Towards evidence-based dosing regimens in children on the basis of population pharmacokinetic pharmacodynamic modelling
When growing up, the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of drugs change, which may alter the effect of drugs. To ensure optimal drug efficacy and safety in paediatric care, PK and PD relationships of drugs need to be explored in children. This article presents an outline on perfo...
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| Veröffentlicht in: | Archives of disease in childhood 2014-03, Vol.99 (3), p.267-272 |
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| container_title | Archives of disease in childhood |
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| creator | Admiraal, Rick van Kesteren, Charlotte Boelens, Jaap Jan Bredius, Robbert G M Tibboel, Dick Knibbe, Catherijne A J |
| description | When growing up, the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of drugs change, which may alter the effect of drugs. To ensure optimal drug efficacy and safety in paediatric care, PK and PD relationships of drugs need to be explored in children. This article presents an outline on performing a population PK/PD study and translating these results into rational dosing regimens, with the development and prospective evaluation of PK/PD derived evidence-based dosing regimen being discussed. Examples on amikacin, morphine and busulfan are provided, showing how PK(/PD) modelling not only led to optimization and individualization in paediatric clinical care for the specific drugs but also to insight in maturation of organ systems involved. It is shown that the latter results can subsequently be used as a basis for dosing of other drugs eliminated through the same pathway. Ultimately, these efforts should lead to predictable drug efficacy and safety across all age groups. |
| doi_str_mv | 10.1136/archdischild-2013-303721 |
| format | Article |
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To ensure optimal drug efficacy and safety in paediatric care, PK and PD relationships of drugs need to be explored in children. This article presents an outline on performing a population PK/PD study and translating these results into rational dosing regimens, with the development and prospective evaluation of PK/PD derived evidence-based dosing regimen being discussed. Examples on amikacin, morphine and busulfan are provided, showing how PK(/PD) modelling not only led to optimization and individualization in paediatric clinical care for the specific drugs but also to insight in maturation of organ systems involved. It is shown that the latter results can subsequently be used as a basis for dosing of other drugs eliminated through the same pathway. 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To ensure optimal drug efficacy and safety in paediatric care, PK and PD relationships of drugs need to be explored in children. This article presents an outline on performing a population PK/PD study and translating these results into rational dosing regimens, with the development and prospective evaluation of PK/PD derived evidence-based dosing regimen being discussed. Examples on amikacin, morphine and busulfan are provided, showing how PK(/PD) modelling not only led to optimization and individualization in paediatric clinical care for the specific drugs but also to insight in maturation of organ systems involved. It is shown that the latter results can subsequently be used as a basis for dosing of other drugs eliminated through the same pathway. 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To ensure optimal drug efficacy and safety in paediatric care, PK and PD relationships of drugs need to be explored in children. This article presents an outline on performing a population PK/PD study and translating these results into rational dosing regimens, with the development and prospective evaluation of PK/PD derived evidence-based dosing regimen being discussed. Examples on amikacin, morphine and busulfan are provided, showing how PK(/PD) modelling not only led to optimization and individualization in paediatric clinical care for the specific drugs but also to insight in maturation of organ systems involved. It is shown that the latter results can subsequently be used as a basis for dosing of other drugs eliminated through the same pathway. Ultimately, these efforts should lead to predictable drug efficacy and safety across all age groups.</abstract><cop>London</cop><pub>BMJ Publishing Group</pub><pmid>24356807</pmid><doi>10.1136/archdischild-2013-303721</doi><tpages>6</tpages></addata></record> |
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| ispartof | Archives of disease in childhood, 2014-03, Vol.99 (3), p.267-272 |
| issn | 0003-9888 1468-2044 |
| language | eng |
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| source | MEDLINE; BMJ Journals - NESLi2 |
| subjects | Alkylating Agents - administration & dosage Alkylating Agents - pharmacokinetics Amikacin - administration & dosage Amikacin - pharmacokinetics Analgesics, Opioid - administration & dosage Analgesics, Opioid - pharmacokinetics Anti-Bacterial Agents - pharmacokinetics Biological and medical sciences Body Composition Body Weight Busulfan - administration & dosage Busulfan - pharmacokinetics Child Company business management Dose-Response Relationship, Drug Evidence Evidence-Based Medicine General aspects Health aspects Humans Infant health services Management Medical sciences Miscellaneous Models, Biological Morphine - administration & dosage Morphine - pharmacokinetics Narcotics Neonates Patients Pediatrics Pharmacokinetics Pharmacology Prevention and actions Profiles Public health. Hygiene Public health. Hygiene-occupational medicine Sampling Statistical Analysis |
| title | Towards evidence-based dosing regimens in children on the basis of population pharmacokinetic pharmacodynamic modelling |
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