{"title":"Developmental pharmacology","authors":"Graeme Wilson","doi":"10.1016/j.mpaic.2024.05.004","DOIUrl":null,"url":null,"abstract":"<div><p>Growth and maturation characterize the transition of neonates to adults. The physiological changes that children undergo present numerous pharmacological conundrums for the anaesthetist. Extensive changes in drug absorption, protein binding, metabolism and excretion during development result in wide variability in drug disposition. Pharmacodynamic differences and genetic polymorphisms further exacerbate these pharmacokinetic disparities. These changes directly affect drug efficacy and toxicity, and an awareness of this is crucial for clinicians involved in paediatric anaesthesia. Population-based pharmacokinetic–pharmacodynamic modelling provides a novel prospect in paediatric pharmacology research. Modelling has the potential to improve safety in clinical trials and enhance our understanding of drug disposition in vulnerable populations like preterm neonates. Although progress is occurring in developmental pharmacology, gaps remain, and a lot yet remains to be elucidated.</p></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia and Intensive Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472029924000857","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
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Abstract
Growth and maturation characterize the transition of neonates to adults. The physiological changes that children undergo present numerous pharmacological conundrums for the anaesthetist. Extensive changes in drug absorption, protein binding, metabolism and excretion during development result in wide variability in drug disposition. Pharmacodynamic differences and genetic polymorphisms further exacerbate these pharmacokinetic disparities. These changes directly affect drug efficacy and toxicity, and an awareness of this is crucial for clinicians involved in paediatric anaesthesia. Population-based pharmacokinetic–pharmacodynamic modelling provides a novel prospect in paediatric pharmacology research. Modelling has the potential to improve safety in clinical trials and enhance our understanding of drug disposition in vulnerable populations like preterm neonates. Although progress is occurring in developmental pharmacology, gaps remain, and a lot yet remains to be elucidated.
期刊介绍：
Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.
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