Off-Label Drugs in Pediatric Unit Essay
An off-label is a medical term that refers to the use of drugs that do not have approved labeling. According to Allen et al. (2018), clinicians use off-label medication on individual patients and not as a whole. Most drugs used in the Pediatric unit are off-label because the United States Food and Drugs Administration requires drug manufacturers to provide evidence-based information concerning the drugs for safety and efficacy. This information should originate from two well-controlled trials. The main reason why off-label medication is essential for children regards the absence of medication that meets their needs. Also, clinicians may use off-label medication on children, especially if the current medications are ineffective. The main examples of common off-label medication clinicians administer to children include antidepressants, antibiotics, and antihistamines Meng et al. (2022). These medications are considered off-label because they need to be administered to individuals that are over 18 years due to their side effects that may affect the children negatively.
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Different healthcare facilities deal with drug dosage and off-label medication differently. That is why most hospitals in the United States have used eHealth to manage overall medication errors within the Pediatric wards. Hence, eHealth is essential in ensuring clinicians improve prescription quality, especially in evaluating drug interactions and making the information available for all healthcare providers (García-López et al., 2020). The other strategy includes clinicians reporting any adverse off-label drug effect to ensure that the children condition is intervened upon as quickly as possible. That means the healthcare providers should uphold the nursing ethics, especially in ensuring that the medication prescribed will benefit the patients and that it does not cause harm since children are vulnerable.
Some off-label drugs that need extra care when being administered to patients include carfilzomib (Kyprolis ®) that is used for radiation therapy in cancer treatment since it may lead the children to become anemic and increase their agitation (Lim et al., 2020). In conclusion, healthcare providers needs to ensure that they administer off-label medication carefully to the children to prevent risking the children’s health.
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References
Allen, H. C., Garbe, M. C., Lees, J., Aziz, N., Chaaban, H., Miller, J. L., … & DeLeon, S. (2018). Off-label medication use in children, more common than we think: a systematic review of the literature. The Journal of the Oklahoma State Medical Association, 111(8), 776. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677268/
García-López, I., Vendrell, M. C. M., Romero, I. M., de Noriega, I., González, J. B., & Martino-Alba, R. (2020). Off-label and unlicensed drugs in pediatric palliative care: a prospective observational study. Journal of pain and symptom management, 60(5), 923-932. https://doi.org/10.1016/j.jpainsymman.2020.06.014
Lim, M., Shulman, D. S., Roberts, H., Li, A., Clymer, J., Bona, K., … & DuBois, S. G. (2020). Off‐label prescribing of targeted anticancer therapy at a large pediatric cancer center. Cancer medicine, 9(18), 6658-6666. https://doi.org/10.1002/cam4.3349
Meng, M., Lv, M., Wang, L., Yang, B., Jiao, P., Lei, W., … & Li, Q. (2022). Off-label use of drugs in pediatrics: a scoping review. European Journal of Pediatrics, 1-11. https://doi.org/10.1007/s00431-022-04515-7
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The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.
To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.
By Day 5 of Week 11
Write a 1-page narrative in APA format that addresses the following:
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.