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.