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Paediatric and perinatal drug therapy最新文献

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Registering paediatric clinical trials 注册儿科临床试验
Pub Date : 2006-12-01 DOI: 10.1185/146300906X148567
M. Bonati, C. Pandolfini, V. Rossi, E. Santoro, J. M. A. D. Bolós, I. D. Carreras, I. F. Camps, JM Llobet, É. Jacqz-Aigrain, S. Zarrabian, I. Choonara, H. Sammons, Coral Smith
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引用次数: 1
Reducing inter-individual variability in amikacin clearance in preterm neonates 减少早产儿阿米卡星清除率的个体差异
Pub Date : 2006-12-01 DOI: 10.1185/146300906X148558
K. Allegaert, J. Hoon, M. Rayyan, J. Anker
The bactericidal efficacy of amikacin mainly relates to intermittent, discontinuous peak concentrations due to the post-antibiotic effect, while renal side effects and oto-toxicity relate to the average plasma concentration, based on saturation of renal and cochlear cell binding sites. This combination of efficacy and safety has resulted in the concept of administration of relative larger doses with extended dosing intervals between consecutive administrations. However, the important interindividual variability in amikacin pharmacokinetics (PK) due to renal maturation makes it difficult to achieve a safe and effective dosing regimen in the individual premature neonate, most prominent in extremely preterm neonates and at birth. We report on the consecutive steps we took over a period of 7 years to reduce inter-individual variability in order to achieve a safe and effective dosing regimen in preterm neonates at birth. Individual amikacin pharmacokinetics were calculated in 273 preterm neonates (546 paired observations, <31 weeks postmenstrual age (PMA), on respiratory support). Based on different dosing regimes used during consecutive time intervals, we were able to illustrate the PMA-dependent clearance, the negative effect of co-administration of a non-selective cyclo-oxygenase inhibitor on amikacin clearance and the impact of implementation of these observations on the amikacin trough levels observed. However, still important unexplained interindividual variability was observed. The subsequent introduction of a paediatric vial in a more recently treated cohort further reduced the variability in amikacin clearance observed. We have illustrated (i) the influence of perinatal renal function on amikacin clearance and (ii) the impact of a paediatric vial on the further reduction of the observed variability in amikacin clearance to dosing regimens.
阿米卡星的杀菌效果主要与抗生素后作用导致的间歇性、不连续的峰值浓度有关,而肾脏副作用和耳毒性则与平均血浆浓度有关,基于肾脏和耳蜗细胞结合位点的饱和度。这种有效性和安全性的结合产生了在连续给药之间延长给药间隔的相对大剂量给药的概念。然而,由于肾成熟导致的阿米卡星药代动力学(PK)的重要个体间差异,使得很难在个体早产儿中实现安全有效的给药方案,尤其是在极度早产的新生儿和出生时。我们报告了我们在7年期间采取的连续步骤,以减少个体间的差异,以便在早产新生儿出生时实现安全有效的给药方案。计算273例早产儿(546例配对观察,经后年龄<31周,呼吸支持)阿米卡星的个体药代动力学。基于在连续时间间隔内使用的不同给药方案,我们能够说明pma依赖的清除率,非选择性环加氧酶抑制剂对阿米卡星清除率的负面影响,以及实施这些观察对阿米卡星槽水平的影响。然而,仍然观察到重要的无法解释的个体间变异性。随后在最近治疗的队列中引入儿科小瓶进一步降低了观察到的阿米卡星清除率的变异性。我们已经说明了(i)围产期肾功能对阿米卡星清除率的影响和(ii)儿科小瓶对进一步减少观察到的阿米卡星清除率对给药方案的变异性的影响。
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引用次数: 2
New publisher, new opportunities 新的发行商,新的机遇
Pub Date : 2006-12-01 DOI: 10.1185/146300906X148549
I. Choonara, P. Garner
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引用次数: 0
Drug metabolism studies in the newborn infant and children using an oral erythromycin breath test 新生儿和儿童口服红霉素呼吸试验的药物代谢研究
Pub Date : 2006-12-01 DOI: 10.1185/146300906X148576
C. Cocking, E. Webster, J. McIntyre, T. Preston, I. Choonara
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引用次数: 3
A single-dose, randomised, crossover study to compare the rate and extent of absorption of lisinopril solution versus tablets in healthy volunteers 一项单剂量、随机、交叉研究,比较健康志愿者赖诺普利溶液和片剂的吸收率和程度
Pub Date : 2006-12-01 DOI: 10.1185/146300906X148585
A. Leary, M. Dowling, A. Wilson, B. McKenna, J. Rothwell
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引用次数: 2
Paediatric Clinical Pharmacology in Europe 欧洲儿科临床药理学
Pub Date : 2006-11-01 DOI: 10.1185/146300906778876198
M. Bonati, J. Breitkreutz, I. Choonara, K. Hoppu, É. Jacqz-Aigrain, J. Langhendries, G. Pons, A. Rane, H. Seyberth, J. Anker
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引用次数: 13
Generalised oedema in an extremely low birthweight infant during treatment with dexamethasone for chronic lung disease 地塞米松治疗慢性肺部疾病期间极低出生体重婴儿的全身性水肿
Pub Date : 2006-11-01 DOI: 10.1185/146300906778876215
S. Iijima, N. Uga
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引用次数: 0
Fetal valproate syndrome: a review 胎儿丙戊酸综合征:综述
Pub Date : 2006-11-01 DOI: 10.1185/146300906778876233
U. Kini
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引用次数: 32
Adenosine in paediatric arrhythmias 腺苷在小儿心律失常中的作用
Pub Date : 2006-11-01 DOI: 10.1185/146300906778876189
C. Wren
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引用次数: 6
Can paediatric junior hospital doctors prescribe competently 儿科初级医院的医生能胜任开处方吗
Pub Date : 2006-11-01 DOI: 10.1185/146300906778876260
L. Menon, Z. Taylor, D. Tuthill
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引用次数: 17
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Paediatric and perinatal drug therapy
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