Gladtke E
Monatsschr Kinderheilkd (1902). 1979 Apr;127(4):166-70.
Dosage recommandations are mostly established empirically. With many drugs more accurate dosage is necessary and possible: antibiotics, cytostatic drugs, but also heart glycosides and anticonvulsives. Some pharmacokinetic standard values vary according to age. The distribution volume in infants is normally substantially greater than in older children. For infants the first or single dose has to be higher in relation to body weight to get the same concentration as for older children. In general, the elimination rate is slower in younger children. Therefore in long-time therapy the interval between doses has to be longer. After the 6th to 12th week the differences in elimination rates are negligible. The absorption from the rectum is neither reliable nor predictable. Suppositories are only allowed if it is possible to calculate the effect of a drug on the patient. Enteral absorption in infants is slower than in older children. Therefore maximum concentration will be reached later and will be not as high as in older children. The local concentration correlates well with plasma concentration. Drugs in bib or feeder have no effect.
剂量推荐大多是根据经验确定的。对于许多药物,更精确的剂量是必要且可行的:抗生素、细胞毒性药物,还有强心苷和抗惊厥药。一些药代动力学标准值会因年龄而异。婴儿的分布容积通常比大龄儿童大得多。对于婴儿,首剂或单次剂量相对于体重必须更高,才能达到与大龄儿童相同的浓度。一般来说,年幼儿童的消除率较慢。因此,在长期治疗中,给药间隔必须更长。在第6至12周后,消除率的差异可忽略不计。经直肠吸收既不可靠也不可预测。只有在能够计算药物对患者的作用时才允许使用栓剂。婴儿的肠内吸收比大龄儿童慢。因此,最高浓度会在更晚的时候达到,且不会像大龄儿童那样高。局部浓度与血浆浓度相关性良好。奶瓶或奶瓶喂养器中的药物无作用。