Parenteral drug administration guidelines for the pediatric patient: one hospital's recommendations.

With the increasing use of intravenous drug therapy in the pediatric population, pharmacists are frequently faced with questions concerning appropriate methods of parenteral drug delivery. In some instances, these patients are also receiving parenteral nutrition solutions, and often have a limited fluid capacity caused by disease states such as congestive heart failure or renal insufficiency. Limited vascular access is also a frequent concern in the treatment of these patients. As a result, pharmacists are frequently asked whether a medication may be administered along with the PN solution. Although this practice is strongly discouraged, in many cases, especially in the pediatric patient, it is the only way to ensure that the patient is receiving adequate nutrition as well as appropriate drug therapy. Also, by administering medication with the PN solution, rather than interrupting the PN to administer medication, the patient is less likely to develop rebound hypoglycemia. The practice of administering medication through a central venous line intended for PN solutions is not without risks, however. Catheter sepsis and occlusion may result.