Neonatal Pharmacology and Nutrition Update
Référence: 9783318027358
Drug metabolism is the enzymatic conversion of one chemical compound into another, ultimately resulting in a product that can be excreted by the kidneys. In the processes by which the body excretes drugs into fluids such as urine or bile, metabolism is an essential step in converting drugs into more water-soluble compounds by increasing their polarity. This metabolism can be classified into phase I and phase II reactions.
The liver is the main organ of interest for metabolism, although some processes occur in the lungs, intestine, kidneys and plasma. For one group of enzymes, the level and activity are greatest during the fetal stage, and for a second group, the activity begins during fetal life, continues after birth and can be observed in adults. For a third group of enzymes, the activity can only be detected after birth, and the highest activity is found in children, adolescents and adults.
The unique pattern, ontogeny, and development of the metabolizing enzymes for each substance makes it impossible to generalize data from adults to children. Interindividual variability is immense, particularly among newborns and infants. The maturation of drug-metabolizing enzymes is the most important factor in determining the rate of metabolism and thus in determining the optimum dose for the individual patient.
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