Drug dosing in neonates
Neonates have specific physiological differences from older children and adults that influence drug pharmacokinetics (PK) and pharmacodynamics (PD).1-4 These differences necessitate adjustments in drug dosing in order to ensure efficacy and avoid toxicity in the perioperative period. Knowledge pertaining to the ontogeny of neonatal organ systems is required to ensure safety and optimal care of these patients.
The myriad of moral and operational concerns pertaining to neonatal research limits our ability to perform prospective trials and gain sufficient data to determine ideal drug dosing in this heterogenous population. Certain advances in PK and PD modelling, especially allometric theories, have improved our recent understanding and highlighted that age, maturation of organ systems and patient size must be taken into account.2-4
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