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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

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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...
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Factors Affecting Drug Response: Overview01:21

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When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

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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...
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Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

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Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

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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,...
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Pharmacogenomics in pregnancy.

Hannah K Betcher1, Alfred L George2

  • 1Department of Psychiatry, Northwestern University Feinberg School of Medicine, 676N St. Clair St. Ste 1000, Chicago IL, USA; Mayo Clinic, Rochester, MN, USA.

Seminars in Perinatology
|February 22, 2020
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Summary
This summary is machine-generated.

Medication effectiveness in pregnant women is impacted by physiological changes and genetic factors. More research is needed on pharmacogenomics and pharmacokinetics to optimize drug therapy during pregnancy.

Keywords:
Drug metabolismDrug therapyPharmacogeneticsPharmacogenomicsPregnancy

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Area of Science:

  • Pharmacogenomics
  • Pharmacokinetics
  • Drug Metabolism

Background:

  • Pregnant women commonly use prescription and over-the-counter medications.
  • Physiological changes during pregnancy can alter drug efficacy.
  • Genetic factors may further influence drug response and disposition.

Purpose of the Study:

  • To highlight the need for increased research in pharmacogenomic and pharmacokinetic influences on drug disposition during pregnancy.
  • To emphasize the importance of understanding physiological and metabolic changes during gestation for safe medication prescribing.
  • To underscore the role of pharmacogenomics in inter-individual variability of drug response.

Main Methods:

  • Review of existing clinical investigations on drug metabolizing enzyme activity during pregnancy.
  • Analysis of emerging evidence on pharmacogenomic variability and drug response.
  • Synthesis of current understanding of physiological and metabolic changes affecting drug therapy in pregnant women.

Main Results:

  • Altered activity of key drug metabolizing enzymes has been observed during pregnancy.
  • Pharmacogenomic variability influences responses to commonly used medications in pregnancy.
  • Dynamic physiological and metabolic shifts during gestation significantly impact drug disposition.

Conclusions:

  • Understanding pharmacogenomic and pharmacokinetic factors is crucial for managing medications in pregnant women.
  • Further research is essential to optimize drug therapy and ensure patient safety during pregnancy.
  • Integrating pharmacogenomic insights can improve individualized drug selection and dosing.