Drug interactions: Take extra care with children

Nurse Leader Insider, August 14, 2007

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With infants and children at a high risk for prescription errors, administration errors, and serious drug interactions, it's important to take necessary precautions. Historically, drug development in children has not been based on the same rigors of evidence as adults. But children and the elderly are more vulnerable to drug events, including route of administration mistakes, dosage miscues (including frequency), and narrow therapeutic indexes.

Some of the gaps that the FDA has identified include unnecessary exposure to ineffective therapies in the pediatric population, along with ineffective dosing and overdosing of effective drugs, which has significant effects on metabolism and drug clearance. As the result of discrepancies in appropriate prescribing practices and selection of products, pediatric adverse effects have increased.

Kids are not stand-ins for adults

Tricycling in pediatrics is essential for the safety of our smallest clients. Children are not little adults! The tricycle is the interdisciplinary approach among physicians, nurses, and pharmacies in developing and maintaining safe drug administration practices, from prescribing to drug preparation and administration.

That said, what are some of the practices that you can implement to prevent drug interactions in children?

  • Prioritize drug safety interventions according to child's level of growth and development
  • Always verify safe dosages
  • Provide education to the child and family
  • Use accurate measuring devices, such as oral syringes and medicine cups for exact amounts
  • Check the color, shape, size, and smell of medicines
  • Perform drug research regarding incompatible drugs
  • Follow special instructions, such as taking the medication with or without food

Tips for including parents

While you run the drug administration show for a child under your care, it's necessary to pass the knowledge on to parents. After all, they'll be calling the shots when they get home. Pass over the directorial duties to them with these helpful tips:

  • Parents should know how much medication to give, how often, and how long the medication will be taken
  • Encourage parents to ask what to do if the child misses a dose
  • Discuss common side effects
  • Have the parents teach the child that medicines are not candy

Editor's Note: This excerpt was adapted from the book Stressed Out About Drug Interactions, published by HCPro and written by Sheri Lynn Jacobson, MS, APRN. For more information on this book (and others!), click here and be connected to HCPro's online resource,

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