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Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future

Kate O'Hara1, Ian M R Wright2,3,4, Jennifer J Schneider5

  • 1School of Medicine and Public Health, University of Newcastle, Newcastle.

British Journal of Clinical Pharmacology
|August 11, 2015
PubMed

Insights

Pediatric drug dosing faces challenges due to developmental changes. Population pharmacokinetic modeling offers improved methods for safe and effective medication in neonates and children.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Drug Development

Background:

  • Paediatric patients, especially preterm neonates, present unique pharmacological challenges.
  • Dosing information is often extrapolated from adult data due to difficulties in pediatric clinical trials.
  • Physiological changes during growth impact drug absorption, distribution, metabolism, and excretion (ADME).

Purpose of the Study:

  • To highlight the challenges in pediatric drug dosing.
  • To discuss the limitations of extrapolating adult data to pediatric populations.
  • To explore innovative approaches for optimizing pediatric pharmacokinetics.

Main Methods:

  • Review of existing literature on pediatric pharmacokinetics.
  • Discussion of weight-based dose adjustments as a current estimation method.
  • Exploration of population pharmacokinetic (PopPK) modeling as an innovative tool.

Main Results:

  • Extrapolation of adult dosing to pediatric patients carries risks of over- or underestimation.
  • Limited information exists on developmental changes in drug metabolism pathways.
  • Weight-based dosing is the primary method for estimating pharmacokinetic changes.

Conclusions:

  • Population pharmacokinetic modeling offers promising opportunities for pediatric clinical trials.
  • Improved pharmacokinetic research is crucial for enhancing drug safety and efficacy in vulnerable pediatric populations.
  • Further research is needed to ensure optimal drug therapy for neonates and children.

Keywords:
neonatepaediatricpharmacokineticspopulation pharmacokinetic modelling

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