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Paediatric acetaminophen dose

Amit A Somani, Kirstin Thelen, Songmao Zheng, Mirjam N Trame, Katrin Coboeken, Michaela Meyer, Katrin Schnizler, Ibrahim Ince, Stefan Willmann, Stephan Schmidt
AIMS: Evidence suggests that the rate of oral drug absorption changes during early childhood. Yet, respective clinical implications are currently unclear, particularly for preterm neonates. The objective of this study was to evaluate changes in oral drug absorption after birth for different Biopharmaceutics Classification System (BCS) class I and II compounds to better understand respective implications for paediatric pharmacotherapy. METHODS: Two paradigm compounds were selected for BCS class I (paracetamol (acetaminophen) and theophylline) and II (indomethacin and ibuprofen), respectively, based on the availability of clinical literature data following intravenous and oral dosing...
January 2016: British Journal of Clinical Pharmacology
Katarzyna Kominek, Agnieszka Pawłowska-Kamieniak, Agnieszka Mroczkowska-Juchkiewicz, Paulina Krawiec, Elżbieta Pac-Kożuchowska
INTRODUCTION: Paracetamol is one of the most commonly used analgesics and antipyretics available without limits as preparations of the OTC group (over the counter drugs). Overdose and poisoning with this drug always brings about the risk of acute hepatic failure. The objective of the study was a retrospective evaluation of patients hospitalized in the Paediatric Clinic during the period 2004-2012 due to poisoning with paracetamol. MATERIAL AND METHODS: The analysis covered 44 patients hospitalized in the Paediatric Clinic during 2004-2012 due to poisoning with paracetamol...
2015: Postȩpy Higieny i Medycyny Doświadczalnej
Nieves Velez de Mendizabal, Ricardo Jimenez-Mendez, Erin Cooke, Carolyne J Montgomery, Joy Dawes, Michael J Rieder, Katarina Aleksa, Gideon Koren, Carlos O Jacobo-Cabral, Rodrigo Gonzalez-Ramirez, Gilberto Castañeda-Hernandez, Bruce C Carleton
BACKGROUND AND OBJECTIVES: Currently, the majority of the surgical procedures performed in paediatric hospitals are done on a day care basis, with post-operative pain being managed by caregivers at home. Pain after discharge of these post-operative children has historically been managed with oral codeine in combination with paracetamol (acetaminophen). Codeine is an opioid, which elicits its analgesic effects via metabolism to morphine and codeine-6-glucuronide. Oral morphine is a feasible alternative for outpatient analgesia; however, the pharmacokinetics of morphine after oral administration have been previously described only sparsely, and there is little information in healthy children...
October 2015: Clinical Pharmacokinetics
R A Moore, S Derry, P J Wiffen, S Straube, D J Aldington
BACKGROUND: Ibuprofen and paracetamol have long been used as analgesics in a range of acute, intermittent and chronic pain conditions. Paracetamol is often the first line analgesic recommended, without consensus about which is the better analgesic. METHODS: An overview review of systematic reviews and meta-analyses directly compares ibuprofen and paracetamol at standard doses in particular painful conditions, or uses indirect comparisons against placebo. Electronic searches for systematic reviews were sought published since 1995 using outcomes approximating to ≥50% pain intensity reduction...
October 2015: European Journal of Pain: EJP
J Rajanayagam, J R Bishop, P J Lewindon, Helen M Evans
BACKGROUND: In children, paracetamol overdose due to deliberate self-poisoning, accidental exposure or medication errors can lead to paediatric acute liver failure and death. In Australia and New Zealand, the nature of ingestion and outcomes of paracetamol-associated paediatric acute liver failure have not been described. OBJECTIVE: To describe the nature and outcomes of paracetamol-associated paediatric acute liver failure. DESIGN: Retrospective analysis of paracetamol-associated paediatric acute liver failure cases presenting 2002-2012...
January 2015: Archives of Disease in Childhood
Rikke Lindgaard Hedeland, Jesper Andersen, Natasha Askbo, Amne Iskandar, Marianne Hørby Jørgensen
AIM: The data on severe acetaminophen-induced hepatotoxicity in children are very limited. This study explored the dose-response relationship between ingested acetaminophen and hepatotoxicity, the early biochemical and clinical predictors of hepatotoxicity, the impact of early N-acetylcysteine treatment on hepatotoxicity and the incidence of nephrotoxicity. METHODS: We carried out a retrospective case study on 25 children aged 11-16 years with severe acetaminophen poisoning...
November 2014: Acta Paediatrica
L Hedén, L von Essen, G Ljungman
AIM: The aim was to investigate whether children experience less pain, fear and/or distress when they receive high-dose paracetamol compared with placebo, using a needle insertion in a subcutaneously implanted intravenous port as a model. METHODS: Fifty-one children ranging from 1 to 18 years of age being treated in a paediatric oncology setting were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port...
March 2014: Acta Paediatrica
Lauren Hanly, Michael J Rieder, Shih-Han S Huang, Tetyana L Vasylyeva, Rikin K Shah, Osvaldo Regueira, Gideon Koren
Nephrotoxicity is a serious side effect associated with ifosfamide use. It can affect up to 30% of children who are treated with this chemotherapeutic drug, and treatment may necessitate lifelong supplementations, renal dialysis, renal transplant, and in severe cases may result in death. The antioxidant n-acetylcysteine is a promising strategy for mitigating this renal toxicity. It is currently used in children for acetaminophen overdose in the 21-hour IV protocol, a dose which has also been suggested to provide renal protection against ifosfamide...
2013: Journal of Population Therapeutics and Clinical Pharmacology
J N van den Anker
Fever and pain in children, especially associated with infections, such as otitis media, are very common. In paediatric populations, ibuprofen and paracetamol (acetaminophen) are both commonly used over-the-counter medicines for the management of fever or mild-to-moderate pain associated with sore throat, otitis media, toothache, earache and headache. Widespread use of ibuprofen and paracetamol has shown that they are both effective and generally well tolerated in the reduction in paediatric fever and pain...
January 2013: International Journal of Clinical Practice. Supplement
Laura Cuzzolin, Roberto Antonucci, Vassilios Fanos
Neonates can perceive pain, therefore an adequate analgesic therapy is a major issue not only from an ethical perspective but also to improve short- and long-term outcome. Fever during the neonatal period requires hospitalization and needs a treatment with an antipyretic agent because of the high risk of severe complications. Paracetamol (acetaminophen), the most commonly prescribed drug in paediatric patients for its analgesic and antipyretic effects, is the only agent recommended for use as an antipyretic in the newborn and has been recently proposed as a supplement therapy to opioids for postoperative analgesia...
February 2013: Current Drug Metabolism
H Evren Eker, Oya Yalçin Cok, Pınar Ergenoğlu, Anış Ariboğan, Gülnaz Arslan
PURPOSE: Electroshock wave lithotripsy (ESWL) is a painful procedure performed with sedoanalgesia in paediatric patients. The propofol-ketamine combination may be the preferable anaesthesia for this procedure, and propofol-ketamine consumption may be decreased with the administration of intravenous (IV) paracetamol. In this study we investigated the effect of IV paracetamol administration on propofol-ketamine consumption, recovery time and frequency of adverse events in paediatric patients undergoing ESWL...
June 2012: Journal of Anesthesia
B Dhingra, D Mishra
BACKGROUND: Local and minor systemic adverse events are frequently seen after routine immunisation with diphtheria-pertussis-tetanus. Antipyretics are frequently prescribed for these events and prophylactic administration of acetaminophen is occasionally recommended. OBJECTIVE: To determine whether prophylactic administration of acetaminophen has any effect in reducing the incidence of post-vaccination side-effects. DESIGN: A prospective, comparative trial with telephone interview-based outcome assessment...
2011: Annals of Tropical Paediatrics
Stephen Smith, Agron Collaku, Louise Heaslip, Yong Yue, Yan-Yan Starkey, Geoffrey Clarke, Nick Kronfeld
The objective of this study was to compare the rate and extent of paracetamol absorption from the new Paracetamol pediatric suspension (PPS) with two marketed paracetamol suspensions: Children's panadol (CP) and Panodil baby & infant (PBI). The study also assessed the effect on paracetamol absorption of light-calorie, low-fat food consumed 2 h before dosing. Twenty eight male adult volunteers received a single oral dose of 1000 mg of paracetamol from each of three treatments, in both fasted and fed states according to a randomized, single-center, open-label, six-way crossover study design...
March 2012: Drug Development and Industrial Pharmacy
Céire Costelloe, Alan A Montgomery, Niamh M Redmond, Margaret Fletcher, Sandra Hollinghurst, Tim J Peters, Alastair D Hay
OBJECTIVE: To determine the accuracy with which parents can estimate preschool children's weight using home scales in order to calculate antipyretic dose. DESIGN: Cross-sectional, method comparison study. SETTING AND PARTICIPANTS: 156 preschool children aged 6 months to 6 years recruited from primary care and the community to an antipyretic strategies trial and managed at home. COMPARISON AND OUTCOME MEASURES: Research nurse weight estimate using Seca 835-2 digital paediatric scales compared with parental weight estimate using usual home scales...
December 2011: Archives of Disease in Childhood
Tuula Pelkonen, Irmeli Roine, Manuel Leite Cruzeiro, Anne Pitkäranta, Matti Kataja, Heikki Peltola
BACKGROUND: New antimicrobials or adjunctive treatments have not substantially reduced mortality from acute childhood bacterial meningitis. Paracetamol seems to have beneficial effects in bacteraemic adults and some experts recommend initial slow β-lactam infusion. We investigated whether these treatments had benefits in children with bacterial meningitis. METHODS: We did a prospective, double-blind, single-centre study with a two-by-two factorial design in Luanda, Angola...
August 2011: Lancet Infectious Diseases
Francesca G Iodice, Mark Thomas, Isabeau Walker, Vanessa Garside, Martin J Elliott
OBJECTIVE: We introduced a fast-track program for our cardiac operations requiring adjustment in anaesthesia techniques to facilitate rapid extubation and discharge from the intensive care unit (ICU). Our objective was to investigate the quality of analgesia in fast-track paediatric cardiac patients. METHODS: We performed a retrospective review of the records of all patients who were fast-tracked in our institution between January 2006 and January 2007. Data collected included surgical procedure, anaesthesia technique, intra-operative opioids, ventilation time, intensive care stay, postoperative morphine consumption, pain scores, patient-controlled analgesia/nurse-controlled analgesia (PCA/NCA) duration, supplemental analgesia and incidence of vomiting...
September 2011: European Journal of Cardio-thoracic Surgery
J-Y Hong, S W Han, W O Kim, E J Kim, H K Kil
BACKGROUND: Dexamethasone has a powerful anti-inflammatory action and has demonstrated reduced morbidity after surgery. The aim of this study was to examine the effects of a single i.v. dose of dexamethasone in combination with caudal block on postoperative analgesia in children. METHODS: Seventy-seven children (aged 1-5 yr) undergoing day-case orchiopexy were included in this prospective, randomized, double-blinded study at a single university hospital. After inhalation induction of general anaesthesia, children received either dexamethasone 0...
October 2010: British Journal of Anaesthesia
Baba S Mohammed, Garry A Cameron, Lindsay Cameron, Gabrielle H Hawksworth, Peter J Helms, James S McLay
UNLABELLED: WHAT IS ALREADY KNOWN ABOUT THE SUBJECT: Finger-prick blood samples are increasingly used for the clinical and biomedical measurement of drugs and endogenous substance concentration. The use of different sampling sites can give rise to different drug concentration measurements. WHAT THIS STUDY ADDS: During the absorption phase, the paracetamol concentration in finger-prick blood samples is significantly greater than that in venous blood samples, following oral administration...
July 2010: British Journal of Clinical Pharmacology
Michael Shepherd, Richard Aickin
Paediatric limb fracture is a common injury that presents frequently to the ED. The primary objective of the present study was to determine whether ibuprofen provides better analgesia than paracetamol for paediatric patients discharged with acute limb fractures. A prospective, randomized controlled study was conducted in a children's ED. Children aged 5-14 years with an acute limb fracture were randomized to be prescribed paracetamol 15 mg/kg/dose every 4 h or ibuprofen 10 mg/kg/dose every 8 h. Objective (child-reported) pain scores using the 'Faces' pain scale were measured over a 48 h period...
December 2009: Emergency Medicine Australasia: EMA
Brian J Anderson, Nick H G Holford
Growth and development are two major aspects of children not readily apparent in adults. Clearance in the paediatric population should be investigated using models that describe size, maturation and organ function influences. Size is the primary covariate and although lean body weight is argued as a better measure than total body weight, the use of different fractions of fat mass to explain how pharmacokinetic parameters vary with body composition has been proposed. Allometric scaling using an empiric power exponent of 3/4 is superior to scaling using body surface area...
2009: Drug Metabolism and Pharmacokinetics
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