1. Drug Therapy for Pediatric Clients
Chapter 5
Drug Therapy for Pediatric Clients

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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3. Absorption Gastric acid (hydrochloric acid) secretion in infants
Choosing the intramuscular injection site
Topical drug absorption
Intravenous drug administration
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4. 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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5. Metabolism Difficult to predict Maternal drug history is important
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6. Excretion Kidney maturation Excretion increases as the kidney matures
Drug toxicity decreases as the kidney matures
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7. 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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8. Pediatric Dosages Determined by using a nomogram
Nomograms are generally accurate after the attainment of mature liver and kidney function.
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9. 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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10. Administration Methods
Liquid medications are administered using an infant dropper, syringe without a needle, or a small spoon
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11. 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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12. 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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13. 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)
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14. (continued)
Anterior view of the location of the vastus lateralis muscle in a young child.
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15. 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.
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.