Pharmacotherapy of pediatric lung disease: differences between children and adults.

Drug dosages for infants and children differ significantly from those used in adults (Table 5). This is due to normal developmental physiologic differences that affect absorption, distribution, and clearance. In general, infants and children require higher dosages of many therapeutic agents on a weight basis. Parenteral drug administration difficulties are complicated by the slow fluid infusion rates often used in infants and young children. The use of syringe infusion pump devices is critical for accurate therapeutic drug monitoring and dosage adjustment in pediatrics than in adults. Aerosol administration in pediatrics is more complicated and is poorly studied. Difficulty with coordinating metered-dose aerosols with inhalation and drug raining out on small endotracheal tubes of ventilated patients are two significant problems. Chronic and acute pulmonary disease can significantly affect drug disposition and metabolism, but has been poorly studied in children. The pharmacokinetics of a number of drugs have been evaluated in cystic fibrosis and may provide insight into the effect of disease states on drug disposition.