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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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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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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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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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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 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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Pediatric Firearm Survivors as a Medically Complex Population.

Lisa C Lindley1, Meaghann S Weaver2

  • 1Lisa C. Lindley, PhD, RN, FPCN, FAAN , is professor, College of Nursing, University of Tennessee, Knoxville, TN.

Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association
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Summary

Pediatric firearm survivors are children with medical complexity, facing chronic health conditions and significant long-term needs. Recognizing this reframes firearm survivorship for better care and support.

Keywords:
children with medical complexityfirearm injuryfirearm survivorsgunshotpalliative care

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Area of Science:

  • Pediatric health
  • Trauma survivorship
  • Public health

Background:

  • Firearm injury is the leading cause of death for US children and adolescents.
  • Many children survive gunshot wounds but face lasting consequences.
  • Pediatric firearm survivors are often overlooked as a distinct population with complex needs.

Purpose of the Study:

  • To reframe pediatric firearm survivorship.
  • To establish pediatric firearm survivors as a population with medical complexity.
  • To inform palliative care nursing practice for this group.

Main Methods:

  • Application of established frameworks for children with medical complexity.
  • Analysis of long-term consequences for firearm survivors.
  • Reframing survivorship as a chronic condition.

Main Results:

  • Pediatric firearm survivors fit the definition of children with medical complexity.
  • Survivors experience multisystem trauma, neurological impairment, chronic pain, and functional deficits.
  • They require long-term rehabilitation, specialized support, and intensive caregiving.

Conclusions:

  • Recognizing firearm survivors as medically complex is crucial for healthcare.
  • This perspective supports trauma-informed, longitudinal palliative care models.
  • Targeted interventions are needed for the persistent medical, functional, and psychosocial burdens.