Other medications cannot be given to a mother who is breastfeeding because
of the toxic effect the medication has on the baby (unless breastfeeding is inter-
rupted for 24 hours to 72 hours).
These medications include amphetamines, bromocriptine, cocaine, cyclophos-
phamide, cyclosporine, doxorubicin, ergotamine, gold salts, lithium, methotrex-
ate, nicotine, and phenindione.
Organs in the neonate might be unable to handle the normal dose of some
medications. For example, the stomach lacks acid, gastric emptying time is
prolonged, the liver and kidneys are immature, and there is a decrease in pro-
tein binding.
ADMINISTERING MEDICATION
TO PEDIATRIC PATIENTS
There isn’t a standard dose for pediatric patients. The dose is calculated using
the patient’s weight or the patient’s body surface area. Some over-the-counter
medications specifies a dose based on the child’s age, but these are really based
on the average weight of a child within that age range. The dose can become
problematic if the child’s weight is lower or higher than that of the age group.
If a child with a very low weight receives an age-related dose it might result in
an undesirable adverse affect from the medication. When a child who is heav-
ier than average receives a dose related to age, the drug may not have a thera-
peutic effect.
Before administering medication to a pediatric patient consult with the par-
ents to assess if the patient has allergies to food, medications, and the environ-
ment, a family history of allergies, an experience with medications and illnesses,
or is taking any other medication or herbal remedies.
Elderly
More than 30% of all prescriptions and more than 50 percent of all over-the-
counter medications in the United States are consumed by patients who are
over 60 years of age. It is this group of patients who are three times more likely
to be admitted to a healthcare facility for an adverse reaction to medication.
CHAPTER 3 Pharmacology and the Nursing Process^55