Related Experiment Video

Updated: May 19, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

Pharmacokinetic- and pharmacodynamic-based antithrombotic dosing recommendations in children

Richard Har Ko1, Guy Young

  • 1Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA.

Expert Review of Clinical Pharmacology
|September 5, 2012
PubMed

Insights

Pediatric anticoagulant dosing requires pharmacokinetic and pharmacodynamic data, not adult extrapolation. This study reviews pediatric anticoagulant studies to provide evidence-based dosing recommendations for improved child safety and efficacy.

Area of Science:

  • Pediatric pharmacology
  • Hematology
  • Drug dosing and safety

Background:

  • Increasing incidence of pediatric venous thromboembolic events necessitates greater anticoagulant use.
  • Current pediatric anticoagulant dosing often relies on adult data extrapolation, which is inappropriate due to physiological differences.

Purpose of the Study:

  • To review existing pharmacokinetic and pharmacodynamic (PK/PD) studies of anticoagulants in pediatric populations.
  • To establish evidence-based dosing recommendations for anticoagulants in children.

Main Methods:

  • Systematic review of published PK/PD studies involving anticoagulants in neonates, infants, and children.
  • Analysis of study findings to inform dosing guidelines.

Main Results:

  • PK/PD data in children demonstrate unique absorption, distribution, metabolism, and excretion profiles compared to adults.
  • Pediatric hemostatic systems differ significantly, impacting therapeutic targets and drug response.

Conclusions:

  • Pediatric anticoagulant dosing must be based on child-specific PK/PD data.
  • Developing tailored dosing guidelines is crucial for optimizing treatment efficacy and minimizing risks in pediatric patients.

More Related Videos

Ferric Chloride-induced Murine Thrombosis Models10:37

Ferric Chloride-induced Murine Thrombosis Models

Published on: September 5, 2016

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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...
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...
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...
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 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...
Dosage Regimens: Partial Pharmacokinetic Parameters01:01

Dosage Regimens: Partial Pharmacokinetic Parameters

It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...