Mechanism based medicine in infancy: complex interplay between developmental pharmacology and pharmacogenetics

Abstract

Introduction of the available knowledge on pharmacogenetics very likely is one of the tools to close the gap between 'population' focused evidence based and 'individual' mechanism based medicine. However, besides pharmacogenetics, other covariates like age, renal function and/or co-medication should also be considered simultaneously when aiming for a 'tailored' pharmacotherapy. To illustrate this, we further extended the tramadol example used by Wilffert et al. to illustrate the complex interplay between developmental pharmacology and pharmacogenetics.

Trends in Medication Use in Very Low-Birth-Weight Infants in a Level 3 NICU over 2 Decades

“…Little is known about the pharmacology of these drugs at various birth weights, gestational ages, and chronological ages. [11][12][13] Even less is known about the long-term effects of medications on premature infants. Given the magnitude of potential harm in the misuse of these drugs and drug errors, all neonatologists are obligated to take a critical look at the medications they use and how they use them.…”

Changes in Individual Drug-Independent System Parameters during Virtual Paediatric Pharmacokinetic Trials: Introducing Time-Varying Physiology into a Paediatric PBPK Model

“…This area has attracted more researchers in the last few years (13)(14)(15)(16)(17)(18) as the limitations of the current available data for the provision of optimal paediatric care have been identified. This, coupled with the increased emphasis on drug research and licencing of medicines in children is driving the need for improved PK/PD models/data in children (14,(19)(20)(21)(22).…”