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Matients that require individualized dosage
- neonates and other pediatric patients
- elderly patients with diminished biologic functions
- patients with compromised liver and or kidney function
- critically ill patients
- patients being treated with highly toxic chemotherapeutic agents
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Premature
less than 37 weeks old
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neonate (newborn)
birth-1 month
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early childhood
1 year-5 years
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late childhood
6 years-12 years
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adolescence
13 years-17 years
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pediatric drug dosing factors
- age
- weight
- overall health status
- condition of biologic functions (respiration, circulation)
- stage of development of body systems for drug metabolism and elimination
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Geriatric Patients
- age related physiologic functions (beak before 30 years of age and gradual subsequent decline)
- kidney function( major consideration in drug dosing, reduced function results in reduced drug elimination)
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Geriatric drug dosing factors
- age
- weight
- body surface area
- health and disease status
- pharmacokinetic factors
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drug dose based on age
- pediatric patients used to be treated as minature adults
- pediatric dose was a fraction of the adult dose based on relative age
- this is NOT used today!!!!!
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Drug dose based on body weight
- specific quantity of drug per unit of patient weight
- miligrams of drug per kilogram of body weight
- (mg/kg)
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Patient dose=
Patient BSA (m2) divided by 1.73 m2 (miltiplied by the drug dose in mg)
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nomogram
- includes both weight and height
- draw a straight line connecting the persons height and weight
- point at which the line intersects the center column indicates the persons BSA is m2
- (the chart given)
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BSA equation
- BSA (m2)=
- square root of ht(mm) times wt(kg) all divided by 3600
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chemotherapy
- treatment of disease with chemical drugs or chemotherapeutic agents
- mainstay of cancer treatment
- single or multiple doses
- treatment cycles
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D 1-4
days 1 to 4 (4 days)
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D 1,4
days 1 and 4 (2 days)
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