Optimizing Pediatric Dosing: A Developmental Pharmacologic Approach

Gail D. Anderson, Ph.D.; Anne M. Lynn, M.D.


Pharmacotherapy. 2009;29(6):680-690. 

In This Article

Pharmacokinetic Principles

The concentration of a drug attained after a single dose depends on its volume of distribution. The effect of age on volume of distribution is dependent on the volume of plasma and tissue and on the fractions of unbound drug in plasma and tissue. After multiple dosing, mean steady-state concentrations reflect the dose and dosage interval, clearance, and bioavailability. Total clearance is based on the sum of the partial metabolic and renal clearances. The weight-corrected concentration:dose ratio is routinely used to approximate clearance. Age-related effects on the elimination half-life, which depends on both volume of distribution and clearance, affects the dosage interval needed to maintain therapeutic concentrations.


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