RxPed

Introduction

Years ago, I came across a simple paracetamol syrup dosing calculator in the app store.

• As a pharmacist, I was clinically curious to see how comprehensively the app addressed maximum dose capping.
• To my surprise, it did not; the dose simply increased indefinitely alongside the inputted weight.

While the intention behind providing the public with a convenient calculator was good, this flaw carried a serious risk of harming pediatric patients through overdosing.

• This experience inspired me to create a quick pediatric drug dosing verifier, RxPed, to safely streamline our daily workflow when verifying prescription doses.

The Complexities of Pediatric Dosing

Creating a reliable pediatric dosing calculator requires addressing several complex variables.

• Different clinical references often recommend slightly different dosages, sometimes specifically tailored to certain indications.
• Furthermore, pediatric dosing is inherently complicated; it demands consideration of fixed dosing by age versus weight-based dosing.
• The dose itself is sometimes a range (minimum to maximum) rather than a single exact figure to multiply against, and doses are typically aggregated by specific age groups.
• Additionally, converting a calculated dose into a liquid volume based on syrup strength involves another layer of calculation.
• Crucially, we must address maximum dose capping to prevent toxicity, especially in severely obese children.

Features and Customization

All of these clinical considerations were carefully integrated into RxPed. To get started, the app includes a pre-configured list of common pediatric syrups, complete with references and indications.

• Tailor Your Dashboard: You can customize your main dashboard by "favoriting" frequently used medications to make them appear, or by deleting formulas you do not need.
• Custom Formulary: Users can add custom drugs with appropriate dosage values (by age or weight). If a reference suggests a fixed value instead of a range, you can simply fill in the minimum dosage field or enter the same value in both the min and max fields. Once you have fully customized your formulary, you can export the data as a JSON file to easily import it onto another device.
• Source Tracking: To address conflicting pediatric dosing data, there is individual optional fields for entering the clinical source and indications.
• Stay Updated: To receive the latest updates for the default starter formulas, simply click the reset button. However, this will overwrite your formulas.

NOTE: Although great care has been taken to ensure dosage accuracy in the starter database, potential input errors can occur, and I welcome any rectification notices from users.

Using the Main Dashboard

On the main dashboard, simply input the patient's age (in months or years) and weight, and the matching dosage data will appear.

• You may notice multiple drug cards for the same medication; this occurs when different clinical sources provide varying recommendations.

To quickly find the exact drug you need, use the quick search field (please allow a few seconds for the debounce delay to populate the results).

Summary

RxPed is a customizable tool designed to help clinicians safely and efficiently verify pediatric prescriptions, featuring a built-in formulary, source referencing, and the ability to export/import custom data.