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Challenges Associated with Route of Administration in Neonatal Drug Delivery

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Abstract

The administration of drugs to neonates poses significant challenges. The aim of this review was to provide insight into some of these challenges and resolutions that may be encountered with several of the most commonly used routes of administration and dosage forms in neonatal care, including oral, parenteral, transdermal, intrapulmonary, and rectal. Important considerations include fluctuations in stomach pH hours to years after birth, the logistics of setting up an intravenous infusion, the need for reduced particle size for aerosol delivery to the developing neonatal lung, and variation in perirectal venous drainage. Additionally, some of the recently developed technologies for use in neonatal care are described. While the understanding of neonatal drug delivery has advanced over the past several decades, there is still a deficiency of technologies and formulations developed specifically for this population.

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Authors and Affiliations

  1. Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA

    Matthew W. Linakis, Jessica K. Roberts, Michael G. Spigarelli, Robert M. Ward & Catherine M. T. Sherwin

  2. Department of Pharmaceutical Chemistry, University of Utah, School of Pharmacy, Salt Lake City, UT, USA

    Matthew W. Linakis

  3. Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Anita C. Lala & David M. Reith

  4. School of Pharmacy, University of Otago, Dunedin, New Zealand

    Natalie J. Medlicott

  5. Division of Neonatology, Department of Pediatrics, University of Utah, School of Medicine, Salt Lake City, UT, USA

    Robert M. Ward

  6. Department of Pharmacology/Toxicology, University of Utah College of Pharmacy, Salt Lake City, UT, USA

    Robert M. Ward

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Correspondence to Catherine M. T. Sherwin.

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Matthew W. Linakis, Jessica K. Roberts, Anita C. Lala, Michael G. Spigarelli, Natalie J. Medlicott, David M. Reith, Robert M. Ward, and Catherine M.T. Sherwin have no conflicts of interest to declare that are directly relevant to the content of this review.

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Linakis, M.W., Roberts, J.K., Lala, A.C. et al. Challenges Associated with Route of Administration in Neonatal Drug Delivery. Clin Pharmacokinet 55, 185–196 (2016). https://doi.org/10.1007/s40262-015-0313-z

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