Not all medications come in dosage forms that are suited to pediatric administration. When altering medications for use in pediatric patients (e.g.,) compounding liquid preparations, cutting or crushing tablets, or making powder dilutions), the following should be considered:
- Most medications are manufactured for adults; therefore, children will rarely receive a whole vial, tablet, or unit dose cup of any medication. Obtaining an entire adult dosage form or multiple vials or tablets to administer a pediatric dose should be a red flag for the nurse to double-check the dose.
- Liquids are the ideal oral dosage forms for pediatric patients because many find it difficult-or simply refuse-to swallow solid medications.
- Chewable tablets are not available for many drugs, but they can be useful for patients older than four years of age. Younger children may not be able to chew and swallow the tablet completely and thus are at risk for choking on the solid dosage form.
- As a general rule, nurses may NOT alter extended-release products due to the risk of dose-dumping with disruption of the timed-release properties. Extended-release products also should not be chewed or given in food that a young patient may chew.
—Jill Duncan, RN, MS, MPH