Značaj farmakokinetike u doziranju lekova kod pedijatrijskih pacijenata

  • Marija Jovanović Univerzitet u Beogradu – Farmaceutski fakultet, Katedra za farmakokinetiku i kliničku farmaciju
  • Katarina Vučićević Univerzitet u Beogradu – Farmaceutski fakultet, Katedra za farmakokinetiku i kliničku farmaciju
DOI: https://doi.org/10.5937/arhfarm72-37605
Ključne reči: deca, sazrevanje, razvoj, farmakokinetička varijabilnost, režim doziranja

Sažetak


Optimizacija doziranja lekova kod pedijatrijskih pacijenata u rutinskoj kliničkoj praksi i procena doze pre započinjanja kliničkih studija je i dalje značajan izazov. Pedijatrijska populacija se razlikuje od odraslih pacijenata u odgovoru na lekove, što je uzrokovano izmenjenom farmakokinetikom i/ili farmakodinamikom, a odgovor može varirati i među decom različitog uzrasta. Međutim, najveće razlike u odnosu na farmakokinetičke profile odraslih pacijenata primećuju se kod dece mlađe od 2 godine. Sazrevanje jetre i bubrega, kao i promene u udelu telesnih tečenosti i masnog tkiva u odnosu na ukupnu telesnu masu, smatraju se glavnim izvorima farmakokinetičke varijabilnosti. Dakle, pored specifičnih farmakodinamičkih karakteristika, razumevanje razvojnih promena u resorpciji, raspodeli i eliminaciji leka je fundamentalno za optimizaciju efikasnosti i bezbednosti terapije. Ovaj rad sumira farmakokinetičke promene tokom detinjstva, zajedno sa uticajem razvojnih promena na izračunavanje doze leka. U kliničkoj praksi se obično koriste režimi doziranja zasnovani na starosti i telesnoj masi. Uprkos preporukama za doziranje na osnovu godina i/ili telesne mase, i dalje se uočava varijabilnost u farmakokinetici i farmakodinamičkom odgovoru, što ukazuje na potrebu za praćenjem pacijenata i optimizacijom režima doziranja prema fiziološkim karakteristikama, karakteristikama bolesti i terapiji.

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Objavljeno
2022/06/29
Broj časopisa
Vol. 72 Br. Notebook 3 (2022): Arhiv za farmaciju
Rubrika
Pregledni (Revijalni) rad
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