Drug treatment of children and adults obviously differs already alone the fact that they carried weight or oberlächenbezogen in children in most cases. Dosage (and dosage regimen) are different, because there are age-related differences in the absorption, distribution, metabolism and in the excretion. A child can tolerate neither adult dose, nor can it be assumed that the dose for children is proportional to the adult dose, so that, for example. As a 7-kg child should get a tenth of the dose of an adult weighing 70 kg. Most drugs are not adequately tested in children, although the legislation (Best Pharmaceuticals for Children Act of 2001 and the Pediatric Equity Act of 2003 [both renewed 2012]) to begin the pivotal legal requirements, these studies creates. Side effects and toxicity In general, children are affected by the same side effects as adults (ADRs), however, is for certain drugs due to the different pharmacokinetic or because of the adverse effect on growth and development increased risk. Drugs often used with specific or increased risk of side effects in children are in Table lists the act unusual toxic in children drugs. Drugs that act unusual toxic in children drug Clinical Syndromes mechanism Comments anesthetics, topical (z. B. benzocaine, mixture of lidocaine and prilocaine) cyanosis formation of methemoglobin (divalent iron to trivalent iron oxidized) rare incidence ceftriaxone jaundice Kernicterus bilirubin albumin displaced only works on Neugeb orenen codeine respiratory depression dying Ultrafast metabolism of codeine to morphine gene variant deaths after surgery and at a nursing infant whose mother codeine took occurred Diphenoxylate respiratory depression dying CNS depression (with immature CNS) overdose syndrome, usually in children <2 years fluoroquinolones cartilage toxicity Unknown Presumably based on Studies with animal experiments, but adverse effects in humans unproven; short-term use is possibly safe lindane (topical) Seizures CNS toxicity should not be used in children <50 kg probably increased absorption in children (an alternative is found) Prochlorperazine Altered CNS function Extrapyramidal effects opisthotonus Pralle fontanels actions over several CNS receptors feverish and dehydrated children are particularly vulnerable SSRIs suicidal thoughts Unknown Increased incidence of suicidal thoughts in children and adolescents Tetracycline discoloration and pitting of the enamel chelation with Ca in growing teeth not to be administered to children <8 years For smaller children there is a particularly large risk of accidental intoxication when the vitamins or medication of a carer discover and play. Infants are vulnerable to the drugs that are used by adults; toxicity may occur both prenatally by transplacental transmission and postnatally through breast milk (numerous substances; - Breastfeeding: Drugs and see Table: Some medications that are contraindicated for nursing mothers) or by skin contact with the caregiver that applied just topical medicines has (z. B. scopolamine seasickness, malathion against lice). Side effects to death have occurred in children after taking over the counter cold remedies, some of them in combination with an antihistamine, decongestant sympathomimetics and with the cough suppressant dextromethorphan. Current recommendations are that such products should not be given to children <4 years.