Neonates dose determination

The demonstration that injected or force-fed neonatal rodents given extremely high doses of MSG showed evidence of brain lesions, has led to much additional research to determine any possible link between neurotoxicity and human use of MSG (33). However, no evidence from animal tests indicates that MSG in the diet causes brain damage in humans (34). 

Although there is no reason to suspect that the pharmacokinetics of 1,4-dichlorobenzene differs in children and adults, scant data are available to support or disprove this statement. Studies of absorption, distribution, metabolism, and excretion in children would aid in determining if children are at an increased risk, particularly if conducted in an area where a high-dose acute or low-dose chronic exposure to an environmental source were to occur. With regard to exposure during development, additional research on maternal and fetal/neonatal toxicokinetics, placental biotransformation, the mechanism of... 

In dermatotoxicology, the amount of toxicant per area of skin (e.g., mg/cm2), rather than the amount of toxicant per unit of body weight (e.g., mg/kg), used in oral and parenteral studies is the primary determinant of dose. This explains why infants, with a relatively small ratio of skin surface area to body mass, are particularly prone to systemic toxicity from topical poisons when large areas of skin are exposed. This is further potentiated in neonates, who do not have a fully developed cutaneous barrier. 

In a prospective study to determine if standardized vancomycin doses could produce adequate serum concentrations in 25 full-term neonates with sepsis 13 had adequate peak vancomycin serum concentrations (20-40 mg/ml) and one had a peak concentration with a risk of ototoxicity (over 40 qg/ml) (130). Only 12 had adequate trough concentrations (5-10 mg/ml) and 7 had a risk of nephrotoxicity (over 10 qg/ml). There was no significant difference between peak or trough concentrations and good or bad clinical outcomes. 

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