Pediatric Considerations

Absorption in Neonates

Neonates have less developed absorption than adolescents, resulting in delayed or hindered GI absorption of medications.

Gastric pH at Birth

Gastric pH is alkaline at birth, with acid production beginning in the neonatal period.

Intestinal Surface Area Development

The intestinal surface area in neonates does not reach adult levels until 20 weeks old.

Gastric Emptying Times

Gastric emptying in neonates and infants reaches adult levels between 6-8 months of age.

Body Water Percentage in Infants

Neonates and infants have about 75% body water compared to an adult's 60%, leading to diluted drug concentrations.

Blood-Brain Barrier (BBB) in Neonates

The BBB in neonates is immature, allowing drugs to pass more easily into the central nervous system.

Hepatic Blood Flow

Hepatic blood flow in infants is reduced until approximately 1 year of age.

Glomerular Filtration Rate (GFR) in Neonates

The GFR of neonates is about 30% of an adult's, increasing the risk for drug toxicity through retention.

Oral Drug Administration in Pediatrics

Most pediatric drugs are administered orally as it is least invasive and can be given by caretakers.

Preferred IM Injection Sites in Children

Ventrogluteal and vastus lateralis are the preferred sites for intramuscular injections in children.

IV Infusion Considerations

IV infusion sites must be protected from infants and toddlers who do not understand the importance of maintaining the site.

Oral Route Variability by Age

Dosage forms vary by age; neonates receive indication-dependent doses, while older children may receive solids and liquids.

Special Considerations for Oral Medications

Medications can be made tastier with food, but honey is contraindicated for children under 1 year due to botulism risk.

Hepatic Metabolism Development

Hepatic drug metabolizing enzymes do not reach adult levels until around 11 years of age.

Neurological Development and Drug Absorption

Increased risk for toxicity in infants is due to decreased protein concentrations and fewer drug receptor sites.