Chapter 27
Pediatrics
Children are not small adults
Pediatric Pharmacotherapy: A Moving Target
Children make up nearly one-third of the U.S. population and receive about 30% of community prescriptions, yet only ~25% of marketed drugs carry an FDA-approved pediatric indication -- so most pediatric dosing is off-label.
The single most important idea in this chapter: a child's pharmacokinetics change constantly as they mature from neonate to adolescent. Absorption, distribution, metabolism, and elimination are all immature at birth and mature at DIFFERENT rates over the first years of life. The study of these changes is called developmental pharmacology.
Why So Much Off-Label Use?
About 75% of drugs have been USED in children, but only ~25% are FDA-approved for them. Dosing often comes from case reports and small trials, so pharmacists must know pediatric-specific references and the PK/PD differences that make children unique.
📖 “Children ~1/3 of population, ~30% of community prescriptions; only ~25% of drugs FDA-approved for pediatrics (~75% used off-label). Developmental pharmacology = study of maturational PK/PD changes.”