Pediatric Pharmacotherapy
Pediatric Pharmacotherapy
Pediatric Pharmacotherapy
Common terms
• Children undergo considerable physiologic changes between birth and
adulthood.
Common Equations Used for Calculations in
Paediatric Patients
Pediatric pharmacokinetics: absorption
oral
• Neonates gastric acid reduced to near neutral PH ( reaches adult value after 2-3 years)
Intramuscular
- Absorption reduced muscle size, weaker muscle contractions, and an immature vasculature
resulting in more erratic blood flow to and from the muscle
Absorption…cont
• subcutaneous administration, transdermal or percutaneous administration
results in greater drug absorption in neonates than it does in older children and
adults.
• Rectal administration is a useful route of drug delivery for many pediatric
patients
Drug Distribution
• Extracellular fluid and total body water per kilogram of body weight are increased
in neonates and infants, resulting in higher Vd for water-soluble drugs, such as
aminoglycosides, and decreases with age
• Neonates and infants have a lower normal range for serum albumin (2–4 g/dL,
20–40 g/L), reaching adult levels after 1 year of age.
• Highly protein bound drugs, such as sulfamethoxazole-trimethoprim, are not
typically used in neonates due to theoretical concern for bilirubin displacement.
This displacement may result in a complication known as kernicterus, from
bilirubin encephalopathy
• Some medications (eg, vancomycin, phenobarbital) may also reach higher
concentrations in the central nervous system of neonates due to an immature
blood-brain barrier
Metabolism and excretion