Concerns About Medication Dosage for Children in Emergency Care - Pediatrics

More Info

---

When it comes to pediatric emergency care, the appropriateness of prescribed medications and their dosages is a critical concern for parents, especially when the child is young and has a fever. In your case, your child, who is 5 years and 1 month old and weighs 28 kg, was prescribed several medications after a diagnosis of bronchiolitis. The medications included Panadol (acetaminophen), Erythromycin (an antibiotic), Periactin (cyproheptadine), and Medicon A (a cough syrup).


Evaluating the Prescribed Medications
1. Panadol (Acetaminophen): The typical dosage for children is 10-15 mg per kg per dose, every 4-6 hours as needed. For a child weighing 28 kg, the appropriate dose would be between 280 mg and 420 mg per dose. A 500 mg dose, taken three times a day (tid), is on the higher end but may not be excessive if the child is experiencing significant discomfort from fever. However, it is essential to monitor for any signs of overdose, such as nausea, vomiting, or abdominal pain.

2. Erythromycin: The recommended dosage for children is generally 30-50 mg per kg per day, divided into doses every 6-8 hours. For your child, this would translate to a total daily dose of 840 mg to 1400 mg. A 250 mg dose three times a day (750 mg total) is below the lower threshold of the recommended range, which raises questions about whether the antibiotic is adequately dosed for the infection being treated.

3. Periactin (Cyproheptadine): This medication is an antihistamine that can also stimulate appetite. The typical pediatric dose is 0.25-0.5 mg per kg per day, divided into doses. For your child, a 4 mg dose three times a day (12 mg total) is significantly higher than the recommended dosage, which could lead to side effects such as sedation or increased appetite.

4. Medicon A: This medication is often used for cough and cold symptoms. The dosing for children aged 2-6 years is typically lower than what is prescribed for adults. The exact dosage can vary, but caution is warranted, especially in young children.


Concerns and Recommendations
Given the dosages prescribed, there are valid concerns regarding the appropriateness of the medications and their dosages. It is essential to understand that pediatric dosing is not simply a scaled-down version of adult dosing; it requires careful consideration of the child's age, weight, and overall health.
1. Consult a Pediatrician: It is advisable to follow up with a pediatrician who specializes in child health to review the medications and dosages prescribed. They can provide clarity on whether the medications are appropriate for your child's specific condition and weight.

2. Monitor for Side Effects: Keep a close eye on your child for any adverse reactions or side effects from the medications. If you notice any unusual symptoms, such as excessive drowsiness, gastrointestinal upset, or changes in behavior, seek medical attention promptly.

3. Educate Yourself: As a parent with a nursing background, it is beneficial to familiarize yourself with pediatric medication guidelines. Resources such as the American Academy of Pediatrics or the Pediatric Dosage Handbook can provide valuable information.

4. Advocate for Your Child: If you feel uncertain about a prescription, it is essential to voice your concerns. Healthcare providers appreciate informed parents who advocate for their children's health.

In conclusion, while the prescribed medications may not necessarily be harmful, the dosages raise concerns that warrant further investigation. Engaging with a pediatric specialist will help ensure that your child receives the safest and most effective care possible.