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Pharmacokinetics in the infant

R L Milsap1, W J Jusko

  • 1Department of Pharmaceutics, School of Pharmacy, State University of New York at Buffalo 14260, USA.

Environmental Health Perspectives
|December 1, 1994
PubMed

Insights

Drug absorption, distribution, metabolism, and excretion processes are immature in neonates and infants, requiring careful dosage adjustments. Pediatric drug therapy must account for rapid developmental changes in drug processing and response.

Area of Science:

  • Pharmacology
  • Neonatal Medicine
  • Pediatric Pharmacology

Background:

  • Drug pharmacokinetics and pharmacodynamics are significantly altered in neonates and infants due to physiological immaturity.
  • Immature physiological processes affect how drugs are absorbed, distributed, metabolized, and excreted in young children.

Purpose of the Study:

  • To review the developmental changes in drug absorption, distribution, metabolism, excretion, and pharmacodynamics in neonates and infants.
  • To highlight the implications of these changes for pediatric drug dosage and therapeutic management.

Main Methods:

  • Literature review of studies on drug pharmacokinetics and pharmacodynamics in pediatric populations.
  • Analysis of physiological differences between neonates, infants, and adults relevant to drug disposition.

Main Results:

  • Absorption is influenced by gastric pH and emptying time.
  • Distribution is affected by low serum protein and high body water content.
  • Metabolism and renal excretion pathways are immature at birth but mature rapidly within the first year.
  • Infants exhibit increased sensitivity to certain drugs, such as d-tubocurarine.

Conclusions:

  • Pediatric drug therapy requires continuous dosage regimen modification due to rapid developmental changes.
  • Understanding altered drug processing in neonates and infants is crucial for safe and effective pediatric pharmacotherapy.

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