What are the effects of children's age characteristics on drugs?

Answer 1

Children were not the "mini" version of adults. Children of different ages had different physiological characteristics, and the effects on drugs were mainly reflected in the following aspects:

** I. Pharmacokinetics **
1. ** Absorb **
- Neonates and infants have less gastric acid secretion and a long gastric emptying time, which will affect the absorption speed and degree of the drug. For example, some drugs that are easily absorbed in an acidic environment may be less absorbed in newborns and infants.
- Children's skin is thin and highly penetrable. They may absorb more drugs when they are externally applied than adults, increasing the risk of drug overdosage.
2. ** Dispersion **
- Children's body fluid accounted for a higher proportion of their body weight than adults, and the proportion of their extra-cellular fluid was also higher, which would affect the distribution volume of the drug. For example, water-based drugs have a relatively large volume of distribution in children's bodies, and may require a higher initial dose (calculated by body weight) to achieve effective blood concentration.
- Children's plasma protein content is relatively low, and their ability to combine with drugs is weak. The concentration of free drugs may be higher, thus increasing the pharmacology and adverse reactions of drugs.
3. ** Metabolization **
- The liver of newborns and young children had an incomplete development of the metabolism system, and their metabolism ability to certain drugs was weak. For example, the activity of the liver's mitochondria P450 system varied at different ages in children. Some drugs that relied on the metabolism of these membranes would be digested at a different rate in children than in adults, which could lead to the accumulation of drugs in the body.
4. ** Excretion **
- The kidney function of newborns and infants was not fully developed. The glomerular filtration rate and the secretion function of the kidney tubulae were relatively low. The drugs that were secreted by the kidneys were eliminated slowly in the body, which could easily cause drug accumulation and poisoning. For example, there was a higher risk of kidney toxicity in children due to the poor kidney secretion function of children and the longer the drug stayed in the kidneys.

** 2. Effect of medication **
1. ** Medicines for different ages **
- In terms of sedative, hypnotic, and anti-seizure drugs, children under 6 years old should avoid using methyphenate, children under 6 years old should not use amomepramate, children under status quo should not be the first choice for pheytoin, infants under 6 months should be careful with Diazepan, children under 4 years old should not use or use Benzhexol with caution, etc.
- In terms of respiratory medication, bromhexine was mostly used in older children (>6 years old), pentaverine was generally used in children over 5 years old, dexmethorphan under 2 years old should follow the doctor's advice, formoterol under 4 years old should follow the doctor's advice, etc. This was because children of different ages had different physiological characteristics of the respiratory system, and their response and tolerance to drugs were also different.
- In terms of digestive system drugs, the colloid bis subcitrate was generally not suitable for young children, ranitidine was prohibited under the age of 8, and omeprazol was used with caution in infants. The development of the digestive system of children of different ages affected the adaptability of the drug.
2. ** Determination of dosage **
- The dosage recommended by age and weight in the antipyretic instructions may not be consistent. Under normal circumstances, parents should use antipyretic according to the recommended dosage of age and weight in the instructions. However, in recent years, with the development of economic level, the weight of children of the same age had increased greatly. When there was a difference in the dosage corresponding to weight and age, the medicine should be given according to the child's weight. When the child's weight has exceeded the normal range, the dosage should be used under the guidance of a doctor. Also, parents must pay attention to the dosage of medication for slightly older children. They must not exceed the dosage of medication for adults. This reflected the combined influence of age, weight and other factors on the determination of drug dosage.

** 3. Drug Safety **
1. ** Drug Taboo **
- Don't use morphine under 1 year old, and don't use paraments, acetin, and codaine under 7 years old. These were all based on the tolerance and sensitivity of children of different ages to drugs. The younger they were, the more sensitive they might be to the adverse reactions of certain drugs.
- The safety requirements for children's medication were even higher. Although some drugs were very effective, they were not suitable for children due to the consideration of large toxic side effects or special toxic side effects for children. For example, the drugs such as gentamin, Kanaxin, streptomycin-like drugs had strong ototoxicity and kidney toxicity for children. The younger one was, the less mature their organs were, and the more serious the damage they might suffer from these toxic side effects.
2. ** Medication compliance **
- For some chronic diseases such as asthma, epilepsy, kidney syndrome, and rheumatism fever, long-term use of steroids is required. Younger children may require more care and supervision from their parents. The acceptance of parents and the ability to continuously supervise medication will directly affect the child's prognosis. In addition, younger children may cry and resist more strongly during oral medication, muscle injection, scalp infusion, and other treatments. This requires that age factors should be considered when choosing treatment methods and drug dosage forms to improve compliance with medication, such as small baby granules, oral liquids, etc. At the same time, pay attention to choosing granules suitable for children's taste and color to facilitate smooth oral administration.
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