Parameters for administering pediatric blood pressure medication

[Kaelif2015]

Hi all kind of a weird question. My 6 year old son is on guanfacine and was recently upped to 2mg.  His BP hasn't been handling the increase well, he's often in the mid to low 80s systolic, usually 60 diastolic, intermittently symptomatic. I've been pushing fluids as hard as I can, he's well hydrated. He did seem to be doing better on the 2mg as far as ADHD symptoms so his provider wants me to try to work him up to 2mg and just watch his BP closely. I asked about parameters for when I should give 1mg vs 2mg, and he avoided the question and said "it depends more on his symptoms" which I understand up to a point, but it's not smart to give a kid who's BP is 82/60 something that will push it lower. I've never worked with peds so I'm not familiar with hold parameters for that age group. Per Up To Date the criteria for hypotension in a 6 year old would be a systolic of 82, but I'm assuming my hold parameters should be higher than that. Do any of you work at a facility where you have hold parameters for pediatric BP meds and if so what are those? Just so I can get a feel for what is normal. 

[Rose_Queen, BSN, MSN, RN]

Hello, as this pertains to your son and the members of Allnurses cannot provide medical advice, we will close this topic. Please seek advice from your son's care team. We wish you and him well.