Neonates/infants

Nystatin drops (Mycostatin) 200,000 units (2 mL) orally four For concurrent treatment of the neonate/infant regardless of... 

Elevated opening pressure (may be decreased in neonates, infants, and children)... 

PENICILLIN G BENZATHINE, IM Administer by deep IM injection in the upper outer quadrant of the buttock. In neonates, infants, and small children, the midlateral aspect of the thigh may be preferable. When doses are repeated, rotate the injection site. Do not administer IV. 

Developmental differences in drug absorption between neonates, infants and older children are summarized in Table 1. It must be recognized that the data contained therein reflect developmental differences which might be expected in healthy pediatric patients. Certain conditions and disease states might modify the function and/or structure of the absorptive surface area(s). GI motility and/or systemic blood flow can further impact upon either the rate or extent of absorption for drugs administered by ex-travascular routes in pediatric patients. 

Table 5. Drug metabolism in the neonate, infant and child...

Administration This is for IM use only. In adults the injection should be given in the deltoid region in neonates and infants the injection should be given in anterolateral thigh. Dose for adults and children above 10 years is 20 meg and for neonates, infants and children below 10 years the dose is 10 meg. Three doses are given as above. For rapid immunization the... 

Renal failure (all ages) Neonate Infant Children Adolescent Adult... 

Roffwarg HP, Dement WC, Fisher, C. Preliminary observations of the sleep-dream pattern in neonates, infants, children, and adults. In Harms, E, ed. Problems of Sleep and Dreams in Children. Monographs on Child Psychiatry, no. 2. New York Pergamon Press, 1964 60-72. 

Neonate Infant Exposure of juvenile mice to pesticides caused Parkinson-like declines in dopaminergic neurons in adulthood (Cory-Slechta et al., 2005) Hydronephrosis with dioxin exposure during neonatal and infantile periods in rats (Bimbaum, 1995) Maternal grooming affects ability to respond to stress in adulthood in rats (Gilbert, 2005)... 

Neonate Infant Increased incidence of respiratory mortality following exposure to particulates in the air (Glinianaia et al., 2004) ... 

Prediction of Clearance and its Variability in Neonates, Infants, and Children... 

Johnson, T.N. et al. Prediction of the clearance of eleven drugs and associated variability in neonates, infants and children. Clin Pharmacokinet 2006,45 931-956. 

It is estimated that about 2000 years ago, the average life expectancy (birth to death) of a Roman citizen was 22 years (W6). From then to 1900 it increased to 47 years in the United States and over the subsequent nine decades (1992) increased to 75.8 years (G16) (Fig. 1). This remarkable increase in life expectancy since 1900 is due primarily to the prominent decline in neonatal, infant, and maternal mortality rates, along with the control of various infectious diseases. More recently, there has been a significant, albeit much less, reduction in early deaths due to coronary heart disease and stroke (i.e., due to atherosclerosis), as well as to improved management and treatment of diabetes mellitus, cancer, and various other chronic disorders. Nevertheless, the maximum theoretical life span has possibly increased slightly over the past many centuries. The oldest-ever documented person in the world, Jeanne Calment of France, died on August 4, 1997, at the age of 122 years, 5 months, and 14 days (W10). It has recently been suggested that the maximum life span could be extended to 130 years or more (M6). 

Foam film formation by three preparations used as surfactant replacement therapy by injection into the lungs in neonatal infants with surfactant insufficiency (RDS) has been... 

The clinical concentration exceeds the actual intraalveolar concentration that might be expected during therapy, because the material is diluted in situ by the liquid in the air spaces and their surfaces [65]. Other information gives some indication of the surfactant concentration in the normal lungs. The concentration in normal foetal pulmonary liquid [66] and the concentration required to restore alveolar function to immature neonatal infants and lambs [67] change from about 0.5 to 1.8 mg PL cm 3. These concentrations are close but slightly higher than both C, and just above C,. 

The major route of elimination is hepatic metabolism. The variability in the metabolism and pharmacokinetics in neonates, infants and children necessitates monitoring of drug concentrations in the plasma, particularly when it is co-administered with phenytoin, phenobarbital or rifampin. 

Chesney RW (1990) Requirements and upper limits of vitamin D intake in the term neonate, infant, and older child. Journal of Pediatrics 116, 159-66. 

The cycloplegic can be administered alone or as a combination cycloplegic-mydriatic solution to permit adequate binocular indirect ophthalmoscopy in neonates, infants, and young children after cycloplegic retinoscopy. The combination drugs can be administered individually or as a combination solution. 

In some cases, it is desirable to have a pharmaceutical protein in an aggregated state because it is the bioactive form of the protein. An example of this is surfactant protein B (SP-B), a pulmonary surfactant protein necessary for normal lung function in neonatal infants. " The protein exists exclusively as a homodimer in which the monomers are linked by a disulfide bond. In studies investigating efficacy of the SP-B monomer compared with the dimer in transgenic mice, it was found that although the surfactant action was preserved in the monomeric form of the protein, altered lung hysteresis was noted. The authors concluded that SP-B dimerization is required for optimal lung function. 

To better understand changes in drug disposition, the pediatric population needs to be categorized into various groups (Table 1) because children vary markedly in their absorption, distribution, metabolism, and elimination of medications. This occurs because neonates, infants, children, adolescents, and adults have different body compositions (i.e., as to their percentages of body water and fat) and have their body organs in different stages of development. 

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