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Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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

Pharmacokinetics in Pediatric Patients: Drug Excretion

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

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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...
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

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...
Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

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

Pharmacokinetics in Pediatric Patients: Drug Distribution

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, compared...

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When Science Outpaces Infrastructure: People, Process, and Technology Challenges for Precision Dosing in Children.

Tamorah Lewis1,2, Karim Jessa2, Vijay Ivaturi3,4

  • 1Division of Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada.

Clinical and Translational Science
|June 19, 2026
PubMed
Summary
This summary is machine-generated.

Implementing precision medicine in pediatrics requires collaboration and overcoming barriers in people, process, and technology. Successful integration of precision drug-dosing tools into electronic health records (EHR) demands careful planning and institutional support.

Keywords:
MIPDimplementationpharmacology

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Area of Science:

  • Pediatric Precision Medicine
  • Clinical Informatics
  • Health Technology Implementation

Background:

  • Novel precision medicine tools require significant shifts in pediatric care paradigms.
  • Implementing precision drug-dosing in a neonatal intensive care unit (NICU) involved a multi-specialty team over several years.

Purpose of the Study:

  • To identify and discuss barriers encountered during the implementation of a precision drug-dosing project.
  • To provide insights and mitigation strategies for future precision medicine initiatives based on a case example.

Main Methods:

  • A multi-specialty team collaborated on a precision drug-dosing project in a NICU.
  • Analysis of foreseen and unforeseen barriers encountered during the multi-year project.
  • Thematic analysis focusing on "people," "process," and "technology" aspects of implementation.

Main Results:

  • Integration into electronic health records (EHR) requires coordination between clinical, IT, and informatics teams.
  • Ethics boards face challenges with novel technologies like AI/ML, necessitating diverse representation.
  • Technical integration across borders is complex due to differing standards; privacy and compliance are critical.

Conclusions:

  • Successful implementation of precision medicine innovations hinges on addressing "people," "process," and "technology" factors.
  • Sustaining these innovations requires institutional investment beyond initial research funding.
  • Careful coordination, ethical oversight, and robust technical integration are essential for pediatric precision medicine.