Quality Drug Therapy in Children: Formulations and Delivery

Abstract

The majority of medications that a chronically ill child under the age of 12 may receive are not formulated for easy or accurate administration. The younger the child the more likely this lack of appropriate formulation exists. Even in the instance of extemporaneously compounded pediatric formulations, generally there are no data on the bioavailability of these products. Therefore, administration of medication is inherently a less precise process in children than in adults. This precision is further reduced by the equipment employed in drug delivery, particularly intravenous delivery. This lack of precision has led to medication errors, drug-drug incompatibilities, and unnecessary and inappropriate blood level monitoring. Ofien, clinicians are unsure as to whether a lack of desired effect is related to the child, the delivery system, or the formulation. When a drug is formulated for pediatric use, several factors unique to pediatrics must be examined. Additives, including common preservatives and sugar; must be chosen carefully. With the release of new drugs formulated for adults but with expected use in children, helpful basic information about product stability will ease the concern associated with preparing extemporaneous pediatric formulations. Finally, future research should not only answer current formulation needs but also investigate new routes of drug delivery for infants and children.

Clinical Significance of Medication Reconciliation in Children Admitted to a UK Pediatric Hospital

“…Conversely, there is a large body of evidence that demonstrates that medication errors in hospital can harm patients, including pediatric patients. [5,10,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Knowledge of the patient's current medication regimen as presented by the patient or their caregiver is a prerequisite for determining the AMOs. However, the hospital prescriber also needs to know the most recent medication regimen as prescribed by the patient's usual healthcare professional.…”

Clinical Significance of Medication Reconciliation in Children Admitted to a UK Pediatric Hospital

“…Conversely, there is a large body of evidence that demonstrates that medication errors in hospital can harm patients, including pediatric patients. [5,10,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Knowledge of the patient's current medication regimen as presented by the patient or their caregiver is a prerequisite for determining the AMOs. However, the hospital prescriber also needs to know the most recent medication regimen as prescribed by the patient's usual healthcare professional.…”

Preparation of extemporaneous oral liquid in the hospital pharmacy

“…4 -In the absence of liquid oral formulation in pharmacopoeias and formularies, the pharmacist can search for the formulations in the scientific literature (Figure 1/situation 4), such as books (Fernandez, Atienza, 2002;Jackson, Lowey, 2010;Jew et al, 2010), and scientific journals (Mcrorie, 1996;Nahata, 1999;Brion, Nunn, Rietour, 2003;Nunn, Williams, 2005; FIGURE 1 -Situational analysis to the preparation of extemporaneous oral liquid (Glass, Haywo, 2006). Page 10 / 15 Glass, Haywood, 2013;Johohann, Mastroianni, 2016;Campbell, Vallejo, 2015;Mimouni, Van der Anker, 2015;Dijkers et al, 2017;Roque, 2017).…”

Clinical Significance of Medication Reconciliation in Children Admitted to a UK Pediatric Hospital

“…Conversely, there is a large body of evidence that demonstrates that medication errors in hospital can harm patients, including pediatric patients. [5,10,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Knowledge of the patient's current medication regimen as presented by the patient or their caregiver is a prerequisite for determining the AMOs. However, the hospital prescriber also needs to know the most recent medication regimen as prescribed by the patient's usual healthcare professional.…”

Preparation of extemporaneous oral liquid in the hospital pharmacy

“…4 -In the absence of liquid oral formulation in pharmacopoeias and formularies, the pharmacist can search for the formulations in the scientific literature (Figure 1/situation 4), such as books (Fernandez, Atienza, 2002;Jackson, Lowey, 2010;Jew et al, 2010), and scientific journals (Mcrorie, 1996;Nahata, 1999;Brion, Nunn, Rietour, 2003;Nunn, Williams, 2005; FIGURE 1 -Situational analysis to the preparation of extemporaneous oral liquid (Glass, Haywo, 2006). Page 10 / 15 Glass, Haywood, 2013;Johohann, Mastroianni, 2016;Campbell, Vallejo, 2015;Mimouni, Van der Anker, 2015;Dijkers et al, 2017;Roque, 2017).…”

Clinical Significance of Medication Reconciliation in Children Admitted to a UK Pediatric Hospital

“…Conversely, there is a large body of evidence that demonstrates that medication errors in hospital can harm patients, including pediatric patients. [5,10,12,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Knowledge of the patient's current medication regimen as presented by the patient or their caregiver is a prerequisite for determining the AMOs. However, the hospital prescriber also needs to know the most recent medication regimen as prescribed by the patient's usual healthcare professional.…”

Preparation of extemporaneous oral liquid in the hospital pharmacy

“…4 -In the absence of liquid oral formulation in pharmacopoeias and formularies, the pharmacist can search for the formulations in the scientific literature (Figure 1/situation 4), such as books (Fernandez, Atienza, 2002;Jackson, Lowey, 2010;Jew et al, 2010), and scientific journals (Mcrorie, 1996;Nahata, 1999;Brion, Nunn, Rietour, 2003;Nunn, Williams, 2005; FIGURE 1 -Situational analysis to the preparation of extemporaneous oral liquid (Glass, Haywo, 2006). Page 10 / 15 Glass, Haywood, 2013;Johohann, Mastroianni, 2016;Campbell, Vallejo, 2015;Mimouni, Van der Anker, 2015;Dijkers et al, 2017;Roque, 2017).…”