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Pharmacokinetics In Special Populations

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Pharmacokinetics In Special Populations Pharmacokinetics In Special Populations Presentation Transcript

  • PHARMACOKINETICS IN SPECIAL POPULATIONS Presented by: P.C.Campo
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  • MATERNAL ADAPTATIONS IN PREGNANCY Expanded intravascular volume Increased renal blood flow and GFR Increased progesterone activated hepatic metabolism Decreased gastrointestinal motility Increased thinning of fetomaternal barrier with advancing gestation Increased minute ventilation Decreased albumin
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    • Absorption
      • Altered nutritional habits
      • Greater consumption of nonprescription drugs
      • Changes in gastric emptying
    • Distribution
      • Reduced lean body mass
      • Reduced body water
      • Increased fat as a percentage of body mass
      • Decrease in serum albumin
      • Increase in serum orosomucoid ( α – acid glycoprotein)
    PHARMACOKINETIC CHANGES IN THE ELDERLY
    • Metabolism
      • Greatest changes are in phase I metabolism
      • Caused by decreased liver blood flow
      • There is a decline with age of the liver’s ability to recover from injury
      • Malnutrition and diseases that affect hepatic function are common in this age group
    • Elimination
      • Decline in creatinine clearance with age
      • Marked prolongation of half-life of many drugs
      • Reduced respiratory capacity due to increased incidence of pulmonary diseases, excretion of volatile drugs are altered
    PHARMACOKINETIC CHANGES IN THE ELDERLY
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  • PEDIATRIC PHARMACOKINETICS Adult pattern Adult pattern Colonization phase MICROBIAL FLORA Developed Developed by 1 yr Decreased PANCREATIC ENZYME ACTIVITY Developed Developed Underdeveloped BILIARY FUNCTION Normal Normal Reduced ABSORBING GUT SURFACE Increased Increased Decreased, irregular INTESTINAL MOTILITY Decreased Decreased at 6-8 mth Increased Increased (delayed) GASTRIC EMPTYING Adult values Adult values at 3 mth Neutral at birth up to 1 hrs GASTRIC CHILDREN INFANTS NEWBORNS PHYSIOLOGIC VARIABLES FACTORS AFFECTING ABSORPTION IN CHILDREN
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