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paracetamol and neonates

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https://www.readbyqxmd.com/read/27807736/-analgesic-drugs-during-pregnancy
#1
S Hultzsch, C Schaefer
Some important limitations must be taken into consideration for analgesic therapy during pregnancy. Paracetamol is the agent of choice for mild to moderate pain in any stage of pregnancy. Ibuprofen is the non-steroidal anti-inflammatory drug (NSAID) of choice; however, these substances are contraindicated after 28 weeks of gestation due to the increasing risk of premature closure of the ductus arteriosus and impairment of fetal kidney function. Even opioids can be used for severe pain but peripartum administration can lead to neonatal respiratory depression and adaptation disorders and long-term therapy up to the end of pregnancy can lead to neonatal withdrawal symptoms...
November 2, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27785937/paracetamol-and-morphine-for-infant-and-neonatal-pain-still-a-long-way-to-go
#2
Manuel A Baarslag, Karel Allegaert, John N Van Den Anker, Catherijne A J Knibbe, Monique Van Dijk, Sinno H P Simons, Dick Tibboel
Pharmacologic pain management in newborns and infants is often based on limited scientific data. To close the knowledge gap, drug-related research in this population is increasingly supported by the authorities, but remains very challenging. This review summarizes the challenges of analgesic studies in newborns and infants on morphine and paracetamol (acetaminophen). Areas covered: Aspects such as the definition and multimodal character of pain are reflected to newborn infants. Specific problems addressed include defining pharmacodynamic endpoints, performing clinical trials in this population and assessing developmental changes in both pharmacokinetics and pharmacodynamics...
November 9, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27716943/paracetamol-acetaminophen-for-prevention-or-treatment-of-pain-in-newborns
#3
REVIEW
Arne Ohlsson, Prakeshkumar S Shah
BACKGROUND: Newborn infants have the ability to experience pain. Hospitalised infants are exposed to numerous painful procedures. Healthy newborns are exposed to pain if the birth process consists of assisted vaginal birth by vacuum extraction or by forceps and during blood sampling for newborn screening tests. OBJECTIVES: To determine the efficacy and safety of paracetamol for the prevention or treatment of procedural/postoperative pain or pain associated with clinical conditions in neonates...
October 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27714809/physical-compatibility-of-total-parenteral-nutrition-and-drugs-in-y-site-administration-to-children-from-neonates-to-adolescents
#4
Vigdis Staven, Herra Iqbal, Siri Wang, Ingrid Grønlie, Ingunn Tho
OBJECTIVES: Infusion of precipitate or destabilized emulsion can be harmful. The purpose of this study was to obtain Y-site compatibility data on intravenous drugs and total parenteral nutrition (TPN) relevant for children. METHODS: Two three-in-one TPN admixtures (Olimel N5E and Numeta G16E) used for children of different age groups were tested with ten drugs (ampicillin, ceftazidime, clindamycin, dexamethasone, fluconazole, fosphenytoin, furosemide, metronidazole, ondansetron and paracetamol)...
October 7, 2016: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27698754/oral-paracetamol-vs-oral-ibuprofen-in-the-treatment-of-symptomatic-patent-ductus-arteriosus-in-premature-infants-a-randomized-controlled-trial
#5
Bo Yang, Xiangyu Gao, Yi Ren, Yun Wang, Qinglin Zhang
The aim of the present study was to analyze the changes of plasma and urinary prostaglandin E2 (PGE2) levels in preterm infants with symptomatic patent ductus arteriosus (sPDA) treated with oral ibuprofen and acetaminophen. A total of 87 preterm infants with sPDA admitted to the Neonatal Ward of the Affiliated Xuzhou Hospital of Medical College of Southeast University from October, 2012 to June, 2015 were selected and randomly divided into the ibuprofen group (n=43, 10 mg/kg ibuprofen administered orally as initial dose, followed by 5 mg/kg during the first 24 and 48 h later) and acetaminophen group (n=44, 15 mg/kg acetaminophen administered orally once every 6 h for three days)...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27364566/clinical-pharmacology-of-analgosedatives-in-neonates-ways-to-improve-their-safe-and-effective-use
#6
Anne Smits, John N van den Anker, Karel Allegaert
OBJECTIVES: To propose approaches tailored to the specific needs of neonates, such as structured product development programmes, with the ultimate goal to improve the safe and effective use of analgosedatives in these fragile patients. KEY FINDINGS: The feasibility and relevance of a structured product development programme in neonates (optimal study design based on preliminary data; model development; internal, external and prospective evaluation; an individualized dosing regimen; long-term safety; pharmacogenetics) are illustrated for the use of morphine...
June 30, 2016: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27275051/efficacy-of-intravenous-paracetamol-on-pressor-response-in-patients-undergoing-cesarean-section-under-general-anesthesia
#7
Sanum Kashif, Mohammad Hamid
BACKGROUND AND AIMS: Profound hemodynamic alterations due to stress and pain during endotracheal intubation may cause deleterious effects. The purpose of this study was to evaluate the effect of intravenous (IV) paracetamol on hemodynamic changes due to endotracheal intubation during cesarean section under general anesthesia. MATERIAL AND METHODS: Random allocation of one hundred and ten patients in two groups (Group A - placebo and Group B - paracetamol), was achieved as per computer generated table...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27212765/comparison-of-preoperative-rectal-paracetamol-with-paracetamol-diclofenac-combination-for-postoperative-analgesia-in-pediatric-surgeries-under-general-anesthesia
#8
Srivishnu Vardhan Yallapragada, Thrivikram Shenoy
CONTEXT: Traditionally, pain in children is a topic that has received only minimal attention. However, in the recent times, considerable progress has been made in the field of neonatal and pediatric pharmacology. The concept of preemptive analgesia is important in combating postoperative pain in children. In this study, we sought to compare the effectiveness of preemptive analgesia provided by paracetamol alone and by its combination with diclofenac when administered per rectum. AIMS: To compare the efficacy of preoperative rectal paracetamol with paracetamol - diclofenac combination for postoperative analgesia in pediatric surgeries under general anesthesia...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27209292/neonatal-maturation-of-paracetamol-acetaminophen-glucuronidation-sulfation-and-oxidation-based-on-a-parent-metabolite-population-pharmacokinetic-model
#9
Sarah F Cook, Chris Stockmann, Samira Samiee-Zafarghandy, Amber D King, Nina Deutsch, Elaine F Williams, Diana G Wilkins, Catherine M T Sherwin, John N van den Anker
OBJECTIVES: This study aimed to model the population pharmacokinetics of intravenous paracetamol and its major metabolites in neonates and to identify influential patient characteristics, especially those affecting the formation clearance (CLformation) of oxidative pathway metabolites. METHODS: Neonates with a clinical indication for intravenous analgesia received five 15-mg/kg doses of paracetamol at 12-h intervals (<28 weeks' gestation) or seven 15-mg/kg doses at 8-h intervals (≥28 weeks' gestation)...
November 2016: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27197952/pharmacotherapy-for-patent-ductus-arteriosus-current-options-and-outstanding-questions
#10
Sara E Rostas, Christopher C McPherson
Management of the patent ductus arteriosus (PDA) represents an ongoing challenge in the care of extremely premature neonates. Determining the optimal treatment strategy requires careful consideration of the potential risks and benefits of available therapies. Surgical ligation results in reliable ductal closure, but may result in numerous short-term complications and have a negative impact on long-term outcome. Intravenous indomethacin was the first pharmacologic agent widely utilized for PDA closure. Intravenous indomethacin effectively closes the ductus arteriosus and prevents pulmonary hemorrhage and severe intraventricular hemorrhage, but fails to mitigate short-term morbidities and improve long-term outcomes...
2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27108085/status-of-neonatal-pain-assessment-and-management-in-jordan
#11
Nadin M Abdel Razeq, Akuma O Akuma, Sue Jordan
Current pain assessment and management in neonates need to be fully described before neonatal pain care can be optimized. This study's purpose was to report neonatal nurses' knowledge, existing pain assessment practice, and pharmacological pain management of neonates in Jordan. A cross-sectional descriptive study was conducted. Eighteen neonatal intensive care units in Jordan were included in the study. One hundred eighty-four neonatal nurses participated. Questionnaires were distributed by and returned to the neonatal intensive care units' managers between June and August 2014...
August 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/27087155/neonatal-pain-management-still-in-search-for-the-holy-grail
#12
REVIEW
Karel Allegaert, John N van den Anker
Inadequate pain management but also inappropriate use of analgesics in early infancy has negative effects on neurodevelopmental outcome. As a consequence, neonatal pain management is still in search for the Holy Grail. At best, effective pain management is based on prevention, assessment, and treatment followed by a re-assessment of the pain to determine if additional treatment is still necessary. Unfortunately, epidemiological observations suggest that neonates are undergoing painful procedures very frequently, unveiling the need for effective preventive, non-pharmacological strategies...
July 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/26914846/neonatal-paracetamol-treatment-reduces-long-term-nociceptive-behaviour-after-neonatal-procedural-pain-in-rats
#13
N J van den Hoogen, D Tibboel, W M M Honig, D Hermes, J Patijn, E A Joosten
BACKGROUND: Pain from skin penetrating procedures (procedural pain) during infancy in the neonatal intensive care unit (NICU) may result in changes of nociceptive sensitivity in later life. This supports the need for pain management during such vulnerable periods in life. This study, therefore, analyses the short- and long-term consequences of neonatal paracetamol (acetaminophen) treatment on pain behaviour in an experimental rat model of neonatal procedural pain. METHODS: A repetitive needle-prick model was used, in which neonatal rats received four needle pricks into the left hind paw per day from postnatal day 0 to day 7 (P0-P7)...
September 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/26897160/oral-paracetamol-for-closure-of-patent-ductus-arteriosus-in-selected-preterm-neonates
#14
Pankaj Kumar Mohanty, N Karthik Nagesh, Abdul Razak
We prospectively studied the effect of oral paracetamol in closing hemodynamically significant Patent ductus arteriosus in preterm infants (gestational age <32 weeks) where Ibuprofen was contraindicated. 29 of 40 neonates (72.5%) showed successful response while 11 (29.5%) failed to show any response. No major complications were seen.
February 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/26876125/recent-advances-in-the-treatment-of-preterm-newborn-infants-with-patent-ductus-arteriosus
#15
REVIEW
Hannes Sallmon, Petra Koehne, Georg Hansmann
A patent ductus arteriosus (PDA) is associated with several adverse clinical conditions. Several strategies for PDA treatment exist, although data regarding the benefits of PDA treatment on outcomes are sparse. Moreover, the optimal treatment strategy for preterm neonates with PDA remains subject to debate. It is still unknown whether and when PDA treatment should be initiated and which approach (conservative, pharmacologic, or surgical) is best for individual patients (tailored therapies). This article reviews the current strategies for PDA treatment with a special focus on recent developments such as oral ibuprofen, high-dose regimens, and the use of paracetamol (oral, intravenous)...
March 2016: Clinics in Perinatology
https://www.readbyqxmd.com/read/26705524/effect-of-intravenous-acetaminophen-paracetamol-on-hemodynamic-parameters-following-endotracheal-tube-intubation-and-postoperative-pain-in-caesarian-section-surgeries
#16
Ghasem Soltani, Amirmasoud Molkizadeh, Shahram Amini
BACKGROUND: Use of analgesics, especially opioids, before delivery during cesarean section for preventing hemodynamic changes after endotracheal intubation and postoperative analgesia is limited due to their adverse effects on the neonate. OBJECTIVES: The aim of this study was to investigate the effect of intravenous acetaminophen (paracetamol) in blunting hemodynamic responses to endotracheal intubation and postoperative pain in parturient undergoing cesarean section by general anesthesia...
December 2015: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/26639709/developing-drug-formularies-for-the-national-medical-holding-jsc
#17
N S Akhmadyar, B E Khairulin, S Amangeldy-Kyzy, M A Ospanov
BACKGROUND: One of the main problems of drug provision of multidisciplinary hospitals is the necessity to improve the efficiency of budget spending. Despite the efforts undertaken in Kazakhstan for improving the mechanism of drug distribution (creation of the Kazakhstan National Formulary, Unified National Health System, the handbook of medicines (drugs) costs in the electronic register of inpatients (ERI), having a single distributor), the number of unresolved issues still remain."National Medical Holding" JSC (NMH) was established in 2008 and unites 6 innovational healthcare facilities with up to 1431 beds (700 children and 731 adults), located in the medical cluster - which are "National Research Center for Maternal and Child Health" JSC (NRCMC), "Republic Children's Rehabilitation Center" JSC (RCRC), "Republican Diagnostic Center" JSC (RDC), "National Centre for Neurosurgery" JSC (NCN), "National Research Center for Oncology and Transplantation" JSC (NRCOT) and "National Research Cardiac Surgery Center" JSC (NRCSC)...
2015: International Journal of Risk & Safety in Medicine
https://www.readbyqxmd.com/read/26571452/simultaneous-quantification-of-acetaminophen-and-five-acetaminophen-metabolites-in-human-plasma-and-urine-by-high-performance-liquid-chromatography-electrospray-ionization-tandem-mass-spectrometry-method-validation-and-application-to-a-neonatal-pharmacokinetic
#18
Sarah F Cook, Amber D King, John N van den Anker, Diana G Wilkins
Drug metabolism plays a key role in acetaminophen (paracetamol)-induced hepatotoxicity, and quantification of acetaminophen metabolites provides critical information about factors influencing susceptibility to acetaminophen-induced hepatotoxicity in clinical and experimental settings. The aims of this study were to develop, validate, and apply high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC-ESI-MS/MS) methods for simultaneous quantification of acetaminophen, acetaminophen-glucuronide, acetaminophen-sulfate, acetaminophen-glutathione, acetaminophen-cysteine, and acetaminophen-N-acetylcysteine in small volumes of human plasma and urine...
December 15, 2015: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/26323410/development-of-a-physiologically-based-pharmacokinetic-model-for-preterm-neonates-evaluation-with-in-vivo-data
#19
REVIEW
Karina Claassen, Kirstin Thelen, Katrin Coboeken, Thomas Gaub, Jorg Lippert, Karel Allegaert, Stefan Willmann
Among pediatric patients, preterm neonates and newborns are the most vulnerable subpopulation. Rapid developmental changes of physiological factors affecting the pharmacokinetics of drug substances in newborns require extreme care in dose and dose regimen decisions. These decisions could be supported by in silico methods such as physiologically-based pharmacokinetic (PBPK) modeling. In a comprehensive literature search, the physiological information of preterm neonates that is required to establish a PBPK model has been summarized and implemented into the database of a generic PBPK software...
2015: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/26323200/intravenous-paracetamol-decreases-requirements-of-morphine-in-very-preterm-infants
#20
Antti Härmä, Outi Aikio, Mikko Hallman, Timo Saarela
OBJECTIVE: To determine whether intravenous paracetamol therapy is effective in pain therapy in premature infants. STUDY DESIGN: From June 2009 to December 2011, 108 infants born very low gestational age (<32 weeks) (VLGA) were given intravenous paracetamol before the age of 72 hours. The loading dose was 20 mg/kg followed by 7.5 mg/kg every 6 hours. One hundred ten VLGA infants admitted from October 2007 to May 2009 formed the comparison group who received no paracetamol...
January 2016: Journal of Pediatrics
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