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Using medications in children 

Using medications in children
Chapter:
Using medications in children
Author(s):

Nigel Ballantine

and Elizabeth Bing Daglish

DOI:
10.1093/med/9780199595105.003.0017
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date: 20 January 2020

The term ‘therapeutic orphans’ was coined by H. Shirkey in 1968 when referring to the lack of a sound scientific basis for the delivery of drug treatment to children and neonates. More than four decades later, our understanding of the maturation of physiological processes has undoubtedly grown, enabling drug treatment to be delivered more rationally to children from a more informed position. However, certain groups of children remain therapeutic orphans. This is particularly true of those receiving palliative care. The complexities of the interaction between maturing physiological function, underlying disease, terminal illness, and ethical considerations result in a lack of research data. These difficulties are addressed in the following sections through an examination of the maturation of pharmacokinetic and pharmacodynamic function, and the effect of acute and chronic disease.

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