Pharmacokinetics in the newborn

Alcorn, Jane; McNamara, Patrick J.

doi:10.1016/s0169-409x(03)00030-9

Cited by 207 publications

(166 citation statements)

References 169 publications

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“…Neonates also have higher circulating bilirubin and free fatty acids which can displace drugs from albumin binding sites [6]. Changes in the volume of distribution are also related to changes in blood flow, tissue perfusion, membrane permeability and cardiac output, all affected in conditions such as sepsis [25].…”

Section: Distributionmentioning

confidence: 99%

Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future

O’Hara

Wright

Schneider

et al. 2015

Brit J Clinical Pharma

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Paediatric patients, particularly preterm neonates, present many pharmacological challenges. Due to the difficulty in conducting clinical trials in these populations dosing information is often extrapolated from adult populations. As the processes of absorption, distribution, metabolism and excretion of drugs change throughout growth and development extrapolation presents risk of over or underestimating the doses required. Information about the development these processes, particularly drug metabolism pathways, is still limited with weight based dose adjustment presenting the best method of estimating pharmacokinetic changes due to growth and development. New innovations in pharmacokinetic research, such as population pharmacokinetic modelling, present unique opportunities to conduct clinical trials in these populations improving the safety and effectiveness of the drugs used. More research is required into this area to ensure the best outcomes for our most vulnerable patients.

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Section: Distributionmentioning

confidence: 99%

Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future

O’Hara

Wright

Schneider

et al. 2015

Brit J Clinical Pharma

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“…Adult levels of gastric acid production are reached at about two years of age. The alkaline gastric pH in newborns and infants may lead to enhanced bioavailability of weakly basic compounds but reduced bioavailability of weakly acidic compounds (Alcorn & McNamara, 2003).…”

Section: Absorption Distribution Metabolism and Eliminationmentioning

confidence: 99%

“…For example, the relatively larger extracellular fluid volume of the infant means somewhat greater dilution of water-soluble chemicals (Friis-Hansen, 1971;Rylance, 1988;Kearns et al, 2003). However, the lipid-soluble substances would be distributed in a smaller volume of fat in infants relative to adults (Alcorn & McNamara, 2003). The volume distribution of chemicals is also determined by plasma protein concentrations.…”

Section: Absorption Distribution Metabolism and Eliminationmentioning

confidence: 99%

“…The binding affinity may also be different in neonates and adults. The neonate-adult difference in albumin binding affinity for many drugs is likely related to the differences in the form of protein as well as the amino acid content of albumin (Alcorn & McNamara, 2003).…”

Section: Absorption Distribution Metabolism and Eliminationmentioning

confidence: 99%

“…A systematic comparison of the available information on agedependent maturation of metabolic and elimination processes as well as the toxicokinetics of chemicals in developing neonatal and young animals with that in infants and children can be found elsewhere (Gladtke, 1973;Stewart & Hampton, 1987;Crom, 1994;Renwick, 1998;Clewell et al, 2002;Alcorn & McNamara, 2003;Kearns et summarizes the age dependency of toxicokinetic processes and determinants in children compared with adults.…”

Section: Absorption Distribution Metabolism and Eliminationmentioning

confidence: 99%

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Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

Liu

Xia

Guo

et al. 2012

J Expo Sci Environ Epidemiol

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The urinary metabolites of phthalates are well-accepted exposure biomarkers for adults and children older than 6 years but are not commonly used for infants owing to non-convenient sampling. In the light of this situation, a novel sampling method based on monitoring the urine expressed from the gel diaper was developed. The urine was expressed from the gel absorbent after mixing the absorbent with CaCl2 and then collected by a laboratory-made device; the urinary phthalate metabolites were extracted and cleaned using a solid-phase extraction (SPE) column and analyzed with high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry / mass spectrometry. To evaluate the method's feasibility, the following factors were investigated: the proportion of CaCl2 to gel absorbent, the urination volume variation and the target compounds' deposition bias in the diaper, the matrix blank of the different diaper brands, the storage stabilities and the recoveries of creatinine and phthalate metabolites in the expressed urine. Mono-methyl phthalate, mono-ethyl phthalate, mono-butyl phthalate, mono-benzyl phthalate, mono-2-ethylhexyl phthalate and mono-2-ethyl-5-oxohexyl phthalate were involved. 70-80% of the urine can be expressed from the diaper, and the expressed spiking recoveries and the limit of detection of mono-phthalates ranged from 88.5-115% and 0.21-0.50 ng/ml. The method was applied to measure phthalate metabolites in 65 gel diaper samples from 15 infants, and the pilot data suggests the infants are commonly exposed to phthalates. In summary, the method for monitoring of infant exposure to phthalates is sound and validated, and the potential health effects from the vulnerable infants' exposure to phthalates should be concerned.39th Scientific Research Foundation for the Returned Overseas Chinese Scholars (SRF for ROCS); Hundred Talent Program of Chinese Academy of Sciences (CAS); CAS/SAFEA International Partnership Program for Creative Research Teams [KZCX2-YW-T08

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Physiologically Based Pharmacokinetic (PBPK) Models in Cancer Risk Assessment

Valcke

Krishnan

2010

Cancer Risk Assessment

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Pharmacokinetics in the newborn

Cited by 207 publications

References 169 publications

Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future

Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

Physiologically Based Pharmacokinetic (PBPK) Models in Cancer Risk Assessment

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