Optimizing pediatric esmolol dosing using computerized practitioner order entry

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
Tihua ChaoEdmund V Capparelli

Abstract

The aims of this study were to 1) describe the cardiovascular dose-response of esmolol and dose-limiting adverse effects in pediatric patients; 2) assess an institutional guideline for protocol adherence, efficacy, and achievement of therapeutic targets for pediatric patients with tachyarrhythmias or systemic hypertension; and 3) revise the protocol accordingly. In this prospective study, pediatric/neonatal subjects were identified using a medication utilization report in the electronic medical record and treated with esmolol for blood pressure or rhythm control at Rady Children's Hospital San Diego between November 1, 2012, and February 28, 2013. Inclusion criteria required subjects to be under intensive care and have bedside telemetry monitoring. Data collection consisted of patient demographic information, administration history of esmolol, concurrent administration of other cardiovascular medications, patient cardiovascular goals, and vital signs. A total of 8 subjects representing 10 administrations of esmolol were included in the study. Whereas esmolol was found to be safe and effective overall for control of hypertension and tachyarrhythmia, protocol adherence was poor, leading to subtherapeutic dosing schemes, dose chan...Continue Reading

References

May 12, 1998·The Journal of Thoracic and Cardiovascular Surgery·D B WiestR M Sade
Jul 13, 2006·Pediatric Cardiology·Peter C AdamsonMark S Schreiner

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