Pediatrics – Pharmacology across the Lifespan (Nursing)

00:01 Hi, welcome to one of our Pharmacology Across the Lifespan videos.

00:06 On this one, we're going to focus on the pediatric patients and their special needs.

00:11 But before we jump right into the pediatric part, I want to see if you can remember what are the four main pharmacokinetic processes? Now, I'll give you a clue.

00:21 Remember, kinetic is movement, so that's the movement of the drug through the body.

00:26 There was four of them.

00:28 See if you can remember the names.

00:33 Okay, so first, we had absorption.

00:36 Next is distribution, third, metabolism, and finally, how the drug leaves the body with excretion.

00:45 Now see if you can come up with the definitions of those terms in your own words.

00:50 So take a minute, pause the video and see if you can write out the definition of those four pharmacokinetic terms.

01:03 Okay, so let's get right into it for pharmacology for pediatric patients.

01:07 So when we're talking about a pediatric patient, I mean from birth to age of 16 years.

01:13 So the biggest difference with pediatric patients is that their organ systems are immature, particularly, the youngest patients.

01:21 Younger patients are usually more sensitive to drugs than adults, so that means there's an increased risk for them to have an adverse drug reaction.

01:30 So the first concept I want you to be very clear on before we step through the rest of this birth to age 16 years, is that younger patients, the pediatric patients, have more immature organ systems, and that makes them at an increased risk to have adverse drug reactions.

01:46 Okay. Now that we've got that concept down, let's start looking at how we group these by age.

01:52 Now if you look at the screen, you can see prenatal or 36 to 40 weeks of gestational age as full-term infants.

02:02 Postnatal is the first 4 postnatal weeks, and we call them a Neonate.

02:08 Infants are considered 5 to 52 weeks.

02:11 Children are age 1 year to 12 years, and adolescents will define as age 12 to 16.

02:19 Now, you might want to keep this as a reference, but we'll come back to these definitions throughout the presentation, but don't let that, kind of, overwhelm you.

02:26 Sometimes we see that many numbers and words it gets a little confusing, but we're talking about prenatal, before the regular birth; postnatal, after birth, just infants, children and adolescents.

02:38 Okay. So let's go back to comparing pediatric patients to adult patients, because there is a wide range of variability between pediatric patients when you compare them to adults.

02:50 And pediatric research with medication is really problematic.

02:54 You know, you don't want to do research on little kids, so that's why it's been very limited.

03:00 But let me give you some kind of big, overall, arching concepts and thoughts about pediatric patients compared to adult patients.

03:08 20% of the drugs that were studied were ineffective in children that were effective in adults.

03:14 So while one medication, if we give it to an adult client, might work great, it's not going to be effective in children in 20% of the cases that were studied.

03:23 30% of the drug studied caused an unanticipated side effect and some of them were lethal when they were given to pediatric patients, compared to what adults experienced.

03:35 And finally, 20% of the drugs that were studied require different dosages and those that they had been extrapolated from an adult dose.

03:43 That means they took the dosage that we thought is safe to give to an adult, and they figured out what should be safe to give to a child, and 20% of the time, it was not safe to give that to a child.

03:55 So while we don't have a lot of information or research about giving pediatric patients drugs in comparison to adults, what we do have enough to completely support the idea that pediatric patients' organ systems work differently when it comes to the pharmacokinetic processes of adults.