Drug Handling In Neonates, Infants And Children

Question 0

What are different types of absorption?

Answer 0

Gastrointestinal 
Intramuscular 
Percutaneous (topical)
Rectal 
Intravenous

Question 1

What factors affect drug dose and response?

Answer 1

Growth and development 
Drug absorption 
Drug distribution 
Metabolism
Excretion

Question 2

How does drug absorption affect drug dose and response?

Answer 2

Prolonged gastric emptying/irregular motility can delay drug absorption but percutaneous absorption is enhanced due to decreased thickness of the stratum corneum

Question 3

How does drug distribution affect drug dose and response?

Answer 3

A higher total body water and ECF volume means the volume of distribution for water soluble drugs in higher

Question 4

How does protein binding affect drug dose and response?

Answer 4

A lower plasma concentration of albumin means protein binding is reduced in the neonate which may result in an increased drug concentration

Question 5

How does an incomplete blood brain barrier affect drug dose and response?

Answer 5

This may mean increased penetration of lipid soluble drugs into the brain

Question 6

How does hepatic metabolism affect drug dose and response?

Answer 6

Due to immature drug metabolism systems, this is reduced in the neonate resulting in longer plasma half life

Question 7

How does renal function affect drug dose and response?

Answer 7

GFR, tubular secretion and tubular reabsorption are reduced in the neonate resulting in reduced clearance of finally cleared drugs (risk of drug accumulation)