药物不良反应课件.pptVIP

The clinical pharmacologyof neonat1 n Characteristic of medicine reactionn Characteristic of pharmacokineticsn Significance of drug monitoringn Medication of breast milk feedingneonatn Special reaction of neonatal medicinen Rational administration of neonatalcommon disease2 Definition ofneonatalbornpostnatal 28ds3 Characteristic of neonatn 1. functional underdevelopment of organ,underdevelopment of enzymatic system,slow drug metabolism and evacuationn 2．Variation of drug metabolism and evacuationvelocity according to the birth weight, fetal age andpostnatal daysn 3．individual difference among the sick babiesn 4．Function weakenn So, dosage, dosing interval and administration route willbe different4 Drug absorption and route ofadministrationn Administration by gastrointestinal tract(GI/GIT): gastric acidity, gastric emptyingtime, pathologic status (PS)n Administration by nongastrointestinal tract1. hypodermic injection，intramuscularinjection : regional flow, characteristic ofmedicine2. intravenous injection：fast5 Pay attention to neonatalintravenous injectionn ①Administration according to specifyvelocityn ②To bring about constitution necrosis by drugeffusionn ③To cause thrombophlebitis by injecting thesame blood vessel repeatedly→Injection siteshould be changedn ④To avoid using hypso-concentration6 Drug dispositionDrug distribute to sys by bloodcirculationorganization, fat, pH;Liposolubility, molecular wieght,protein binding rate, barrier7 Characteristic of drug disposition ofneonatn More total body water and extracellularfluid volumen Less fat massn Low degree of plasma protein bindingn Underdevelopment of blood-brain barrier8 Drug metabolismn Organ: liver;Accretion rate: size of hepar, metabolic capability ofenzymatic systemn Liposoluble substances: excreted by binding withglucuronate or sulfaten A decline of the accretion rate : lowenzymatic activity of glucuronyl transferase of neonat9 Drug metabolismn binding with glucuronate : indomethacin,salicylate, chloramphe