Risk analysis and management of use of chloral hydrate solution in pediatric patients in our hospital / 中国药学杂志

ABSTRACT

OBJECTIVE: To analyze the actual dosages of chloral hydrate solution used in pediatric patients in our hospital and discuss how to prevent excessive dosing or accumulated overdose. METHODS: The prescriptions of chloral hydrate solution for outpatients under or equal to 18 years old during the period of July 2015 to December 2015 in our hospital were extracted. The information about departments, patient age, and dosages were collected. The dose ranges of chloral hydrate according to the height and weight standardized growth charts for children were calculated in order to determine whether the prescribed dosage was too high and whether there was risk of overuse and cumulative overdose. RESULTS: A total of 1 086 chloral hydrate prescriptions were extracted, mostly prescribed by the departments of neurology, pediatrics, ENT and other departments for sedation before examinations. The children under or equal to 12 years old were mostly prescribed 10 mL of chloral hydrate solution, while those over 13 years old were prescribed 30 mL. The risk of overdose was 12.8%. The actual dosages were too small for some children. There existed drug waste phenomenon and potential risks of accidental medication and overuse. There were 12 patients with repeated prescriptionson the same day, resulting in a repeated medication risk. CONCLUSION: In order to avoid the risk of overdose and repeated use of chloral hydrate solution in pediatric children, it is necessary to comply with the high-risk drug management system, improve the hospital information system, write prescriptions correctly, and change the preparation package of chloral hydrate solution. Pharmacists need to play a more active role.