Pharmacokinetic variability in the adolescent: implications of body size and organ function for dosage regimen design.

Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

Pharmacokinetic variability in the adolescent: implications of body size and organ function for dosage regimen design.

J Adolesc Health. 1994 Dec;15(8):654-62. Unique Identifier : AIDSLINE MED/95210289
Rodman JH; Pharmaceutical Department, St. Jude Children's Research Hospital,; Memphis, Tennessee 38105.

Abstract: Although there are convincing clinical studies demonstrating important pharmacokinetic differences between the adult and pediatric patient, guidelines for adjusting the dosages of specific drugs are often based on empirical and limited data. Adult doses often provide the reference point for therapy in children with adjustment for body size. Both body weight and body surface area (BSA) are commonly used to adjust adult doses for pediatric patients but yield substantially different absolute doses. For the child age five years, the BSA-based dose will be more than 50 percent greater than the dose adjusted for body weight. The choice of weight or BSA is often arbitrary and may be an important confounding variable when evaluating drugs over wide ranges of age in pediatric patients or comparing two drugs for which doses are not adjusted in a similar manner. For example, comparative trials for HIV-infected pediatric patients are evaluating zidovudine dosed by BSA with zalcitabine dosed by body weight. Organ function changes with age in pediatric patients yet little information is available on the effects of maturation on hepatic or renal function and the consequences for drug disposition. The use of model substrates for organ function offers potential for elucidating organ function relative to maturation and, in particular, to those functional capacities associated with the onset of puberty and gender differentiation.

Keywords: *Adolescence Adult Age Factors Body Constitution Body Height Body Surface Area Body Weight Child Child, Preschool Clinical Trials Comparative Study Drugs/*ADMINISTRATION & DOSAGE Female Human Kidney/METABOLISM/PHYSIOLOGY Liver/METABOLISM/PHYSIOLOGY Male *Pharmacokinetics Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE
950730
M9570931

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, Gill Foundation, the National Library of Medicine, Quest Diagnostics, Roche and Trimeris, and donations from users like you. Always watch for outdated information. This article first appeared in 1995. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1995. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .