Navigating Pediatric Medications Dosages: A Guide for Parents in India and World 2024|Watchdoq: Top Hospitals, Doctors,

A Parent's Guide to Pediatric Medication Dosages: Precise Care for Precious Lives

In the realm of pediatric dosing, understanding the right medication amounts is crucial. This comprehensive guide ensures your child receives precise care.

Parenting comes with its set of challenges, and when your little ones fall ill, navigating the world of pediatric medications can be overwhelming. Ensuring accurate dosages tailored to your child's age and weight is paramount for their well-being. This guide is your ally in deciphering the complexities of pediatric dosing, offering a detailed breakdown for commonly used medications.

Paediatric Dosing

Child Age	Child's Weight (kg)	Paracetamol (120 mg/5 ml)	Ibuprofen (100 mg/5 ml)	Amoxicillin (125 mg/5 ml)	Amoxicillin + Clavulanic acid (125 mg + 31.25 mg)/5 ML	Cephalexin (125 mg/5 ml)	Erythromycin (200 mg/5 ml)	Cloxacillin (125 mg/5 ml)	Metronidazole (125 mg/5 ml)	Cefuroxime (125 mg/5 ml)	Chlorpheniramine (2 mg/5 ml)	Triprolidine & phenylephrine
1 year	7.5 kg	6.25 ml	3.75 ml	4.5 ml	3.6 ml	3.75 ml	1.875 ml	4.5 ml	2.25 ml	3.75 ml	Not recommended	Not recommended
2 years	10 kg	7.5 ml	5 ml	6 ml	4.8 ml	5 ml	2.5 ml	6 ml	3 ml	5 ml	2.5 ml	Not recommended
3 years	12 kg	8.75 ml	6 ml	7.2 ml	5.76 ml	6 ml	3 ml	7.2 ml	3.6 ml	6 ml	3.5 ml	2.4 ml
4 years	14 kg	10 ml	7 ml	8.4 ml	6.72 ml	7.2 ml	3.5 ml	8.4 ml	4.2 ml	8.4 ml	4 ml	2.8 ml
5 years	16 kg	11.2 ml	8 ml	9.6 ml	7.68 ml	8 ml	4 ml	9.6 ml	4.8 ml	9.6 ml	4.5 ml	3.2 ml
6 years	18 kg	12.5 ml	9 ml	10.8 ml	8.64 ml	9 ml	4.5 ml	10.8 ml	5.4 ml	10.8 ml	5 ml	3.6 ml
7 years	20 kg	13.7 ml	10 ml	12 ml	9.6 ml	10 ml	5 ml	12 ml	6 ml	12 ml	5.5 ml	4 ml
10 years	32.5 kg	20.3 ml	16.2 ml	13.2 ml	15.6 ml	16.25 ml	8.126 ml	19.6 ml	9.76 ml	19.5 ml	8.12 ml	6.5 ml

Medication Calculation

Medication	Calculation
Paracetamol 120 mg/5 ml	--- kg X 0.6 ml = --- ml
Ibuprofen 100 mg/5 ml	--- kg X 0.5 ml = --- ml
Amoxicillin 125 mg/5 ml	--- kg X 0.6 ml --- ml
Amoxicillin + Clavulanic acid (125 mg + 31.25 mg)/5 ML	--- kg X 0.5 ml = --- ml
Cephalexin 125 mg/5 ml	--- kg X 0.6 ml --- ml
Erythromycin 200 mg/5 ml	--- kg X 0.25 ml = --- ml
Cloxacillin 125 mg/5 ml	--- kg X 0.6 ml --- ml
Metronidazole 125 mg/5 ml	Under 2 years: --- kg X 0.4 ml = --- ml, Above 2 years: --- kg X 0.6 ml = --- ml
Cefuroxime 125 mg/5 ml	Under 2 years: --- kg X 0.3 ml = --- ml, Above 2 years: --- kg X 0.6 ml = --- ml
Chlorpheniramine 2 mg/5 ml	0.1 mg/kg/dose, Not recommended
Triprolidine & phenylephrine	125 mg/kg/dose, Not recommended

Navigating Pediatric Medications: A Guide for Parents in 2023

Stepping into the intricate realm of pediatric medication administration, the initial issue of Child India in 2023 aims to equip parents with essential knowledge. The process of administering drugs to children isn't merely clinical; it's a nuanced art requiring a delicate balance between medical precision and parental understanding.

In the realm of pediatric medicine, crafting a precise prescription is relatively straightforward after a thorough examination. However, translating these instructions into dos and don'ts for parents is a complex task, not only due to its time-consuming nature but also because of the challenge in ensuring parents comprehend the nuances of different drug preparations. For example, the commonly prescribed paracetamol comes in varying forms, ranging from 100mg/ml drops to 500mg/5ml syrups. The potential for errors, such as giving a 500mg syrup to an infant instead of 0.5 ml drops, underscores the importance of informed administration.

Challenges in Pediatric Medication Administration

1. Oral Liquid Medications:

Administering liquid medications to infants and young children requires careful guidance. Educating caregivers about this process is essential.

2. Clear Communication:

Physicians must clearly explain the indication, dosage, frequency, and expected clinical response of each prescribed drug. Managing parental expectations and explaining potential side effects enhances compliance.

3. Taste Preferences:

Children's discerning taste buds may detect even minor alterations in the taste of medications mixed with food. Addressing taste preferences is crucial for successful administration.

4. Resistance:

Forcing medication on a resistant child may heighten their aversion to taking any medicine. Strategies to ease administration need consideration.

5. Formulation Acceptance:

Various factors, including religious, cultural, and personal beliefs, influence a child's acceptance of medication formulations. Physicians should be equipped to address these aspects.

6. Medication Availability:

Non-availability of sugar-free or child-friendly formulations poses challenges, especially for children prone to dental issues.

Routes of Medication Administration

Pediatric medications are administered through diverse routes, each with its own considerations:

Oral Administration: Liquids, tablets, capsules, and dispersible tablets.

Inhaled: Metered-dose inhalers, powder devices, and compressed air nebulizers.

Topical: Solutions, suspensions, ointments, creams, lotions, powders, and shampoos.

Injected: Subcutaneous, intramuscular, intravenous, intrathecal, or intraosseous.

Rectal: Enema, suppositories, and ointments.

Oral Administration of Liquids

Ensuring compliance in children under 5 years requires addressing taste preferences. Taste masking through flavoring agents or mixing with preferred foods is a common practice. However, caution is necessary to prevent altered drug absorption and bioavailability. Excipients in liquid medications, including sugar, salt, and alcohol, require identification, particularly for children with specific sensitivities.

Choosing the Right Administration Method

Selecting the appropriate method for medication administration depends on factors such as the child's age, feeding style, and the nature of the medicine. Options include calibrated syringes, baby bottles, medicine droppers, dosing cups, spoons, and tablets. Each method has its considerations, and healthcare providers should guide parents in choosing the most suitable approach.

Inhalational Route for Respiratory Ailments

Administering medications through inhalation is a logical choice for respiratory issues, ensuring targeted delivery with minimal side effects. Caregivers and adolescent patients should be educated on available devices, and the child's preferences should be considered to enhance long-term compliance.

In conclusion, effective communication between healthcare providers and parents is pivotal in navigating the intricacies of pediatric medication administration. By addressing challenges and providing tailored guidance, we can ensure the well-being of our children and promote optimal health outcomes.

Medication Guidelines: Timing and Food Intake

Understanding when and how to take medications is crucial for their efficacy and safety. Here is a guide to help you navigate the timing and food requirements for certain medications:

Medications to Take on an Empty Stomach:

Alendronate

Ampicillin

Astemizole

Bethanechol

Bisacodyl

Captopril (Take 1 hour before meals)

Dicloxacillin

Didanosine

Etidronate

Indinavir

Lansoprazole (Take before eating)

Levothyroxine

Loratadine

Methotrexate

Mycophenolate

Omeprazole (Take before eating)

Penicillamine

Rifampin

Roxithromycin

Sucralfate (Take at least 15 minutes before or after a meal)

Co-trimoxazole

Sulfadiazine

Tetracycline

Zafirlukast (Do not take with milk or other dairy products)

Medications to Take with Food:

Allopurinol

Atovaquone

Amoxicillin

Aspirin (Take after a meal) + Clavunic acid

Amiodarone

Baclofen sodium

Clofazimine

Carvedilol

Carbamazepine

Cefpodoxime

Chloroquine

Cimetidine

Diclofenac

Doxycycline

Felbamate

Fenofibrate

Fludrocortisone

Griseofulvin

Hydrocortisone

Hydrochlorothiazide

Indomethacin

Iron preparations

Itraconazole

Ketoconazole (Take in-between meals; if GI upset, take with food)

Lithium

Metronidazole

Misoprostol

Mebendazole

Methylprednisolone

Naproxen

Nitrofurantoin

Niacin

Piroxicam

Potassium salt

Prednisolone

Procainamide

Ritonavir

Saquinavir

Spironolactone

Sulfasalazine

Valproate sodium

Note: Always adhere to your healthcare provider's instructions and seek clarification if you have any doubts about the timing or dietary restrictions associated with your medications. Following these guidelines ensures the optimal effectiveness of the prescribed treatments and promotes your overall well-being.

Empowering Parents: A Guide to Administering Medications to Children

Ensuring proper administration of medications is vital for the well-being of children. Here are essential insights from the IAP Drug Formulary that can empower parents in managing their child's treatment:

Inhalational Drugs:

Empowerment Through Education:

Inform caregivers and adolescents about the advantages of inhalational drugs, emphasizing minimal side effects.

Encourage children to choose their preferred inhaler device to enhance long-term compliance.

Technique Matters:

Teach proper techniques for various devices (MDI, MDI with spacer, dry-powder inhalers) for effective drug delivery.

Emphasize the importance of device care and regular reviews to ensure functionality.

Ophthalmic Preparations:

Sterility is Key:

Stress the importance of keeping ophthalmic preparations sterile, discarding them after 28 days of opening to prevent bacterial contamination.

Application Techniques:

Provide guidance on dropping solutions into the eye, avoiding contact and ensuring the child's head position for optimal effect.

Aural Medications:

Administering to the External Auditory Canal:

Offer a step-by-step guide for administering aural medications, including warming ear drops and gentle massage for effective absorption.

Nasal Route Administration:

Intranasal Administration Tips:

Advise on laying the child down for nasal drops, tilting the head forward for nasal spray, and avoiding touching the applicator to prevent the spread of germs.

Topical Applications:

Understanding Topical Medications:

Educate on different topical forms (creams, lotions, ointments, gels, pastes) and their respective properties.

Highlight considerations for choosing the right vehicle based on skin condition and lesion type.

Vehicle Impact:

Emphasize the role of the vehicle in enhancing penetration and efficacy, considering cooling, drying, emollient, or protective actions.

Caution against potential side effects such as excessive drying or occlusion.

By imparting this knowledge, parents can confidently navigate the administration of medications, ensuring the well-being and comfort of their children. Always consult healthcare professionals for personalized guidance and clarification.

Here's a summary focusing on essential information for parents regarding the administration of drugs to children:

1. General Considerations:

Drugs administered to various body spaces must be sterile and pyrogen-free.

Skin preparation with antiseptic (70% isopropyl alcohol) is common, but iodophor may be used in iodine-tolerant children.

Topical anesthetic cream may be used in some cases.

Recognition and addressal of needle-related fears in children of different age groups.

Parental assistance with restraining and comforting during the procedure, respecting individual comfort levels.

2. Subcutaneous Route:

Used for small volumes of isotonic solutions, such as insulin self-injection.

Rotation of injection sites is crucial to avoid fat atrophy or hypertrophy.

Techniques for injecting in thinner children.

3. Intramuscular Route:

Avoided whenever possible, used for concentrated and irritating solutions.

Needle choice affects pain; shorter and narrower needles are preferred.

Checking for blood withdrawal before injection to avoid intravascular administration.

Regular inspection of injection sites to prevent muscle damage and scarring.

4. Intravenous Route:

Risk of IV medication errors in hospitalized children.

Weight-based dosing, double-checking calculations, and standardization of policies and procedures are crucial.

Considerations for drug concentration, vial size, and infusion techniques.

Safety measures and corrective actions at every stage of care to prevent errors.

5. IV Medication Preparation:

Attention to drug concentration, vial size, infusion technique, and medication duration.

Aseptic technique during preparation and administration.

Involving play and distraction techniques for children.

Pain management strategies based on age groups.

6. IV Cannulation:

Dressing considerations, use of IV boards/splints for immobilization.

Inspection and maintenance of splints.

Importance of dressing security, visibility, and avoiding complications.

7. Changing Cannulas and Removal of IVs:

Re-cannulation avoided if possible.

Reasons for removal include infiltration, extravasation, completion of treatment, or patient discomfort.

Proper removal technique and aftercare.

8. Prevention of Infections:

Emphasis on good hand hygiene, aseptic technique, and regular inspection of IV sites.

Inspection for signs of infection, phlebitis, infiltration, and extravasation.

9. Intraosseous Route:

Used in emergencies when peripheral IV access is challenging.

Proximal tibia commonly chosen site in children.

Rapid access with few complications.

10. Per-Rectal Administration:

Used when oral or IV administration is not feasible.

Administration technique for infants and considerations for certain drugs.

Disadvantages and contraindications.

This summary provides a concise overview of the key information that parents may find useful when their children require drug administration.

Important Information for Parents:

Intravenous (IV) Access in Children:

Rapid administration of medication or fluid may be necessary in children without IV access.

Complications such as extravasation and compartment syndrome are risks associated with intraosseous (IO) insertion.

Regular checks and adherence to aseptic techniques during insertion are crucial to avoid complications.

Intrathecal Route for Pain Management:

Intrathecal analgesia and drug delivery systems offer pain control with reduced side effects.

Only a few medications are FDA-approved for intrathecal use, including morphine, Fentanyl, ziconotide, and baclofen.

Patient selection for intrathecal drug delivery system therapy is based on various factors, including the type of pain and the patient's overall condition.

Recommended Dosages for Intrathecal Medications:

Specific dosage ranges for intrathecal medications, including morphine, hydromorphone, ziconotide, Fentanyl, Bupivacaine, clonidine, and sufentanil.

Intraventricular Drug Delivery:

Intraventricular drug delivery involves delivering medication directly into the cerebrospinal fluid.

It is used for managing head and neck pain, particularly in cases of tumors.

Lumbar intrathecal antibiotics can be effective for post-neurosurgical infections, with minimal relapse rates.

Drug Administration via Enteral Feeding Tube:

Administration of drugs through enteral feeding tubes requires careful attention.

Guidelines include confirming tube position, stopping feed during drug administration, and flushing the tube adequately.

Avoid adding drugs to feeds, and monitor for complications such as tube blockage.

Endotracheal Route for Drug Administration:

The endotracheal route may be used when IV or IO access is not possible in life-threatening situations.

Medications are absorbed through this route, but optimal doses are often unknown.

Methods of Giving Medicines to Children:

The approach to administering medicine depends on the child's age and understanding.

Safety measures include ensuring the correct formulation, precise dosing, and understanding administration methods.

Ensuring Safety of Medicines for Children:

Doctors, parents, and caregivers play a crucial role in ensuring the safety of medicines for children.

Steps include accurate prescribing, diligent calculation of doses, and proper storage and administration.

In a Nutshell:

Administering medicines to children requires cooperation and understanding.

Different oral formulations are suitable for children of different ages.

Lack of appropriate formulations compromises children's right to safe medicines.

Caregivers should be informed about medicines and their administration methods.

Well-coordinated actions are essential to ensure children receive medicines correctly and safely.

Navigating the intricacies of pediatric medication involves more than just numbers; it requires a delicate balance of science and empathy. The bond between a caregiver and a child is sacred, and ensuring their health demands precision.

This guide empowers you to make informed decisions, providing not just dosages but a roadmap to your child's well-being. Always consult with healthcare professionals for personalized advice, and remember, your attentive care makes all the difference.

Reference: iapindia

RPH, Clinical Pharmacist