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Pediatric PK (Neonates vs. Adults (Increased gastric pH, Decrease BA of…
Pediatric PK
Neonates vs. Adults
Increased gastric pH
Decrease BA of acidic drugs
Approches adult values at 6-8 months
Skin fully develops by adolescense
Greater capillary density than adults
Decreases to adult values by age 1
Fetal albumin still present
Reaches adult values by 10yrs
Decreased in neonates but increased in children compared to adults
Kidney matures throughout childhood
A
&
P Factors
reduced HCl secretion
Decreased Gastric Emptying
Thin Stratum Corneum
Reduced muscular blood flow
Increased body water %
Decreased Protein Binding
Decreased CYP 450
Altered glucoronidation
Kidney maturation
Drugs Affected
increase BA of penicillin
PK & Clinical Implications
Increased BA of basic drugs
Slow Rate of absorption
Unintentional absorption through skin contact
Delayed IM absorption
Larger Vd
Increase in unbound drugs
Decreased hepatic metabolism
Altered phase 2 metabolism
Decreased Gfr=lower doses and longer intervals
Decrease BA of Phenytoin
Phenobarbital
Aminoglycosides
Phenytoin
Acetaminophen
Digoxin
Absorbtion
Distribution
Metabolism
Elimination