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Drug Dosing in Adult and Paediatric Population in Developing Countries: Possible Pharmaceutical Misadventure (A Review)

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Author(s): I.C. Maduka | E.E. Neboh | E.N. Shu | E.J. Ikekpeazu

Journal: British Journal of Pharmacology and Toxicology
ISSN 2044-2459

Volume: 1;
Issue: 2;
Start page: 77;
Date: 2010;
Original page

Keywords: Antimalarial | administration | age-to-weight | body mass index | drug dosing | paediatric

ABSTRACT
Drug dosage should be based on weight rather than age and this study aims at highlighting the problems of possible over-dosage or under-dosage where the weight of the patient is not considered before prescription is given, as is being practice by clinicians in most developed and developing countries. Drug dosing has always been a vital issue in drug administration over time. For instance, the paediatric clinician encounters several limitations of information in paediatric pharmacotherapy which includes small numbers on patients with rare disease, small size studies and huge inter-patient variability among this population. The physiology, pharmacokinetics and pharmacodynamics of medications are highly variable and there is need to simplify this variation as much as possible. Tailoring the therapy for children according to their developmental stage as well as chronological age, w hich include selecting the appropriate dosage regimen and age-specific ways to prevent medication errors and enhanced compliance of paediatric patients are both significant problems to be further addressed in paediatric therapy. The basic principles of management of severe falciparum malaria include, initiating treatment immediately; checking of the weight and blood sugar level of patient; choosing drug regimen and calculation of the drug dosage according to patient’s body weight. Unfortunately, this is usually not done in most developing/ developed countries, during adult administration of artemisinin derivatives (orally), which might most likely lead to under dosage of most adult patients predisposing them to possible drug resistance development.
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