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Related Concept Videos

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 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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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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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...
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Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

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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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Anatomy of the Intestines01:23

Anatomy of the Intestines

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Although digestion of proteins, carbohydrates, and lipids may begin in the stomach, it is completed in the intestine. The absorption of nutrients, water, and electrolytes from food and drink also occurs in the intestine. The intestines can be divided into two structurally distinct organs—the small and large intestines.
Small Intestines
The small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the...
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Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

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Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
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Assessment of Child Anthropometry in a Large Epidemiologic Study
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Normal anthropometry does not equal normal body composition in pediatric intestinal failure.

Dianna Yanchis1,2,3, Christina Belza1,2,3, Debra Harrison1,2,3

  • 1Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.

JPEN. Journal of Parenteral and Enteral Nutrition
|September 12, 2021
PubMed
Summary

Children with intestinal failure often have abnormal body composition, even with normal growth. Routine body composition measurement is crucial for guiding nutrition interventions in these pediatric patients.

Keywords:
body compositionintestinal failurenutrition assessmentparenteral nutritionpediatrics

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Area of Science:

  • Pediatric Gastroenterology
  • Nutritional Science
  • Body Composition Analysis

Background:

  • Previous studies linked abnormal body composition in pediatric intestinal failure to poor growth.
  • This study focuses on body composition in normally growing children with intestinal failure.

Purpose of the Study:

  • To report the body composition of pediatric patients with intestinal failure who exhibit normal growth.
  • To identify potential risks for abnormal body composition in this specific patient group.

Main Methods:

  • Retrospective analysis of 34 children (8-18 years) with intestinal failure undergoing dual-energy x-ray absorptiometry (DXA).
  • Collected data included demographics, residual bowel anatomy, nutrition support, height, weight, bone mineral density (BMD), fat mass (FM), and fat-free mass (FFM).
  • DXA data were compared with age- and sex-matched literature controls.

Main Results:

  • Patients had normal height and weight z-scores but a mean BMD z-score of -1.0 ± 1.3, with 26% showing reduced BMD.
  • Children with intestinal failure exhibited significantly higher fat mass (P = .02) and lower fat-free mass (P = .02) compared to controls.
  • Abnormal body composition was observed despite normal growth parameters.

Conclusions:

  • Children with intestinal failure are at risk for abnormal body composition, irrespective of normal height and weight.
  • Routine body composition assessment is recommended for pediatric patients with intestinal failure.
  • Body composition data can inform and direct tailored nutrition interventions.