6 Questions
Which parameter is used to estimate renal function in children?
Glomerular filtration rate
What method is recommended by the British National Formulary for estimating renal function in children?
Modified Bedside Schwartz
Why is it difficult to predict drug clearance in children?
The wide inter-patient variation in children
What parameter is used to calculate renal function in neonates according to the Modified Bedside Schwartz method?
Height
In the UK, at what age do children reach their full complement of glomeruli?
36 weeks of gestation
What is a common challenge in predicting drug doses for children?
Variability in drug clearance among children
Study Notes
Children: Are they really different?
- Children make up around 25% of the population in the UK.
Developmental Differences
- By 26-40 weeks of gestation, all organs are present but are smaller and less functional.
- Full complement of organs is reached by 36-40 weeks of gestation.
- There is wide inter-patient variation, making it difficult to predict drug clearance.
Renal Function
- Glomerular filtration rate (GFR) varies depending on the age and size of the infant:
- Term infant: 40 ml/min
- Preterm infant > 1kg: 2-3 ml/min
- Preterm infant < 1kg: 0.5 ml/min
Calculating Renal Function
- Estimated GFR (ml/min/1.73m2) in paediatrics can be calculated using:
- Modified Bedside Schwartz (recommended by BNFC):
- Neonate: = 30 × height / serum creatinine (height in cm; serum creatinine in micromol/litre)
- Child over 1 month: = 40 × height / serum creatinine (height in cm; serum creatinine in micromol/litre)
- Modified Bedside Schwartz (recommended by BNFC):
Learning Objectives
- Discuss how children are different from adults.
- Discuss pharmacokinetics and pharmacodynamics in children.
- Understand how to calculate drug doses for children.
- Discuss paediatric-specific issues relating to drug formulations.
- Define 'unlicensed' and 'off-label' medicines.
- Explore how children talk about their medicine.
- Understand 'medication risk' in the context of paediatrics.
- Use and recommend relevant information sources to aid safe paediatric drug prescribing.
This quiz provides an overview of how children differ from adults in terms of pharmacology, discussing topics such as pharmacokinetics, pharmacodynamics, and calculating drug doses for children. It was written by Nicola Husain MRPharmS MSc and presented by Noushin Yadollahi-Farsani, both specializing in pediatric pharmacy at Kings College London.
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