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There are important differences among the preterm neonate, term neonate, and young infant in terms of drug disposition (absorption, distribution, metabolism, and elimination). Variables such as gestational age, body composition, postnatal age, concomitant drug therapy, acidemia/hypoxemia, and end-organ perfusion may affect and complicate drug therapy. Additionally, developmental issues pertain to drug-receptor interactions, receptor number, receptor affinity, and receptor regulation and modulation. The neonate is in a rapid and continuous state of maturation, which can influence significantly the therapeutic and toxic effects of drug therapy. Our understanding of the age- and disease-related differences in the preterm neonate continues to advance through detailed clinical pharmacokinetic and pharmacodynamic evaluations. The purpose of this article is to: 1) explore the differences in drug disposition for the preterm infant and consider how these differences affect drug therapy regimens, 2) review common pharmacokinetic principles as they relate...

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