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Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG

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https://www.readbyqxmd.com/read/28638308/pediatric-news
#1
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May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638307/rectal-metyrapone-for-treatment-of-hypercortisolism-in-an-infant-with-mccune-albright-syndrome
#2
Kate Verbeeten, Stasia Hadjiyannakis, Melody Cameron, Jaime McDonald
Infantile Cushing syndrome is an infrequent yet potentially fatal manifestation of McCune-Albright syndrome, for which there are few safe treatments available. Ketoconazole is limited by potential hepatotoxicity in this population. Metyrapone may be an effective treatment, but it may not be tolerated when given orally. An infant with McCune-Albright syndrome presented with severe Cushing syndrome. Oral metyrapone resulted in feeding refusal, and ketoconazole caused an increase in liver enzymes; however, she was successfully treated with metyrapone given rectally...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638306/effect-of-maternal-obesity-on-maternal-fetal-transfer-of-preoperative-cefazolin-at-cesarean-section
#3
Stephanie McKenney Groff, Wareef Fallatah, Samuel Yang, Jamie Murphy, Christopher Crutchfield, Mark Marzinke, Joanne Kurtzberg, Carlton K K Lee, Irina Burd, Azadeh Farzin
OBJECTIVES: American Congress of Obstetricians and Gynecologists recommends a single dose of antibiotic prophylaxis before all cesarean sections (C/S). This recommendation is based on pharmacokinetic studies that include only non-obese patients. We sought to evaluate 1) cefazolin plasma concentrations among obese and non-obese patients after administration of a 2-g cefazolin dose for prevention of surgical wound infections, and 2) whether cefazolin concentration in fetal circulation may be protective against pathogens that cause early onset neonatal sepsis...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638305/predictors-of-adverse-outcomes-in-children-with-staphylococcus-aureus-bacteremia
#4
Ganesh Kumarachandran, Jennifer Kristie Johnson, Debbie-Ann Shirley, Eileen Graffunder, Emily L Heil
OBJECTIVES: Staphylococcus aureus bacteremia is a common infection, associated with significant morbidity and mortality in children. Factors associated with adverse treatment outcomes are poorly understood in the pediatric population. METHODS: Our study compared clinical and microbiologic characteristics of children admitted during a 5-year period (2007-2012) to a large university-based hospital and found to have S aureus bacteremia with outcome measures, in order to identify risk factors associated with treatment failure (defined as 30-day mortality, delayed microbiologic resolution, or recurrence of S aureus bacteremia within 60 days of completing effective antibiotic therapy)...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638304/extended-infusion-of-piperacillin-tazobactam-in-children
#5
Chad A Knoderer, Lauren C Karmire, Katie L Andricopulos, Kristen R Nichols
OBJECTIVES: Extended-infusion piperacillin/tazobactam (TZP) has been associated with positive clinical outcomes in adults, but similar data in children are lacking. The objective of this study was to describe efficacy outcomes with pediatric patients receiving extended-infusion TZP. METHODS: This was a retrospective case series of children aged 1 month to 17 years who had documented Gram-negative infection and received extended-infusion TZP between April 2011 and March 2012...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638303/the-use-of-gabapentin-for-pain-and-agitation-in-neonates-and-infants-in-a-neonatal-icu
#6
Gretchen L Sacha, Maria G Foreman, Kay Kyllonen, Ricardo J Rodriguez
OBJECTIVES: Limited data support how to safely and effectively treat refractory pain and agitation in neonates and infants. Gabapentin has been used in this patient population and has shown promising results, yet there is still a paucity of data about its clinical efficacy. There is a need for a larger evaluation to determine its effectiveness. This study describes one institution's experience with gabapentin for the treatment of refractory pain and agitation in the neonatal intensive care unit (NICU)...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638302/extended-stability-and-sterility-of-antihemophilic-factor-human
#7
Sarah Shields, Abby Kim, Joshua Elder
OBJECTIVES: Antihemophilic factor human is a factor VIII product used to supplement those with hemophilia. Recent data show treatment benefit and cost saving opportunities if factor products are administered as a continuous infusion rather than conventional bolus dose. This method has not been widely used given the lack of evidence for safe and effective use beyond 3 hours from preparation. The objectives of this study were to determine the physical and chemical stability and sterility of antihemophilic factor human over a 7-day period...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638301/toxic-and-essential-trace-element-content-of-commonly-administered-pediatric-oral-medications
#8
Robert A Yokel, Sarah E Seger, Jason M Unrine
OBJECTIVES: The aim of this study was to test the hypothesis that commonly administered pediatric oral medications are a significant source of toxic elements. The concentrations of 16 elements were determined in 14 frequently used pediatric oral medications. METHODS: Samples were prepared for analysis by dilution or nitric acid microwave-assisted digestion and analyzed by inductively coupled plasma mass spectrometry. The intake of each element from administration for 1 week of the medication's maximum recommended daily dose to 6-month-olds was calculated and compared to an exposure guideline for that element...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638300/characteristics-of-pediatric-clinical-interventions-documented-by-a-school-of-pharmacy
#9
Lea S Eiland
OBJECTIVES: Documentation of interventions by pharmacists has become a standard of practice in clinical practice sites. Pharmacists' interventions in pediatric practice settings for short periods of time have been reported in the literature. A single study has described faculty and student interventions in the pediatric setting. The objective of this study was to characterize 4 years of interventions by faculty and students of a school of pharmacy that occurred at various pediatric practice sites throughout a state...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28638299/cannabinoids-in-pediatrics
#10
REVIEW
Christopher T Campbell, Marjorie Shaw Phillips, Kalen Manasco
Despite its controversial nature, the use of medical marijuana and cannabis-derived medicinal products grows more popular with each passing year. As of November 2016, over 40 states have passed legislation regarding the use of either medical marijuana or cannabidiol products. Many providers have started encountering patients experimenting with cannabis products for a wide range of conditions. While the debate continues regarding these agents for both medicinal and recreational use in the general population, special consideration needs to be made for pediatric use...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469538/temperature-instability-in-an-infant-treated-with-propranolol-for-infantile-hemangioma
#11
Betsy Walters Burkey, Joshua A Jacobs, Hany Aziz
Infantile hemangiomas are prevalent in the first few months of life and can be associated with risks of scarring, blindness, ulcerations, and airway obstruction depending on the location of lesions. Options for therapy include surgery, laser therapy, or medications. Propranolol is the only US Food and Drug Administration-approved medication option. Propranolol is a nonselective beta-blocker that crosses the blood-brain barrier because of its high lipophilicity, which increases the likelihood of central nervous system effects...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469537/rituximab-for-treatment-of-refractory-anti-nmda-receptor-encephalitis-in-a-pediatric-patient
#12
Sarah Hallowell, Esli Tebedge, Margaret Oates, Elizabeth Hand
Anti-N-methyl d-aspartate receptor (anti-NMDAR) encephalitis is a devastating disease that is increasingly being identified in both children and adults with psychosis, language disturbances, behavioral changes, and motor deficits. Currently no consensus guidelines exist for the optimal management of patients with this disease, although intravenous immune globulin (IVIG) therapy is often considered first-line pharmacotherapy. We present a case of an otherwise healthy 4 year-old-child who presented with seizures, loss of age-appropriate language skills, and behavioral changes, in whom anti-NMDAR was subsequently diagnosed...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469536/effects-of-maternal-magnesium-sulfate-treatment-on-neonatal-feeding-tolerance
#13
Meghan K Belden, Sarah Gnadt, Ann Ebert
OBJECTIVE: To determine whether antenatal exposure to magnesium sulfate has an effect on neonatal enteral feeding tolerance. METHODS: In this single-center, retrospective, observational study, charts of pregnant women who received intravenous magnesium sulfate infusions prior to delivery between July 1, 2012, and July 31, 2013, were reviewed. Neonates born at 24 weeks' gestational age or greater admitted to the neonatal intensive care unit (NICU) whose mothers received magnesium sulfate infusions prior to delivery were included...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469535/association-between-deep-sedation-from-continuous-intravenous-sedatives-and-extubation-failures-in-mechanically-ventilated-patients-in-the-pediatric-intensive-care-unit
#14
Jennifer M Schultheis, Travis S Heath, David A Turner
OBJECTIVE: The primary objective of this study was to determine whether an association exists between deep sedation from continuous infusion sedatives and extubation failures in mechanically ventilated children. Secondary outcomes evaluated risk factors associated with deep sedation. METHODS: This was a retrospective cohort study conducted between January 1, 2009, and October 31, 2012, in the pediatric intensive care unit (PICU) at Duke Children's Hospital. Patients were included in the study if they had been admitted to the PICU, had been mechanically ventilated for ≥48 hours, and had received at least one continuous infusion benzodiazepine and/or opioid infusion for ≥24 hours...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469534/effect-of-vitamin-d-supplementation-on-delayed-hyperphosphatemia-in-pediatric-acute-lymphoblastic-leukemia-patients-during-induction-chemotherapy
#15
Anthony W Lee, Gale L Romanowski, James A Proudfoot, Dennis J Kuo
OBJECTIVES: Vitamin D plays a role in maintaining bone health and calcium metabolism, but recent studies cast doubt on vitamin D supplementation's benefits in survivors of acute lymphoblastic leukemia (ALL). Vitamin D supplementation could increase serum phosphate through increased intestinal absorption of phosphate and suppression of parathyroid hormone, which would lead to decreased renal phosphate excretion. Because of the potential for renal injury during induction chemotherapy for ALL, Vitamin D supplementation's potential for increasing hyperphosphatemia could outweigh its suggested but unproven benefits...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469533/effect-of-a-pediatric-prescription-medication-discharge-program-on-reducing-hospital-readmission-rates
#16
Laura A Leathers, Kristy L Brittain, Kelly Crowley
OBJECTIVES: To evaluate the pediatric prescription medication discharge delivery and counseling program, implemented at an 186-bed children's hospital integrated within a larger academic medical center, and its effectiveness on reducing hospital readmissions. METHODS: This study was a retrospective chart review of existing data in the electronic medical record from patients <21 years of age who were discharged from our institution between September 1, 2014, and November 30, 2014...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28469532/neonatal-herpes-simplex-viral-infections-and-acyclovir-an-update
#17
REVIEW
John Brock Harris, Amy P Holmes
Neonatal herpes simplex virus (HSV) infections have high morbidity and mortality rates. Optimization of treatment and prevention strategies are imperative to improve the care and outcomes of neonates infected with HSV. Management of HSV includes reducing neonatal transmission, treating acute infections, and limiting adverse neurodevelopmental outcomes and future cutaneous outbreaks after acute infections. Transmission risk may be affected by route of delivery and maternal suppressive therapy. Neonatal HSV infections are divided into 3 categories: localized skin, eyes, or mouth; localized central nervous system; or disseminated infections...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28337087/medication-dosage-in-overweight-and-obese-children
#18
Kelly L Matson, Evan R Horton, Amanda C Capino
Approximately 31.8% of U.S. children ages 2 to 19 years are considered overweight or obese. This creates significant challenges to dosing medications that are primarily weight based (mg/kg) and in predicting pharmacokinetics parameters in pediatric patients. Obese individuals generally have a larger volume of distribution for lipophilic medications. Conversely, the Vd of hydrophilic medications may be increased or decreased due to increased lean body mass, blood volume, and decrease percentage of total body water...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28337086/pediatric-antimicrobial-stewardship-programs
#19
Kristen Nichols, Sylvia Stoffella, Rachel Meyers, Jennifer Girotto
The frequent use of antimicrobials in pediatric patients has led to a significant increase in multidrug-resistant bacterial infections among children. Antimicrobial stewardship programs have been created in many hospitals in an effort to curtail and optimize the use of antibiotics. Pediatric-focused programs are necessary because of the differences in antimicrobial need and use among this patient population, unique considerations and dosing, vulnerability for resistance due to a lifetime of antibiotic exposure, and the increased risk of adverse events...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28337085/duty-to-advocate-human-papillomavirus-vaccination
#20
Kristen Nichols, Jennifer Girotto, Amy Mitchell-Van Steele, Sylvia Stoffella
Despite the excellent benefit-to-risk ratio for human papillomavirus (HPV) vaccination and recommendations for its routine use from the Advisory Committee on Immunization Practices (ACIP), significant controversy surrounding HPV vaccination continues to exist. In light of this controversy and continued low rates of vaccination among U.S. adolescents, the Pediatric Pharmacy Advocacy Group (PPAG) endorses the safety and efficacy of HPV vaccination and agrees with ACIP recommendations for protection of the U.S...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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