Challenges in paediatric prescribing

Abstract

Children are not ‘small adults’, and are a heterogenous group of patients who are constantly changing, particularly in the way they metabolize specific drugs. The prescriber caring for children needs to be aware of the pharmacokinetic and the pharmacodynamic challenges associated with this patient population, and also needs to decide on the best route of drug administration for each individual case. Compliance poses an additional challenge, and both parents and carers may need repeated counselling and support from the practitioner to safely and efficiently help in the process. A paediatric drug formulary such as the British National Formulary for Children should always be consulted when prescribing for children. Adverse drug events should be readily identified, managed and reported. Nurse prescribers have an important role to play in paediatric practice, not only by safely prescribing drugs but also in educating and supporting colleagues. There is a need for continuing education and regular revalidation, to ensure the highest-quality and safest drug prescribing. This article addresses the complexities that may arise in paediatric drug prescribing.