Pediatric Pharmacology and Fluid Management

Medication management and fluid resuscitation are the cornerstones of providing safe procedural sedation for any patient, pediatric or adult. Due to the immature organ systems, vastly different body sizes and compositions, unique pathologies, and altered metabolic pathways, knowledge of adult pharmacology and fluid management cannot be directly applied to the pediatric patient. This chapter describes the principles of pediatric pharmacology and their applications in various common healthy and diseased physiologic states. Drug administration, clinical effects, common pitfalls, and metabolism and elimination for the most important perioperative medications are discussed in detail. Knowledge of proper perioperative fluid administration in the healthy pediatric patient, as well as fluid resuscitation in shock states and common electrolyte disturbances common to pediatric patients, can easily be lifesaving. The assessment and treatment of these pathologic states are described in detail.