Developmental Changes in Pharmacokinetics and Pharmacodynamics

J Clin Pharmacol. 2018 Oct:58 Suppl 10:S10-S25. doi: 10.1002/jcph.1284.

Abstract

Effective drug therapy to optimally influence disease requires an understanding of a drug's pharmacokinetic, pharmacodynamic, and pharmacogenomic interrelationships. In pediatrics, age is a continuum that can and does add variability in drug disposition and effect. This article addresses the many important factors that influence drug disposition and effect relative to age. What is known about the influence of maturation on the processes of drug absorption, distribution, metabolism, excretion, and drug receptor dynamics are outlined. Our state of understanding of many of these factors remains in flux, however, and only with additional study will we be able to better anticipate and model drug-response relationships across the age continuum. Being able to continuously improve our care of the ill pediatric patient while simultaneously being able to accurately determine the utility of new drugs and chemical entities in this population requires our enhanced understanding of these disposition characteristics.

Keywords: developmental pharmacology; drug transporters; drug-metabolizing enzymes; pediatric pharmacology; pharmacodynamics; pharmacokinetics.

Publication types

  • Review

MeSH terms

  • Aging / metabolism*
  • Child
  • Child Development*
  • Humans
  • Intestinal Absorption
  • Kidney / metabolism
  • Pharmaceutical Preparations / metabolism
  • Pharmacokinetics*
  • Pharmacological Phenomena*
  • Tissue Distribution

Substances

  • Pharmaceutical Preparations