Children ibuprofen

Ibuprofen is given by oral, rectal or topical application (800-2400 mg/day) and in a lower dose (40 mg/kg day) for the treatment of fever in children. Ibuprofen is given as free base or a variety of salts, esters and other derivatives. 

Although extraordinary in its powers, aspirin is also more dangerous than commonly believed. Only about 15 g can be fatal to a small child, and aspirin can cause stomach bleeding and allergic reactions in long-term users. Even more serious is a condition called Reye s syndrome, a potentially fatal reaction to aspirin sometimes seen in children recovering from the flu. As a result of these problems, numerous other NSAIDs have been developed in the last several decades, most notably ibuprofen and naproxen. 

Age does not significantly affect plasma concentrations or disposition of ibuprofen however, investigators have determined that the onset of antipyresis and maximum antipyretic effect is greater in children less than one year old as compared to children older than 6 years [43]. The authors hypothesized that this accelerated response was related to the greater relative body surface area of the young child. It should be noted that cystic fibrosis patients do have a higher clearance of ibuprofen [43a]. 

G.B. Zuckerman, and C.C. Uy, Shock metabolic acidosis, and coma following ibuprofen overdose in a child. Ann. Pharmacother. 29 869-871, 1995. 

Ibuprofen is available in liquid, sachet, capsule, melt and tablet form. The licensed age range for ibuprofen depends on the product formulation. Ibuprofen is only indicated for children over six months of age over the counter. It has additional anti-inflammatory properties which may be helpful in conditions such as otitis media. Ibuprofen has the potential to cause gastrointestinal disturbances, although if given with food this is unlikely. Note Caution if using in a child with history of severe asthma or renal disease. 

Carson SM. Alternating acetaminophen and ibuprofen in the febrile child lamination of the evidence regarding efficacy and safety. PediatrNurs (2003) 29, 379-82. 

There is a large increase in enzyme production and activity at birth, especially in the liver. However, even after birth small children are more sensitive than adults to many chemicals because the defense mechanisms do not mature quickly. This is why some drugs taken by adults should be given to a smcdl child only in smaller doses (e.g., ibuprofen). Ibuprofen is stored in the body almost exclusively in plasma proteins. These proteins are not fully developed in infcmts. Because less ibuprofen is stored in the proteins, more is available to act in the body. This increases the effective dose a small child receives as compared with cm adult. It is not until children are several years old that all of their chemical defenses are fully developed. 

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