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Developmental pharmacokinetics in pediatric populations

Hong Lu1, Sara Rosenbaum1

  • 1Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|March 13, 2015
PubMed

Insights

Pediatric drug dosing is complex due to age-related changes in absorption, distribution, metabolism, and excretion (ADME). Understanding these pharmacokinetic and pharmacodynamic differences is crucial for safe and effective medication in children.

Area of Science:

  • Pharmacology
  • Pediatrics
  • Drug Metabolism

Background:

  • Knowledge of drug absorption and disposition in children has grown, but age-specific effects on pharmacokinetics, pharmacodynamics, and dosing remain unclear.
  • Pediatric physiological differences, including gastric pH, emptying time, plasma protein levels, and body water composition, significantly impact drug absorption and distribution.

Purpose of the Study:

  • To review age-related changes in drug absorption, distribution, metabolism, and elimination (ADME) in infants and children.
  • To discuss age-related dosing regimens for the pediatric population based on pharmacokinetic and pharmacodynamic understanding.

Main Methods:

  • Review of existing literature on pediatric pharmacokinetics and pharmacodynamics.
  • Analysis of age-specific physiological factors influencing drug disposition in neonates, infants, and children.

Main Results:

  • Immature metabolic processes and reduced renal excretion in neonates lead to decreased drug clearance and prolonged half-lives.
  • Significant variations in drug absorption, distribution, metabolism, and elimination exist across different pediatric age groups.
  • Limited data on pediatric pharmacodynamics necessitates a mechanistic approach to dose determination.

Conclusions:

  • Age-related physiological maturation influences drug pharmacokinetics and pharmacodynamics in children.
  • Continual modification of drug dosage regimens is required as pediatric patients mature.
  • Understanding these age-related changes is essential for establishing appropriate and safe pediatric drug dosing.

Keywords:
cytochrome P450developmentpediatricspharmacodynamicspharmacokinetics

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