Administration Considerations for Children Biochemically, a drug displays the same mechanisms of action in all people. But the response to a drug can be affected by a child's age and size, as well as by the maturity of the target organ. To ensure optimal drug effect and minimal toxicity, consider the following factors when giving drugs to children. To read the rest of this blog, go here: InPharmation ...read more
By New Pharmacy Solutions January 18, 2010
Most drugs a breast-feeding mother takes appear in breast milk. Drug levels in breast milk tend to be high when drug levels in maternal blood are high, especially right after each dose. Advise the mother to breast feed before taking each drug dose, not after. A mother who wants to breast feed usually may continue to do so with her prescriber's advice. However, breast feeding should be temporarily interrupted and replaced with bottle-feeding when the mother must take tetracycline, chloramphenicol, a sulfonamide ( during the first 2 weeks post partum), an oral anticoagulant, a drug that contains iodine, or an antineoplastic. Caution the breast feeding patient to protect her infant by not taking drugs indiscriminately. Instruct the mother to first check with her prescriber to be sure she's taking the safest drug at the lowest dose. Also instruct her to give her prescriber a list of all drugs and herbs she's currently taking. ...read more
By New Pharmacy Solutions January 17, 2010
Drug therapy in children Providing drug therapy to infants, children, and adolescents is challenging. Physiologic differences between children and adults, including those in vital organ maturity and body composition, significantly influence a drug's effectiveness. Physiologic changes affecting drug action A child's absorption, distribution ( including drug binding to plasma proteins), metabolism, and excretion processes undergo profound changes that affect drug dosage. To ensure optimal drug effect and minimal toxicity, consider these factors when giving drugs to a child. Absorptions Drug absorption inchildren depends on the form of the drug, its physical properties, simultaneous ingestion of other drugs or food, physiologic changes, and concurrent disease. The PH of neonatal gastric fluid is nuetral or slightly acidic; it becomes more acidic as the infant matures, which affects drug absorption. For example, nafcillin and penicillin G are better absorbed in an infant than in an adult because of low gastric acidity. Various infant formulas or milk products may increase gastric pH and impede absorption of acidic drugs. If possible, give a child oral drugs on an empty stomach. Gastric emptying time and transit time through the small intestine – which takes longer in children than in adults – can affect absorption. Also, intestinal hypermotility ( as occurs in patients with diarrhea ) can diminish the drug's absorption. A child's comparatively thin epidermis allows increased absorption of topical drugs. Distribution As with absorption, changes in body weight and physiology during childhood can significantly influence a drug's distribution and effects. In a premature infant, body fluid makes up about 85% of total body weight; in a full term infant, it makes up 55% to 70%; in an adult, 50% to 55%. Extracellular fluid( mostly blood) constitutes 40% of a neonate's body weight, compared with 20% in an adult. Intracellular fluid remains fairly constant throughout life and has little effect on drug dosage. Extracellular fluid volume influences a water-soluble drug's concentration and effect because most drugs travel through extracellular fluid to reach their receptors. Compared with adults, distribution area in children is proportionately greater because their fluid to solid body weight proportion is larger. Because the proportion of fat to lean body mass increases with age, the distribution of fat – soluble drugs is more limited in children than in adults. As a result, a drug's fat or water solubility affects the dosage for a child. Metabolism A neonate's ability to metabolize a drug depends on the integrity of the hepatic enzyme system, intrauterine exposure to the drug, and the nature of the drug itself. Certain metabolic mechanisms are underdeveloped in neonates. Glucuronidation is a metabolic process that renders most drugs more water soluble, facilitating renal excretion. This process isn't developed enough to permit fulll pediatric doses until the infant is age 1 month. The use of chloramphenicol in a neonate may cause gray baby syndrome because the infant's immature liver can't metabolize the drug and toxic levels accumulate in the blood. Reduce dosage in a neonate and periodically monitor his levels. Conversely, intrauterine exposure to drugs may induce precocious development of hepatic enzyme mechanisms, increaing the infant's capacity to metabolize potentially harmful substances. Older children can metabolize some drugs ( theophylline, for exmaple) more rapidly than adults. This ability may come from their increased hepatic metabolic activity. Doses larger than those recommended for adults may be required. Also, more than one drug given to a child simultaneously may change the hepatic metabolism and initiate production of hepatic enzymes. Phenobarbital, for example, accelerates the metabolism of drugs taken with it and causes hepatic enzyme production. Excretion Renal excretion of a drug is the net result of glomerular filtration, active tubular secretion, and passive tubular reabsorption. Many drugs are excreted in the urine. The degree of renal development or presence of renal disease can greatly affect a child's dosage requirements because if a child can't excrete a drug renally, the drug may accumulate to toxic levels. Physiologically, an infant's kidneys differ from an adult's because infants have a high resistance to blood flow and their kidneys receive a smaller proportion of cardiac output. Infants have incomplete glomerular and tubular development and short, incomplete loops of Henle. ( child's GFR reaches an adult value between ages 2 1/2 and 5 months; his tubular secretion rate may reach an adult value between ages 7 and 12 months) Infants also are less able to concentrate urine or reabsorb certain filtered compounds. The proximal tubules in infants also are less able to secrete organic acids. Children and adults have dirnal variations in urine pH that correlate with sleep patterns ...read more
By New Pharmacy Solutions January 17, 2010
Homemade skin treatments are often organic; therefore, better for your skin. There are a variety of ways that you can treat your skin at home using things that you already have. There are no harsh chemicals that can dry out your skin leaving it feeling worse than it did before. ...read more
Most of the cosmetics we put on our skin make its way into the blood stream. Many cosmetic companies are still using dangerous ingredients in cosmetic and personal care products. Paraben is one of the ingredients found in cosmetics, and can cause cancer, weight gain and even ages your skin. You can fi... ...read more