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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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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...
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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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Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

135
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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Analysis of Population Pharmacokinetic Data01:12

Analysis of Population Pharmacokinetic Data

556
Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
556

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Characterizing Pharmacogenetic Testing Among Children's Hospitals.

Jacob T Brown1, Laura B Ramsey2,3, Sara L Van Driest4

  • 1Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota Duluth, Duluth, Minnesota, USA.

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|December 16, 2020
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Summary

Pharmacogenetic testing implementation varies in children's hospitals. Financial barriers like reimbursement and cost are major hurdles, especially for low-use sites, highlighting a need for education.

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Area of Science:

  • Pharmacogenomics
  • Pediatric Medicine
  • Healthcare Implementation Science

Background:

  • Pharmacogenetic testing is increasingly used in various medical fields.
  • Significant variation exists in the adoption and implementation of pharmacogenetics in pediatric centers.
  • Limited data are available on the full scope of pharmacogenetic testing practices in children's hospitals.

Purpose of the Study:

  • To survey and characterize the availability of pharmacogenetic testing in children's hospitals.
  • To identify concerns and barriers related to pharmacogenetic testing implementation.
  • To compare barriers between high-use and low-use pharmacogenetic testing sites.

Main Methods:

  • Nationwide survey distributed to institutions within the Children's Hospital Association.
  • Data collected from 14 children's hospitals regarding pharmacogenetic practices.
  • Analysis of perceived barriers, including financial, knowledge-based, and logistical factors.

Main Results:

  • Primary barriers identified were test reimbursement, test cost, and general financial concerns.
  • Low-use sites reported significantly higher barriers related to knowledge and therapy changes.
  • Financial constraints remain a key obstacle despite decreasing test costs.

Conclusions:

  • Financial barriers significantly impede the clinical implementation of pharmacogenetic testing in pediatric institutions.
  • Educational outreach may be crucial for low-use sites to overcome perceived implementation barriers.
  • Addressing cost and reimbursement issues is essential for wider adoption of pediatric pharmacogenetics.