Sadozai et al reported the POPI tool (Pediatrics: Omission of Prescriptions and Inappropriate Prescriptions) for problematic therapies for pediatric patient. Categories included neurologic therapeutics. The authors are from multiple institutions in Paris.

Patient selection: pediatric patients



(1) fever

(2) pain

(3) epilepsy

(4) anorexia

(5) depression

(6) attention deficit disorder (ADD)


Inappropriate prescriptions:

(1) prescribing 2 alternating antipyretics as a first line treatment for fever

(2) prescribing a drug other than acetaminophen as a first line treatment of pain (exception: migraine)

(3) rectal administration of paracetamol/acetaminophen as a first line treatment for pain

(4) combined use of 2 NSAIDS for pain

(5) use of an opiate to treat a migraine attack

(6) carbamazepine, gabapentin, oxcarbazepine, phenytoin, pregabalin, tiagabine or vigabatrin for myoclonic epilepsy or epilepsy with absence seizures

(7) tricyclic antidepressants to treat depression

(8) pharmacologic treatment for ADD before 6 years of age unless severe

(9) antipsychotic drugs to treat ADD without hyperactivity

(10) 2 daily doses of slow-release methylphenidate for ADD rather than a single dose


Therapeutic omissions:

(1) giving a sugar solution to an infant under 4 months of age 2 minutes before venipuncture

(2) giving an osmotic laxative to a patient treated with morphine for > 48 hours

(3) recording a growth chart if the patient is taking methylphenidate for ADD

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