05- pediatric pharmacology
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Pediatric Pharmacology
dr. Putrya Hawa, M.BiomedFaculty of Medicine, UII
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Pediatric…
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• ↑ In topical administrationSkin barrier
• ↑ in i.m administration toxicity↓ Muscle mass, peripheral blood flow
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Liver blood flow
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Pharmacodynamic
• Immature neuromuscular junction curare, atracurium
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Drug Dosage
Pediatric dose:1.Based on body weight2.Young Formula
: adult dosage x age (years)age + 12
3.Clark’s Formula: adult dose x weight (kg)
70
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Example: Neonatal Sepsis
• Leading cause of mortality in premature neonates
• Causes: Group B strep, E.coli, Klebsiella,rare but serious Listeria monocytogenes
• Empiric therapy: ampicillin and gentamicin• Safe, inexpensive, well studied
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Gentamicin
• Water-soluble with a large volume of distribution
• Approximately 0.6 L/kg in neonate versus 0.25 L/kg in an adult
• Renal elimination slower than adult• Half-life 3-10 hours in a neonate, compared to 1-2 hours in an adult
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Gentamicin (Con’t)
• Target levels same as adults– Peak 4-8 mcg/mL, trough < 2 mcg/mL
• Infused over 30 minutes• Usual dose 2.5 mg/kg given every 8 to 36
hours• Interval determined by weight, gestational
age, and renal function
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Extended Gentamicin Interval
• Doses of 4 mg/kg given once daily in larger newborns
• Limited data in newborns < 32 weeks GA• Risk for toxicity if unable to clear large initial
dose• Use with caution in infants with potential
renal impairment
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Thank you…