"The only thing I know is that I know nothing": 5-fluorouracil in human milk

Genetic polymorphisms in drug targets have emerged as critical determinants of interindividual variability in drug response and toxicity. Pharmacogenomic investigations increasingly focus on identifying these variations to personalize and optimize therapeutic interventions. A drug target may be a receptor, enzyme, or signaling protein involved in pharmacologic responses or disease-related pathways. While early pharmacogenetic studies focused primarily on drug metabolism, current research...

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...

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...

Drug excretion involves various organs, including the liver, intestines, skin, and eyes. In the case of drugs or toxins, they can be actively secreted into bile by transporters in the hepatocyte's canalicular membrane. These substances enter the GI tract during digestion and may be reabsorbed into the body from the intestine. This process, known as enterohepatic recycling, can significantly prolong the presence and effects of a substance in the body. To interrupt this cycle, specific substances...

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...

Gaseous substances like general anesthetics are absorbed and excreted through the lungs via simple diffusion. This process depends on factors such as pulmonary blood flow, respiration rate, and the substance's solubility. Gaseous anesthetics like nitrous oxide with low blood solubility are excreted rapidly, while compounds like alcohol, with high blood and tissue solubility, are excreted slowly.
Drugs can also be excreted in breast milk, which is crucial for breastfeeding infants. The process...