Drug administration

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By the end of this chapter you will be introduced to the concepts of pharmacokinetics and pharmacodynamics with specific emphasis on the infant, child, and young person. You will be presented with the current evidenced- based practice in relation to differing routes of drug administration in children and young people, underpinned by a firm rationale throughout. The key points to consider when administering medications via differing routes to children will be explored. Throughout this chapter the importance and method of drug calculations and mental mathematics will be highlighted, as befits their importance in the safe preparation and administration of all medications. It is anticipated that you will be able to do the following once you have read and studied this chapter: ● Discuss pharmacokinetics and pharmacodynamics as they relate to drug administration with children. ● Understand the mathematical calculations required to accurately prepare and administer medications in children. ● Understand the key nursing skills required to administer medications to children and young people via differing routes. Historically, drug development specifically for children was only conducted for common disorders/diseases where medication was part of the accepted treatment. Examples are medicines for epilepsy or asthma, antibiotics, or vaccines (Rose, 2005). Because the numbers of children are small in comparison with adults, and the child population is subdivided into age groups from neonates to teenagers, pharmaceutical companies are governed by the commercial market. Consequently they assign limited resources to drug development in the child population because of more limited profit margins. However, this situation is changing, as the European Union established a European Network for Drug Investigation in Children in 1998, with a commitment to improve both clinical use and research into drugs for children (Van den Anker & Choonara, 1999). An international meta-register of controlled clinical trials has been created where particular emphasis is placed on paediatric aspects (Bonati et al., 2001). All of these initiatives serve to change the prevailing view of children as ‘therapeutic orphans’ to an acknowledgement that children are consumers of healthcare services and as such have the right both ethically and morally to medications that are designed and trialled for them specifically.