1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 20 Pediatric Oral and Parenteral Medications

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pediatric Medications Most pediatric oral medications prepared as liquids Dosages for children dramatically smaller than dosages for adults

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pediatric Medications Most pediatric dosages based on child’s weight in kg –e.g., acetaminophen dosage 10 to 15 mg/kg

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pediatric Medications Most parenteral medications administered intravenously due to: –Limited IM sites in children –Pain involved with IM injections Immunizations are exception

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pediatric Calculations Same calculation methods learned to determine adult dosages are used for pediatric dosages

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Oral Medications Liquid medications: –Facilitate ease in swallowing –Usually experience more rapid absorption and action than solid dosage forms

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Measuring Liquid Medications Oral syringe Needleless hypodermic syringe Dropper

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Oral Syringe Contains metric calibrations –Similar to hypodermic syringes

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Needleless Hypodermic Syringe May be used if oral syringe not available

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Syringes Excellent for administering oral medications to infants and small children –Use appropriate techniques when administering to these special clients

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dropper Some common oral medication preparations incorporate calibrated medication dropper –e.g., infant acetaminophen If oral syringes available, syringes provide more ease in measuring desired dosages

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Suspensions Insoluble drug in liquid base Common preparation for many oral liquid medications

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Considerations with Suspensions Require thorough mixing immediately prior to measurement and prompt administration –Prevents settling of insoluble drugs

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Tablets/Capsules Child’s mouth must be checked to ensure medication swallowed Some medications prepared as chewable tablets

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Crushing Tablets Some tablets can be crushed Can be given in small amounts of applesauce, juice, or ice cream

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Safety Point If administering crushed tablets to infants, never mix with infant formula –Changes taste of infant’s primary food source Enteric coated and timed release tablets or capsules cannot be crushed

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parenteral Medications Dosages frequently calculated to nearest hundredth Measured using TB syringe

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Subcutaneous Medications Insulin Immunizations specifically requiring subcutaneous route Administered in any subcutaneous site with sufficient tissue –Upper arm most common

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. IM Medications Immunizations most common –e.g., diphtheria, tetanus, and pertussis (DTaP) Inject no more than 1 mL of medication into any site Rotate site regularly

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. IM Sites For infants and small children, choose vastus lateralis or rectus femoris in thigh –Gluteal muscles do not develop until child learns to walk