Dosage is the heart of drug therapy. It is therapy in action. Right or wrong, it is the final expression of diagnostic and therapeutic acumen.
Many factors, including absorption, distribution, storage, degradation, conjugation, and excretion, contribute to correct dosage, and marked differences in these factors exist in the various age groups. Yet, for many years, children's dosages have, for the most part, been poorly derived as fractions of adult doses.
Ideally, the best dose is the minimal quantity that produces the desired effect without causing adverse reactions. Unfortunately, adverse reactions are an inevitable part of the total effect of a drug; however, they can be minimized by correct dosage.
The United States Pharmacopeia1 and the National Formulary2 define the usual dose as "that which may be expected ordinarily to produce in adults, following oral administration at such time intervals as may be specified, the therapeutic effect for which the
Shirkey HC. Drug Dosage for Infants and Children. JAMA. 1965;193(6):443–446. doi:10.1001/jama.1965.03090060033009
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