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Physiology, Diseases andDevelopmental Pharmacology. . Appreciation of at least five phases of development. Physiology: Large body surface Increased skin permeability Reduced surfactant synthesis Aortopulmonary shunts Immaturity of the brain stem No ciruclatory autoregulation Incomplete retinal vascularisation .
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1. 2nd Joint Annual Meeting – Club Phase I and AGAHPositioning Human Pharmacology for the Future
22. An important dosage-principle in the NICU Given:
Result:
Examples: Vd ?
Clearance ?
Loading dose (LD) ?
Maintenance dose (MD) ?
Phenobarbital, Phenytoin, Methylxanthine, Digoxin, Aminoglykoside, Indometacin Chloramphenicol, Furosemide
Doses per KG as this is clinical practice! Increased drug dosing intervals and/or reduced maintenances doses (renal clearance!):
Example Gentamycin:
initially 5mg/kg KG i.v.,
then 3,5 mg/kg KG/ single dose, every 12 h for >SSW 37, every 18 h <37>30 SSW, Every 24 h <30. SSW
Example Digoxin:
i.v. saturation dose FG 20-30,. TG 40µg/kgKG, maintenance dose FG 5, RG 8-10 µg/kgKG
Doses per KG as this is clinical practice! Increased drug dosing intervals and/or reduced maintenances doses (renal clearance!):
Example Gentamycin:
initially 5mg/kg KG i.v.,
then 3,5 mg/kg KG/ single dose, every 12 h for >SSW 37, every 18 h <37>30 SSW, Every 24 h <30. SSW
Example Digoxin:
i.v. saturation dose FG 20-30,. TG 40µg/kgKG, maintenance dose FG 5, RG 8-10 µg/kgKG
30. Examples on long-term adverse effects of medicines in early infancy and childhood
