When is a child an adult with meds?

**canoehead, BSN, RN** · Feb 7, 2007

When I worked peds it was 100lb, but we still had to be careful, as you would with a small elderly patient. Definitely at 150lb they were ready for an adult dose, unless you were talking one of the 125lb 4yo out there, then we would work from the ideal weight and watch for effect.

kimber1985 · Feb 7, 2007

100lbs sounds good to me, but I am seeing in peds rotation a 83lb getting adult doses.

I have Solumedrol 25 mgs for a 34.8kg 10 year old, q 6 does - that sound high?

Book says 835mcg/kg q 12-24

34.8 x 835 is 29mg. but what about the q 6 versus q 12-24.

discobunni · Feb 13, 2007

Hi there,

I am not an RN yet, but my son weighs 70 lbs and has severe ADHD and CPP. He is on an adult dose of Focalin (40 mg qd) as well as several other drugs (risperdal, clonidine) and more!! His doctor says he like other patients he sees have to be adjusted according to their metabolism. He says some people metabolize at a much greater speed than others (totally throws the half-life thing out the window) but...makes sense.

Why Bob over there can eat ding-dongs all day and not gain an ounce while Sally gains 10 lbs from smelling just a slice of pizza (ok, I know I'm exaggerating but you get the jest of it!!)

Not everything is going to work for everyone in the exact same way.

I'm not basing this on any scientific evidence, but I trust my doctor because he is the only one who has been able to help my son function in school and otherwise....and if he misses any dose of anything...the principal is calling me on the phone because of his behavior (he's jumping around like a bunny rabbit)!

This what my doctor has explained to me why some need stronger doses than others, even though they may weigh the same or be the same age etc.....

prmenrs, RN · Feb 14, 2007

It's not their wt so much as their age. No matter what a 16y/o (even thru college age) weighs their bodies don't metabolize drugs as effectively as an adult. Livers and kidneys are just not "there" yet.

Obviously, pts who are 15-21 do get adult drugs and adult doses, but the prescriber needs to be acutely aware that the pt is NOT an adult w/regard to medications.

CHATSDALE · Feb 14, 2007

some drugs are absorbed different after puberty

others are based on weight--metabolism

if in doubt talk with parmacy - they can save your hiney