Developmental pattern of hepatic drug-metabolizing enzymes in pediatric population and its role in optimal drug treatment

Abstract

Pediatric pharmacokinetics (PK) and pharmacodynamics (PD) differ from adults in multiple aspects. The extrapolation of PK/PD data from adults to children is not always simple because children are not small adults. Differential development of metabolic enzymes in children affects both PK and PD of a drug. Thus, the study of the developmental patterns of drug-metabolizing enzymes is essential to establish the PK and PD profile of drugs in the pediatric population. Further, these patterns may also aid to establish models for appropriate extrapolation of adult data for any newer drugs. We conducted a literature search on PubMed Central, Medline database, and Google Scholar with relevant search terms to obtain articles for this narrative review. The research on developing pattern of drug metabolizing enzymes is still evolving. This review presents an overview of the existing literature on developmental patterns of key metabolic enzymes in children. Greater emphasis needs to be given to study developmental pattern of metabolic enzymes as it not only helps drug development but also to optimize drug therapy in children.

Keywords

• Adults
• adverse drug reaction
• children
• dose
• metabolism
• ontogeny
• pediatric population
• pharmacokinetics