THERAPEUTICS

Rationale
Prerequisites
Competencies

Rationale
Appropriate and successful treatment requires choice of the correct medication, the appropriate dose, and both a dosage form and a dosing regimen that will maximize compliance. The pharmacokinetics (absorption, metabolism, distribution and elimination) of medications change under the influence of growth and physiologic maturation. Child behavior and psychomotor development influence the form of medication dispensed and the expectation for compliance.

Prerequisites

• Knowledge of general pharmacokinetics and pharmacodynamics
• Knowledge of the physiologic and behavioral changes that occur during childhood

Competencies

Knowledge:

1. Describe how to assess whether a drug is excreted in the breastmilk and safe to use by a breast-feeding mother. (CP)
2. List medications such as aspirin, tetracycline, and oral retinoic acid that are contraindicated or must be used with extreme caution in specific pediatric populations. (CP)
3. Describe the appropriate use of the following common medications in the outpatient setting, including when it is NOT appropriate to treat with a medication: (U)
   
   
   • Analgesics / antipyretics
   • Antibiotics
   • Bronchodilators
   • Corticosteroids
   • Cough and cold preparations
   • Ophthalmic preparations
   • Otic preparations
   • Vitamin / mineral supplements
   
   
4. Select generally accepted pharmacologic therapy for common or life-threatening conditions in pediatric patients. (CP) These conditions could include:

   Common conditions seen in ambulatory settings:

   • Acne
   • Acute otitis media
   • Allergic rhinitis
   • Asthma
   • Atopic dermatitis
   • Candida dermatitis
   • Fever
   • Impetigo
   • Streptococcal pharyngitis
   • Common conditions seen in hospitalized patients
   • Bronchiolitis
   • Life threatening conditions
   • Sepsis/meningitis
   • Status epilepticus (M)
     
     
5. Describe the ways medication errors are systemically prevented. (U)

Skills:

1. Calculate a drug dose for a child based on body weight. (CP)
2. Write a prescription e.g. for a common medication such as an antibiotic. (U)
3. Negotiate a therapeutic plan with the patient and family to maximize adherence with the agreed upon treatment regimens and assess the family's understanding of the plan. (MU)

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