Question

1. Provide an overview of the pharmacokinetics of neonates and infants.
2. Discuss drug absorption in neonates and infants, focusing on a drug’s physicochemical properties and its effects on absorption.
3. Discuss drug absorption as it relates to the route of administration in pediatric patients.
4. Discuss factors directly related to drug distribution in neonates and infants (e.g., protein binding and the blood–brain barrier).
5. Discuss hepatic metabolism and compare the drug-metabolizing capacity of a newborn with that of a 1-year-old infant.
6. Discuss renal excretion and compare the drug-excreting capacity of a newborn with that of a 1-year-old infant.
7. Discuss the pharmacokinetics of children 1 year old or older.
8. Discuss reasons pediatric patients are subject to adverse drug reactions when drug levels rise too high.
9. Discuss dosage determination, noting that pediatric doses have been established for some drugs but not for others and, therefore, for drugs that do not have established pediatric doses, the doses can be extrapolated from adult doses.
10. Discuss methods that are effective at and critical to promoting parent and guardian adherence to pediatric drug regimens.
11. Summarize some of the main reasons a very young patient may be considered “highly” sensitive to drugs, considering both pharmacokinetic factors (absorption, distribution, and elimination) and pharmacodynamic factors that affect this apparent sensitivity.

Answer 1

Q. No 1. Answer :

Pharmacokinetics of neonates and infants :

Metabolic processes are immature at birth so that little metabolism, which can leads to reduced clearance and increased half life.

In new born or infants the glomerular filtration rate also low due to immature organs, by the one year of age these pharmacokinetics may improve in infants.

Q. No. 2. Answer :

* Drug absorption in neonates or infants affected by maturation process of organ system.

* Drug physicochemical properties are solubility and passive permeability.

* The water soluble drugs are greater absorption in neonates than older adults, due to high muscular water content.

* If drugs are administer intradermally to the neonates the absorption may high because thinner stratum carnium.

* Immature vosomotor control leads to increased skin perfusion.

Q. No 5.Answer :

Drug metabolism capacity of neonates or new born is less than the one year or older infants, because of immaturity of organ and age related drug sensitivity characteristics can cause for difference in drug metabolism of new born and older than one year infants.

More than one year child have the more capacity of drug metabolism in liver due to maturity of an organ.

Q. No 6. Answer :

Renal excretion in neonates : the glomerular rate in neonates are low that is 20 ml per minute, so drug excretion capacity also less in neonates.

Renal excretion rate in older children : the GFR is almost all

50- 75 ml per minute, so the excretion rate is high in one year and older children.