Abstract：
UNASSIGNED: Despite a steady increase of antipsychotic prescriptions in children and adolescents, knowledge about pharmacokinetics and dosing of antipsychotics in children and adolescents remains limited.
UNASSIGNED: We discuss seven issues with major impact on the pharmacokinetics of antipsychotics in youth: estrogens, ii) obesity, iii) ethnicity, iv) smoking, v) inflammation, vi) drug-drug interactions (DDIs), and vii) pharmacogenetics. Despite their major impact, these issues have not been adequately considered in the context of dosing algorithms for antipsychotics in youth. A simple tool to quantify the impact of these pharmacokinetics issues on antipsychotics is therapeutic drug monitoring (TDM), which refers to the quantification of the prescribed medication in the blood of the patients, as a surrogate for the peripheral antipsychotic exposure. We also provide summary tables extrapolated from the adult literature on metabolism, therapeutic reference ranges (TRRs) and DDIs.
UNASSIGNED: Despite considerable experience with TDM for antipsychotics in the management of other patient subgroups, TDM use for antipsychotics in children and adolescents may be limited with TRRs invariably being extrapolated from adult patients. Advancing TDM knowledge is expected to help clinicians address the special properties of pharmacokinetics of antipsychotics and ultimately enable antipsychotic dose individualization in youth.
UNASSIGNED: We discuss seven issues with major impact on the pharmacokinetics of antipsychotics in youth: estrogens, ii) obesity, iii) ethnicity, iv) smoking, v) inflammation, vi) drug-drug interactions (DDIs), and vii) pharmacogenetics. Despite their major impact, these issues have not been adequately considered in the context of dosing algorithms for antipsychotics in youth. A simple tool to quantify the impact of these pharmacokinetics issues on antipsychotics is therapeutic drug monitoring (TDM), which refers to the quantification of the prescribed medication in the blood of the patients, as a surrogate for the peripheral antipsychotic exposure. We also provide summary tables extrapolated from the adult literature on metabolism, therapeutic reference ranges (TRRs) and DDIs.
UNASSIGNED: Despite considerable experience with TDM for antipsychotics in the management of other patient subgroups, TDM use for antipsychotics in children and adolescents may be limited with TRRs invariably being extrapolated from adult patients. Advancing TDM knowledge is expected to help clinicians address the special properties of pharmacokinetics of antipsychotics and ultimately enable antipsychotic dose individualization in youth.
摘要：
■尽管儿童和青少年的抗精神病药处方稳步增加，关于儿童和青少年抗精神病药物的药代动力学和剂量的知识仍然有限.
■我们讨论了对青年抗精神病药的药代动力学有重大影响的七个问题：雌激素，ii)肥胖，iii)种族，iv)吸烟，v)炎症,vi)药物-药物相互作用(DDIs)，和vii)药物遗传学。尽管有重大影响,在青少年抗精神病药物的给药算法中没有充分考虑到这些问题.量化这些药代动力学问题对抗精神病药的影响的简单工具是治疗药物监测（TDM），这是指量化患者血液中的处方药，作为外周抗精神病药物暴露的替代品。我们还提供了从成人代谢文献推断的汇总表，治疗参考范围(TRRs)和DDI。
■尽管在其他患者亚组的治疗中使用抗精神病药的TDM有相当多的经验，TDM在儿童和青少年中抗精神病药的使用可能受到限制，而TRR总是从成年患者推断。提高TDM知识有望帮助临床医生解决抗精神病药物的药代动力学的特殊特性，并最终使青年抗精神病药物剂量个体化。
■我们讨论了对青年抗精神病药的药代动力学有重大影响的七个问题：雌激素，ii)肥胖，iii)种族，iv)吸烟，v)炎症,vi)药物-药物相互作用(DDIs)，和vii)药物遗传学。尽管有重大影响,在青少年抗精神病药物的给药算法中没有充分考虑到这些问题.量化这些药代动力学问题对抗精神病药的影响的简单工具是治疗药物监测（TDM），这是指量化患者血液中的处方药，作为外周抗精神病药物暴露的替代品。我们还提供了从成人代谢文献推断的汇总表，治疗参考范围(TRRs)和DDI。
■尽管在其他患者亚组的治疗中使用抗精神病药的TDM有相当多的经验，TDM在儿童和青少年中抗精神病药的使用可能受到限制，而TRR总是从成年患者推断。提高TDM知识有望帮助临床医生解决抗精神病药物的药代动力学的特殊特性，并最终使青年抗精神病药物剂量个体化。
