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Drug disposition during the perinatal period
International Journal of Biological Research in Pregnancy
|January 1, 1981
Summary
Drug disposition changes significantly in newborns due to physiological adaptations. Neonatal drug metabolism and elimination are reduced, leading to prolonged drug half-lives and necessitating therapeutic drug monitoring.
Area of Science:
- Perinatal pharmacology
- Neonatal drug disposition
- Pharmacokinetics
Background:
- Physiological changes occur during the perinatal period, impacting drug disposition.
- Adaptation to extrauterine life alters drug absorption, distribution, metabolism, and elimination.
Purpose of the Study:
- To highlight the challenges in drug disposition during the perinatal period.
- To explain the pharmacokinetic alterations in neonates.
- To emphasize the importance of therapeutic drug monitoring in newborns.
Main Methods:
- Review of physiological changes affecting drug disposition in neonates.
- Analysis of altered drug absorption, distribution, metabolism, and elimination pathways.
- Discussion of pharmacokinetic principles relevant to neonatal drug therapy.
Main Results:
- Neonates exhibit slower drug absorption and reduced serum protein binding.
- Impaired hepatic metabolic functions (oxidation, glucuronidation) and reduced renal elimination are observed.
- Prolonged elimination half-lives for many drugs in newborns compared to older infants.
Conclusions:
- Drug disposition is significantly altered in neonates, requiring careful consideration.
- Standard dosage calculations based on body surface area are not always applicable.
- Individualized therapeutic drug monitoring, aided by computer programs, is crucial for safe and effective neonatal drug therapy.