title: Pharmacokinetics in neonatal prescribing: evidence base, paradigms and the future.
abstract: Paediatric patients, particularly preterm neonates, present many pharmacological challenges. Due to the difficulty in conducting clinical trials in these populations dosing information is often extrapolated from adult populations. As the processes of absorption, distribution, metabolism and excretion of drugs change throughout growth and development extrapolation presents risk of over or underestimating the doses required. Information about the development these processes, particularly drug metabolism pathways, is still limited with weight based dose adjustment presenting the best method of estimating pharmacokinetic changes due to growth and development. New innovations in pharmacokinetic research, such as population pharmacokinetic modelling, present unique opportunities to conduct clinical trials in these populations improving the safety and effectiveness of the drugs used. More research is required into this area to ensure the best outcomes for our most vulnerable patients.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle.
authors.forename: Kate
authors.initials: K
authors.lastname: O'Hara
authors.affiliation: University of Wollongong and Illawarra Health & Medical Research Institute, Wollongong.|University of Newcastle and Hunter Medical Research Institute, Newcastle.|Clinical Lead, Newborn Services, Division of Paediatrics, Illawarra Shoalhaven Local Health District, NSW.
authors.forename: Ian M R
authors.initials: IM
authors.lastname: Wright
authors.affiliation: School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Schneider
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle.|Executive Dean Faculty Science, Medicine and Health, University of Wollongong, Wollongong.|Deputy Director, Illawarra Health and Medical Research Institute, Wollongong, Australia.
authors.forename: Alison L
authors.initials: AL
authors.lastname: Jones
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Newcastle.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Martin
mesh_terms: D001189:Aryl Hydrocarbon Hydroxylases / Q000502:physiology; D019388:Cytochrome P-450 CYP1A2 / Q000502:physiology; D019389:Cytochrome P-450 CYP2D6 / Q000502:physiology; D051544:Cytochrome P-450 CYP3A; D006801:Humans; D007231:Infant, Newborn / Q000378:metabolism*; D008954:Models, Biological; D010599:Pharmacokinetics; D014018:Tissue Distribution
chemical_list: D001189:Aryl Hydrocarbon Hydroxylases; C103123:CYP3A7 protein, human; D019388:Cytochrome P-450 CYP1A2; D019389:Cytochrome P-450 CYP2D6; D051544:Cytochrome P-450 CYP3A
keywords: neonate; paediatric; pharmacokinetics; population pharmacokinetic modelling