Overweight kids overdosed
August 28, 2012
THERE is significant confusion
amongst pharmacists surrounding
the appropriate dose of
paracetamol that should be given
to overweight and obese children,
according to a new study.
Published in the European Journal
of Hospital Pharmacy the Perceived
and actual paracetamol dosing in
overweight and obese children
study looked at 28 community
pharmacists to see what dose of
paracetamol they thought should
be given to an eight year old child,
weighing 25, 32 or 50kgs.
The researchers, hailing from the
University of South Australia, also
observed doses of paracetamol
given to 86 children, one in three of
whom was overweight/obese, in
the emergency care department of
a specialist children’s hospital.
According to the researchers, the
recommended paracetamol dose
per day for children weighing up to
60kgs (or 90kgs if under medical
supervision) is between 15 and 20
mg/kg every 4 to 6 hours, whilst for
children who are more than 120%
above their ideal body
weight, experts say this dose
should be reduced.
“But it is unclear whether
children should be dosed according
to their actual, rather than their
ideal, body weight,” the authors
said.
Interestingly, when posed with
the dosing question, the majority
of community pharmacists stated
the correct doses for children who
weighed 25 and 32kgs, however
when it came to 50kgs, responses
varied greatly, with pharmacists
recommending a twofold variation
in dose.
When the doses were corrected
according to actual and ideal body
weight, one in four pharmacists
underdosed the children in the
overweight category.
Looking at the children in the
emergency departments the
researchers found that only a few
children were given doses above 20
mg/kg when corrected for a child’s
actual body weight, however they
also discovered that the further a
child was above their ideal body
weight, the higher the dose of
paracetamol they were given.
This dosing trend flys in the face
of current expert opinion that
paracetamol doses be tapered
down in overweight children.
“Simple evidence based dosing
guidelines must be developed and
communicated to practitioners to
reduce the potential for confusion,
which may lead to adverse
consequences for these children,”
the researchers said.
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