Manipulation of drugs to achieve the required dose is intrinsic to paediatric practice but is not supported by guidelines or evidence

BMC Pediatrics

Volumn 13, Issue 1, 2013, Pages

  Richey, Roberta H ^a   Shah, Utpal U ^a,b,c   Peak, Matthew ^a,b   Craig, Jean V ^d   Ford, James L ^c   Barker, Catrin E ^a,c   Nunn, Anthony J ^a,e   Turner, Mark A ^e,f  

^a ALDER HEY CHILDREN'S NHS FOUNDATION TRUST   (United Kingdom)

^b Cheshire   (United Kingdom)

^c LIVERPOOL JOHN MOORES UNIVERSITY   (United Kingdom)

^d UNIVERSITY OF EAST ANGLIA   (United Kingdom)

^e UNIVERSITY OF LIVERPOOL   (United Kingdom)

^f LIVERPOOL WOMEN S HOSPITAL   (United Kingdom)

Author keywords

Children's medicines; Dosage forms; Drug manipulation; Survey

Indexed keywords

ALGINIC ACID; ANALGESIC AGENT; ANTIBIOTIC AGENT; ANTICOAGULANT AGENT; ANTICONVULSIVE AGENT; ANTIDEPRESSANT AGENT; ANTIEMETIC AGENT; ANTIHYPERTENSIVE AGENT; ANTIVIRUS AGENT; BENZODIAZEPINE; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; BRONCHODILATING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; ENEMA; HISTAMINE H2 RECEPTOR ANTAGONIST; IMMUNOSUPPRESSIVE AGENT; INOTROPIC AGENT; INSULIN; LAXATIVE; MINERAL; MUSCARINIC RECEPTOR BLOCKING AGENT; NEUROLEPTIC AGENT; NEUROMUSCULAR BLOCKING AGENT; OPIATE; PROTON PUMP INHIBITOR; SPASMOLYTIC AGENT; STEROID; THYROID HORMONE; UNINDEXED DRUG;

ARTICLE; DISPERSION; DRUG CAPSULE; DRUG DOSAGE FORM; DRUG EFFICACY; DRUG FORMULATION; DRUG MANIPULATION; DRUG SAFETY; EVIDENCE BASED PRACTICE; HUMAN; NURSE; OBSERVATIONAL STUDY; PEDIATRICS; PHARMACOLOGICAL PARAMETERS; POLICY; POWDER; PRACTICE GUIDELINE; PROSPECTIVE STUDY; QUESTIONNAIRE; TABLET; TRANSDERMAL PATCH;

ADOLESCENT; CHILD; CHILD, PRESCHOOL; DOSAGE FORMS; DRUG ADMINISTRATION ROUTES; DRUG PRESCRIPTIONS; EVIDENCE-BASED MEDICINE; GREAT BRITAIN; HEALTH CARE SURVEYS; HUMANS; INFANT; INFANT, NEWBORN; NURSE'S PRACTICE PATTERNS; PEDIATRICS; PHYSICIAN'S PRACTICE PATTERNS; PRACTICE GUIDELINES AS TOPIC; QUESTIONNAIRES; YOUNG ADULT;

EID: 84877902537     PISSN: None     EISSN: 14712431     Source Type: Journal    
DOI: 10.1186/1471-2431-13-81     Document Type: Article

References (19)

1. Kayitare E, Vervaet C, Ntawukulilyayo JD, Seminega B, Bortel V, Remon JP. Development of fixed dose combination tablets containing zidovudine and lamivudine for paediatric applications. Int J Pharm 2009, 370:41-49. 10.1016/j.ijpharm.2008.11.005, 19059324.
2. Fontan JE, Mille F, Brion F. Drug administration to paediatric patients. Arch Pediatr 2004, 11:1173-1184. 10.1016/j.arcped.2004.06.024, 15475272.
3. Nunn AJ. Making medicines that children can take. Arch Dis Child 2003, 88:369-371. 10.1136/adc.88.5.369, 1719550, 12716697.
4. Nahata MC. Lack of pediatric drug formulations. Pediatrics 1999, 104:607-609.
5. Conroy S, Choonara I, Impicciatore P, Mohn A, Arnell H, Rane A, Knoeppel C, Seyberth H, Pandolfini C, Raffaelli MP, Rocchi F, Bomati M, Jong G, de Hoog M, van den Anker J. Survey of unlicensed and off label use in paediatric wards in European countries. European Network for Drug Investigation in Children. Br Med J 2000, 320:79-82.
6. Rocchi F, Tomasi P. The development of medicines for children. Pharmacol Res 2011, 64:169-175. 10.1016/j.phrs.2011.01.016, 21376810.
7. Standing JF, Tuleu C. Paediatric formulations - Getting to the heart of the problem. Int J Pharm 2005, 300:56-66. 10.1016/j.ijpharm.2005.05.006, 15979830.
8. Verrue C, Mehuys E, Boussery K, Remon JP, Petrovic M. Tablet splitting: a common yet not so innocent practice. J Adv Nurs 2011, 67:26-32. 10.1111/j.1365-2648.2010.05477.x, 21158902.
9. Skwierczynski C, Conroy S. How long does it take to administer oral medicines to children?. Paediatric Perinatal Drug Therapy 2008, 8:145-149.
10. Conroy S, Sweis D, Planner C, Yeung V, Collier J, Haines L, Wong IC. Interventions to reduce dosing errors in children: a systematic review of the literature. Drug Saf 2007, 30:1111-1125. 10.2165/00002018-200730120-00004, 18035864.
11. Sayeed VA, Gupta A, Khan MA. Stability of split tablets. Chpt 20. Pharmaceutical Stability Testing to Support Global Markets 2010, New York: American Association of Pharmaceutical Scientists, Huynh-Ba K.
12. Quinzler R, Gasse C, Scheider A, Kaufmann-Kolle P, Szecsenyi J, Haefeli WE. The frequency of inappropriate tablet splitting in primary care. Eur J Clin Pharmacol 2006, 12:1065-1073.
13. Richey RH, Craig JV, Shah UU, Ford JL, Barker CE, Peak M, Nunn AJ, Turner MA. The manipulation of drugs to obtain the required dose: systematic review. J Adv Nurs 2012, 68:2103-2112. 10.1111/j.1365-2648.2011.05916.x, 22221111.
14. Nunn AJ, Richey RH, Shah UU, Barker CE, Craig JV, Peak M, Ford JL, Turner MA. Estimating the requirement for manipulation of medicines to provide accurate doses for children. Eur J Hospital Pharm 2013, 20:3-7.
15. Hill SW, Varker AS, Karlage K, Myrdal PB. Analysis of drug content and weight uniformity for half-tablets of 6 commonly split medications. J Manag Care Pharm 2009, 15:253-261.
16. van Santen E, Barends DM, Frijlink HW. Breaking of scored tablets: a review. Eur J Pharm Biopharm 2002, 53:139-145. 10.1016/S0939-6411(01)00228-4, 11879995.
17. Shah RB, Collier JS, Sayeed VA, Bryant A, Habib MJ, Khan MA. Tablet splitting of a narrow therapeutic index drug: a case with levothyroxine sodium. AAPS Pharm Sci Tech 2010, 11:1359-1367.
18. Broadhurst EC, Ford JL, Nunn AJ, Rowe PH, Roberts M. Dose uniformity of samples prepared from dispersible aspirin tablets for paediatric use. Eur J Hospital Pharm Sci 2008, 14:27-31.
19. BNF for Children [2008/2009] 2008/2009, London: BMJ Group, Pharmaceutical Press, and RCPCH Publications, Paediatric Formulary Committee.