Ontogeny of oral drug absorption processes in children.
BACKGROUND
A large proportion of prescribed drugs to children are administered orally. Age-related change in factors affecting oral absorption can have consequences for drug dosing.


METHODS
For each process affecting oral drug absorption, a systematic search has been performed using Medline to identify relevant articles (from inception till February 2012) in humans. This review presents the findings on age-related changes of the following processes affecting oral drug absorption: gastric pH, gastrointestinal motility, bile salts, pancreatic function, intestinal pH, intestinal drug-metabolizing enzymes and transporter proteins.


CONCLUSIONS
Clinicians should bear in mind the ontogeny of oral drug absorption processes when prescribing oral drugs to children. The authors' review shows large information gaps on almost all drug absorption processes. It is important that more knowledge is acquired on intestinal transit time, intestinal pH and the ontogeny of intestinal drug-metabolizing enzymes and drug transporter proteins. Furthermore, the ultimate goal in this field should be to predict more precisely the oral disposition of drugs in children across the entire pediatric age range.
Erasmus MC-Sophia Children's Hospital, Department of Pediatric Surgery and Intensive Care, Rotterdam, The Netherlands.
Miriam G
MG
Mooij
Barbara A E
BA
de Koning
Mark L
ML
Huijsman
Saskia N
SN
de Wildt
D000284:Administration, Oral; D001647:Bile Acids and Salts / Q000378:metabolism; D001682:Biological Availability; D002352:Carrier Proteins / Q000378:metabolism; D002648:Child; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007408:Intestinal Absorption / Q000502:physiology*; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000187:drug effects; D010179:Pancreas / Q000187:drug effects / Q000378:metabolism; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000378:metabolism*; D010599:Pharmacokinetics
D001647:Bile Acids and Salts; D002352:Carrier Proteins; D004364:Pharmaceutical Preparations