CLINICAL PEDIATRIC PHARMACOLOGY
WORKING TOGETHER SUPPORT TO THE HEALTH OF ALL CHILDREN BY ONLINE EDUCATION SUPPORTS.
Advancing of the future pediatric to optimalized physical, mental and social health and well being for fetal, newborn, infant, children, adolescents and young adult
CLINICAL PEDIATRIC PHARMACOLOGY
be a global resource and advocate in the field of pediatric pharmacology, advancing excellence in clinical care through education and information online
WELCOME SPEECH
Today, only 25% of drugs used to treat children have actually been studied in children. The Pediatric Pharmacology Program at the University of Utah is working to eliminate this deficiency in accordance with FDA regulations, and in response to the stimulus from the Best Pharmaceuticals for Children’s Act and the Pediatric Research Equity Act which requires drug studies for children during the drug development and approval process.
The first year of life is associated with major changes in the processes affecting the absorption, distribution, metabolism and excretion of drugs. Drug absorption by the oral route is affected by reduced gastric emptying so that this route is unreliable in the neonate. The intramuscular route is also unreliable but transdermal absorption is often greater, with risks of toxicity. The volume of distribution of many drugs is often markedly increased in the neonate, partly because of reduced plasma protein binding (both to albumin and to –l–acid glycoprotein) but also because of an increased volume of extracellular fluid relative to total body water. These factors both result in increased half-life of elimination of drugs. Metabolic processes are often immature at birth and this results in reduced clearance rates and prolonged half-life of elimination of those drugs for which metabolism is a significant mechanism for elimination. Renal excretion in the newborn is reduced although glomerular filtration rate (a passive process) and active tubular secretory rate increase relatively rapidly during infancy. Since these processes tend to be the most important drug elimination mechanism for antibiotics, dose adjustment is particularly important; methods using calculated glomerular filtration rate and the role of therapeutic drug monitoring are described. Finally, the pharmacokinetic processes develop at different rates during the first year of life and an understanding of these factors can help in the safe and effective prescribing of antibiotics.
Clinical Pediatric Pharmacology clinical research efforts focused on the development of new drugs for the treatment of childhood diseases through the study of pharmacokinetics, pharmacogenetics and pharmacodynamics
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