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INTRODUCTION

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Illustration by George Folz, © 2020 McGraw-Hill Education

BACKGROUND

Pediatrics is a field devoted to the health and well-being of infants, children, and adolescents up to the age of 18 years.1 A common framework for categorizing pediatric patients by age is presented in Table 6-1.1,2 A holistic approach to caring for the physical, mental, social, and psychological needs of children is required for them to achieve their full potential.3 Growth and development during this phase of life is characterized by ongoing and often rapid change, which presents challenges that make caring for this population unique. Medications may act differently when administered to a child compared to an adult.1 For example, the amount of drug absorbed through the gastrointestinal tract into the bloodstream, how efficiently the drug is then broken down by the liver, and how quickly it gets eliminated from the body through the kidneys can differ within the pediatric population.4 The movement of drugs, how they get into and out of the body, is called pharmacokinetics. A similar term, pharmacodynamics, is used to describe the actions or responses a drug elicits in the body. Research over several decades has revealed that pharmacokinetic and pharmacodynamic data obtained from adults cannot be directly extrapolated to the pediatric population. Pediatric patients, in other words, are unique, and so, too, are their medication needs.

Table 6-1Categorization Scheme for Pediatric Patients by Age

Currently, children represent nearly 30% of the world’s population, which makes pediatrics one of the largest specialty areas in healthcare.2,5 Within the field of pediatrics, there are many subspecialties to optimize care, and pediatric pharmacists practice in many of these areas.6,7 Pediatric pharmacy practice subspecialties are included in Table 6-2.7 Pediatric care begins at the time of conception and continues through infancy, childhood, adolescence, and young adulthood.1

Table 6-2Subspecialties* in Pediatric Pharmacy Practice

Nearly 50% of medications are used off label in children; meaning, they have neither been studied in children nor approved for use in children by the US Food and Drug Administration (FDA).8 Most medications available on the market were developed with adults in mind, and thus ...

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