ASHP Peds Guidelines
ASHP Peds Guidelines
ASHP Peds Guidelines
be taken to school or daycare. Children should be included The prevention of accidental ingestion of medications should
whenever possible in discussions concerning their medica- also be emphasized. The benefits of educational programs are
tions. In the ambulatory care setting, the pharmacist is well best realized when a cooperative multidisciplinary approach
positioned to play a role in preventive health care, including is used. Sharing of pertinent information by all participants
poison prevention and immunization.7 is fundamental to the success of patient education services.9
Drug information services should provide the pharmacist Systems for the recognition, documentation, and prevention
practicing in the pediatric setting with information unique of medication errors are essential for the pediatric population.
to the pediatric population. References should include Pharmacist participation in quality-improvement committees
pediatric medical texts and current information on pediatric and the participation of pharmacists, nurses, physicians, and
dosages, extemporaneous formulations, drug compatibilities risk managers are important in minimizing medication errors
and stability, poison control, and drug effects during preg- in pediatric patients. The development and enforcement of
nancy and lactation. Drug information should be available policies and procedures for minimizing medication errors
in areas where decisions are being made about drug therapy. are essential. Pediatric patients are especially vulnerable
Literature supporting the use of drugs for unlabeled uses to errors caused by mistakes in calculations. Pharmacists
in pediatric patients should also be available.8 Pharmacists should recognize that since some commercially available
should provide other health care professionals with informa- products are available in strengths that can be potentially
tion on new and investigational drugs, adverse effects of and toxic to a pediatric patient, special scrutiny of these products
contraindications to drug therapy, compatibility and stability is necessary.5
information, dosage computations, pharmacokinetics, and drug
interactions. This may be accomplished through educational Adverse Drug Reactions
presentations, seeing patients in conjunction with other care-
givers (“rounding”), and printed materials (e.g., newsletters). Pediatric patients frequently have the same kinds of adverse
drug reactions that adults have, but adverse reactions in
Therapeutic Drug Monitoring the pediatric population may be harder to recognize or of
greater or lesser intensity. The lack of literature on newly
Therapeutic drug monitoring enables assessment of thera- introduced therapeutic agents makes it imperative to monitor
peutic outcomes and recognition at the earliest moment of an experience with new drugs initially used in the pediatric popu-
undesirable response to a drug. Both desired and undesired lation. Comprehensive adverse drug reaction monitoring and
effects should be documented. The person performing thera- reporting programs are important in reducing the occurrence
peutic drug monitoring should take into consideration the of these reactions in pediatric patients.10
age-related differences in dosage when recommending or
reviewing drug therapy. Drug-Use Evaluation
research. Examples of pediatric research topics include, but 3. American Society of Hospital Pharmacists. ASHP
are not limited to, the following: guidelines: minimum standard for pharmacies in
institutions. Am J Hosp Pharm. 1985; 42:372–5.
• Safety and efficacy of drug products in pediatric patients; 4. Folli HL, Poole RL, Benitz WE, et al. Medication er-
• Pharmacokinetics and pharmacodynamics of new ror prevention by clinical pharmacists in two children’s
medications; hospitals. Pediatrics. 1987; 79:718–22.
• Stability, safety, and efficacy of extemporaneously 5. American Society of Hospital Pharmacists. ASHP
compounded sterile and nonsterile drug products; guidelines on preventing medication errors in hospitals.
• Safety and efficacy of administration techniques; Am J Hosp Pharm. 1993; 50:305–14.
• Comparative evaluations of medications addressing 6. American Society of Hospital Pharmacists. ASHP
treatment regimens, outcomes of therapy, and their technical assistance bulletin on single unit and unit
relative costs; dose packages of drugs. Am J Hosp Pharm. 1985;
• Behavioral and socioeconomic compliance issues in 42:378–9.
pediatric pharmaceutical care; and 7. American Society of Hospital Pharmacists. ASHP
• New and existing pharmacy drug distribution systems technical assistance bulletin on the pharmacist’s role
and services for pediatric patients. in immunization. Am J Hosp Pharm. 1993; 50:501–5.
8. American Society of Hospital Pharmacists. ASHP
Examples of direct involvement include statement on the use of medications for unlabeled
uses. Am J Hosp Pharm. 1992; 49:2006–8.
• Serving as a member of an institutional review board; 9. American Society of Hospital Pharmacists. ASHP
• Maintenance, oversight, and dissemination of all guidelines on pharmacist-conducted patient counseling.
information on investigational drug studies and com- Am J Hosp Pharm. 1993; 50:505–6.
parative trials involving medications in the pediatric 10. American Society of Hospital Pharmacists. ASHP
population; and guidelines on adverse drug reaction monitoring and
• Maintenance, coordination, and oversight of policies reporting. Am J Hosp Pharm. 1989; 46:336–7.
and procedures involving investigational drug studies
and comparative trials involving medications in the
pediatric population. Approved by the ASHP Board of Directors, April 27, 1994.
Developed by the ASHP Council on Professional Affairs.
References
Copyright © 1994, American Society of Hospital Pharmacists, Inc.
1. American Society of Hospital Pharmacists. ASHP All rights reserved.
statement on pharmaceutical care. Am J Hosp Pharm.
1993; 50:1720–3. The bibliographic citation for this document is as follows: American
2. Pediatric Pharmacy Administration Group Committee on Society of Hospital Pharmacists. ASHP guidelines for providing pe-
Pediatric Pharmacy Practice. Pediatric pharmacy practice diatric pharmaceutical services in organized health care systems.
guidelines. Am J Hosp Pharm. 1991; 48:2475–7. Am J Hosp Pharm. 1994; 51:1690–2.