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References
Acetaminophen

Either article by Temple will give you the basics of dosing.

Temple AR. Pediatric dosing of acetaminophen. Pediatr Pharmacol (New York) 1983;3(3-4):321-7.

Temple AR. Appropriate dosage of acetominophen for infants.
J Emerg Nurs (United States), Jun 1991, 17(3) p127.



An article by Gribetz discusses some of the problems of getting a correct dose with existing droppers and label instructions.

Gribetz B. Underdosing of acetaminophen by parents. Pediatrics 1987; 80(5):630-33. No data on how effective in reducing fevers, but dosage mistakes fairly common in small children avg 23 months of age: "68% of the parents administered a dose less than the recommended 10 15 mg/kg per dose, with 31% of parents giving less than 6 mg/kg per dose. A dose greater than 15 mg/kg per dose was given 6% of the time." (Inner city walk-in clinic.) Author also suggests dosing on the high side, mostly because children grow so fast: "To help assure correct treatment, the prescriber should routinely calculate the acetaminophen dose for a small child on the basis of 15 mg/kg per dose rather than 10 mg/kg per dose."


An article about the FDA's fairly recent meetings gives good overviews of the situation with acetaminophen.

Mechcatie E. Antipyretics, Analgesics May Have Infant Dosing Label. Pediatric News 31(11):1, 1997. At a meeting of the Food and Drug Administration's Nonprescription Drugs Advisory Committee [to my knowledge 10-01 the FDA has yet to actually implement this change], the panel unanimously recommended that single-ingredient analgesics and antipyretic suspension products could be safely and effectively labeled for direct use in children under age 2. They agreed that the instructions could go down to at least 6 months, and possibly even 2 months. Current labeling advises caretakers to consult their physician for children under age 2. Other labeling modifications recommended by the panel included labeling that reflects the preference of dosing based on weight rather than age. Dr. Temple said that not every parent knows a child's weight, so instructions based on both weight and age are necessary, but agreed that "anything we can do to encourage use of weight would be ideal.".

Safety stats: Dr. Temple said that between 1992 and 1997, 4.7 billion doses of Tylenol were shipped and 30 serious adverse events in children under age 12 were reported to the company.

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