Prescribing gets riskiest at the two ends of life, and both are heavily tested for good reason. Children aren’t small adults, and older adults handle medications in ways that turn a routine dose into a hazard. A few pearls worth keeping front of mind:
Pediatrics. Weight-based dosing is the rule, and the arithmetic is where errors creep in — a missed decimal is a tenfold mistake. Some drug classes carry age-specific cautions (the classic teaching on certain antibiotics and tendons, aspirin and Reye syndrome, the developmental considerations around psychotropics). Formulations matter too: a dose that’s trivial to give as a liquid can be impossible as a tablet. And children’s faster clearance of some agents changes intervals in ways worth remembering.
Geriatrics. The theme is cumulative burden and narrowed margins. Renal and hepatic function decline, so standard doses can accumulate. Anticholinergic load stacks across seemingly unrelated medications and drives confusion and falls. Polypharmacy multiplies interactions, and tools like the Beers criteria exist precisely because certain drugs that are fine at 40 are risky at 80. The safe move is often “start low, go slow” — and periodically ask what can come off the list.
These distinctions reward review because they’re easy to blur when your daily practice skews toward one age group. The Pharmacology Review Course reinforces age-specific prescribing alongside the rest of the high-yield map — 12.5 hours of AAPA Category 1 CME, class by class, with teaching explanations. It’s $399.99 for 30 months, with the optional $100–$1,500 Amazon or Apple gift-card add-on.