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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...

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Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
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Transient hepatic attenuation differences in neonates.

Alexander J Towbin1, Jun Ying, Robert Fleck

  • 1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. ML 5031, Cincinnati, OH 45241, USA. Alexander.Towbin@cchmc.org

Pediatric Radiology
|May 14, 2009
PubMed
Summary
This summary is machine-generated.

Transient hepatic attenuation differences (THADs) are common in neonates, appearing significantly more frequently in infants under one month old. These benign findings on CT scans require no further imaging for neonates.

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Area of Science:

  • Radiology
  • Pediatric Imaging
  • Hepatology

Background:

  • Transient hepatic attenuation differences (THADs) are hepatic perfusion anomalies resulting from altered liver dual blood supply.
  • THADs have been documented in adolescents and adults but not previously in neonates.

Purpose of the Study:

  • To describe the appearance and frequency of THADs in neonates (<=1 month).
  • To compare THAD incidence in neonates versus infants up to 2 years old.

Main Methods:

  • Retrospective analysis of CT angiograms in infants (<2 years) from 2000-2007.
  • Comparison of THAD incidence across four age groups.
  • Logistic regression model for statistical significance.

Main Results:

  • 128 CT angiograms were reviewed.
  • THADs were observed in 9/26 neonates (<1 month), 3/50 infants (1-6 months), 1/23 infants (6 months-1 year), and 1/29 infants (1-2 years).
  • THADs occurred significantly more often in neonates (<1 month) than older infants (P<0.05).

Conclusions:

  • THADs are benign and considered normal findings in the neonatal population.
  • Characteristic THAD appearance on CT necessitates no further investigation in neonates.