Abstract:
OBJECTIVE:The aim of this study was to characterize the relationship between morphine plasma concentration and repeated time to postoperative remedication events in children undergoing cardiac surgery. METHODS:Data from our previously published study of morphine pharmacokinetics were utilized in this pharmacodynamic study. A population survival analysis based on hazard functions was undertaken in NONMEM(®). RESULTS:Hazard was best described by a Gompertz function changing in steps over time. Concentration and age were the only predictors of the hazard function. Concentration producing 50 % reduction in hazard was 19.6 (bootstrap 95 % confidence interval 5.90-49.5 ng/ml). The hazard ratio for a 1-year-old child to a 1-month-old child was 1.91 (1.35-2.86). Sensitivity to morphine decreased with age and leveled off after 1-year of life. Morphine sulfate doses >0.1 mg/kg did not noticeably increase tolerable pain durations. CONCLUSION:Time to remedication is a clinically useful endpoint for assessing opioid-induced analgesia. Sensitivity to morphine treatment is age-dependent. Morphine sulfate doses of 0.1-0.2 mg/kg are adequate for the management of postoperative pain in children. Our findings may help avoid unnecessary large morphine doses in children.
journal_name
Clin Pharmacokinetjournal_title
Clinical pharmacokineticsauthors
Elkomy MH,Drover DR,Galinkin JL,Hammer GB,Glotzbach KLdoi
10.1007/s40262-016-0398-zsubject
Has Abstractpub_date
2016-10-01 00:00:00pages
1217-1226issue
10eissn
0312-5963issn
1179-1926pii
10.1007/s40262-016-0398-zjournal_volume
55pub_type
杂志文章abstract:BACKGROUND:Olmesartan medoxomil (CS-866) is a new orally active angiotensin II receptor antagonist that is highly selective for the AT1 receptor subtype. OBJECTIVE:To develop a population pharmacokinetic model for olmesartan (RNH-6270), the active metabolite of olmesartan medoxomil, in healthy volunteers and hypertens...
journal_title:Clinical pharmacokinetics
pub_type: 杂志文章,meta分析
doi:10.2165/00003088-200544120-00011
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journal_title:Clinical pharmacokinetics
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abstract:: ...
journal_title:Clinical pharmacokinetics
pub_type: 评论,信件
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更新日期:1992-07-01 00:00:00
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