Pediatrics

  

                                                      

                                                                                                                 

The goal for compounding for pediatric patients is to improve compliance and optimize drug therapy through the preparation of products based on specific body weight, age, special needs and preferences of patients and their care givers. We consult with our pediatric patients, their physicians and guardians to create the most appropriate drug delivery system that includes but not limited to:

 

                                     Capsules                                     Suckers/Lollipops

                                     Powders                                      Popsicles

                                     Oral liquids                                  Troches/Lozenges

                                     Gummy gel                                  Pudding/Jellos

                                     Chewing gum

                                      

For patients who cannot swallow or refuse to, suppositories or transdermal gels can be made. Other forms of drug delivery include:

 

                                    Creams                                            Intramuscular Injections

                                    Ointments                                         Subcutaneous Injections

                                    Patches                                            Eye Drop Preparations

                                    Intravenous injections

                                  

 

There is a great need for extemporaneous formulations in pediatric  patients specially in infants and young children who require much smaller doses than those provided commercially. "Off label" use of drugs is not uncommon in pediatric patients. In fact, it would unethical not to use extemporaneous preparations when the intended doses are to be based strictly on body weight of infants and children.

  

 

A widely used pediactric dosage form is transdermal gels for nausea and vomitting, this lets parents avoid putting their children through the discomfort of using a suppository and is not commercially available.

Promethazine is commonly used for nausea and vomitting and can be incorporated into a topical gel which can then be rubbed into the wrists or any area where the skin is thinnest.

 

 

For a child suffering from a sore throat lollipops are available. These can be made in any flavor and the strengths of medication in them can range depending on what the pediatrician feels is necessary. 

 

 

Orally administered liquids constitute the majority of commonly used and commercially available dosage form for the pediatric population. However, there are many needed oral liquids and suspension that cannot be manufactured due to issues related to limited demand, profitability, or the lack of shelf-life. Below is a partial list of non commercially available suspensions and liquids that can be prepared by a trained compounding pharmacist:

 

 

Oral Liquids/Suspensions/Solutions:

 

       Acetazolamide 25mg-50mg/mL                                    

       Adderal 1mg/mL                                                          

       Allopurinol 10mg-40mg/mL                                           

       Amiodarone 10mg-20mg/mL                                       

       Amlodipine 1mg-2mg/mL                                             

       Atenolol 2mg-4mg/mL                                                   

       Azathioprine 10mg-50mg/mL                                         

       Baclofen 1mg-10mg/mL                                                 

       Bethanecol 5mg/mL                                                       

       Busulfan 2mg/mL                                                           

       Captopril 1mg-2mg/mL                                                   

       Carbidopa 1.25mg/mL                                                    

       Chloroquine 9mg-10mg base/mL                                   

       Clonazepam 0.1mg-0.4mg/mL                                        

       Clonidine 0.01mg-0.1mg/mL                                           

       Carbidopa 1.25mg/mL                                                    

       Cyclophosphamide 2mg/mL                                            

       Dapsone 2mg/mL                                                           

       Diltiazem 5mg-20mg/mL                                                 

       Dipyridamole 5mg-10mg/mL                                          

       Disoopyramide 1mg-10mg/mL                                         

       Enalapril 0.5mg-1mg/mL                                                 

       Ethacrynic Acid 1mg/mL                                                 

       Etoposide 10mg/mL                                                        

       Erythromycin 400mg/mL                                                 

       Flecainide Acetate 5mg-20mg/mL                                 

       Flucytosine 10mg/mL                                                     

       Folic Acid 200mcg-400mcg/mL                                       

       Ganciclovir 25mg/mL                                                      

       Glycopyrrolate 0.5mg-1mg/mL                                       

       Griseofulvin 25mg/mL                                                     

       Granisetron Hydrochloride 0.05mg-0.2mg/mL               

       Hydralazine 5mg-10mg/mL                                            

       Isoniazide 10mg/mL                                                       

       Isradipine 1mg/mL                                                         

       Ketoconazole 20mg/mL                                                  

       Labetalol 10mg-40mg/mL                                               

       Lamotrigine 1mg/mL                                                       

       Lansoprazole 3mg/mL                                                     

       Levodopa 5mg/mL
       Levodopa 5mg/mL & Carbidopa 1.25mg/mL 
       Levofloxacin 50mg/mL
       Levothyroxine 25mcg/mL
       Lisinopril 2mg/mL
       Methotrexate 2.5mg-5mg/mL
       Methyldopa 25mg/mL
       Metolazone 0.5mg-1mg/mL
       Metoprolol10mg-20mg/mL
       Metronidazole 10mg-50mg/mL
       Mexiletine 10mg/mL
       Naratriptan 0.5mg/mL
       Neomycin 10mg-100mg/mL
       Nizatidine 2.5mg/mL
       Omeprazole 2mg/mL
       Pantoprazole 2mg/mL
       Pentoxyfylline 20mg/mL
       Phenoxybenzamine 2mg/mL
       Potassium Perchlorate 10-15mg/mL
       Prednisone 1mg-10mg/mL
       Procainamide 50mg/mL
       Progesterone 40mg/mL
       Propylthiouracil 5mg/mL
       Pyrazinamide 10-100mg/mL
       Quinidine 10mg-20mg/mL
       Ranitidine 15mg/mL
       Rifabutin 20mg/mL
       Rifampin 25mg-50mg/mL
       Spironolactone 2.5mg-25mg/mL
       Spironolactone 5mg/mL & Hctz 5mg/mL
       Sulfasalazine 100mg/mL
       Tacrolimus 0.5mg/mL
       Terbinafine 25mg/mL
       Terbutaline 1mg/mL
       Thioridazine 100mg/mL
       Tiagabine 1mg/mL
       Ursodiol 20mg-60mg/mL
       Valcyclovir 50mg/mL
       Verapamil 50mg/mL

  

We have a WIDE variety of flavorings for oral syrups/suspensions. For example: Tutti Frutti, Grape, Bubble Gum, Orange, Cotton Candy, Butterscotch, Salt Water Taffy, Root Beer, Tropical Punch, Lemon and MANY More!!!

 

Diaper Rash:

For persistent diaper rash, particularly associated with diarrhea we have a special ointment formultaion. By using Cholestyramine powder mixed with Aquaphor & Zinc Ointment ,these products put together bind up the bile acids that cause the redness and irritation.

 

  

Diseases/Disorders:

 

Attention Deficit Hyperactivity Disorder:

 

Strengths of commercially available medications are sometimes not appropriate for a school aged child who may find it embarassing to take his or her medication mid day through school hours. We can help in compounding medications with slow-release characters to combat this problem.

  

Autism: 

Autism affects people of all racial, ethnic and socioeconomic backgrounds. It is a life-long brain disorder that is usually diagnosed in early childhood. Finding the exact causes of autism is one of the most challenging areas of medical science. This makes it difficult to find  effective standarized therapies. The disorder is complex and varies in severity from one person to another. Patients range from those with no speech and limited cognitive ability to those of high IQ and typically highly-focused interests and abilities. Boys are four times more likely to have autism than girls. We at MSC/pharmacy are aware of aware of the alarming rate at which the disorder is growing. Current statistics predict that one out 150 children is destined to develop autism. We employee the latest techniques in compounding medications appropriate for autistic patients who are not quite efficient in detoxifying toxins and other heavy metals in their systems. Abnormalities in biochemical functions such as sulfation and methylation result in a compromised immune system leading to attention deficit, low cognition, and hyperactivity in addition to problems associated with the nervous system and inflammation of the intestinal tract. Our trained pharmacists can help in providing the following preparations:

 

Methylcobalamin (Methyl-Vitamin B12): 

Methylated Vitamin B12 helps improve the methylation pathway important to detoxification. This pathway is often not working in children with autism. Methylcobalamin can be provided in an injection, gel, or nasal spray.

 

Dimercaptosuccinic Acid (DMSA): 

DMSA is a chelating agent that helps remove a wide range of toxic metals, inculding mercury, led, nickel, and arsenic. Although rare, some serious side effects may occur with the use of DMSA. Monitoring liver, kidney function, and complete blood count is recomended. We can incorporate DMSA in an oral suspension of 100mg/5mL strength or in suppositories and transdermal gels.

 

Melatonin:

Used for the relief of insomnia, melatonin can be incorporated in preservative free capsules, suspension, and sublingual tablets or lozenges.

 

 

 

Keep your child healthy and happy & bring their prescriptions to Med Solutions Compounding Pharmacy to ensure maxium drug compliance and effect!!!