The basic principles of pediatric drug therapy and toxicity were initially founded on the premise that the infant was simply a small adult. Over the last 20 years, it has been found that this concept is therapeutically inaccurate. Of necessity this has led to intensive investigation into the identification and elucidation of developmental parameters that influence clinical pharmacology. Within the field of pediatric pharmacology, it is generally accepted that there are a number of unique developmental stages which must be considered with respect to drug effect and toxicity. The developmental stages are related to the mode of exposure as follows: In utero the fetus may be inadvertently exposed to drugs secondary to maternal chemical ingestion. The neonate may encounter drugs as a result of maternal administration via the breast milk. At this stage, direct drug exposure can also occur. The older infant and child are no longer subject to lactational exposure, but merely to the direct route.
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