Evidence-based morphine dosing for postoperative neonates and infants.

Abstract:

BACKGROUND AND OBJECTIVES:From a previously validated paediatric population pharmacokinetic model, it was derived that non-linear morphine maintenance doses of 5 μg/kg(1.5)/h, with a 50 % dose reduction in neonates with a postnatal age (PNA) <10 days, yield similar morphine and metabolite concentrations across patients younger than 3 years. Compared with traditional dosing, this model-derived dosing regimen yields significantly reduced doses in neonates aged <10 days. METHODS:Concentration predictions of the population model were prospectively evaluated in postoperative term neonates and infants up to the age of 1 year who received morphine doses according to the model-derived algorithm. The efficacy of this dosing algorithm was evaluated using morphine rescue medication and actual average infusion rates. RESULTS:Morphine and metabolite concentrations were accurately predicted by the paediatric pharmacokinetic morphine model. With regard to efficacy, 5 out of 18 neonates (27.8 %) with a PNA of <10 days needed rescue medication versus 18 of the 20 older patients (90 %) (p = 0.06). The median (interquartile range [IQR]) total morphine rescue dose was 0 (0-20) μg/kg in younger patients versus 193 (19-362) μg/kg in older patients (p = 0.003). The median (IQR) actual average morphine infusion rate was 4.4 (4.0-4.8) μg/kg/h in younger patients versus 14.4 (11.3-23.4) μg/kg/h in older patients (p < 0.001). CONCLUSION:Morphine paediatric dosing algorithms corrected for pharmacokinetic differences alone yield effective doses that prevent over-dosing for neonates with a PNA <10 days. The fact that many neonates and infants with a PNA ≥10 days still required rescue medication warrants pharmacodynamic studies to further optimize the dosing algorithm for these patients.

journal_name

Clin Pharmacokinet

authors

Krekels EH,Tibboel D,de Wildt SN,Ceelie I,Dahan A,van Dijk M,Danhof M,Knibbe CA

doi

10.1007/s40262-014-0135-4

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

553-63

issue

6

eissn

0312-5963

issn

1179-1926

journal_volume

53

pub_type

杂志文章,随机对照试验
  • Exposure-effect population model of inolimomab, a monoclonal antibody administered in first-line treatment for acute graft-versus-host disease.

    abstract:BACKGROUND AND OBJECTIVE:Inolimomab, a monoclonal antibody against interleukin (IL)-2Ralpha (CD25) has shown promising results in the treatment of corticosteroid-resistant acute graft-versus-host disease (GvHD). The objective of the present study was to characterise the pharmacokinetic and pharmacodynamic properties of...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-200746050-00004

    authors: Dartois C,Freyer G,Michallet M,Hénin E,You B,Darlavoix I,Vermot-Desroches C,Tranchand B,Girard P

    更新日期:2007-01-01 00:00:00

  • Pharmacokinetic Studies in Neonates: The Utility of an Opportunistic Sampling Design.

    abstract:BACKGROUND AND OBJECTIVE:The use of an opportunistic (also called scavenged) sampling strategy in a prospective pharmacokinetic study combined with population pharmacokinetic modelling has been proposed as an alternative strategy to conventional methods for accomplishing pharmacokinetic studies in neonates. However, th...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-015-0291-1

    authors: Leroux S,Turner MA,Guellec CB,Hill H,van den Anker JN,Kearns GL,Jacqz-Aigrain E,Zhao W,TINN (Treat Infections in NeoNates) and GRiP (Global Research in Paediatrics) Consortiums.

    更新日期:2015-12-01 00:00:00

  • Prediction of propofol clearance in children from an allometric model developed in rats, children and adults versus a 0.75 fixed-exponent allometric model.

    abstract::For propofol clearance, allometric scaling has been applied successfully for extrapolations between species (rats and humans) and within the human bodyweight range (children and adults). In this analysis, the human bodyweight range is explored to determine for which range an allometric model with a fixed or estimated ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/11319350-000000000-00000

    authors: Peeters MY,Allegaert K,Blussé van Oud-Alblas HJ,Cella M,Tibboel D,Danhof M,Knibbe CA

    更新日期:2010-04-01 00:00:00

  • Multiple-dose non-linear regression analysis program. Aminoglycoside dose prediction.

    abstract::The ability of a new multiple-dose non-linear regression analysis program to predict steady-state aminoglycoside peak and trough serum concentrations was evaluated. 30 patients receiving either amikacin (7), gentamicin (10) or tobramycin (13) were studied. A standard method of prediction which requires the collection ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-198308050-00006

    authors: Koup JR,Killen T,Bauer LA

    更新日期:1983-09-01 00:00:00

  • Pharmacokinetics and safety of ebastine in patients with impaired hepatic function compared with healthy volunteers: a phase I open-label study.

    abstract:OBJECTIVE:To assess the differences between patients with hepatic insufficiency and healthy subjects with regard to the pharmacokinetics, cardiac safety and overall safety of ebastine and its active metabolite carebastine. DESIGN:Open-label parallel-group study. PARTICIPANTS:24 patients with varying degrees of hepati...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003088-200443020-00004

    authors: Lasseter KC,Dilzer SC,Vargas R,Waldman S,Noveck RJ

    更新日期:2004-01-01 00:00:00

  • Dosage adjustment from simple nortriptyline spot level predictor tests in depressed patients.

    abstract::20 routine patients with endogenous depression were investigated in a kinetic and 4 week treatment study. Steady-state plasma nortriptyline concentrations above 200 microgram/L were associated with a highly significant poorer therapeutic outcome. The correlations between the 24, 48 and 72 hour concentrations and stead...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003088-197904020-00005

    authors: Montgomery SA,McAuley R,Montgomery DB,Braithwaite RA,Dawling S

    更新日期:1979-03-01 00:00:00

  • Blockade of the High-Affinity Interleukin-2 Receptors with Daclizumab High-Yield Process: Pharmacokinetic/Pharmacodynamic Analysis of Single- and Multiple-Dose Phase I Trials.

    abstract:BACKGROUND AND OBJECTIVE:Daclizumab high-yield process (DAC HYP) is a humanized monoclonal antibody that selectively blocks the α-subunit (CD25) of the high-affinity interleukin-2 receptors, and has shown robust efficacy as a treatment for multiple sclerosis (MS). This work quantitatively characterized the relationship...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40262-015-0305-z

    authors: Minocha M,Tran JQ,Sheridan JP,Othman AA

    更新日期:2016-01-01 00:00:00

  • Physiologically based pharmacokinetic modelling to predict single- and multiple-dose human pharmacokinetics of bitopertin.

    abstract:BACKGROUND:Bitopertin (RG1678) is a glycine reuptake inhibitor currently in phase 3 trials for treatment of schizophrenia. This paper describes the use of physiologically based pharmacokinetic (PBPK) modelling and preclinical data to gain insights into and predict bitopertin clinical pharmacokinetics. METHODS:Simulati...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40262-013-0061-x

    authors: Parrott N,Hainzl D,Alberati D,Hofmann C,Robson R,Boutouyrie B,Martin-Facklam M

    更新日期:2013-08-01 00:00:00

  • Target-Mediated Drug Disposition Pharmacokinetic-Pharmacodynamic Model of Bosentan and Endothelin-1.

    abstract:BACKGROUND AND OBJECTIVES:Bosentan is a competitive antagonist on endothelin receptor A and B (ETA and ETB), displacing the endogenous binding partner endothelin-1 (ET-1) from its binding sites. After administration of escalating single doses of 10-750 mg as an intravenous (i.v.) infusion, bosentan showed dose-dependen...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-017-0534-4

    authors: Volz AK,Krause A,Haefeli WE,Dingemanse J,Lehr T

    更新日期:2017-12-01 00:00:00

  • Pegylation: a novel process for modifying pharmacokinetics.

    abstract::The use of liposomal carriers and the modification of therapeutic molecules through the attachment of poly(ethylene glycol) [PEG] moieties ('pegylation') are the most common approaches for enhancing the delivery of parenteral agents. Although 'classical' liposomes (i.e. phospholipid bilayer vehicles) have been effecti...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200140070-00005

    authors: Harris JM,Martin NE,Modi M

    更新日期:2001-01-01 00:00:00

  • Pharmacokinetic factors in the adverse cardiovascular effects of antipsychotic drugs.

    abstract::Antipsychotics may cause serious adverse cardiovascular effects, including prolonged QT interval and sudden death. This review considers antipsychotic-induced cardiovascular events from three perspectives: high-risk drugs, high-risk individuals and high-risk drug interactions. Pharmacokinetic drug interactions involvi...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200443010-00003

    authors: Brown CS,Farmer RG,Soberman JE,Eichner SF

    更新日期:2004-01-01 00:00:00

  • Pharmacokinetics of cetirizine in tear fluid after a single oral dose.

    abstract:BACKGROUND:Antihistamines (histamine H(1) receptor antagonists) are effective and convenient drugs for the treatment of allergic conjunctivitis. Because of the short duration of action generally observed for drugs administered topically to the eye, the oral route is often preferred. However, the presence of a selective...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003088-200241070-00006

    authors: Grumetto L,Cennamo G,Del Prete A,La Rotonda MI,Barbato F

    更新日期:2002-01-01 00:00:00

  • Pharmacokinetics of metformin in girls aged 9 years.

    abstract:BACKGROUND AND OBJECTIVE:Metformin is a biguanide used in the treatment of type 2 diabetes mellitus. In girls with a low birth weight, and early-normal and rapidly progressive puberty, metformin therapy is capable of modifying this outcome, prolonging pubertal growth, increasing height gain, delaying the age at menarch...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章

    doi:10.2165/11593970-000000000-00000

    authors: Sánchez-Infantes D,Díaz M,López-Bermejo A,Marcos MV,de Zegher F,Ibáñez L

    更新日期:2011-11-01 00:00:00

  • Renal elimination of amikacin and the aging process.

    abstract:OBJECTIVE:Although amikacin is primarily eliminated via glomerular filtration, drug concentrations are not consistently predicted in all patients. To better describe the relationship between amikacin clearance and both age and renal function, we used a new heuristic approach involving statistical analysis of dependence...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-200140120-00004

    authors: Ducher M,Maire P,Cerutti C,Bourhis Y,Foltz F,Sorensen P,Jelliffe R,Fauvel JP

    更新日期:2001-01-01 00:00:00

  • New insulin analogues and routes of delivery: pharmacodynamic and clinical considerations.

    abstract::Analogues of human insulin have been developed to more closely replicate the physiology of meal-related and basal insulin secretion. Three rapid-acting analogues and two basal analogues are available for clinical use. Insulin aspart and insulin lispro have nearly identical pharmacokinetic and pharmacodynamic profiles ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-200847090-00003

    authors: Roach P

    更新日期:2008-01-01 00:00:00

  • Reduction of saquinavir exposure by coadministration of loperamide: a two-way pharmacokinetic interaction.

    abstract:OBJECTIVE:To assess any pharmacokinetic interactions between loperamide and saquinavir. DESIGN:Double-blind, double-dummy, randomised, placebo-controlled, three-way crossover trial. PARTICIPANTS:Twelve healthy male and female volunteers, aged 24-46 years. METHODS:Saquinavir and loperamide pharmacokinetics were deter...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00003088-200443140-00004

    authors: Mikus G,Schmidt L,Burhenne J,Ding R,Riedel KD,Tayrouz Y,Weiss J,Haefeli WE

    更新日期:2004-01-01 00:00:00

  • Shortcut formulae for pharmacokinetic dosage adjustments.

    abstract::Dosage adjustments can be difficult and time-consuming, especially for the non-specialist. The objective of this investigation was to obtain shortcut formulae to calculate dosage adjustments for (i) a drug obeying linear pharmacokinetics (i.e. first order) and given orally, by a continuous infusion or by an intermitte...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/11313460-000000000-00000

    authors: Belloto RJ Jr

    更新日期:2009-01-01 00:00:00

  • The relationship between fluticasone furoate systemic exposure and cortisol suppression.

    abstract:INTRODUCTION:The inhaled corticosteroid (ICS) fluticasone furoate is in development, in combination with the long-acting beta2-agonist vilanterol for the once-daily treatment of asthma and chronic obstructive pulmonary disease and as a monotherapy treatment for asthma. Corticosteroids, including ICSs, have the potentia...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,meta分析

    doi:10.1007/s40262-013-0078-1

    authors: Allen A

    更新日期:2013-10-01 00:00:00

  • Drug protein binding and the nephrotic syndrome.

    abstract::A reduction in plasma albumin concentration, as seen in patients with the nephrotic syndrome, is usually associated with a decrease in plasma protein binding of highly bound drugs. Therefore, the fraction of the unbound drug increases, but the absolute free concentration remains essentially unchanged due to a compensa...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-197601010-00003

    authors: Gugler R,Azarnoff DL

    更新日期:1976-01-01 00:00:00

  • Comparative serum prednisone and prednisolone concentrations following administration to patients with chronic active liver disease.

    abstract::Following administration of equivalent oral doses (30mg) of either prednisone or prednisolone to 5 patients with chronic active liver disease who had failed to respond to therapy, 5 patients with chronic active liver disease in remission induced by prednisone, and 7 healthy volunteers, corticosteroid concentrations we...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-198207050-00005

    authors: Uribe M,Summerskill WH,Go VL

    更新日期:1982-09-01 00:00:00

  • Pharmacokinetic and pharmacodynamic properties of metoprolol in patients with impaired renal function.

    abstract::The pharmacokinetics of metoprolol have been studied in a group of patients with varying degrees of renal impairment and in healthy subjects after administration of 20 mg of metoprolol tartrate intravenously and 50 mg orally in a single dose and during steady-state conditions. There were no significant differences in ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-198005020-00004

    authors: Jordö L,Attman PO,Aurell M,Johansson L,Johnsson G,Regårdh CG

    更新日期:1980-03-01 00:00:00

  • Cyclosporin clinical pharmacokinetics.

    abstract::Cyclosporin is a powerful immunosuppressive drug used in transplantation medicine and to treat autoimmune diseases. It is a lipophilic molecule, with its bioavailability dependent on food, bile and other interacting factors. Cyclosporin is extensively metabolised in the liver by the cytochrome P450 3A system, which is...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-199324060-00004

    authors: Fahr A

    更新日期:1993-06-01 00:00:00

  • Clinical Pharmacokinetic and Pharmacodynamic Considerations in the Treatment of Inflammatory Bowel Disease.

    abstract::According to recent clinical consensus, pharmacotherapy of inflammatory bowel disease (IBD) is, or should be, personalized medicine. IBD treatment is complex, with highly different treatment classes and relatively few data on treatment strategy. Although thorough evidence-based international IBD guidelines currently e...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.1007/s40262-018-0639-4

    authors: Derijks LJJ,Wong DR,Hommes DW,van Bodegraven AA

    更新日期:2018-09-01 00:00:00

  • Patient-controlled analgesic therapy, Part III: pharmacokinetics and analgesic plasma concentrations of ketobemidone.

    abstract::The effects of anaesthesia and surgery on the pharmacokinetics of ketobemidone were studied in 12 patients. Plasma ketobemidone concentrations were assayed with a mass-fragmentographic method. The peroperative Vd(area) was 5.9 +/- 2.6L/kg and the terminal half-life was 3.9 +/- 1.7 h. In the postoperative period Vd(are...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-198207030-00005

    authors: Tamsen A,Bondesson U,Dahlström B,Hartvig P

    更新日期:1982-05-01 00:00:00

  • Therapeutic drug monitoring of imatinib: Bayesian and alternative methods to predict trough levels.

    abstract:BACKGROUND:The imatinib trough plasma concentration (C(min)) correlates with clinical response in cancer patients. Therapeutic drug monitoring (TDM) of plasma C(min) is therefore suggested. In practice, however, blood sampling for TDM is often not performed at trough. The corresponding measurement is thus only remotely...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/11596990-000000000-00000

    authors: Gotta V,Widmer N,Montemurro M,Leyvraz S,Haouala A,Decosterd LA,Csajka C,Buclin T

    更新日期:2012-03-01 00:00:00

  • Crushed Versus Integral Tablets of Ticagrelor in ST-Segment Elevation Myocardial Infarction Patients: A Randomized Pharmacokinetic/Pharmacodynamic Study.

    abstract:OBJECTIVE:The objective of this study was to assess the pharmacokinetic and pharmacodynamic behavior of ticagrelor administered either as crushed (in the semi-upright sitting position) or as integral (in the supine position) tablets in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percu...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,随机对照试验

    doi:10.1007/s40262-015-0320-0

    authors: Alexopoulos D,Barampoutis N,Gkizas V,Vogiatzi C,Tsigkas G,Koutsogiannis N,Davlouros P,Hahalis G,Nylander S,Parodi G,Xanthopoulou I

    更新日期:2016-03-01 00:00:00

  • Population Pharmacokinetic Model and Pharmacokinetic Target Attainment of Micafungin in Intensive Care Unit Patients.

    abstract:OBJECTIVE:To study the pharmacokinetics of micafungin in intensive care patients and assess pharmacokinetic (PK) target attainment for various dosing strategies. METHODS:Micafungin PK data from 20 intensive care unit patients were available. A population-PK model was developed. Various dosing regimens were simulated: ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.1007/s40262-017-0509-5

    authors: Martial LC,Ter Heine R,Schouten JA,Hunfeld NG,van Leeuwen HJ,Verweij PE,de Lange DW,Pickkers P,Brüggemann RJ

    更新日期:2017-10-01 00:00:00

  • A mechanistic approach for the scaling of clearance in children.

    abstract:BACKGROUND AND OBJECTIVE:Clearance is an important pharmacokinetic concept for scaling dosage, understanding the risks of drug-drug interactions and environmental risk assessment in children. Accurate clearance scaling to children requires prior knowledge of adult clearance mechanisms and the age-dependence of physiolo...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章

    doi:10.2165/00003088-200645070-00004

    authors: Edginton AN,Schmitt W,Voith B,Willmann S

    更新日期:2006-01-01 00:00:00

  • A new microemulsion formulation of cyclosporin: pharmacokinetic and clinical features.

    abstract::Cyclosporin (cyclosporin A) has been used as an immunosuppressive agent after organ transplantation for more than 15 years. The bioavailability of cyclosporin in its conventional oral formulation 'Sandimmun' displays considerable inter- and intra-patient variability. Absorption is also bile dependent. Recently, a new ...

    journal_title:Clinical pharmacokinetics

    pub_type: 杂志文章,评审

    doi:10.2165/00003088-199630030-00001

    authors: Friman S,Bäckman L

    更新日期:1996-03-01 00:00:00

  • Developmental pharmacokinetics of gentamicin in preterm and term neonates: population modelling of a prospective study.

    abstract:BACKGROUND AND OBJECTIVE:Preterm and term newborn infants show wide interindividual variability (IIV) in pharmacokinetic parameters of gentamicin. More extensive knowledge and use of predictive covariates could lead to faster attainment of therapeutic concentrations and a reduced need for concentration monitoring. This...

    journal_title:Clinical pharmacokinetics

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003088-200948040-00003

    authors: Nielsen EI,Sandström M,Honoré PH,Ewald U,Friberg LE

    更新日期:2009-01-01 00:00:00