Pharmacokinetics and adverse effects of amphotericin B in infants and children

1988 ◽  
Vol 113 (3) ◽  
pp. 559-563 ◽  
Author(s):  
Gideon Koren ◽  
Allan Lau ◽  
Julia Klein ◽  
Cheryl Golas ◽  
Monica Bologa-Campeanu ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Amphotericin B ◽  
Infants And Children ◽  
In Infants And Children

Anticoagulation with Warfarin in Infants and Children

1996 ◽  
Vol 30 (11) ◽  
pp. 1316-1322 ◽  
Author(s):  
Marcia L Buck
Keyword(s):  
Clinical Trials ◽  
Adverse Effects ◽  
Case Reports ◽  
Initial Dosage ◽  
Case Series ◽  
Infants And Children ◽  
Target Range ◽  
Search Term ◽  
Cardiac Valves ◽  
In Infants And Children

OBJECTIVE: TO provide a comprehensive review of warfarin use in infants and children, including recommendations for appropriate dosage and monitoring parameters. DATA SOURCES: A MEDLINE search (1966-1995) was used to identify pertinent English-language articles in the medical literature. The key search term was warfarin. Additional material was obtained from references cited in articles retrieved through MEDLINE. STUDY SELECTION: All articles involving children younger than 18 years were evaluated. In addition, articles on the pharmacokinetics and pharmacodynamics in adults, adverse effects, and drug interactions were included. DATA EXTRACTION: Material selected for review included clinical trials, case reports, and surveys of practice. DATA SYNTHESIS: Warfarin has been used as prophylactic therapy in children with prosthetic cardiac valves as well as for prevention of thromboembolic complications associated with autoimmune disorders and protein C or protein S deficiency. Warfarin also has been used to prevent embolization in children with deep-vein thrombosis or clots in central venous catheters. According to the literature, an initial dosage of 0.1 mg/kg/d should provide anticoagulation without significant adverse effects. As in adults, dosing should be adjusted to achieve a target international normalized ratio (INR). Although the target range in children is not well established, INR values of 1.5–3 are recommended for most patients. Higher values have been used in children with prosthetic cardiac valves and hereditary clotting disorders. CONCLUSIONS: Due to its infrequent use, there is limited information on the effects of warfarin in children. Basic guidelines for initiating and monitoring warfarin were developed by using data gathered from clinical trials, retrospective reviews, case series, and surveys of practice.

scholarly journals Clinical pharmacology of lorazepam in infants and children

2022 ◽  
Vol 3 (1) ◽  
pp. 01-07
Author(s):  
Gian Maria Pacifici
Keyword(s):  
Breast Milk ◽  
Adverse Effects ◽  
Human Placenta ◽  
Liver Microsomes ◽  
Intravenous Dose ◽  
Infants And Children ◽  
Published Data ◽  
Elimination Half ◽  
And Migration ◽  
In Infants And Children

Lorazepam is a benzodiazepine has antiepileptic activity; it may be administered intravenously, intramuscularly, orally, by intranasal or buccal application and following oral dosing it is well absorbed. In infants, the initial intravenous dose of lorazepam is 100 µg/kg and in children the initial oral and intravenous dose is 50 to 100 µg/kg and the dose varies according to the child age. Lorazepam has been found efficacy and safe in infants and children but it may induce adverse-effects. Lorazepam is a racemate and the R and S enantiomers are conjugated with glucuronic acid in human liver microsomes and the respective Km and Vmax values are 29+8.9 and 36+10 µM and 7.4+1.9 and 10+3.8 pmol/min*mg. Lorazepam interacts with drugs and the interaction may affect the activity or metabolism of lorazepam. The pharmacokinetics of lorazepam have been studied in infants and children and in diseased children. In infants and children the elimination half-life is about 15 hours and it is about 24 hours and about 37 hours in children with severe malaria and convulsions following intravenous and intramuscular administration, respectively. The treatment and trials with lorazepam have been studied in infants and children. Lorazepam freely crosses the human placenta and poorly migrates into the breast-milk. The aim of this study is to review the published data on lorazepam dosing, efficacy and safety, adverse-effects, metabolism, interaction with drugs, pharmacokinetics, treatment and trials in infants and children and the lorazepam transfer across the human placenta and migration into the breast-milk.

scholarly journals Clinical Pharmacology of Fentanyl in Infants and Children

2022 ◽  
Vol 3 ◽  
pp. 01-08
Author(s):  
Gian Maria Pacifici
Keyword(s):  
Breast Milk ◽  
Adverse Effects ◽  
Placental Transfer ◽  
Infants And Children ◽  
Transdermal Application ◽  
Elimination Half ◽  
Sustained Use ◽  
Interaction Treatment ◽  
And Migration ◽  
In Infants And Children

Fentanyl is a systemic opioid related to the phenylpiperidines, it is used in anaesthetic practice and in analgesia and the analgesic effect is about 100 times higher than that of morphine. Fentanyl is highly lipid soluble, rapidly crosses the blood-brain-barrier, and fentanyl concentrations rapidly decline in plasma and cerebrospinal fluid. Fentanyl causes respiratory depression and decreases the heart rate through vagal activation. Fentanyl may be administered intravenously, orally, by transdermal, intranasal or by buccal application and the oral bioavailability is poor. In infants, fentanyl is given for short term use, sustained use, and during therapeutic hypothermia. In children, fentanyl is given intravenously, by transdermal application, or by buccal administration and the fentanyl dose varies with the child age and body-weight. Fentanyl has been found efficacy and safe in infants and children but it may induce adverse-effects and fentanyl causes different effects in infants and children. Following intravenous administration of fentanyl to infants and children, the fentanyl elimination half-life ranges from 208 to 1,266 min and the distribution volume ranges from 1.92 to 15.2 L/kg. Such variability is due to the wide variation of subject’s demographic characteristics. Fentanyl interacts with drugs, the treatment and trials with fentanyl have been studied in infants and children. Fentanyl freely crosses the human placenta and poorly migrates into the breast-milk. The aim of this study is to review fentanyl dosing, efficacy, safety, effects, adverse-effects, metabolism, pharmacokinetics, drug interaction, treatment, and trials in infants and children, and fentanyl placental transfer and migration into the breast-milk.

scholarly journals Clinical pharmacology of morphine in infants and children

2021 ◽  
Vol 4 (5) ◽  
pp. 01-08
Author(s):  
Gian Maria Pacifici
Keyword(s):  
Breast Milk ◽  
Adverse Effects ◽  
Human Brain ◽  
Human Placenta ◽  
Rectal Administration ◽  
Infants And Children ◽  
Published Data ◽  
And Migration ◽  
Control Pain ◽  
In Infants And Children

Morphine is used to treat pain, for treatment of opioid dependence, and neonatal abstinence syndrome. Morphine is modestly absorbed from the gastrointestinal tract whereas after rectal administration, by intranasal or buccal application morphine is well absorbed. Morphine is eliminated by glomerular filtration and by conjugation with glucuronic acid; morphine-3-glucurinide and morphine-6-glucurinide are the main metabolites and the last has analgesic effect. In infants, morphine is used to treat severe or sustained pain, sedation, and pain relief. In children, morphine is used to control pain and morphine may be administered by subcutaneous or intravenous injection, orally, by rectum, or by continuous subcutaneous infusion and morphine dose varies according to the child age. Morphine has been found efficacy and safe in infants and children but may induce adverse-effects. The effects caused by morphine and the treatment with morphine have been studied in infants and children. In newborns, morphine elimination half-life ranges from 7.7 to 13.5 hours and decreases with infant maturation. In newborns, infants and children, the total body clearance of morphine ranges from 14.5 to 71.1 L/h/70kg and increases with infant maturation and child development. Morphine is transported in the human brain, poorly crosses the human placenta and accumulates in breast-milk. The aim of this study is to review the published data on morphine dosing, efficacy and safety, effects, adverse-effects, pharmacokinetics, metabolism, drug interaction, treatment, transport into human brain of infants and children and morphine transfer across the human placenta and migration into the breast-milk.

scholarly journals Clinical Pharmacology of Sildenafil in Infants and Children

2021 ◽  
Vol 4 (4) ◽  
pp. 01-08
Author(s):  
Gian Maria Pacifici
Keyword(s):  
Breast Milk ◽  
Adverse Effects ◽  
Oral Dose ◽  
Half Life ◽  
Placental Transfer ◽  
Concomitant Administration ◽  
Infants And Children ◽  
Blood Levels ◽  
And Migration ◽  
In Infants And Children

Sildenafil is a competitive and selective inhibitor of phosphodiesterase 5. Sildenafil is cleared by hepatic CYP3A (major route) and CYP2C9 (minor route) and concomitant administration of potent CYP3A inducers (e.g., bosentan) causes decreases in plasma levels of sildenafil. CYP3A4 inhibitors (erythromycin and cimetidine) inhibit sildenafil metabolism prolonging the half-life and elevating blood levels of sildenafil. Sildenafil is a pulmonary arterial vasodilator and it has been used in the treatment of persistent pulmonary hypertension. The initial oral dose is 250 to 500 µg/kg 4 times-daily in infants and the oral dose is 10 to 20 mg thrice-daily in children with a body-weight up to 20 kg or > 20 kg, respectively. Sildenafil has been found efficacy and safe in infants and children but it may induce adverse-effects. Following an oral dosing, the absorption rate constant is 0.343 h-1, and the elimination half-life is 2.41 hours in children suggesting that sildenafil is rapidly absorbed and eliminated. The interaction of sildenafil with drugs and the metabolism of sildenafil have been extensively studied. The principal routes of sildenafil metabolism are: N-demethylation, oxidation, and aliphatic dihydroxylation, and the major metabolite is N-desmethyl sildenafil. The treatment of infants and children with sildenafil has been extensively studied. Sildenafil citrate and sildenafil cross the human placenta and sildenafil migrates into the breast-milk in significant amounts. The aim of this study is to review the sildenafil dosing, efficacy and safety, effects, adverse-effects, pharmacokinetics, interaction with drugs, metabolism, treatments, and sildenafil placental transfer and migration into the breast-milk.

Pharmacokinetics of Amphotericin B in Infants and Children

1987 ◽  
Vol 155 (4) ◽  
pp. 766-774 ◽  
Author(s):  
J. R. Starke ◽  
E. O. Mason ◽  
W. G. Kramer ◽  
S. L. Kaplan
Keyword(s):  
Amphotericin B ◽  
Infants And Children ◽  
In Infants And Children

scholarly journals Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment

2019 ◽  
Vol 5 (1) ◽  
pp. 11 ◽  
Author(s):  
Thomas Walsh ◽  
Aspasia Katragkou ◽  
Tempe Chen ◽  
Christine Salvatore ◽  
Emmanuel Roilides
Keyword(s):  
Amphotericin B ◽  
Invasive Candidiasis ◽  
Safety Data ◽  
Infants And Children ◽  
Diagnosis And Treatment ◽  
Pharmacokinetic Data ◽  
Diagnostic Systems ◽  
Mortality And Morbidity ◽  
Recent Advances ◽  
In Infants And Children

This paper reviews recent advances in three selected areas of pediatric invasive candidiasis: epidemiology, diagnosis, and treatment. Although the epidemiological trends of pediatric invasive candidiasis illustrate a declining incidence, this infection still carries a heavy burden of mortality and morbidity that warrants a high index of clinical suspicion, the need for rapid diagnostic systems, and the early initiation of antifungal therapy. The development of non-culture-based technologies, such as the T2Candida system and (1→3)-β-d-glucan detection assay, offers the potential for early laboratory detection of candidemia and CNS candidiasis, respectively. Among the complications of disseminated candidiasis in infants and children, hematogenous disseminated Candida meningoencephalitis (HCME) is an important cause of neurological morbidity. Detection of (1→3)-β-d-glucan in cerebrospinal fluid serves as an early diagnostic indicator and an important biomarker of therapeutic response. The recently reported pharmacokinetic data of liposomal amphotericin B in children demonstrate dose–exposure relationships similar to those in adults. The recently completed randomized clinical trial of micafungin versus deoxycholate amphotericin B in the treatment of neonatal candidemia provides further safety data for an echinocandin in this clinical setting.

Massage Therapy in Infants and Children under 5 Years of Age: Protocol for an Overview of Systematic Reviews and A Systematic Review

2020 ◽  
Author(s):  
Shucheng CHEN ◽  
Juan Yu ◽  
Sam Chun-Sum Yuen ◽  
Jason Chun-Sing Lam ◽  
Lorna Kwai-Ping Suen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Systematic Reviews ◽  
Treatment Effects ◽  
Massage Therapy ◽  
Infants And Children ◽  
Current Evidence ◽  
Overview Of Systematic Reviews ◽  
In Infants And Children

Abstract Introduction: Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years. Methods and analysis: This protocol was developed based on the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure, and Wanfang Data will be searched from the inception to June 2020 for evidence of the treatment effects. We will include systematic reviews of randomised control trials in infants and children aged < 5 years. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. In addition, a systematic review of the adverse effects of massage on infants and children aged < 5 years will be included in this overview. We will present the treatment effects and adverse effects narratively. The pooled effect estimates for meta-analysed outcomes from the included studies will be extracted when possible. Additionally, we will generate a figure to show the recommendation level of massage therapy for each condition included according to the evidence quality of the studies included in the systematic reviews.Discussion: This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention.Trial registration number: CRD42020186003

Sign in / Sign up

Export Citation Format

Share Document