药物治疗-药物不良反应课件
26页1、1,The clinical pharmacology of neonat,2,Characteristic of medicine reaction Characteristic of pharmacokinetics Significance of drug monitoring Medication of breast milk feeding neonat Special reaction of neonatal medicine Rational administration of neonatal common disease,3,Definition of neonatal,born,postnatal 28ds,4,Characteristic of neonat,1. functional underdevelopment of organ, underdevelopment of enzymatic system, slow drug metabolism and evacuation 2Variation of drug metabolism and evacua
2、tion velocity according to the birth weight, fetal age and postnatal days 3individual difference among the sick babies 4Function weaken So, dosage, dosing interval and administration route will be different,5,Drug absorption and route of administration,Administration by gastrointestinal tract (GI/GIT): gastric acidity, gastric emptying time, pathologic status (PS) Administration by nongastrointestinal tract 1. hypodermic injection,intramuscular injection: regional flow, characteristic of medicin
3、e 2. intravenous injection:fast,6,Pay attention to neonatal intravenous injection,Administration according to specify velocity To bring about constitution necrosis by drug effusion To cause thrombophlebitis by injecting the same blood vessel repeatedlyInjection site should be changed To avoid using hypso-concentration,7,Drug disposition,Drug distribute to sys by blood circulation organization, fat, pH; Liposolubility, molecular wieght, protein binding rate, barrier,8,Characteristic of drug dispo
4、sition of neonat,More total body water and extracellular fluid volume Less fat mass Low degree of plasma protein binding Underdevelopment of blood-brain barrier,9,Drug metabolism,Organ: liver; Accretion rate: size of hepar, metabolic capability of enzymatic system Liposoluble substances: excreted by binding with glucuronate or sulfate A decline of the accretion rate : low enzymatic activity of glucuronyl transferase of neonat,10,binding with glucuronate: indomethacin, salicylate, chloramphenicol
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