Pediatrics - Pharmacology

Special care must be given when administering medication to pediatric patients because their organs are immature and they might have difficulty absorbing, distributing, and excreting the medication. This is especially true with neonatal patients. Neonatal patients can receive some medication through breast milk. However, because the mother has already metabolized and excreted the medication, less than the original dose is passed into breast milk.

Other medications cannot be given to a mother who is breastfeeding because of the toxic effect the medication has on the baby (unless breastfeeding is interrupted for 24 hours to 72 hours).

These medications include amphetamines, bromocriptine, cocaine, cyclophosphamide, cyclosporine, doxorubicin, ergotamine, gold salts, lithium, methotrexate, nicotine, and phenindione.

Organs in the neonate might be unable to handle the normal dose of some medications. For example, the stomach lacks acid, gastric emptying time is prolonged, the liver and kidneys are immature, and there is a decrease in protein binding.


There is n’t a standard dose for pediatric patients. The dose is calculated using the patient’s weight or the patient’s body surface area. Some over-the-counter medications specifies a dose based on the child’s age, but these are really based on the average weight of a child within that age range. The dose can become problematic if the child’s weight is lower or higher than that of the age group. If a child with a very low weight receives an age-related dose it might result in an undesirable adverse affect from the medication. When a child who is heavier than average receives a dose related to age, the drug may not have a therapeutic effect.

Before administering medication to a pediatric patient consult with the parents to assess if the patient has allergies to food, medications, and the environment,a family history of allergies, an experience with medications and illnesses, or is taking any other medication or herbal remedies.

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