College

When determining a dosage for a pediatric patient, what should be considered for calculating the dosage using body surface area versus a standard dosage calculation?

Answer :

Calculating pediatric dosage can be based on standard dosage calculations or body surface area, with the latter often used in cancer chemotherapy. Dosages for children are typically based on body mass (mg/kg), and factors like the risk of toxicity and organ function must be taken into account to adjust the dosage properly.

Calculating Pediatric Dosage

When determining a dosage for a pediatric patient, it is imperative to decide between using a standard dosage calculation or calculating based on body surface area (BSA). For children, dosages are generally based on body mass using mg/kg (milligrams per kilogram of body weight). However, BSA calculations, often used in cancer chemotherapy, take into account the total body surface as a measure to scale doses, since metabolic processes are more closely related to BSA than to body weight alone.

For pediatric patients, especially, these calculations are critical because they are more sensitive to doses than adults. The goal is to achieve the therapeutic effect of the drug while minimizing the risk of side effects. This process usually involves converting body weight from pounds to kilograms, then calculating the total milligram dosage required based on the weight or BSA, and finally, converting this dose into the actual number of tablets or volume of liquid medication.

Moreover, when considering toxicity and side effects, a thorough review of the patient's history regarding liver or kidney function is necessary due to its impact on drug metabolism and clearance. Special attention should be given to pediatric patients with organ dysfunction to avoid increased drug levels that could lead to toxicity.