Medicines use in children and others Flashcards Preview

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Flashcards in Medicines use in children and others Deck (18):

Children dosage and administration

Dose sizes are not one size fits all, dosed by age and/or body weight, high risk of errors
Carefully consider administration: age appropriate formulation, palatability, who/where



Calculated by age and/or weight
Always try to check the actual weight of a child- use guide in back of BNFc, be aware child may not always fit bracket
Always double check dosages- more difficult to spot errors
Label in a way the patient/ carer can relate to e.g. mls vs mgs


Administration considerations

Developmental milestones- all children develop at different rates, normal is a broad descriptor
Administration increasingly occurs outside the home, nanny/ childminder authorised by parents to use certain medication, can encounter difficulties when giving medicines during the school day
Community and hospital pharmacies need to be able to advise parents and children on basic methods of administration of medicines


Successful administration

Positive attitude
Involve the whole family
Be honest
Empower the child
Seek advice
Use incentives


Information provision

Important that age appropriate and relevant information is provided to the parent and patient
Consider safe storage within the home
It is a legal requirement for all dispensed medicines to be supplied with a PIL


Illness in childhood

Acute infection
Congenital disease
Childhood conditions
Mental health



Medicines must be tested in a specific patient group to be granted a marketing authorisation for use in that patient group
No license does not mean medicines are ineffective
Unethical to test new medicines on children
Paediatric specialists will use unlicensed medicines on children in practice
BNFc allows us to utilise these practical experiences


Developmental issues

Doses of medication and administration issues will need regular review as the child develops
Encourage and support children on long term medication to take responsibility for their medication
Opportunities available for health education



Community pharmacists are an important resource for parents
Childhood vaccination schedule
Education and advice


General recommendations

Know differences in appropriate treatments and licensed medications in children
Ensure adverse events are given due consideration
Review recommendations as the child grows
Be able to provide general health advice


Elderly poopulations

Proportion of older people in the UK continues to rise
Anticipated that social factors will drive health and social care arrangements
Current approach must be modified to ensure that care of elderly patients is patient centred and outcome focused
Medicines optimisation to support: patient capability, independence, re-ablement



Medication review to avoid unnecessary polypharmacy
Simplify medication regimes
Medication counselling
Compliance charts
MAR charts
Pictogram labels
Large print labels
Reminder alarms
Multi compartment compliance aids


Compliance aids

Consider suitability of individual medication:
dosage regime
storage requirements
other medication


Practical considerations of compliance aids

Repackaging of medicines out of the manufacturer's original packaging makes them unlicensed- stability, expiry date, PIL
Consider accountability- risk vs benefit, liability
Document discussions with patient/ carer/ prescriber



Difficulty with the act of swallowing- unable to swallow, sensation of sticking, choking episodes, aspiration of food and/or liquids
Some children born with swallowing difficulties: cerebral palsy, cleft lip/ palate, GORD


Treatment of dysphagia

Treatment depends on exact cause: swallowing exercises, SALT, thickened fluids/ feeds, feeding tube
Aim is to return patient to normal


Medicines in dysphagia

Conversion of solid oral dosage forms: alternative formulations or alternative methods of administration
Always use licensed product if available- may need to change drug, formulation, route etc.
Consider specials


Physical impairment

Legal requirement that dispensed medicines are labelled keep out of reach and sight of children
Blister packaging is strengthened
Where packing down, medicines are dispensed with CRC
Consider patient groups e.g. rheumatoid arthritis, parkinsons
Use non-CRC closures with patient education