Therapeutic Drug Monitoring Principles in the Neonate (Nacb Symposium‪)‬

Although infants and toddlers are understood to be very different from adults in their disposition of and response to drugs, information relevant to this group is almost always collected after the drug has been tested in adults. Moreover, the accumulation of these data in young infants is often slow and incomplete: Ethical considerations hinder rigorous studies, and in many cases the lack of micro methods for drug analysis in small volumes hampers detailed trials in infants and small children. We now treat many high-risk, very-low-birth-weight infants with combinations of powerful drugs, and over the last decade this group of patients has prompted intensive research into the disposition of and response to drugs in preterm infants. Here I will review differences in disposition and response to drugs in infants and children. Developmental changes will be dealt with, including specific problems associated with drug administration to this age group.