Neonates experience dramatic changes in the disposition of drugs after birth due to enzyme maturation and environmental adjustment, challenging therapeutic decision making. In this research, we establish postnatal age, postmenstrual age, and body weight as physiologically reasonable predictors of morphine's clearance in neonates. By integrating knowledge of bilirubin, morphine and other drugs metabolized by glucuronidation pathways from previously published studies, we hypothesize that a postnatal age dependent sugar, uridine diphosphate glucuronic acid, plays an important role in the metabolism of morphine during the first week of life. This finding can be extended to other drugs metabolized by UGT pathways in neonates and thus has important clinical implications for the use of drugs in this population. This article is protected by copyright. All rights reserved.
PMID: 31044547 [PubMed - as supplied by publisher]