Optimum Use of Therapeutic Drug Monitoring and Pharmacokinetics-Pharmacodynamics in the NICU

Overview

Journal J Pediatr Pharmacol Ther

Specialty Pediatrics

Date 2012 Oct 12

PMID 23055893

Citations 7

Authors

Peter Gal

Affiliations

Soon will be listed here.

Abstract

Therapeutic drug monitoring is increasingly giving way to dosing drugs based on population-based pharmacokinetic parameters, even when pharmacokinetic values vary quite a bit in individual patients. Further, drug concentrations are often considered appropriate if they are within a defined therapeutic range, even if the patient response is suboptimal. This lecture discusses the limitations of therapeutic ranges in neonates, and proposes greater emphasis on pharmacodynamic curves to individualize drug therapy. Examples are provided using methylxanthines, indomethacin, antiepileptic drugs and aminoglycosides. The potential to use pharmacokinetic findings to describe physiologic changes and occasionally assist with diagnosis is also discussed.

Citing Articles

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Acute and Subchronic Toxicity Profile of a Polyherbal Drug Used in Sri Lankan Traditional Medicine.

Liyanagamage D, Jayasinghe S, Attanayake A, Karunaratne V Evid Based Complement Alternat Med. 2020; 2020:2189189.

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Risk of nonsteroidal anti-inflammatory drug-associated renal dysfunction among neonates diagnosed with patent ductus arteriosus and treated with gentamicin.

Constance J, Reith D, Ward R, Balch A, Stockmann C, Korgenski E J Perinatol. 2017; 37(10):1093-1102.

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Incorporating pharmacodynamic considerations into caffeine therapeutic drug monitoring in preterm neonates.

Yu T, Balch A, Ward R, Korgenski E, Sherwin C BMC Pharmacol Toxicol. 2016; 17(1):22.

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Reply to: 'Is the use of prophylactic theophylline safe for the prevention of severe renal dysfunction in term and post-term neonates with perinatal asphyxia?'.

Al-Wassia H J Perinatol. 2013; 34(1):82-3.

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