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Letters to the Editor Indian Pediatrics 2003; 40:1111-1112 |
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Adolescent Pharmacology |
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This change has many implications, the greatest of which is that Pediatricians who are long used to prescribing drugs in the form of syrups and drops will have to get themselves well acquainted with capsules, tablets and other adult preparations. With the overall improvement in pediatric nutrition late adolescents of 16 or 17 yrs of age nowadays may weigh as much as adults and would require adult dosings and adult preparations. There is another issue-that of overweight and obese adolescents. Thanks to the effect of fast food, idle lifestyle and long hours before the television and computers, obesity among urban adolescents is a growing phenomenon(1) and these days it is not unusual to see adolescents of 13 yrs of age achieving weight upto 50 kg. This phenomenon has added confusion vis-à-vis a pediatrician’s prescribing habits. Suppose he has to prescribe amoxycillin to such a child. According to weight calculation the dose will be 500 mg three times a day but parents may consider it as high dose and moreover Pediatrician himself may not feel comfortable with it. This point raises a relevant question– are adolescent or more precisely early adolescent (since late adolescence merges with adulthood) pharmacokinetics and pharmacodynamics different from adults? In other words should an early adolescent of 13 yrs weighing 50 kg require less dose than an adult of the same weight? This question is very important and needs to be addressed. Many Pediatricians, ill at ease with this issue tend to write medicines to adolescents in underdoses. This practice is hazardous. A robust adolescent of thirteen years weighing fifty kilograms cannot be expected to benefit from a dosage like tablet amoxycillin 250 mg three times a day. We have recently discovered our adolescents. But little has been said about adolescent pharmacology. It is time we discuss this one more but important aspect of adolescence. Mukul Tiwari, Reference
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