Which one of the following actions can minimize the risk of toxicity in neonates and infants, given the lower binding capacity of their albumin for penicillin?
a. Decreasing the amount of drug given
b. Increasing the amount of drug given
c. Shortening the time interval between doses
d. Making the time interval between doses irregular
ANS: A
The albumin in neonates and infants has a lower binding capacity for certain drugs (e.g., pheny-toin, penicillin) compared with the binding capacity of mature albumin. Therefore more unbound drug is free to circulate and act. Thus it is possible that free drug levels will be high enough to produce adverse or toxic effects. To minimize the possibility of toxicity and to compensate for the shorter duration of drug action, it is often necessary to decrease the amount of the drug given and/or lengthen the time between doses.
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