Developmental Pharmacokinetics in Pediatric Populations
Open accessAbstract
Information on drug absorption and disposition in infants and children has increased considerably over the past 2 decades. However, the impact of specific age-related effects on pharmacokinetics, pharmacodynamics, and dose requirements remains poorly understood. Absorption can be affected by the differences in gastric pH and stomach emptying time that have been observed in the pediatric population. Low plasma protein concentrations and a higher body water composition can change drug distribution. Metabolic processes are often immature at birth, which can lead to a reduced clearance and a prolonged half-life for those drugs for which metabolism is a significant mechanism for elimination. Renal excretion is also reduced in neonates due to immature glomerular filtration, tubular secretion, and reabsorption. Limited data are available on the pharmacodynamic behavior of drugs in the pediatric population. Understanding these age effects provide a mechanistic way to identify initial doses for the pediatric population. The various factors that impact pharmacokinetics and pharmacodynamics mature towards adult values at different rates, thus requiring continual modification of drug dose regimens in neonates, infants, and children. In this paper, the age-related changes in drug absorption, distribution, metabolism, and elimination in infants and children are reviewed, and the age-related dosing regimens for this population are discussed.
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Pediatric patients exhibit considerable pharmacokinetic variability.
“In addition, pediatric patients exhibit considerable pharmacokinetic variability [3].”
Immature renal and hepatic functions in pediatric patients make drug metabolism and excretion different from adults, complicating dosage adjustment.
“Their renal and hepatic functions are immature, which makes drug metabolism and excretion different from those of adults, complicating dosage adjustment [2,3].”
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Cho, I. Y., Cho, S., Im, M. Y., Jeong, H. J., Choi, J., Choi, I. H., & Kim, H. Y. (2026) · Child Health Nursing Research · doi:10.4094/chnr.2026.016 · Cited by 1 · see citing works
- Authors
- Lu, H., & Rosenbaum, S.
- Affiliations
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island
- University of Rhode Island (US)
- Corresponding author
- Rosenbaum, Sara
- Venue
- The Journal of Pediatric Pharmacology and Therapeutics
- Publisher
- The Pediatric Pharmacy Association
- Published
- 2014
- Volume
- 19
- Issue
- 4
- Pages
- 262-276
- ISSN
- 1551-6776 (ISSN-L)
- PMC
- PMC4341411
- OpenAlex
- W2179110505
- Cited by
- 358
- References
- 95
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 42 · 2023: 37 · 2022: 54 · 2021: 43 · 2020: 31 · 2019: 46 · 2018: 28 · 2017: 17 · 2016: 12
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Pediatric Pharmacology and Therapeutics (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
- Keywords
- developmental pharmacokinetics, pediatric pharmacokinetics, infants, neonates, drug absorption, gastric pH, gastric emptying, drug distribution, plasma protein binding, drug metabolism, renal excretion, glomerular filtration, pharmacodynamics, dose adjustment, drug clearance
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Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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