Most medications are not labeled for pediatric populations, and when a medication is not approved for use in infants and children, it usually is not available in a suitable pediatric dosage form. Many drugs are not commercially available as liquids, and fewer are available in dosage forms that children like. Fortunately, our Wisconsin pediatric compounding pharmacy is able to help with all of these problems.
The use of medications to treat ADHD has greatly increased, yet the dosage requirements for many children differ from strengths that are commercially available. This often necessitates a midday dose at school, which can be embarrassing to a child. Slow-release dosage forms can be compounded to contain the precise dose of medication needed by each child.
Orally administered anti-emetics can be difficult for a nauseated child to "keep down", and rectal suppositories may not be well accepted by children. Transdermal anti-emetics, such as promethazine, can offer an alternative.
Constipation is a common problem for children with certain disease states and gastrointestinal defects. Commercially available products offer limited flavor choices, which are often not appealing to children, and these products are difficult to reflavor. However, our compounding pharmacists can concentrate preparations such as milk of magnesia, and flavor each prescription differently to please each patient.
Customized formulations containing protectants, absorbents, and bile acid sequestrants can provide relief for irritated skin. We can also compound medications, such as cholestyramine ointment, to prevent site irritation in ostomy patients.
Emergence of resistant pathogens emphasizes the need for alternatives to antimicrobial agents for acne therapy. We can compound cosmetically-appealing customized formulations.
Topical anesthesia is needed for common pediatric procedures such as suturing, wound cleaning, and injection administration. The ideal topical anesthetic would provide complete anesthesia following a simple pain-free application, not contain narcotics or controlled substances, and have an excellent safety profile. The compounded combination of topical anesthetics lidocaine and tetracaine and the vasoconstrictor epinephrine has been used successfully for anesthesia prior to suturing linear scalp and facial lacerations in children. A triple-anesthetic gel containing benzocaine, lidocaine, and tetracaine has also been reported to be effective when applied prior to laser and cosmetic procedures. Convenience of application without need for occlusion is an advantage of these anesthetics.
The use of compounded urea plasters may have advantages for removing nails in children; they are inexpensive, several nails can be treated in one session, and the procedure is essentially painless. Various synergistic combinations can be compounded for antifungal therapy. Topical medications usually have a lower adverse drug-reaction profile than systemic medications.
Resistant warts and molluscum contagiosum have been treated successfully with compounded dermatological topical medications, avoiding discomfort associated with freezing, scraping, electrocautery and laser therapy.
Concerns about emerging resistance and the potential harm of using permethrins have prompted a search for effective pediculicidal therapies that are not harmful to children with repeated use. We can compound herbal formulations for head lice. We can also compound topical and oral doses titrated for each patient for the treatment of head lice and scabies.
Children with cancer, burn patients, and those who are developmentally challenged can all benefit from customized medications.