Abstract:
The pharmacokinetics (PK), pharmacodynamics (PD) and side effect profile of most medications used in children differ from those in adults; these differences are most pronounced in neonates. PK are affected by maturation of organ function and body composition, altered protein binding, distinct disease spectrum, diverse behaviour and dissimilar receptor patterns (Kearns et al., N Engl J Med 349(12):1157–67, 2003). The capacity of the end organ, such as the brain, heart or skeletal muscle, to respond to medications may also differ in children compared with adults (PD effects). Dose modification to achieve the desired clinical response and avoid toxicity is required for children. Dose calculations are based on knowledge of PK and PD (Anderson and Holford, Arch Dis Child. 98(9):737–44, 2013).
