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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

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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...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

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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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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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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...
145
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

139
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...
139
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

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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: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

108
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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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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FIRS: Neonatal considerations.

Jonathan Muraskas1, Lauren Astrug1, Sachin Amin1

  • 1Loyola University Medical Center, 2160 South 1st Avenue, Division of Neonatal and Perinatal Medicine, Maywood, IL, 60153, USA.

Seminars in Fetal & Neonatal Medicine
|September 11, 2020
PubMed
Summary

Fetal Inflammatory Response Syndrome (FIRS) affects newborns exposed to inflammation, potentially impacting multiple organs. Early consideration of FIRS is crucial, especially in neonatal encephalopathy cases without clear causes.

Keywords:
ChorioamnionitisFetal inflammatory response syndromeHypoxic-ischemic encephalopathyIL-6Newborn multi-organ failurePartial prolonged asphyxia

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Area of Science:

  • Perinatology
  • Neonatology
  • Pediatric Pathology

Background:

  • Fetal Inflammatory Response Syndrome (FIRS) is the fetal manifestation of systemic inflammation.
  • It arises from fetal exposure to inflammation in fetal membranes or placental circulation.
  • FIRS can lead to adverse organ effects with significant neonatal implications.

Purpose of the Study:

  • To highlight the importance of considering FIRS in neonatal encephalopathy.
  • To emphasize the link between maternal/fetal infection and FIRS.
  • To advocate for placental and membrane histopathology evaluation.

Main Methods:

  • Review of existing literature on FIRS and neonatal outcomes.
  • Analysis of cases where FIRS is a potential etiology for neonatal encephalopathy.
  • Correlation of maternal, fetal, and neonatal infection markers with FIRS.

Main Results:

  • FIRS can affect multiple fetal organs, leading to short and long-term neonatal issues.
  • Chorioamnionitis is a significant risk factor for FIRS.
  • In unexplained neonatal encephalopathy, FIRS should be considered.

Conclusions:

  • FIRS is a critical condition with widespread organ effects in newborns.
  • Evidence of infection warrants placental and membrane histopathology to diagnose FIRS.
  • Prompt evaluation for FIRS is essential for affected neonates.