or Liquid)=Amount to Give
H (dose on hand)
Example: Order-Dilantin 50mg p.o. TID                   Drug available-Dilantin 125 mg/5ml

7. Pediatric Pharmacology
Provider order:
Look up pediatric dosage range
Calculate dose to ensure it is safe
Critically Think: Is this an appropriate drug given the clinical situation?
Are there any assessments or labs to be done or checked prior to giving this dose?
How can drug be administered (correct route?)
How to reconstitute drug
How quickly or slowly to give medication
What potential side effects to assess for
OK you are the nurse. Go through these steps