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15 papers 0 to 25 followers Neonatal abstinence syndrome articles
By Lauren Kelly Pediatric clinical pharmacologist
https://www.readbyqxmd.com/read/26672650/feasibility-of-collaborative-care-treatment-of-opioid-use-disorders-with-buprenorphine-during-pregnancy
#1
Leena Mittal, Joji Suzuki
BACKGROUND: Medication-assisted treatment with buprenorphine or methadone is recommended for pregnant patients with opioid use disorders to minimize adverse maternal and neonatal outcomes. Collaborative care approaches have been successfully utilized with office-based opioid treatment with buprenorphine in primary care settings, but research is significantly limited in the obstetric setting. Our aim with this study is to demonstrate the feasibility of a collaborative care model for pregnant patients with opioid use disorder...
December 16, 2015: Substance Abuse
https://www.readbyqxmd.com/read/26712409/mechanistic-population-pharmacokinetics-of-morphine-in-neonates-with-abstinence-syndrome-after-oral-administration-of-diluted-tincture-of-opium
#2
Tao Liu, Tamorah Lewis, Estelle Gauda, Jogarao Gobburu, Vijay Ivaturi
Conducting and analyzing clinical trials in vulnerable neonates are extremely challenging. The aim of this analysis is to develop a morphine population pharmacokinetics (PK) model using data collected during a randomized control trial in neonates with abstinence syndrome (NAS). A 3-compartment morphine structural PK model after intravenous (IV) administration from previously published work was utilized as prior, whereas an allometric scaling method with physiological consideration was used to extrapolate a PK profile from adults to pediatrics...
August 2016: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/9197336/current-management-of-the-neonatal-abstinence-syndrome-a-critical-analysis-of-the-evidence
#3
REVIEW
J G Theis, P Selby, Y Ikizler, G Koren
OBJECTIVE: To systematically and critically analyse and summarise the published evidence for the rational choice of pharmacologic treatment of the neonatal abstinence syndrome (NAS), a frequently observed condition in neonates born to mothers who are dependent on physically addicting drugs. DESIGN: Studies comparing different pharmacological agents for the treatment of NAS were identified utilising MEDLINE and additionally the references cited in pertinent articles...
1997: Biology of the Neonate
https://www.readbyqxmd.com/read/20484620/clonidine-clearance-matures-rapidly-during-the-early-postnatal-period-a-population-pharmacokinetic-analysis-in-newborns-with-neonatal-abstinence-syndrome
#4
RANDOMIZED CONTROLLED TRIAL
Hong-Guang Xie, Ying Jun Cao, Estelle B Gauda, Alexander G Agthe, Craig W Hendrix, Howard Lee
The population pharmacokinetic (PK) profile of oral clonidine was characterized in newborns with neonatal abstinence syndrome, and significant covariates affecting its PK parameters were identified. Plasma clonidine concentration data were obtained from a clinical trial in which 36 newborns, aged 1 to 25 days (postnatal age, PNA) and weighing 2.1 to 3.9 kg, were enrolled to take multiple oral doses of clonidine. The population PK model of clonidine was developed by NONMEM, and significant covariates were identified, followed by nonparametric bootstraps (2000 replicates) and simulation experiments...
April 2011: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/23949834/efficacy-of-clonidine-versus-phenobarbital-in-reducing-neonatal-morphine-sulfate-therapy-days-for-neonatal-abstinence-syndrome-a-prospective-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
B Surran, P Visintainer, S Chamberlain, K Kopcza, B Shah, R Singh
OBJECTIVE: To compare the efficacy of clonidine versus phenobarbital in reducing morphine sulfate treatment days for neonatal abstinence syndrome (NAS). STUDY DESIGN: Prospective, non-blinded, block randomized trial at a single level III NICU (Neonatal Intensive Care Unit). Eligible infants were treated with a combination of medications as per protocol. Primary outcome was treatment days with morphine sulfate. Secondary outcomes were the mean total morphine sulfate dose, outpatient phenobarbital days, adverse events and treatment failures...
December 2013: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/19398463/clonidine-as-an-adjunct-therapy-to-opioids-for-neonatal-abstinence-syndrome-a-randomized-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Alexander G Agthe, George R Kim, Kay B Mathias, Craig W Hendrix, Raul Chavez-Valdez, Lauren Jansson, Tamorah R Lewis, Myron Yaster, Estelle B Gauda
OBJECTIVE: To determine if oral clonidine would reduce the duration of opioid detoxification for neonatal abstinence syndrome. METHODS: Infants with intrauterine exposure to methadone or heroin and neonatal abstinence syndrome (2 consecutive modified Finnegan scores of > or =9) were enrolled at 2 hospitals during 2002-2005 and followed until final hospital discharge. All enrolled infants (80) received oral diluted tincture of opium according to a standardized algorithm and were randomly assigned to receive oral clonidine (1 microg/kg every 4 hours) (40 infants) or placebo (40 infants)...
May 2009: Pediatrics
https://www.readbyqxmd.com/read/26364984/pharmacokinetics-of-oral-methadone-in-the-treatment-of-neonatal-abstinence-syndrome-a-pilot-study
#7
Jason R Wiles, Barbara Isemann, Tomoyuki Mizuno, Meredith E Tabangin, Laura P Ward, Henry Akinbi, Alexander A Vinks
OBJECTIVE: To characterize the population pharmacokinetics of oral methadone in neonates requiring pharmacologic treatment of neonatal abstinence syndrome and to develop a pharmacokinetic (PK) model toward an evidence-based treatment protocol. STUDY DESIGN: Based on a methadone dosing protocol, serum concentrations of methadone and its metabolites were assessed by high performance liquid chromatography-tandem mass spectrometry from dried blood spots. Population PK analysis was performed to determine the volume of distribution and clearance of oral methadone...
December 2015: Journal of Pediatrics
https://www.readbyqxmd.com/read/25941308/a-quality-improvement-project-to-reduce-length-of-stay-for-neonatal-abstinence-syndrome
#8
Lindsey Asti, Jacqueline S Magers, Erin Keels, Jonathan Wispe, Richard E McClead
BACKGROUND AND OBJECTIVE: Neonatal abstinence syndrome (NAS), a self-limiting condition, is associated with clinical symptoms that may require pharmacological intervention. Optimal treatment of NAS remains undetermined, but the hospital length of stay (LOS) for patients with NAS is partially dependent upon a standard treatment protocol used. Prolonged LOS for patients with NAS can lead to adverse patient harm, impaired maternal-infant attachment, and significant health care costs. Therefore, we conducted a quality improvement study to reduce the LOS for infants with NAS...
June 2015: Pediatrics
https://www.readbyqxmd.com/read/25913111/increasing-incidence-of-the-neonatal-abstinence-syndrome-in-u-s-neonatal-icus
#9
MULTICENTER STUDY
Veeral N Tolia, Stephen W Patrick, Monica M Bennett, Karna Murthy, John Sousa, P Brian Smith, Reese H Clark, Alan R Spitzer
BACKGROUND: The incidence of the neonatal abstinence syndrome, a drug-withdrawal syndrome that most commonly occurs after in utero exposure to opioids, is known to have increased during the past decade. However, recent trends in the incidence of the syndrome and changes in demographic characteristics and hospital treatment of these infants have not been well characterized. METHODS: Using multiple cross-sectional analyses and a deidentified data set, we analyzed data from infants with the neonatal abstinence syndrome from 2004 through 2013 in 299 neonatal intensive care units (NICUs) across the United States...
May 28, 2015: New England Journal of Medicine
https://www.readbyqxmd.com/read/25670522/ondansetron-pharmacokinetics-in-pregnant-women-and-neonates-towards-a-new-treatment-for-neonatal-abstinence-syndrome
#10
M H Elkomy, P Sultan, B Carvalho, G Peltz, M Wu, C Clavijo, J L Galinkin, D R Drover
Ondansetron is the drug of choice to prevent nausea in women undergoing cesarean surgery and can be used to prevent neonatal abstinence syndrome (NAS). The pharmacokinetics of ondansetron have not been characterized in pregnant women or in newborns. A nonlinear mixed-effects modeling approach was used to analyze plasma samples obtained from 20 nonpregnant and 40 pregnant women following a single administration of 4 or 8 mg ondansetron, from umbilical cord blood at delivery, and from neonates after birth. The analysis indicates that: ondansetron disposition is not affected by pregnancy (P > 0...
February 2015: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/25624389/morphine-versus-clonidine-for-neonatal-abstinence-syndrome
#11
RANDOMIZED CONTROLLED TRIAL
Henrietta S Bada, Thitinart Sithisarn, Julia Gibson, Karen Garlitz, Rhonda Caldwell, Gilson Capilouto, Yinglei Li, Markos Leggas, Patrick Breheny
OBJECTIVE: The study goal was to determine whether clonidine treatment of neonatal abstinence syndrome (NAS) would result in a better neurobehavioral performance compared with morphine. METHODS: This pilot study prospectively enrolled infants ≥ 35 weeks' gestational age admitted for treatment of NAS. After informed consent was obtained, infants were randomized to receive morphine (0.4 mg/kg per day) or clonidine (5 μg/kg per day) divided into 8 doses. A 25% dose escalation every 24 hours was possible per protocol (maximum of 1 mg/kg per day for morphine and 12 μg/kg per day for clonidine)...
February 2015: Pediatrics
https://www.readbyqxmd.com/read/25070317/a-multicenter-cohort-study-of-treatments-and-hospital-outcomes-in-neonatal-abstinence-syndrome
#12
MULTICENTER STUDY
Eric S Hall, Scott L Wexelblatt, Moira Crowley, Jennifer L Grow, Lisa R Jasin, Mark A Klebanoff, Richard E McClead, Jareen Meinzen-Derr, Vedagiri K Mohan, Howard Stein, Michele C Walsh
OBJECTIVES: To compare pharmacologic treatment strategies for neonatal abstinence syndrome (NAS) with respect to total duration of opioid treatment and length of inpatient hospital stay. METHODS: We conducted a cohort analysis of late preterm and term neonates who received inpatient pharmacologic treatment of NAS at one of 20 hospitals throughout 6 Ohio regions from January 2012 through July 2013. Physicians managed NAS using 1 of 6 regionally based strategies. RESULTS: Among 547 pharmacologically treated infants, we documented 417 infants managed using an established NAS weaning protocol and 130 patients managed without protocol-driven weaning...
August 2014: Pediatrics
https://www.readbyqxmd.com/read/25062525/neonatal-abstinence-syndrome-evaluating-the-effectiveness-of-an-evidence-based-multidisciplinary-care-approach
#13
Carla Saunders, Terry King, Sheri Smith, John Buchheit, Kyle Cook, Jill Edds, Linda Mefford
An evidence-based, multidisciplinary neonatal abstinence syndrome protocol was developed using a stepwise continuous quality improvement (CQI) approach with the goal of standardizing care procedures for these infants. A retrospective secondary data analysis was performed to evaluate the differential effects of each step of the CQI project on 4 key clinical outcome measures: length of stay (total and post-opioid wean), weaning time from opioids, and use of adjunct medications. Data were analyzed from 386 newborn infants with a diagnosis of neonatal abstinence syndrome undergoing treatment in a level III neonatal intensive care unit...
July 2014: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/23241498/neonatal-abstinence-syndrome-clinical-practice-guidelines-for-ontario
#14
Kimberly Dow, Alice Ordean, Jodie Murphy-Oikonen, Jodie Pereira, Gideon Koren, Henry Roukema, Peter Selby, Ruth Turner
Ontario's clinical practice guidelines for neonatal abstinence syndrome (NAS) provide evidence-informed recommendations that address the needs of substance using pregnant women and newborns at risk of NAS. NAS is a complex and multifaceted issue that is escalating along with rapidly rising opioid use in Ontario. Reducing the incidence and impact of NAS requires immediate action in order to improve the care of affected women and infants. This includes optimizing and standardizing treatment strategies, assessing and managing social risk, better monitoring of prescribing practices and facilitating the implementation of better treatment and prevention strategies as they become available...
2012: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/21142534/neonatal-abstinence-syndrome-after-methadone-or-buprenorphine-exposure
#15
RANDOMIZED CONTROLLED TRIAL
Hendrée E Jones, Karol Kaltenbach, Sarah H Heil, Susan M Stine, Mara G Coyle, Amelia M Arria, Kevin E O'Grady, Peter Selby, Peter R Martin, Gabriele Fischer
BACKGROUND: Methadone, a full mu-opioid agonist, is the recommended treatment for opioid dependence during pregnancy. However, prenatal exposure to methadone is associated with a neonatal abstinence syndrome (NAS) characterized by central nervous system hyperirritability and autonomic nervous system dysfunction, which often requires medication and extended hospitalization. Buprenorphine, a partial mu-opioid agonist, is an alternative treatment for opioid dependence but has not been extensively studied in pregnancy...
December 9, 2010: New England Journal of Medicine
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