Pregnancy Absorptio n 1- progesterone - stomach contractility - gastric emptying absorption rate not extent 2- Vomiting - absorption - Reduce bioavailability

Distributi on

1- Water soluble drugs : steroid hormones - water retention - ECF - drug Vd - drug concentration in blood 2- Lipid Soluble : Fat - Vd - Drug concentration ( diazepam phenytoin) 3- Weak acids drugs : serum albumin Free free weak acids drugs. ( diazepam phenytoin) 4- Weak base drugs : alpha 1 acid glycoprotein - free weak base drugs - concentration (basic , lipid and water soluble) and ( acidic) , Vd (basic , lipid and water soluble ) and (acidic)

Neonate or newborn ( 1 month) 1- Oral : ( vomiting + motility) - emptying absorption 2- Best : IV 3- Other : Buccal rectal through trachea 4- Through skin in PT : thin skin - absorption - concentration - toxicity. 1- Water soluble drug : water - Vd - concentration. 2- Lipid soluble drug in PT : Fat - Vd - concentration. (digoxin) 3- ( albumin + bilirubin + FFA ) = free drug.

Children 1- Oral : Best Oral absorption increase close to adult

Elderly gastric emptying + motility + blood flow - absorption Absorption Decreased

1- ECF - Vd - conc. 2- Low albumin ( reach adult in 3 years) 3- Low alpha 1-acid glycoprotein reach adult in 7-12 years) Distribution of water soluble drugs decreased

Metabolis m

1- Capacity limited drugs : progesterone microsomal enzymes induction - phase 1 oxidation - metabolism ( phenytoin) 2- Flow limited drugs : Normal hepatic blood flow normal metabolism ( propranolol) - Metabolism in capacity limited normal in flow limited.

Clearance ( metabolism + exertion) : 1- Liver inmature - elimination 2- bilirubin compete in enzymes with drug - glucoronic acid

1- Phase 1 mature in 6 months - metabolism 2- Phase 2 mature in 3-4 years - metabolism - Metabolism increase ( more

1- body water - Vd - concentration of water soluble drugs(digoxin). 2- muscle mass ( enzymes activity + Vd of water soluble drugs) - concentration. 3- plasma albumin - free acidic drugs 4- fat - Vdclearance - Increase in (lipid soluble with delay in clearance) + acidic - Decrease in water soluble 1- hepatic blood flow - flow limited drugs. 2- hepatic mass ( phase one) - capacity limited metabolized by phase one.

conjugation - elimination 3- Kidney not 100% functional - elimination - Elimination ( clearance) decreased Exertion Water soluble (ionized ) drugs : steroid hormones water retention - renal blood flow - GFR - exertion - Exertion increased -

than adults)

Metabolism decreased

1- Mature of kidneys in 8-12 months - GFR - excretion.

Excretion increased Vd : volume of distribution GFR : glomerular filtration rate FFA : free fatty acid- conc.: concentration

1- renal blood flow - GFR - excretion. 2- elimination of volatile drugs by the lung. Excretion :