Challenges of pediatric pharmacotherapy: A narrative review of pharmacokinetics, pharmacodynamics, and pharmacogenetics.

Purpose: Personalized pharmacotherapy, including for the pediatric population, provides optimal treatment and has emerged as a major trend owing to advanced drug therapeutics and diversified drug selection. However, it is essential to understand the growth and developmental characteristics of this p...

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Published in:European Journal of Clinical Pharmacology Vol. 80; no. 2; pp. 203 - 222
Main Authors: Watanabe, Hirofumi, Nagano, Nobuhiko, Tsuji, Yasuhiro, Noto, Nobutaka, Ayusawa, Mamoru, Morioka, Ichiro
Format: pictorial research systematic review tables/charts Journal Article
Published: Springer Nature Feb2024
Online Access:View this record in EBSCOhost
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      dt: Feb2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00228-023-03598-x
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        atl: Challenges of pediatric pharmacotherapy: A narrative review of pharmacokinetics, pharmacodynamics, and pharmacogenetics.
      aug:
        au:
          Watanabe, Hirofumi
          Nagano, Nobuhiko
          Tsuji, Yasuhiro
          Noto, Nobutaka
          Ayusawa, Mamoru
          Morioka, Ichiro
        affil: https://ror.org/05jk51a88 Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Kami-cho Ooyaguchi, Itabashi-ku, 173-8610, Tokyo, Japan
      sug:
        subj:
          Pediatrics Methods
          Disease Drug Therapy
          Pharmacogenetics Standards
          Pharmacokinetics Standards
          Pharmacy and Pharmacology Standards
          Human
          Child
          Systematic Review
          Child Development
          Drug Interactions
          Adverse Drug Event
          Drug Monitoring Methods
          Biological Markers
          Health Personnel Psychosocial Factors
          Health Care Delivery
          Risk Assessment
          Child: 6-12 years
      ab: Purpose: Personalized pharmacotherapy, including for the pediatric population, provides optimal treatment and has emerged as a major trend owing to advanced drug therapeutics and diversified drug selection. However, it is essential to understand the growth and developmental characteristics of this population to provide appropriate drug therapy. In recent years, clinical pharmacogenetics has accumulated knowledge in pediatric pharmacotherapy, and guidelines from professional organizations, such as the Clinical Pharmacogenetics Implementation Consortium, can be consulted to determine the efficacy of specific drugs and the risk of adverse effects. However, the existence of a large knowledge gap hinders the use of these findings in clinical practice. Methods: We provide a narrative review of the knowledge gaps in pharmacokinetics (PK) and pharmacodynamics (PD) in the pediatric population, focusing on the differences from the perspective of growth and developmental characteristics. In addition, we explored PK/PD in relation to pediatric clinical pharmacogenetics. Results: The lack of direct and indirect biomarkers for more accurate assessment of the effects of drug administration limits the current knowledge of PD. In addition, incorporating pharmacogenetic insights as pivotal covariates is indispensable in this comprehensive synthesis for precision therapy; therefore, we have provided recommendations regarding the current status and challenges of personalized pediatric pharmacotherapy. The integration of clinical pharmacogenetics with the health care system and institution of educational programs for health care providers is necessary for its safe and effective implementation. A comprehensive understanding of the physiological and genetic complexities of the pediatric population will facilitate the development of effective and personalized pharmacotherapeutic strategies.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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