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Paediatric Drugs

Steven L Ciciora, Frederick W Woodley
Gastroesophageal reflux (GER) is the retrograde movement of gastric (and sometimes duodenal) contents into the esophagus. While the majority of GER is physiologic, for patients, it can be associated with symptoms. While some symptoms are merely bothersome (crying), others can be life threatening (cough, gagging, choking). The main driver of GER in infants is the frequent feedings that produce increased intra-abdominal pressure, which is known to trigger transient relaxations of the lower esophageal sphincter...
September 10, 2018: Paediatric Drugs
O C Smibert, M A Paraskeva, G Westall, Greg Snell
Lung transplantation can offer life-prolonging therapy to children with otherwise terminal end-stage lung disease. However, infectious complications, like those experienced by their adult counterparts, are a significant cause of morbidity and mortality. These include bacteria, viruses, and fungi that infect the patient pretransplant and those that may be acquired from the donor or by the recipient in the months to years posttransplant. An understanding of the approach to the management of each potential infecting organism is required to ensure optimal outcomes...
September 6, 2018: Paediatric Drugs
Silvia Salvatore, Antonio Ripepi, Koen Huysentruyt, Kristel van de Maele, Luana Nosetti, Massimo Agosti, Alessandro Salvatoni, Yvan Vandenplas
BACKGROUND: Guidelines are contradictory regarding the use of alginate in infants with persisting gastroesophageal reflux (GER). While The British National Institute for Health and Care (NICE) guidelines consider alginate as a treatment option, the guidelines of the European and North-American Societies for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN, NASPGHAN) do not recommend alginates. AIMS: We assessed the efficacy of alginate to reduce GER episodes in infants...
September 4, 2018: Paediatric Drugs
Nicole Bitencourt, Bonnie L Bermas
Pediatric patients often have poor pregnancy outcomes. Systemic lupus erythematosus predominantly impacts women in their second to fourth decade of life, with childhood-onset disease being particularly aggressive. Reproductive issues are an important clinical consideration for pediatric patients with systemic lupus erythematosus (SLE), as maintaining good disease control and planning a pregnancy are important for maternal and fetal outcomes. In this clinical review, we will consider the safety of medications in managing childhood-onset SLE during conception, pregnancy, and breastfeeding...
September 3, 2018: Paediatric Drugs
Stuart M MacLeod
No abstract text is available yet for this article.
August 23, 2018: Paediatric Drugs
Rolf C R Ljung
Regular prophylactic treatment with factor VIII (FVIII) and factor IX (FIX) concentrates in hemophilia A and B, respectively, is introduced in early infancy and has resulted in dramatic improvement of the conditions. Recombinant FVIII and FIX concentrates have been available for > 25 years and have been modified and refined through the years; however, unfortunately frequent intravenous administrations are still necessary. The half-lives of these products have now been extended (EHL) by fusion with albumin, the Fc-portion of IgG, or by being PEGylated...
August 21, 2018: Paediatric Drugs
Harold J Lochner, Nizar F Maraqa
Chlamydia, gonorrhea, and syphilis continue to be significant burdens to the health of pregnant women and their children despite easy and effective guidance for screening and treatment. Specific guidelines exist for screening for these infections as well as treatment and follow-up. In this article, we review the epidemiology of chlamydia, gonorrhea, and syphilis. Testing methodology is also reviewed as molecular-based techniques have replaced culture as the current gold standard tests of choice for chlamydia and gonorrhea...
August 21, 2018: Paediatric Drugs
Valentina Shakhnovich, P Brian Smith, Jeffrey T Guptill, Laura P James, David N Collier, Huali Wu, Chad E Livingston, Jian Zhao, Gregory L Kearns, Michael Cohen-Wolkowiez
BACKGROUND AND AIMS: Pharmacokinetic data for proton pump inhibitors (PPIs), acid-suppression drugs commonly prescribed to children, are lacking for obese children who are at greatest risk for acid-related disease. In a recent multi-center investigation, we demonstrated decreased, total body weight adjusted, apparent clearance (CL/F) of the PPI pantoprazole for obese children compared with their non-obese peers. Subsequently, we developed a population-based pharmacokinetic (PopPK) model to characterize pantoprazole disposition and evaluated appropriate pantoprazole dosing strategies for obese pediatric patients, using simulation...
August 11, 2018: Paediatric Drugs
Julie Park, Urmi Das, Mohammed Didi, Renuka Ramakrishnan, Matthew Peak, Paul Newland, Joanne Blair
BACKGROUND: Hydrocortisone is the preferred treatment for adrenal insufficiency in childhood. A small minority of children experience low cortisol concentrations and symptoms of cortisol insufficiency, poorly responsive to modifications in dosing. We speculated that treatment with modified-release hydrocortisone Plenadren® may be beneficial in these selected patients. OBJECTIVE: The aim of this article was to report cortisol profiles during treatment with standard formulation hydrocortisone and Plenadren, and growth and weight gain during treatment with Plenadren in selected children with adrenal insufficiency...
August 7, 2018: Paediatric Drugs
Ozkan Ilhan, Meltem Bor, Senem Alkan Ozdemir, Sinem Akbay, Esra Arun Ozer
BACKGROUND: Given the severity and high mortality of multidrug-resistant Gram-negative bacilli (MDR-GNB) infections, the use of colistin will increase in patients with MDR-GNB infection. OBJECTIVE: This study aims to assess the efficacy and safety of intravenous colistin in very low birth weight (VLBW; birth weight < 1500 g) preterm infants. METHODS: We retrospectively analyzed the medical records of patients who received colistin between June 2016 and December 2017...
August 3, 2018: Paediatric Drugs
Catherine Habashy, Erin Springer, Elizabeth A Hall, Doralina L Anghelescu
Methadone is a synthetic opioid with unique pharmacodynamic and pharmacokinetic properties. It is effective in treating both nociceptive and neuropathic pain, which commonly co-exist in children with cancer. Upon reviewing the literature describing the use of methadone in pediatric oncology patients, publications are limited in number and low in quality of evidence; nevertheless, there is support for the safety and efficacy of methadone in treating pain in children with cancer, particularly when pain is refractory to conventional treatment...
July 26, 2018: Paediatric Drugs
Andrew M Tomlin, David J Woods, Hywel S Lloyd, Murray W Tilyard
BACKGROUND: Research examining trends in the outpatient prescription medicine use of New Zealand children is limited. OBJECTIVES: Our objective was to provide an overview of prescription medicine use in New Zealand children and assess changing patterns in use from 2010 to 2015. METHODS: We conducted a retrospective cohort study including all New Zealand primary care-registered children aged < 18 years using data from the national pharmaceutical claims database...
July 25, 2018: Paediatric Drugs
Giulia Iapadre, Ganna Balagura, Luca Zagaroli, Pasquale Striano, Alberto Verrotti
Selecting the most appropriate antiepileptic drug (AED) or combination of drugs for each patient and identifying the most suitable therapeutic regimen for their needs is increasingly challenging, especially among pediatric populations. In fact, the pharmacokinetics of several drugs vary widely in children with epilepsy because of age-related factors, which can influence the absorption, distribution, metabolism, and elimination of the pharmacological agent. In addition, individual factors, such as seizure type, associated comorbidities, individual pharmacokinetics, and potential drug interactions, may contribute to large fluctuations in serum drug concentrations and, therefore, clinical response...
July 12, 2018: Paediatric Drugs
Ruairi Wilson, Caroline Osborne, Christina Halsey
Prophylactic eradication of central nervous system (CNS) leukaemia is the current standard of care in treating childhood acute lymphoblastic leukaemia (ALL). This is conventionally achieved through regular lumbar punctures with intrathecal injections of methotrexate into the cerebrospinal fluid (CSF). Ommaya reservoirs are subcutaneous implantable devices that provide a secure route of drug delivery into the CSF via an intraventricular catheter. They are an important alternative in cases where intrathecal injection via lumbar puncture is difficult...
August 2018: Paediatric Drugs
Kallirroi Kotilea, Nicolas Kalach, Matjaž Homan, Patrick Bontems
Helicobacter pylori infection is acquired mainly in childhood and remains an essential cause of peptic ulcer disease and gastric cancer. This article provides commentary on the last ESPGHAN/NASPGHAN guidelines and on publications made after the consensus conference of 2015. The majority of infected children are asymptomatic and pediatric studies do not support a role for H. pylori in functional disorders such as recurrent abdominal pain. The role of H. pylori infection in failure to thrive, children's growth, type I diabetes mellitus (T1DM), and celiac disease remains controversial...
August 2018: Paediatric Drugs
Anne van Rongen, Marloes P van der Aa, Maja Matic, Ron H N van Schaik, Vera H M Deneer, Marja M van der Vorst, Catherijne A J Knibbe
BACKGROUND: In view of the increased use of metformin in obese adolescents, the aim of this study was to determine the pharmacokinetics of metformin in overweight and obese adolescents. METHODS: In overweight and obese adolescents receiving metformin 500 or 1000 mg twice daily for 37 weeks during a clinical trial, blood samples were collected over 8 h during an oral glucose tolerance test. Population pharmacokinetic modeling was performed using NONMEM. RESULTS: Data for 22 overweight and obese adolescents with a mean total body weight (TBW) of 79...
August 2018: Paediatric Drugs
Gideon Koren, Matitiahu Berkovitch, Asher Ornoy
Since the inception of clinical teratology, the vast majority of scientific work has focused on identification of drugs and environmental agents causing malformations in humans as a dichotomous variable (i.e. yes or no), as well as the relative and absolute risks of such occurrences. Generally, the dose dependency of such events has not been investigated. With the establishment of large pregnancy databases, dose-dependence relationships are being uncovered for increasing numbers of medications, including valproic acid, carbamazepine, phenobarbital, lamotrigine, topiramate, and lithium...
August 2018: Paediatric Drugs
B Grant, J A Salpekar
Lithium has been an intriguing treatment option in psychiatry for over a century. While seemingly just a simple elemental compound, it has powerful treatment effects for both depression and bipolar disorder. The evidence base for treatment of pediatric bipolar disorder is relatively small, but, in recent years, additional clinical trial data have enabled lithium to re-emerge as a valuable and, in many cases, preferred treatment. Pharmacologically, lithium is complex, with varied effects at both intracellular and extracellular levels...
August 2018: Paediatric Drugs
Suresh Durgam, Changzheng Chen, Raffaele Migliore, Chandran Prakash, John Edwards, Robert L Findling
BACKGROUND: Major depressive disorder (MDD) is a serious illness in children and adolescents. Vilazodone is a selective serotonin reuptake inhibitor approved for MDD in adults. This study evaluated the efficacy, safety, and tolerability of vilazodone in adolescent patients, ages 12-17 years, with MDD (NCT01878292). METHODS: This double-blind, randomized, placebo-controlled, parallel-group, fixed-dose study was conducted at 56 study centers in the United States and was 10 weeks in duration (a 1-week screening period, an 8-week double-blind treatment period, and a 1-week double-blind down-taper period)...
August 2018: Paediatric Drugs
Roberto Antonucci, Luca Antonucci, Cristian Locci, Annalisa Porcella, Laura Cuzzolin
Adrenaline, also known as epinephrine, is a hormone, neurotransmitter, and medication. It is the best established drug in neonatal resuscitation, but only weak evidence supports current recommendations for its use. Furthermore, the available evidence is partly based on extrapolations from adult studies, and this introduces further uncertainty, especially when considering the unique physiological characteristics of newly born infants. The timing, dose, and route of administration of adrenaline are still debated, even though this medication has been used in neonatal resuscitation for a long time...
June 19, 2018: Paediatric Drugs
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