Can diazoxide be crushed for administration to a pediatric patient?

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From the Research

Crushing diazoxide for pediatric patients is generally not recommended as a first option, instead consider using the oral suspension form of diazoxide (Proglycem), which is specifically designed for pediatric use. If the oral suspension is unavailable, consult with a pharmacist before crushing the tablets, as improper crushing may affect drug absorption and efficacy 1. When crushing is absolutely necessary, mix the crushed tablet with a small amount of soft food like applesauce or yogurt and administer immediately. Do not mix with liquids as this may cause uneven distribution of the medication. Diazoxide is used to treat hypoglycemia in children, and proper dosing is critical for maintaining blood glucose levels. The medication works by inhibiting insulin release from the pancreas, so altering its formulation could potentially impact its pharmacokinetics and therapeutic effect.

Some key points to consider when administering diazoxide to pediatric patients include:

  • The use of diazoxide has increased over time, and it is commonly used in neonatal intensive care units (NICUs) to treat hypoglycemia 2.
  • Low-dose diazoxide has been shown to be safe and effective in infants with transient hyperinsulinism, with a mean effective dose of 3 mg/kg/day 3.
  • However, diazoxide can have adverse effects, such as pulmonary hypertension and neutropenia, and monitoring for these effects is crucial 1.
  • The oral suspension form of diazoxide is preferred for pediatric use, but if crushing is necessary, it should be done with caution and under the guidance of a pharmacist.

Always document any manipulation of medication in the patient's chart and monitor blood glucose levels closely after administration. It is also important to note that diazoxide should be used with caution and under close monitoring, as it can have serious adverse effects, such as those reported in a case of severe diazoxide toxicity 4.

References

Research

Management and Appropriate Use of Diazoxide in Infants and Children with Hyperinsulinism.

The Journal of clinical endocrinology and metabolism, 2020

Research

Prevalence and safety of diazoxide in the neonatal intensive care unit.

Journal of perinatology : official journal of the California Perinatal Association, 2018

Research

A case of severe diazoxide toxicity.

Paediatric anaesthesia, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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