Use of Medicines in Children: Pharmacological and Practical Issues

Pediatric patients have very different pharmacokinetic and pharmacodynamic profiles compared to adults. A number of anatomical and physiological factors determine the pharmacokinetic profile of a drug. Differences in physiology in pediatric populations compared with adults can influence the concentration of drug within the plasma or tissue. When considering medication for a child or adolescent, one should be cautious about extrapolating from adult studies or practices. Always remember, children are not small adults. Children tend to have higher rates of metabolism and elimination than adults. As a result, children generally require higher weight-adjusted doses of most medications to achieve similar blood levels as adults. As pharmacokinetics is hard to predict in children, and thus a ‘start low and go slow’ approach is important. This review details key pharmacological and practical considerations which a healthcare professional should be aware of to understand consequences of drug use and dose adjustments in infants and children.