In the treatment of children more can be accomplished by good hygienic surroundings, careful feeding, and proper nursing than by the administration of drugs. Drugs are necessary under certain conditions, when it is better to give divided doses frequently than a large amount at one time. Drugs well borne by children include alcoholic stimulants, which should be diluted eight times before administration, quinin, calomel, iodids, cod-liver oil, bromids, chloral, and belladonna. Belladonna often causes an erythema or redness of the skin even when given in small quantities, but this does not necessarily mean that the drug is producing deleterious effects. Chloral should be given by the rectum. When given by mouth it causes irritation of the mucous membranes. Drugs poorly borne by children include opium, usually given in the form of Dover's powder, salicylates, iron, and acids. Children are more susceptible to opium than adults. The other drugs mentioned have a tendency to derange the digestion.
<Callout type="important" title="Dosage Rules">Young’s Rule: Add twelve to the age of the child and divide the sum into the age. This gives the proportional quantity of an adult dose.</Callout>
Crowling's Rule: Divide the age of the child at the following birthday by twenty-four, and the result is the proportionate dose for that child.
The therapeutic limit of a drug is the furthest point to which a drug can be pushed, with safety, in the treatment of a disease. The therapeutic limits of various drugs are listed along with their contraindications.
Key Takeaways
- Good hygiene and proper nursing are more effective than drug use in treating children's diseases.
- Dosage rules for children should be based on their age relative to an adult dose.
- Certain drugs have specific contraindications that must be considered.
Practical Tips
- Always dilute alcoholic stimulants eight times before administering them to a child.
- Use Young's Rule or Crowling's Rule for calculating appropriate drug dosages in children.
- Be cautious with opium and salicylates as they are poorly tolerated by children.
Warnings & Risks
- Administering too much belladonna can cause severe side effects such as rapid pulse and pupil dilation.
- Chloral given orally may irritate the mucous membranes, so rectal administration is preferred.
Modern Application
While this chapter provides valuable historical insights into drug dosages for children, modern medical practices have advanced significantly. However, understanding these early rules can still be useful in emergency situations where conventional medical advice might not be available.
Frequently Asked Questions
Q: What are the two main rules for calculating drug doses for children?
Young's Rule and Crowling's Rule are used to calculate appropriate drug dosages based on a child’s age relative to an adult dose.
Q: Why should chloral be given by rectum rather than orally?
Chloral can cause irritation of the mucous membranes when administered orally, so it is recommended to give it via the rectum instead.
Q: What are some drugs that children tolerate well according to this chapter?
Drugs such as alcoholic stimulants (diluted), quinin, calomel, iodids, cod-liver oil, bromids, chloral, and belladonna are listed as being well-tolerated by children.