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Children face additional challenges when it comes to the quest of helping them through prescription drugs. Medically speaking, children are not just “little adults.” Their bodies function in slightly different ways than those of adults, and this makes them harder to effectively treat with pharmaceuticals.

  • They have higher metabolisms and may burn through a drug more quickly.

  • Drug metabolism also works differently in kids than it does in adults, so a drug may work faster or slower or build up in their body differently.

  • They are a “moving target” – growing and changing on a daily basis.

  • They have immature organs, which affects how well their body can handle and rid itself of toxins.

  • They eat, drink, and breathe more per pound of body weight.

Most of all, their bodies are still developing, which means that any chemical that alters their physiology has the potential to be much more disruptive to their long-term health. “The adage that a child is not just a small adult is true,” says Peter Adamson, a pediatrician and pharmacologist at Children’s Hospital of Philadelphia. “You can’t simply scale down a dose of a drug from adults and expect it to behave identically in a small child.” (Wenner-Moyer, 2012)

“When doctors downsize an adult dosage to suit a child’s weight or body surface area,” add the editors at Scientific American, “a drug can prove ineffective or harmful. Infants have immature livers and kidneys, so even a seemingly small dose of medicine can build up quickly in their bodies. As children mature, their organs can develop faster than their body size, so they need to take disproportionately more of the drug.” (Scientific American, 2012)

Lack of pediatric drug testing and the guesswork involved in prescribing kids medication
Unfortunately, these most sensitive little things are also the patients we know least about. Drug companies rarely test their products on children-it’s difficult and they don’t have to, since there are no rules governing what doctors prescribe to kids. “Children make up a small fraction of the world’s drug recipients, so developing and testing new medicines for them is rarely worthwhile from a business perspective,” write the editors at
Scientific American (2012). Even the financial incentives offered to companies who conduct pediatric testing hasn’t really worked out the way it was intended to. Companies will abuse the incentive to test their blockbuster adult drugs on children for the added monopoly rights, but data on the less-profitable drugs children are more likely to be taking is just as sparse as ever.

“Only half of the medicines doctors prescribe to patients 18 and younger have been through the same rigorous trials as those drugs prescribed to adults. The other half are given off-label – that is, in circumstances for which they were never properly vetted, putting children at risk for overdoses, side effects and long-term health problems. For newborns, that fraction rises to 90 percent.” (Scientific American, 2012) A study and government data released in February 2012 painted an even more dire picture, concluding that most of the time doctors are forced to prescribe drugs to young patients without adequate data, putting kids at risk for overdoses, harmful side effects, and long-term health problems. (Wenner-Moyer, 2012)

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