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Compounding for The Pediatric Patients

 

Coloring Outside the Lines

 

  • The number of new drugs marketed in the US is constantly increasing.  However,.most new drugs are not labeled for certain populations, such as infants and children.  When a drug is not specifically approved by the FDA for use in infants and children, it us usually not available in a suitable dosage forms.  The off-label use of drugs is common in pediatric patients.  
  • Extemporaneous formulations have an important role, especially in the treatment of infants and young children ( younger than 6 years of age) who are unable to swallow tablets or capsules.
  • In addition those patients require doses based on body size and weight.  The fixed doses intended for adults are not appropriate for use in infants and children.

Creative Solutions To Unusual Situations

 

  • There is the need to be innovative, to think "outside the lines" with respect to addressing the individual needs of pediatric patients, who are not just little adults.  Those pharmacologic needs of children should be addressed by using the innovative options available to the pharmacist.  Providing these innovative options is what we do.
  • Pediatricians are dedicated to addressing the unique needs of their young patients, and we possess the creativity to help serve those needs.  

Laxative Formulations

 

  • Constipation is an occasional problem for many children, but it is an every day occurrence for those with certain GI defects and disease states.  How distasteful for a young pediatric patient for consume large amounts of mineral oil, senna syrup, or mild of magnesia on a daily basis.  The ability to flavor each of these preparations or to offer a child a concentrated Milk of Magnesia product in a wide variety of flavors would certainly be appreciated by patients and parents alike.
  • Commercially available products are usually flavored with adult flavors such as mint, however by compounding our own nonflavored concentrate version of these products we can offer a patient their own "favorite" flavor.

Antinausea Medications

 

  • An occasional bout with the flu or a case of GI distress is common in children.  There are situations in which nausea and vomiting are of significant concern and must be addressed by a pediatrician.  
  • The nausea and vomiting that accompany motion sickness can be inconvenient and can spoil a family outing, a trip to the amusement park, or a lengthy drive.  Orally administered antiemetics can be sedating, which is not always a desired effect.  Rectal administration of antiemetics us usually  Not a favored route for patients or parents.  
  • We can offer another option in the form of  transdermal antiemetics.  Dispensed in a graduated syringe, the transdermal antiemetic enables precise administration of the medication to the child's inner wrist or arm.   As the medication enters the circulation, the dose can be regulated to control nausea and vomiting while the child remains awake and alert if desired.
  • Head Lice Medications

    • Our skills as a compounding pharmacy provide special advantages in the treatment of head lice.  Parents, physicians and pharmacists have been searching for effective treatment alternatives since the publication of the Harvard study that described head lice in the U.S.. that are not susceptible to permethrins.  The search for effective alternatives has brought in view more effective chemicals to which lice would be susceptible to that would not  be harmful if used repeatedly by children.  We have compounded alternatives that can be taken orally or used topically
    • The other area of interest in the treatment of head lice involves the use on nontoxic nonchemical entities.  Nonchemical alternatives usually considered are homeopathic pediculicides, immobilizing agents, enzyme treatments, and herbal remedies.  
    • These and other solutions to common problems are just a few of the many capabilities we have for treating the pediatric patient.

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