Pediatric Pharmacokinetics - Duke Pediatrics Intranet

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Metabolism• Two phases of hepatic metabolism– Phase I – oxidation– Phase II – conjugation• Phase I done by Cytochrome P-450(CYP)• CYP 3A7 very high in fetal liver, gone inadulthood – detoxifies anabolic steroids& retinoic acid breakdown products(which happen to be teratogenic)
CYP Enzymes• CYP isoforms vary with age• For example, clearance of midazolam byCYP 3A4 and 3A5 goes from 1.2ml/min/kg to 9 ml/min/kg over first fewmonths of life• Carbamezapine (3A4) clearance fasterin children than adults – requires higherdoses
Page 1 and 2: Pediatric Pharmacokinetics:Why Chil
Page 3 and 4: Problems• Absorption may be more
Page 5 and 6: Absorption - 2• Villous formation
Page 7: 1 Yr5 Yr10 Yr20 Yr40 Yr9 Mo6 Mo3 Mo
Page 11 and 12: Glomerular Filtration Rate (GFR) by
Page 13 and 14: Targets - non-Host• Antibiotics t
Page 15 and 16: Formulations• Not all meds can be
Page 17: Summary• The catchphrase is, “C

Pediatric Pharmacokinetics - Duke Pediatrics Intranet

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