For children, one dose doesn't fit all

June 14, 1994|By Doug Podolsky

Less isn't always best. One study found that two-thirds of parents who rushed feverish children to emergency rooms had given their kids too little acetaminophen to do any good. The study was published seven years ago, but the findings are still valid, says co-author Shea Cronley, now a Philadelphia pediatrician. One solution now being tried: keying doses to a person's weight.

Most parents are all too familiar with the way children's over-the-counter cold and cough remedies are doled out. Typically, the dose is based on age: 6 years to "under 12" years of age, kids might get two teaspoonfuls of some medicines; those 12 and over might get four.

But since age has no direct bearing on the amount of active ingredient a child's body requires, many drug manufacturers are switching to weight-based dosages. Now, kids 48 to 95 pounds might take two teaspoonfuls; heavier kids four. In a few cases, every additional 11 pounds or so ups the dosage by half a teaspoon.

Over-the-counter medications for adults still typically follow one-dose-fits-all practice. Of course, doctors often consider the patient's weight when prescribing drugs -- but not always. The blood-thinner Heparin has been used for decades as an anti-clotting drug. Yet it was only last November that a study was published in Annals of Internal Medicine showing patients given weight-based dosages achieved the anti-clotting effect far quicker.

The most precise way to tailor dosages is "titration" tests, which examine how quickly a drug's active ingredient reaches the bloodstream. They do add to the medical bill, however. But for serious, chronic problems, such as hypertension and epilepsy, the right dosage is often as important as the right medicine.

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