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LEARNING OBJECTIVES

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LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Define different age groups within the pediatric population.

  2. Explain general pharmacokinetic and pharmacodynamic differences in pediatric versus adult patients.

  3. Identify factors that affect selection of safe and effective drug therapy in pediatric patients.

  4. Identify strategies for appropriate medication administration to infants and young children.

  5. Apply pediatric pharmacotherapy concepts to make drug therapy recommendations, assess outcomes, and effectively communicate with patients and caregivers.

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KEY CONCEPTS

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  • Image not available. Despite the common misconception of pediatric patients as "smaller adults" where doses are scaled only for their smaller size, there are multiple factors to consider when selecting and providing drug therapy for patients in this specific population.

  • Image not available. Due to multiple differences including age-dependent development of organ function in pediatric patients, pharmacokinetics, efficacy, and safety of drugs within the pediatric population often differs from adults; thus pediatric dosing should not be calculated based on a single factor of difference.

  • Image not available. It is appropriate to use a drug off-label when no alternatives are available; however, clinicians should refer to published studies and case reports for available safety, efficacy, and dosing information.

  • Image not available. Medication errors among pediatric patients are possible due to differences in dose calculation and preparation; it is important to identify potential errors through careful review of orders, calculations, dispensing, and administration of drug therapy to infants and children.

  • Image not available. Comprehensive and clear parent/caregiver education improves medication adherence, safety, and therapeutic outcomes; thus caregiver education is essential because they are often responsible for the administration and monitoring of drug therapy in infants and young children.

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INTRODUCTION

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Pediatric clinical practice involves the care of infants, children, and adolescents with the goal of optimizing their health, growth, and development toward adulthood. Clinicians serve as advocates for this unique and vulnerable patient population to optimize their well-being.

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There is a continued need for pediatric healthcare resources, evidenced by the annual increase in the number of infants born in the United States.1 Ambulatory care settings, such as the pediatrician office and emergency department, as well as hospitals, require the expertise of knowledgeable clinicians with pediatric experience. In fact, national data have noted the lack of appropriate services and supplies for pediatric patients at many institutions.2 Pediatric care accounts for a considerable amount of total patient care annually. For example, patients younger than 15 years accounted for more than 20% of outpatient visits in the United States in 2008.3 Among pediatric visits, more than half of the medications documented were new drug therapies with the majority being antibiotics.4,5 Image not available. Despite the common misconception of pediatric patients as "smaller adults" where doses are scaled only for their smaller size, there are multiple factors to consider when selecting and providing drug therapy for patients in this specific population. Pediatric patients significantly differ within their age groups and from adults regarding drug administration, ...

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