NURSING CONSIDERATIONS
PEDIATRIC
Infants have immature renal
function. Because of this, a
higher resistance to blood flow
means that drugs are excreted
more slowly which could cause
an accumulation of drugs. This
could lead to toxicity.
Basal Metabolism Rate in
children is higher than in adults
which leads to faster
metabolism of drugs. Some
drug dosages relative to body
weight may need to be higher
for children than adults.
Children, especially infants,
have smaller muscle mass
which means that there are
fewer sites for intramuscular
administration of drugs.
Infants have immature hepatic .
function. Most drugs are
metabolized in the liver and in
newborns and premature
infants, the given dose may not
all be metabolized.
Frequent feeding in children
can impede drug absorption.
Not only do drugs compete
with nutrients for absorption,
milk can increase the alkalinity
of gastric secretions which
prevents the absorption of
medications that need an
acidic environment and
enhances absorption of
medications that need an
alkaline environment.
ADOLESCENT
The changes in body
composition (body fat or
lean body tissue) for both
male and female may affect
drug distribution.
The presence of sex
steroids in both male and
female alters the
metabolism in the liver
which creates a difference
in biotransformation rate
between males and
females.
Adolescents have a slower
metabolic rate than children.
Dieting, the development of
eating disorders, and
starvation may also affect
drug absorption.
GERIATRIC
Renal function in older clients
is reduced which results in
drugs being excreted slowly.
Older clients may be required
to have lower or less frequent
dosages.
Older patients may be
sensitive to anticholinergic
drug effects and it is notable
in patients with cognitive
impairments as it can cause
adverse effects in the central
nervous system.
An increase in body fat in
older adults increases the
volume of distribution of
lipophilic drugs.
Geriatric clients have reduced
liver blood flow and liver size
which means there is a
decrease in metabolizing
enzymes. Certain drugs are
also inducers and inhibitors
which affects the rate of
metabolism of drugs.
An increase in gastric pH
may inhibit absorption of
drugs that need an acidic
environment. This could also
cause an early release of
enteric-coated drugs which
may lead to gastrointestinal
adverse effects.
REFERENCES:

Carr, R. R., & Ensom, M. H. H. (2002). Drug Disposition and Therapy in Adolescence: The
Effects of Puberty. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3469156/pdf/i1551-6776-8-2-86.pdf
Medication Administration and Safety for Infants and Children. (n.d.). Retrieved from
nursekey.com/medication-administration-and-safety-for-infants-and-children/
Pharmacokinetics in Infants and Children. (n.d.). Retrieved from
deanza.edu/faculty/hrycykcatherine/Pharmacokinetics%20in%20Infants%20and%20Chil
dren.pdf
Pharmacokinetics in the older patient. (n.d.). Retrieved from
rosemontpharma.com/health-professionals/pharmacokinetics-in-the-older-patient
Ruscin, J. M. (2022). Pharmacokinetics in Older Adults. Retrieved from
msdmanuals.com/professional/geriatrics/drug-therapy-in-older-adults/pharmacokinetcs-i
n-older-adults