Open AccessOptimum Use of Therapeutic Drug Monitoring and Pharmacokinetics-Pharmacodynamics in the NICU
Author(s) -
Péter Gál
Publication year - 2009
Publication title -
the journal of pediatric pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.456
H-Index - 15
eISSN - 2331-348X
pISSN - 1551-6776
DOI - 10.5863/1551-6776-14.2.66
Subject(s) - pharmacokinetics , pharmacodynamics , medicine , therapeutic drug monitoring , dosing , drug , therapeutic index , pharmacology , population , intensive care medicine , environmental health
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.