Naloxone Use in Newborns

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 667-669
Author(s):  
Sydney Segal ◽  
Walter R. Anyan ◽  
Reba M. Hill ◽  
Ralph E. Kauffman ◽  
Howard Mofenson ◽  
...  
Keyword(s):  
Respiratory Depression ◽  
Opiate Receptors ◽  
Endogenous Opioids ◽  
Infants And Children ◽  
Narcotic Antagonist ◽  
Narcotic Analgesics ◽  
Antagonist Activity ◽  
Drug Of Choice ◽  
Healthy Infants ◽  
In Infants And Children

Naloxone hydrochloride (Narcan) is a pure narcotic antagonist that is the drug of choice in the treatment of central nervous system and cardiores-piratory depression due to narcotic agonist drugs. It has virtually no agonist activity and therefore produces no narcotic effect even when administered in greater than recommended doses, in contrast to nalorphine hydrochloride and levallorphan tartrate, which have mixed agonist-antagonist activity. In 1975 the FDA approved a dosage form of naloxone in a concentration of 0.02 mg/ml that was specifically designed for use in newborns whose mothers receive narcotic analgesics during labor and who are born with narcotic-induced respiratory depression; this drug was marketed for general prescription use. Three years after its introduction, the role of naloxone in the management of the depressed newborn merits clarification. In addition, recent information regarding opiate receptors and endogenous opioids raises questions concerning the long-term safety of naloxone in neonates. A review of available published and unpublished data pertaning to naloxone use in the newborn infant by the Committee on Drugs forms the basis for the following commentary and recommendations. EFFICACY The potent narcotic antagonist activity of naloxone is well documented in infants and children as well as in adults. Naloxone has been effectively used postoperatively to reverse respiratory depression in infants and children who received narcotics for analgesia.1,2 Additional cases have been reported in which naloxone was successfully and safely used to treat children who were poisoned with narcotic agonists such as diphenoxylate hydrochloride (Lomotil),3,4 methadone hydrochloride, 57 and propoxyphene hydrochloride (Darvon).8 Most of the controlled clinical trials to study the safety and efficacy of naloxone in treating respiratory depression in the narcotic-exposed newborn have been carried out on full-term, healthy infants whose mothers received morphine or meperidine hydrochloride during labor, but who showed no overt clinical evidence of respiratory or CNS depression at birth.

scholarly journals The Role of TLR4 Asp299Gly and TLR4 Thr399Ile Polymorphisms in the Pathogenesis of Urinary Tract Infections: First Evaluation in Infants and Children of Greek Origin

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Panagiota Karananou ◽  
Despoina Tramma ◽  
Socrates Katafigiotis ◽  
Anastasia Alataki ◽  
Alexandros Lambropoulos ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Infections ◽  
Pediatric Population ◽  
Infants And Children ◽  
Healthy Children ◽  
Healthy Infants ◽  
Tract Infections ◽  
In Infants And Children

Urinary tract infections are one of the most common and serious bacterial infections in a pediatric population. So far, they have mainly been related to age, gender, ethnicity, socioeconomic level, and the presence of underlying anatomical or functional, congenital, or acquired abnormalities. Recently, both innate and adaptive immunities and their interaction in the pathogenesis and the development of UTIs have been studied. The aim of this study was to assess the role and the effect of the two most frequent polymorphisms of TLR4 Asp299Gly and Thr399Ile on the development of UTIs in infants and children of Greek origin. We studied 51 infants and children with at least one episode of acute urinary tract infection and 109 healthy infants and children. We found that 27.5% of patients and 8.26% of healthy children carried the heterozygote genotype for TLR4 Asp299Gly. TLR4 Thr399Ile polymorphism was found to be higher in healthy children and lower in the patient group. No homozygosity for both studied polymorphisms was detected in our patients. In the group of healthy children, a homozygote genotype for TLR4 Asp299Gly (G/G) as well as for TLR4 Thr399Ile (T/T) was showed (1.84% and 0.92 respectively). These results indicate the role of TLR4 polymorphism as a genetic risk for the development of UTIs in infants and children of Greek origin.

scholarly journals Fecal S100A12 in Healthy Infants and Children

2013 ◽  
Vol 35 ◽  
pp. 295-299 ◽  
Author(s):  
A. S. Day ◽  
M. Ehn ◽  
R. B. Gearry ◽  
D. A. Lemberg ◽  
S. T. Leach
Keyword(s):  
Young Children ◽  
Elevated Level ◽  
Gastrointestinal Symptoms ◽  
Infants And Children ◽  
Healthy Children ◽  
Term Infants ◽  
Healthy Infants ◽  
Stool Samples ◽  
Serial Samples ◽  
In Infants And Children

Background and Aims. Fecal S100A12 is shown to be a useful noninvasive marker of gut inflammation. However, the studies to date have not characterised the patterns of expression in healthy young children. This study aimed to determine S100A12 levels in infants and children without symptoms of underlying gut disease.Methods. Stool samples were collected from healthy infants (<12 months) and children without gastrointestinal symptoms. Faecal S100A12 was measured by immunoassay.Results. Fifty-six children were recruited. Serial samples were obtained from seven term infants over the first 6 months of life. Single samples were obtained from 49 healthy children ranging from 0.16 to 13.8 years of age. Median S100A12 levels were 0.5 mg/kg (ranging from 0.39 to 25) in the healthy children, with high values (>10 mg/kg) in five infants only. There was no variation between gender. Median S100A12 levels in healthy infants remained below the established normal cut-off from birth to six months of age.Conclusion. S100A12 levels in well infants and children are almost exclusively lower than the standard cut-off. Transiently higher levels may be seen in early infancy. An elevated level of S100A12 in children older than 12 months of age is likely to represent organic gut disease.

scholarly journals Scabies in children and its outcome with topical permethrin and oral ivermectin: a single center prospective study

2017 ◽  
Vol 4 (6) ◽  
pp. 2083
Author(s):  
Balasaheb B. Suroshe ◽  
Kishor G. Rathod ◽  
Vasant S. Kulkarni ◽  
Rakesh R. Chikhlonde
Keyword(s):  
Prospective Study ◽  
Care Center ◽  
Tertiary Care ◽  
High Index ◽  
Infants And Children ◽  
Tertiary Care Center ◽  
Single Center ◽  
Drug Of Choice ◽  
High Index Of Suspicion ◽  
In Infants And Children

Background: Scabies is highly prevalent in children less than 6 years and more so in less than 2 years of age. Treating scabies in infants and children is challenging. The objective was to study the characteristics and distribution of lesions and outcome with topical Permethrin and Oral Ivermectin in scabies in children.Methods: 264 cases of scabies from the skin and pediatric outpatient of a tertiary care center were enrolled.Results: It is common in children below 5 years of age. The effectiveness of local Permethrin and oral Ivermectin was not significantly different in the form of complete cure.Conclusions: Children tend to scratch the rash repeatedly, the scratch marks and crusting of the rash sometimes make this infection hard to identify, hence high index of suspicion is required to diagnose. Complicated lesions in scabies require more duration than uncomplicated lesions. Permethrin and Ivermectin are equally effective in scabies. Ivermectin being orally administered is a drug of choice in epidemics. 

Naloxone (narcan)

1975 ◽  
Vol 13 (19) ◽  
pp. 75-76
Keyword(s):  
Respiratory Depression ◽  
Narcotic Antagonist ◽  
Narcotic Analgesics ◽  
Partial Agonists ◽  
Allyl Derivative

Naloxone (Narcan - Winthrop), the N-allyl derivative of oxymorphone, is a narcotic antagonist whose most important clinical property is reversal of narcotic-induced respiratory depression. Like nalorphine (Lethidrone - Wellcome) and levallorphan (Lorfan - Roche), it also antagonises the sedative, analgesic and miotic effects of narcotic analgesics.1 There is, however, an important difference. When not preceded by the administration of a narcotic or when given in excess, nalorphine and levallorphan themselves have narcotic effects; by contrast, naloxone has none.2 It is, for all practical purposes, a pure antagonist, whereas nalorphine and levallorphan are partial agonists, with agonist as well as antagonist effects.3

scholarly journals The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America

2011 ◽  
Vol 53 (7) ◽  
pp. e25-e76 ◽  
Author(s):  
John S. Bradley ◽  
Carrie L. Byington ◽  
Samir S. Shah ◽  
Brian Alverson ◽  
Edward R. Carter ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Care Management ◽  
Expert Panel ◽  
Hospital Medicine ◽  
Community Acquired Pneumonia ◽  
Infants And Children ◽  
Healthy Infants ◽  
Inpatient Settings ◽  
Evidenced Based ◽  
In Infants And Children

Abstract Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

Understanding Limited Use of Amplification in Infants and Children Who Are Hard of Hearing

2015 ◽  
Vol 25 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Meredith Spratford
Keyword(s):  
Hard Of Hearing ◽  
Hearing Aid ◽  
Management Strategies ◽  
Infants And Children ◽  
Future Research ◽  
Research Needs ◽  
Case Examples ◽  
Hearing Aid Use ◽  
Wide Range ◽  
In Infants And Children

The effectiveness of amplification for infants and children can be mediated by how much the child uses the device. Existing research suggests that establishing hearing aid use can be challenging. A wide range of factors can influence hearing aid use in children, including the child's age, degree of hearing loss, and socioeconomic status. Audiological interventions, including using validated prescriptive approaches and verification, performing on-going training and orientation, and communicating with caregivers about hearing aid use can also increase hearing aid use by infants and children. Case examples are used to highlight the factors that influence hearing aid use. Potential management strategies and future research needs are also discussed.

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