Neonatal pharmacology--a practical approach.

Pharmacological management of the sick newborn infant offers a substantial challenge to the practising physician, particularly with the improving survival of smaller and less mature infants. In no other area of medical practice is the physician presented with a patient whose physiological development proceeds at a pace such that frequent review of drug dosage regimen may be required. These changes include alterations in. hepatic metabolism, renal function and somatic growth. Furthermore, dose requirements may also vary in newborn infants of differing gestational ages during the first few days of life. The neonatologist is therefore presented with a widely heterogenous and dynamic population. Rational treatment requires some knowledge of the factors which determine drug disposition in the newborn infant. This article will briefly discuss some of these factors and their pharmacological implications for the management of some problems which are unique to the newborn infant.