Paediatric pharmacy—drug therapy

S afe and effective drug treatment for children requires an understanding of the wide variability and constant changes in pharmacokinetic handling and pharmacodynamic response to drugs that occur during the time from birth to adulthood. An awareness of, and empathy with, the problems and challenges of drug administration throughout childhood is essential if the pharmacist is to be competent and confident in becoming part of the multidisciplinary team caring for paediatric patients and their families. Children are not just “small adults”, particularly when drug handling is considered; children are not “just children” either. Patients range from premature babies, born as early as 24 weeks gestation, to 18-yearold adolescents. They suffer from cardiac, respiratory, renal, and other system diseases, in the same way as adults. The “specialist” paediatric pharmacist usually also has to be a “generalist”. Recently, there has been international agreement on age groups to be used when considering medicines for children (see Panel 1, p50). These age groups are aimed at the pharmaceutical industry to help rationalise the licensing of medicines for children. They will avoid product licences having recommendations based on age bands, which have sometimes appeared to be arbitrarily chosen rather than being based on relevant physiological and pharmacokinetic principles. ALTERED PHARMACOKINETICS