Drug formulations that require less than 0.1 mL of stock solution to prepare doses for infants and children

Uppal, Navjeet; Yasseen, Baseer; Seto, Winnie; Parshuram, Christopher S.

doi:10.1503/cmaj.100467

Cited by 26 publications

(21 citation statements)

References 15 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Isaac et al 35 found that 25% of patients on paediatric intensive care units were prescribed a medicine that required a small volume measurement of ≤0.2 mL, with the intravenous route accounting for 80% of the drug delivery methods. Uppal et al 14 provide further support, stating that 7.4% of intravenous doses require preparation with <0.1 mL of stock solution. It was concluded that this is necessary for the paediatric use of a wide range of narcotics and immunosuppressants in Canada14 with captopril, morphine, furosemide and ranitidine the most commonly found in the UK 35…”

Section: Resultsmentioning

confidence: 97%

“…Uppal et al 14 provide further support, stating that 7.4% of intravenous doses require preparation with <0.1 mL of stock solution. It was concluded that this is necessary for the paediatric use of a wide range of narcotics and immunosuppressants in Canada14 with captopril, morphine, furosemide and ranitidine the most commonly found in the UK 35…”

Section: Resultsmentioning

confidence: 97%

“…A further nine references were identified through backward citation tracking14 45–52 and 17 were highlighted by the review team5–9 53–64 (see online supplementary appendix C). …”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 97%

See 1 more Smart Citation

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A retrospective study performed by Uppal and colleagues examined medications that had commercially available parenteral formulations listed in the Hospital for Sick Children formulary, and it was found that 22 % of medications used in neonates had one or more indications that required less than 0.1 mL of stock solution [68]. In an additional clinical observational study, these investigators found that over 7 % of the doses administered to patients admitted to their pediatric intensive care unit over a 1-year period were prepared from less than 0.1 mL of stock solution [68]. While concentration data were not available for patients treated with these drugs, it is likely that there would have been a large variability resulting from the imprecise dosing often seen with doses prepared from less than 0.1 mL of stock solution.…”

Section: Intravenousmentioning

confidence: 99%

Challenges Associated with Route of Administration in Neonatal Drug Delivery

et al. 2015

View full text Add to dashboard Cite

The administration of drugs to neonates poses significant challenges. The aim of this review was to provide insight into some of these challenges and resolutions that may be encountered with several of the most commonly used routes of administration and dosage forms in neonatal care, including oral, parenteral, transdermal, intrapulmonary, and rectal. Important considerations include fluctuations in stomach pH hours to years after birth, the logistics of setting up an intravenous infusion, the need for reduced particle size for aerosol delivery to the developing neonatal lung, and variation in perirectal venous drainage. Additionally, some of the recently developed technologies for use in neonatal care are described. While the understanding of neonatal drug delivery has advanced over the past several decades, there is still a deficiency of technologies and formulations developed specifically for this population.

show abstract

“…There is a risk that the dose delivered will be inaccurate and that medication errors may occur when calculating and preparing doses 4. There is little information about the extent of manipulation in paediatric practice, the accuracy with which dosage forms can be manipulated or the drugs commonly involved 5 6…”

Section: Introductionmentioning

confidence: 99%

Estimating the requirement for manipulation of medicines to provide accurate doses for children

et al. 2012

View full text Add to dashboard Cite

Objective To determine the type and frequency of manipulations of drug dosage forms required to administer smaller doses for children and the drugs involved. Methods An experienced paediatric clinical pharmacist estimated the requirement to manipulate a medicine to achieve accurate dose administration from prescription data in all neonatal and paediatric inpatients collected over 5-day periods and information on drug dosage form availability in a regional children's hospital (RCH) and regional paediatric intensive care unit (RPICU), a regional neonatal intensive care unit (RNICU) and paediatric and neonatal wards of a district general hospital (DGH) using paper-based prescribing systems. Doses were expressed by weight. Ward stock supply with some intravenous drugs ready-to-administer was provided. The main outcome measures were the estimated requirement for dosage form manipulation, nature of the manipulation and drug name. Results Of 5375 evaluated drug administrations, 542 (10.1%) were judged to require manipulation or measurement of a small volume (<0.2 ml). The most frequent manipulation was measurement of oral dose in volumes of 0.1 to <0.2 ml in the DGH. Requirement to measure doses of <0.1 ml (oral and intravenous) accounted for 25.2% of all manipulations, with the need to measure intravenous doses of <0.1 ml being most frequent in the RNICU and RPICU (60.4% and 31.9% of manipulations, respectively). Hydrocortisone was the drug most frequently judged to require manipulation with both measurement of small volumes for intravenous injection (RPICU and RNICU) and segmentation of tablets (RCH). Conclusions Manipulation of medicines (including measurement of very small volumes) to provide accurate smaller doses for children is common in the hospital setting

show abstract

Drug formulations that require less than 0.1 mL of stock solution to prepare doses for infants and children

Abstract: Research

Cited by 26 publications

References 15 publications

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

Accuracy of intravenous and enteral preparations involving small volumes for paediatric use: a review

Challenges Associated with Route of Administration in Neonatal Drug Delivery

Estimating the requirement for manipulation of medicines to provide accurate doses for children

Contact Info

Product

Resources

About