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Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

49
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...
49
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

49
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...
49
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

57
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...
57
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

71
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,...
71
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

68
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...
68
Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

1.0K
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
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Related Experiment Video

Updated: Nov 3, 2025

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
09:44

Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen

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Intravenous Acetaminophen Overdose in an Infant With Toxicokinetic Data.

Joshua Trebach1,2, Sarah G Mahonski1,2, Kristina Melchert3

  • 1Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, 12297NYU Grossman School of Medicine, New York, NY, USA.

Journal of Pharmacy Practice
|June 3, 2021
PubMed
Summary

An infant received a 10-fold higher dose of intravenous acetaminophen (APAP) but experienced no adverse effects after N-acetylcysteine treatment. This case highlights APAP toxicokinetics in neonates, showing a half-life of 2.63 hours.

Keywords:
acetaminophenmedication safetypediatrics

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Last Updated: Nov 3, 2025

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Area of Science:

  • Pediatric Pharmacology
  • Clinical Toxicology
  • Neonatal Pharmacokinetics

Background:

  • Intravenous acetaminophen (APAP) is increasingly used for pain management in pediatric patients.
  • Accidental medication errors can occur, particularly in vulnerable populations like neonates.
  • Understanding the toxicokinetics of APAP in infants is crucial for managing overdose scenarios.

Observation:

  • A 12-month-old infant (24-week gestational age) inadvertently received 1000 mg of IV acetaminophen instead of 100 mg.
  • Serial acetaminophen concentrations were monitored post-administration.
  • The infant was treated with intravenous N-acetylcysteine.

Findings:

  • The patient exhibited no adverse outcomes following the acetaminophen overdose.
  • Calculated elimination rate constant (ke) was 0.263 h-1, resulting in a half-life of 2.63 hours.
  • This half-life aligns with the reported range of 2.6 to 4.9 hours for IV APAP in infants, though variability reasons remain unclear.

Implications:

  • This case contributes to the limited data on IV acetaminophen toxicokinetics in preterm infants.
  • Prompt administration of N-acetylcysteine appears effective in preventing toxicity even after significant overdose.
  • Further research is warranted to elucidate the factors contributing to the variable half-life of IV APAP in this population.