The clinical pharmacology of neonat.ppt

4 The clinical pharmacology of neonat Characteristic of medicine reaction Characteristic of pharmacokinetics Significance of drug monitoring Medication of breast milk feeding neonat Special reaction of neonatal medicine Rational administration of neonatal common disease Characteristic of neonat 1. functional underdevelopment of organ, underdevelopment of enzymatic system, slow drug metabolism and evacuation 2．Variation of drug metabolism and evacuation velocity according to the birth weight, fetal age and postnatal days 3．individual difference among the sick babies 4．Function weaken So, dosage, dosing interval and administration route will be different Drug absorption and route of administration Administration by gastrointestinal tract (GI/GIT): gastric acidity, gastric emptying time, pathologic status (PS) Administration by nongastrointestinal tract 1. hypodermic injection，intramuscular injection: regional flow, characteristic of medicine 2. intravenous injection：fast Pay attention to neonatal intravenous injection ①Administration according to specify velocity ②To bring about constitution necrosis by drug effusion ③To cause thrombophlebitis by injecting the same blood vessel repeatedly→Injection site should be changed ④To avoid using hypso-concentration Drug disposition Drug distribute to sys by blood circulation organization, fat, pH; Liposolubility, molecular wieght, protein binding rate, barrier Characteristic of drug disposition of neonat More total body water and extracellular fluid volume Less fat mass Low degree of plasma protein binding Underdevelopment of blood-brain barrier Drug metabolism Organ: liver; Accretion rate: size of hepar, metabolic capability of enzymatic system Liposoluble substances: excreted by binding with glucuronate or sulfate A decline of the accretion rate : low enzymatic activity of glucuronyl transferase of neonat binding with glucuronate: indomethacin, salicylate, chloramphenicol