The choice of drugs from the standpoint of evidence-based medicine is especially important in pediatrics. It is in this area of medicine that a high frequency of use of “unauthorized” drugs is recorded. medicines(drugs) that are not officially recommended for use in children due to the lack of data on pharmacokinetics, safety or lack of clinical studies.
In principle, the risks associated with mixed consumption are higher than with single consumption; The body and psyche are strengthened more strongly. Individual effects of the substance may be worsened or weakened. It can also have completely unexpected effects that do not add up to the sum of the individual effects. Since exposure to relevant substances may occur in different time and last different lengths, the interaction may occur with a time delay.
There is no such thing as risk-free consumption! Using safe use guidelines can help minimize risks. The sooner you start consuming, the greater the risk of developing worsening or permanent effects and side effects. We advise people with mental instability or mental illness against consumption. Do not forget to catch up with the information before and, if in doubt, refuse consumption.
The drug is usually prescribed to children per 1 kg of body weight, per 1 m 2 of body surface or per year of the child’s life. There are different approaches to calculating doses for children based on the dose of a drug for an adult:
Based on body weight (Clark's rule);
Based on age (Young's rule);
Based on body surface area;
Pay attention to who and who you buy with and ask what you get. However, the substances are difficult to distinguish for inexperienced users. If possible, use while sitting or lying down and not alone because unexpected side effects. Make sure someone around you is aware of your consumption and can get or provide help.
Additionally, the differences in quantity between a “tolerable” dose and an overdose are very small. This makes it difficult to find the right dose without overdosing. Plastic or rubber pipettes are quite unsuitable due to incorrect dosage. The dose is always low. The dose is smaller when consumed on an empty stomach.
Based on dosis factor.
Dose calculation for children based on body weight is carried out using the following formula ( Clarke's rule):
Example 1. Let's calculate the dose for a newborn using Clark's rule based on body weight.
The body weight of the newborn is 3 kg. The average therapeutic dose of the drug for an adult is 350 mg.
Thus, the dose of the drug for a child is 15 mg.
Even if you no longer feel the effects after the intoxication ends, there may still be some in your blood. active substance. For many users, it is often difficult to estimate how much time has passed since their last consumption while intoxicated. To avoid overdose, record the time of last use. Wait at least 2 hours and the dose will be lower when refilling.
If you are alone, a cardiac massage is enough. Keep in mind that overdosing can be very stressful and stressful situation not only for you, but also for the people in your environment - especially if you shoot more often. Drink enough water, take vitamins and minerals and drinks!
Calculation of the dosage of medications for children based on age is based on Young’s rule:
Example 2. Let's calculate the dose for a 6 year old child. The dose for an adult is 350 mg.
The dose of the drug for a six-year-old child will be 117 mg.
Dose calculations based on age or body weight are traditional and tend to underestimate the required dose.
For intravenous use overdose is much easier than oral. It pays to think in advance what, how much, with whom you want to consume or do something. If consumption drives sexual violence, risks in unprotected traffic may no longer be taken as seriously.
Never consume so much that you cannot resist. With regular use, sleep disorders and physical addiction may develop. Tips can be found here. If you're looking to change your consumption, want to quit smoking, or simply have questions, don't be afraid to contact the facility of your choice!
In children who are overweight or underweight, an overdose or a low dosage based on body weight may be observed. In this case, it is better to use the calculation based on body surface area. There are special nomograms that allow you to move when calculating from the patient’s body weight to the body surface area (Table 1 and Table 2). It should be noted that calculations that take into account body surface area are more adequate for choosing the dose of a medicinal substance for children of different ages.
In Leipzig you can find help from the coordination group against sexual violence. That is, menstrual cramps may get worse, disrupted monthly cycle and fertility deteriorates. However, you may become pregnant. There are too few drug pills in the blood so that pregnancy is possible. This information is not a guide or motivation for drug use! This text was written to the best of my knowledge and beliefs. However, errors cannot be ruled out. Drug Researchers are not responsible for damages resulting from any use of the information in this text.
Table 1
Nomograms that allow you to move from the size of a person’s body weight to body surface area.
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Body weight, kg. | |
table 2
He was Vice President of the Spanish Observatory of Medical Cannabis, where he is currently a member of the Board of Directors. He is currently the President of the Ibero-American Society of Cannabis Medicine. If there is any parameter in medical practice with cannabinoids, which raises more doubts among doctors and patients and their families, that is, without a doubt, a question of dosing.
Typically in medicine, the dosage of a drug is calculated based on the patient's weight, using as parameters to calculate the final dose to be administered. Minimum or maximum dose drug that will be administered for each kilogram of the patient's weight with each shot or for 24 hours when we are talking about pediatric age, or a standardized pordose per 70 kg weight if we are talking about adult patients, the latter changing slightly depending on the actual weight person or according to the position applied. All these parameters, commonly used in medicine, are determined after many years of pharmacological research and after many years clinical practice.
Determining the dose of a drug based on body surface area.
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Body weight (kg) |
Approximate age |
Body surface area, m2 |
Percentage of adult dose, % |
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newborn | |||
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Adult What is stated in the previous paragraph in the case of paracetamol applies to the vast majority of drugs used today, that is, the doses used will depend on the person's weight, in the case of children, and the dose is standardized, in the case of adults. Doses of 2.5 mg are commonly used in the elderly and children, although, surprisingly, children have a greater tolerance to the psychoactive effects of cannabis than adults. The only pharmaceutical drug derived from the plant has a highly variable dosage. Average dose in clinical trials in patients with multiple sclerosis is eight sprays per day, although doses exceeding 12 sprays per day are not recommended. On the other hand, although it is recommended to use the drug in two doses, according to the tables presented on the page of the Spanish Agency for Medicines and Health Products, these doses are never the same, always prescribing a higher dose at night than in the morning. | |||
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Adult |
Example 3. Dose calculation for a newborn baby. The dose of the drug is 5 mg/kg for an adult patient.
The dose for an adult patient will be 70 kg x 5 mg/kg = 350 mg.
Let us recalculate the dose for a newborn’s body weight of 3 kg.
We will recalculate the dose taking into account the surface area
Cannabis is not one molecule, there are many
When we talk about medicinal cannabis, we are talking about a substance that bases its multifaceted therapeutic potential on the fact that depending on the different combination of cannabinoids and terpenoids we will have more suitable product for one or another pathology. Thus, we have varieties that are ideal for problems with insomnia or anxiety, while on the other hand we find varieties with powerful euphoric and antidepressant effects. This variability in effects is due not only to the different combination of cannabinoids, but also to the combination of these cannabinoids with the different terpenoids present in each variety.
The correction factor is 0.12 (12%)
The dose of this drug for a newborn is: 14 mg/kg
For children with overweight or underweight, it is advisable to determine the individual dose based on the "DOSIS FACTOR". For this purpose, the dose for an adult, expressed per 1 kilogram of body weight, is multiplied by the dosage factor, which is individual for each age of the child. Calculations based on the “dose factor” take into account the dose recalculation factor in various age categories (Table 3).
Thus, the number of combinations between cannabinoids and terpenoids means that when we talk about medicinal cannabis, we are not talking about one type of "medicine" like when we talked about paracetamol at the beginning of this article. This is why cannabis cannot be dosed like other drugs. To curl more curl, to the above we must add the genetic variability of each individual, because the same 5 mg variety will not produce the same effect applied in two different people, although the product is exactly the same.
Table 3
The "dose factor" indicator for various age categories.
Example 4. The dose of the drug for an adult (weight 70 kg) is 500 mg. Let's calculate the dose for 8 year old child body weight 26 kg.
The dose for an adult is 500 mg / 70 = 7.14 mg/kg
The child's body weight is 26 kg.
The dose of the drug for a child is 7.14 x 26 x 1.4 = 260 mg
Individualization of treatment
What is the only thing Possible Solution this set of obstacles that arise when we want to dose cannabis? This means that each person will have a dose that the best way will suit their health concerns and this will depend on the person, the product used and the route used.
To do this, it is important to invest enough time to find this balance. Increasing the dose too quickly will lead to side effects that often lead to the patient refusing treatment, and if the dose is increased excessively for a long time, lack of effectiveness will result in the patient refusing treatment before treatment. Obvious lack of efficiency.
The reaction to a drug in children of different ages depends on such a large number of factors that it is a priori unpredictable. In this regard, dosing of medications in children cannot be based on formulas for recalculating doses of medications from an adult to a child of a certain age. However, this recalculation does not take into account the pharmacodynamics of the substance, age characteristics of resistance and sensitivity to this drug, as well as the individual characteristics of a particular child. Therefore, drug doses for children are determined in clinical trials.
This is a health problem that many men experience regarding the difficulty or inability to have or maintain an erection. However, this problem affects almost every person reproductive age at some point in his life. This may be episodic or recurrent, in which case medical supervision and drug use and, in some cases, psychotherapeutic treatment are recommended.
This drug has been on the pharmaceutical market for over 20 years and its effects and characteristics have already been widely studied and documented. Its active principle, sildenafil citrate, acts as a vasodilator to promote blood flow to the genital area and allow erection. Viagra is not only the most popular drug in the world for the treatment of erectile dysfunction - it is one of the most popular drugs in the world, taking into account all categories of existing drugs.
It should be noted that despite the presence of numerous articles, a number of methodological recommendations and other sources reflecting issues related to the selection and dosage of medicinal substances in pediatrics, including textbooks on pediatric pharmacology, we did not find an exact answer to this in the literature available to us complex issue pharmacology.
Viagra is estimated to be the sixth best-selling drug in the world. last years. The secret of the success of this drug lies in its high level effectiveness in cases of erectile dysfunction of various origins and levels. After oral administration, the product begins to act within a few minutes, expanding blood vessels genital area and facilitating blood circulation responsible for erection. This effect is obtained through sildenafil citrate and usually lasts for 4 to 6 hours.
Minimum doses of Viagra are recommended for people with moderate cases of erectile dysfunction, for patients who regularly use drugs that interact with sildenafil citrate, and for patients with medical conditions that may be potentiated by the substance.
To optimize drug supply and increase the rationality of pharmacotherapy, various restrictive lists are used: a list of essential drugs, a pediatric formulary.
The list of vital and essential drugs is a list of drugs approved annually by the government of the Russian Federation (Order of the Government of the Russian Federation dated July 30, 2012 N 1378-r “On establishing a list of vital and essential drugs for 2013”). Prices and markups for drugs from this list are subject to government regulation.
This dose is also recommended for patients taking alpha-adrenergic blocking drugs, patients taking Ritonavir or similar, patients over 65 years of age, patients with heart, liver or kidney problems. None of the above mentioned users should use the medicine without medical care. Under no circumstances should these patients increase the dosage of the medication on their own.
This is the recommended dose for the vast majority of Viagra users without pre-existing conditions or other health problems. At first, this dose is sufficient to achieve the desired effect. If the side effects are very strong, it is recommended to reduce Viagra to 25 mg; if the effect is too weak, you can change it to 100 mg.
In 2007, the Formulary Committee of the Russian Academy of Medical Sciences published a Pediatric Formulary.
The main criteria for deciding whether to include a medicinal product in the formulary list are:
1. Documentation of its clinical value (i.e. effectiveness and safety) based on evidence-based medicine;
2. Acceptable cost-effective ratio.
Its content included 370 names of drugs from the generally accepted ATC groups of the first level. In the pediatric formulary, 274 (74.1%) names of drugs belong to the list of essential drugs. In the List of Vital and Essential Drugs, only 10 drugs indicate dosage forms “for children” and only five of them are included in the Pediatric Formulary. When analyzing the instructions for use, it was revealed that 60 drugs in the Pediatric Formulary (16.2%) are not recommended for use in children (usually due to lack of data). For 55 drugs (14.9%), age restrictions on their use were not specified. The instructions for use for 93 drugs (25.1%) do not contain information about the possibility or restrictions of use in children. These results of a critical analysis of the Pediatric Formulary indicate the need for its revision and addition, in particular, indication dosage forms and age restrictions on the use of medications.
A comparative expert assessment of the Pediatric Formulary with the WHO Model List of Essential Medicines for Children (WHO Formulary) showed that 115 medicines from the Pediatric Formulary (31.1%) are included in the WHO Formulary. Among them, eight drugs are not classified as vital drugs.
Thus, we can conclude that the List of Vital and Essential Drugs does not take into account the specifics of the use of drugs in children (51.1% of drugs on this List are not included in the Pediatric Formulary), therefore, it cannot be used as a restrictive drug provision for patients in pediatric hospitals .
However, drug formularies are advisory in nature. The same are the WHO drug formularies for 2007 and 2012. publications The highest single and daily doses of toxic and potent drugs for children of different ages are given in Table X of the USSR Pharmacopoeia, but it was published in 1968. It states that when calculating higher doses for drugs not included in the table, doses are reduced depending on age approximately: for young people 18 years old - 3/4 of the dose of adults.
For children 14 years old – 1/2 adult dose
For children 7 years old – 1/3 of the adult dose
For children 6 years old – 1/4 adult dose
For children 4 years old - 1/6 adult dose
For children 2 years old – 1/8 adult dose
For children 1 year of age – 1/12 of the adult dose
For children under 1 year – 1/24 – 1/12 of the dose for adults.
Higher doses of poisonous and potent drugs for adults are calculated for adults 25 years of age and are indicated in a separate list X of the State Pharmacopoeia of the USSR.
Analyzing the data in this section of the manual, it should be noted that it is necessary to rely on information on pediatric doses, which is provided by the manufacturer in instructions for medical use drug. In the absence of such information, recalculation methods should be followed that take into account body weight, age and body surface area. But you should always remember that the pediatric dose should never exceed the adult dose! And, finally, only clinical trials of drugs by pediatricians can bring complete clarity to the problem of dosing drugs for children.
Drawing. 1. Principles for calculating the dose of a medicinal substance for children.
