Fetal and Neonatal Physiology

Physiology of Lactation

Functional Anatomy of the Breast The human female breast is composed of a tubuloalveolar parenchyma embedded in a connective and adipose tissue stroma. The glandular component of the mature breast is composed of radially organized lobes, each connected to the…

Endocrine Factors Affecting Neonatal Growth

Introduction Growth reflects a complex interaction of genetic, epigenetic, endocrine, and nutritional factors that regulate cell division, differentiation, and function (see Meler et al. for a recent compilation of genetic and epigenetic conditions leading to fetal growth restriction). Various phases of…

Drug Transfer During Breastfeeding

Introduction Since the early 2000s, researchers and clinicians have greatly expanded the knowledge base of drug entry kinetics as they relate to human milk. Most of the physiochemical properties that affect a drug’s transfer into milk are well known and…

Drug Distribution in Fetal Life

Introduction Drug distribution and clearance determine the concentration of drug that will be attained at the site of drug action. Drug targets include cell surface receptors, intracellular receptors, enzymes, transcriptional mechanisms, ion channels, and molecular transport systems. These targets may…

Pharmacogenomics

Introduction Pharmacogenetic variants are DNA variants that influence the metabolism and elimination or the action of medications. Research in pharmacogenetics seeks to understand how these variants influence variability in medication response. For the perinatal pharmacologist, genetic variations that affect drug…

Principles of Pharmacokinetics

Introduction Pharmacokinetics describes the absorption, distribution, metabolism, and excretion of drugs. The pharmacokinetic parameters of a drug are used to characterize the drug concentrations reached within the body after a dose and the changes in those concentrations over time. Clinical…

Basic Pharmacologic Principles

Introduction Pharmacology is a science concerned with the interaction of substances (e.g., drugs) with cells, tissues, and organisms. The in vivo efficacy of a drug is guided by two principles of pharmacology, namely pharmacokinetics and pharmacodynamics. Pharmacokinetics deals with the processes…