Sample Answer for NURS 6521 OFF-LABEL DRUG USE IN PEDIATRICS Included After Question
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
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 Links to an external site.). All papers submitted must use this formatting.
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A Sample Answer For the Assignment: NURS 6521 OFF-LABEL DRUG USE IN PEDIATRICS
Title: NURS 6521 OFF-LABEL DRUG USE IN PEDIATRICS
Off-label drug use entails prescribing medications for indications other than those approved by the FDA. It also involves using a dose or dosage form not approved by the FDA. Off-label drug use has become common because the FDA does not regulate clinical practice. The purpose of this paper is to discuss off-label prescribing in pediatrics.
Prescribing Children Drugs for Off-Label Use
Off-label drug prescribing in pediatrics should only be practiced if no drug is approved to treat a specific condition for that age group. van der Zanden et al. (2021) explain that a specific and unmet medical need should inform off-label drug use in children.
In addition, off-label prescribing should be done in the face of a life-threatening or terminal medical illness, where the clinician prescribed any logical and available treatment, approved by the FDA or not. Off-label drug use can also be practiced if one drug from a particular class has FDA approval.
Strategies to Make The Off-Label Use and Dosage of Drugs Safer For Children
Off-label prescribing can be made safe for pediatrics by conducting a risk-benefit assessment of the intended medication and using age-appropriate dosing recommendations. Besides, alternative treatment options should be compared to identify the safest yet most effective drug for a specific age and condition (van der Zanden et al., 2021). Off-label drugs that should be prescribed with caution in pediatrics include cardiovascular medications like Amlodipine and Lisinopril since they risk causing hemodynamic instability in under or overdose (Rusz et al., 2021). Sedatives like ketamine and lorazepam also need caution since they have long-term adverse effects on the CNS in children.
Conclusion
Off-label drug use in children is indicated when a medical condition requires drug treatment for which no licensed medications are available or for which treatment with approved drugs is not effective or suitable. A risk-benefit assessment of an off-label drug can make off-label drug use safer for pediatrics. Cardiovascular drugs and sedatives should be used with caution in pediatrics.
References
Rusz, C. M., Ősz, B. E., Jîtcă, G., Miklos, A., Bătrînu, M. G., & Imre, S. (2021). Off-Label Medication: From a Simple Concept to Complex Practical Aspects. International journal of environmental research and public health, 18(19), 10447. https://doi.org/10.3390/ijerph181910447
van der Zanden, T. M., Vet, N. J., Neubert, A., Rascher, W., Lagler, F. B., Male, C., … & de Wildt, S. N. (2021). Benefit-Risk Assessment of Off-Label Drug Use in Children: The Bravo Framework. Clinical Pharmacology and Therapeutics, 110(4), 952-965. https://doi.org/10.1002/cpt.2336
A Sample Answer For the Assignment: NURS 6521 OFF-LABEL DRUG USE IN PEDIATRICS
Title: NURS 6521 OFF-LABEL DRUG USE IN PEDIATRICS
Situations When Off Label Medications May be Used in Pediatrics
There are specific situations when medications in the regard of off-label medications can be given to children. For instance, whenever a drug which is meant to manage a particular condition has been used without demonstrable success, a physician can choose a different alternative to save the day (“Off-Label use of Medicines in Children,” n.d.). A physician may be compelled to prescribe a drug to a pediatric when a particular formulation is available in a different country in another possible scenario. Yet there are acute shortages in their areas of jurisdiction. On the other hand, the physician can make an importation request for a drug used in another country for adults but for children in their country (Allen et al., 2018). Examples of the off-label medications used in children include amoxicillin, used for different conditions, including otitis media. There are specific medications which are high risk and should be used with caution in paediatrics, including dopamine, hydromorphone, oxycodone and lorazepam (Czaja et al., 2015). The medication could cause pronounced psychological effects or even unforeseen death.
Strategies for Off-label Medications for Pediatrics
Whenever off-label medications are used in children, there ought to be strategies to ensure they attain the best possible outcomes with minimal adverse effects. More clinical trials should be considered but within the safety and ethical parameters in children to establish the efficacy of medications (Tefera et al., 2017). The healthcare providers, the nurses, physicians and pharmacists should have efficient reporting methods and address the occurrence of adverse effects in children, which would then enhance the use of the medications.
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), 776–783. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/31379392
Czaja, A. S., Reiter, P. D., Schultz, M. L., & Valuck, R. J. (2015). Patterns of off-label prescribing in the pediatric intensive care unit and prioritizing future research. Journal of Pediatric Pharmacology and Therapeutics, 20(3), 186–196. https://doi.org/10.5863/1551-6776-20.3.186
OFF-LABEL USE OF MEDICINES IN CHILDREN | INTERNATIONAL JOURNAL OF PHARMACEUTICAL SCIENCES AND RESEARCH. (n.d.). Retrieved February 2, 2021, from https://ijpsr.com/bft-article/off-label-use-of-medicines-in-children/?view=fulltext
Tefera, Y. G., Gebresillassie, B. M., Mekuria, A. B., Abebe, T. B., Erku, D. A., Seid, N., & Beshir, H. B. (2017). Off-label drug use in hospitalized children: A prospective observational study at gondar university referral hospital, northwestern Ethiopia. Pharmacology Research and Perspectives, 5(2), 304. https://doi.org/10.1002/prp2.304
Rubric
| NURS_6521_Week11_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeExplain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples. |
|
40 pts | ||||
| This criterion is linked to a Learning OutcomeExplain strategies to making off-label use and dosage of drugs safer for children from infancy to adolescence and descriptions and names of off-label drugs that require extra care and attention when used in pediatrics. Be specific. |
|
45 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||