obese kids

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What is everyone doing regarding kids that are obese and dosing meds based on wts? We had a 9yr old who was ordered Tylenol 10mg/kg. Typical dose for our kdis. However, the dose ended up being 1000mg /dose. Everyone was looking at the order and not taking into account that this is an obese child. Our pharmacy even signed off on the order. Does anyone have any protocols for this situation.

thank you!!!!:idea:

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Specializes in Maternal - Child Health.

OMG!

I haven't had my coffee yet, and I'm not using a calculator, but am I correct that this 9 year-old child weighs approximately 220 pounds?

1000mg is the maximum recommended adult dose (every 6 hours, with a max of 4 doses in 24 hours).

How sad for a child to have to deal with such extreme weight problems so early in life.

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And unfortunately, this will be a case (obese children) that will be seen more and more often. I work as a health unit coordinator on an adult floor in which I have to write MD medication orders on the MARS and it is rare that I've seen more than 625 mg of Tylenol ordered.

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Specializes in Geriatrics/Family Practice.

I don't know about all the dosing, but I know when I worked in pharmacy at a hospital they calculated everything by weight because one 9 year old may be 75 lbs, while another is 160lbs, we never of course went over the high end of an adult dose but sometimes it was real close. Actually that reminds me that I weighed in a 160lbs. girl the other day at my prn family practice job. She was about 4'9" and very obese. Blood pressure elevated and definitely on her way to major health problems. I unfortunately see it quite a bit working family practice, actually to often. We attempt to teach the parents about good eating habits, but usually the apple doesn't fall far from the tree.

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Specializes in Pediatrics Only.

Our tylenol protocol is based on weight.

The last dose on our protocol is 650mg for weight > 66kg.

There is a line on the protocol that states " if older then 12 years and weight > 66kg may give 1000mg every 4 hours. Do not exceed 4 doses per day or 4000mg"

There are many obese children -and it amazes me sometimes the amount of medication they require - its normally larger then what I would require.

I also agree with Jolie - its very sad that these kids have to deal with obesity so early in life. We try and do our teaching and have the nutritionist come up and talk to the family - but there is only so much that you can do.

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