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Developmental Pharmacokinetics in Neonates: Maturational Changes and Beyond

Karel Allegaert1, Paola Mian1, John N van den Anker2

  • 1Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands.

Current Pharmaceutical Design
|September 28, 2017
PubMed

Insights

Understanding neonatal pharmacokinetics (PK) and pharmacodynamics (PD) is crucial for safe drug therapy. This study details how maturational and non-maturational factors influence drug behavior in neonates.

Area of Science:

  • Neonatal pharmacology
  • Pediatric pharmacokinetics
  • Drug metabolism and elimination

Background:

  • Effective pharmacotherapy in neonates requires understanding drug pharmacokinetics (PK) and pharmacodynamics (PD).
  • Neonatal populations exhibit unique PK and PD profiles due to developmental and disease-related factors.

Purpose of the Study:

  • To describe general PK aspects of drug absorption, distribution, metabolism, and elimination (ADME) in neonates.
  • To emphasize the impact of both maturational and non-maturational covariates on PK variability.
  • To illustrate these concepts with specific drug examples.

Main Methods:

  • Review of developmental PK principles in neonates.
  • Analysis of maturational covariates (age, weight) affecting ADME processes.
  • Examination of non-maturational covariates (disease, treatment, genetics) influencing PK.

Main Results:

  • Neonatal ADME processes undergo maturation, influenced by various covariates.
  • Maturational covariates include age and weight-dependent changes.
  • Non-maturational covariates encompass disease, environment, co-medications, and genetic background.

Conclusions:

  • Further research should integrate existing knowledge and collect data on non-maturational covariates.
  • Linking PK data with PD is essential for predicting drug effects and side effects.
  • Enhanced understanding of neonatal PK/PD is clinically significant for optimizing drug therapy.
Abstract

Keywords:
Pharmacokineticsabsorptiondistritubioneliminationmetabolismneonatal clinical pharmacology.newborn

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