The Individualized Pediatric Therapeutics (IPT) Clinic at Children's Mercy Hospitals and Clinics is designed to serve as a multi-disciplinary resource in therapeutics for patients and providers within the region.

This clinic will serve patients with complex therapeutic dilemmas who are referred by their primary care physician or sub-specialist. 

This clinic will implement a team approach to address the facets of therapeutic response that are unique to each patient. This will include a weekly comprehensive case discussion of each patient with a team of physicians, researchers and pharmacists. Recommendations may include follow-up, adjustments to the care plan and/or additional testing.

What patients should you refer to the Individualized Pediatric Therapeutics Clinic?

Children who meet any of the following criteria:

Lack of response to a medication despite being prescribed a standard drug dose. This may be addressed with a variety of evaluations:

• Clinical pharmacology evaluation of absorption, distribution and excretion
• Evaluation of drug-drug (drug-diet, drug-disease, drug-development) interactions
• Evaluation of genomic variants known to affect drug metabolism and drug response via clinically available testing
• Assessment of underlying etiology of patient's condition with respect to therapeutic response

Drug side effects

• Toxicities associated with overdose despite "appropriate" drug dose 
  
  • Examples: excessive sedation, excessive nausea
  • Help to establish correct medicine at correct dose for patient's specific condition
  • Help predict "personalized drug of choice"
• Idiosyncratic drug reactions (reaction to a medication with an unknown cause)
• "Hypersensitivity" reactions 
  
  • Collaborative Evaluation with appropriate specialties - dermatology, allergy, organ-specific evaluation, depending on nature of reaction

Family Evaluation

• Assessment of pharmacogenomic variation which may be clinically significant in family members of patients with therapeutic enigmas that have been determined to be related to genetic variation

Examples of patients already referred to the Individualized Pediatric Therapeutics Clinic

• Patient with ADHD who fail to respond clinically to therapeutic treatment as standard dosing
• Unexplained adverse reaction to cough medication
• Patient with asthma who is not responding clinically to systemic steroids at standard dosing