Miquel's Case

Miquel's Case

Miguel (age three) has a genuine sweet tooth and healthy appetite. He happily eats any treat his mother gives him, but she is a little concerned. Last time they visited their family doctor, Miguel’s blood pressure was up in the 95th percentile for boys of his age. Today, the doctor checks his blood pressure again and diagnoses hypertension. He also tests for diabetes and wants to start Miguel on a dose of atenolol at 0.5 mg/kg/day, once-daily, to treat his hypertension [1].

[1] The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health and National Heart, Lung, and Blood Institute; 2005. NIH Publication No. 05-5267.

The Challenge
Miguel weighs 17 kg, so his doctor wants to prescribe him 8.5 mg atenolol per day. As this dosage is commercially unavailable, he calls the pharmacist to discuss compounding an oral suspension. Although he is concerned about giving young Miguel a suspension with preservatives and a high sugar content, he is not sure whether Miguel will accept his medication without taste masking.

The Solution
The pharmacist has the perfect solution for Miguel’s situation. He suggests compounding a 1 mg/ml atenolol suspension with the Atenolol & SyrSpend® SF PH4 kit. SyrSpend® SF PH4 is sugar and preservative-free and has excellent taste-masking properties as well as a sweet, neutral taste. Beginning with a 1 mg/ml suspension, the dose can be adjusted over time as Miguel develops.

The Cure
Six months later, Miguel’s blood pressure has improved and his doctor wants to try to start lowering the dose of atenolol. The pre-diabetes signs that were initially present have diminished and almost gone. His mother has also cut back on the treats, and Miguel has become a lively young fellow. The doctor hopes to eventually have Miguel come off the medication completely.