Case Studies

Chapter 16: Prescribing in children

A 5-year-old boy needs treatment for a medical condition.

• 1. What are the important changes in pharmacokinetics between a 5 year old and an adult?

  Show Answer

  Model answer: Increased hepatic enzyme activity.
  Higher renal excretion rates.
  Different body composition (increased total water).

• 2. What does 'off- label' prescribing mean, and why is it common in children?

  Show Answer

  Model answer: Off-label prescribing is using a licensed medication for a different patient group than the license covers. It occurs commonly in children as many medicines have not been formally tested in children

• 3. What source of information is available to aid prescribers in choosing paediatric medicines regimes?

  Show Answer

  Model answer: BNF for Children.
  Also, Schedule of product characteristics for drug and specialist pharmacists

• 4. What additional considerations about choice of drug and route of administration are needed in this case?

  Show Answer

  Model answer: Will the child be able and willing to take the drug in a particular way (e.g. inhaled)?
  Which manner of administration will be least distressing?
  What drug/route will allow the least frequent dosing?