Abstract:
OBJECTIVES:Acetaminophen (APAP) elixir is a widely used pediatric antipyretic medication. It has been shown that up to 30% of febrile children presenting to a large urban pediatric emergency department received inadequate APAP dosages at home with errors primarily due to age-based dosing. Parental education material in the form of weight-based dosing guides has been proposed; however, validation of current recommended APAP dosages using pharmacokinetic models is needed. This study used a mathematical model of APAP absorption to predict plasma concentrations and to compare them with the range required to reach and achieve antipyresis (10-20 μg/mL). METHODS:A common APAP preparation (Children's Tylenol Elixir) was tested (children aged 2-3 years, 10.9-15.9 kg). The manufacturer's suggested dose of 160 mg was compared with the standard 10 to 15 mg/kg dose range. RESULTS:The model predicts a peak plasma concentration between 6.38 and 8.55 μg/mL for 10 mg/kg dose and 9.57 and 12.8 μg/mL for 15 mg/kg dose. The manufacturer's suggested dose of 160 mg was tested across the limits of the weight range (10.9-15.9 kg). A peak plasma concentration between 9.36 and 12.6 μg/mL was found for the lower weight limit (10.9 kg child) and 6.42 to 8.61 μg/mL for the upper weight limit (15.9 kg child). CONCLUSIONS:With the use of this model, the 10 mg/kg dose does not reach the plasma concentration value for antipyresis (10-20 μg/mL), whereas 15 mg/kg is adequate only if assuming a greater absorption constant. The 160 mg dose is effective only for children weighing 10.9 kg. Individual differences in drug bioavailability, volume of distribution, and absorption/elimination constants undoubtedly exist, and future studies directly measuring plasma APAP concentration and pharmacokinetics are needed. However, these results indicate that dosages for APAP in children should be weight based and manufacturers should review their dosing recommendations.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Abourbih DA,Gosselin S,Villeneuve E,Kazim Sdoi
10.1097/PEC.0000000000000665subject
Has Abstractpub_date
2016-01-01 00:00:00pages
6-8issue
1eissn
0749-5161issn
1535-1815pii
00006565-201601000-00002journal_volume
32pub_type
杂志文章abstract::Ultrasonography can be useful in the evaluation of children with abdominal complaints and may be the initial imaging modality in patients presenting with a newly recognized abdominal mass. Hepatoblastoma is an uncommon cause of acute abdominal pain in children and can rarely metastasize to the heart through vascular i...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001629
更新日期:2018-10-01 00:00:00
abstract::Inflammatory causes of bloody diarrhea during infancy include necrotizing enterocolitis and allergic colitis, often due to cow's milk protein. We report this case of cow's milk protein allergy, managed successfully with elimination of dietary antigen, to highlight the unusual finding of pneumatosis intestinalis on abd...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001369
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:Helicopter emergency medical services (HEMS) are used for 16% of pediatric trauma. National HEMS guidelines advised that triage criteria be standardized for pediatric patients. A national report found pediatric HEMS associated with decreased mortality compared with ground emergency medical services (GEMS) bu...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002263
更新日期:2020-10-22 00:00:00
abstract:OBJECTIVE:Trauma is a leading cause of death among children. Detailed knowledge of the epidemiology of traumatic childhood deaths is necessary for allocating available treatment resources and for preventing injuries at both community and regional levels. To our knowledge, there has been no report comparing urban to rur...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0b013e31827b50a7
更新日期:2013-01-01 00:00:00
abstract::Retropharyngeal abscess is a rather rare, deep-neck infection of children and may seriously compromise the airway and mimic other diseases. A retrospective review of 17 cases of retropharyngeal abscess presenting to The Children's Hospital, Denver, from 1976 to 1986 was performed. Nine children (56%) had stridor or ai...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-198803000-00003
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess which knowledge deficits and dietary habits in an urban pediatric emergency department (ED) population are risk factors for obesity. METHODS:This cross-sectional study in an urban pediatric ED used a modified version of the Diet and Health Knowledge Survey, an in-perso...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181f39879
更新日期:2010-10-01 00:00:00
abstract::Subconjunctival hemorrhages in infants and children can be a finding after nonaccidental trauma. We describe 14 children with subconjunctival hemorrhages on physical examination, who were subsequently diagnosed by a child protection team with physical abuse. Although infrequent, subconjunctival hemorrhage may be relat...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318280d663
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:Pediatric refusal of medical assistance (RMA) is a potentially high-risk event with implications for both individual patient outcomes and greater emergency medical services system efficiency. The purpose of this study was to describe characteristics of pediatric RMA calls and outcomes. METHODS:Single emerge...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000002018
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:Sickle cell disease is the most common hemoglobin variant in the world and can present with recurrent vaso-occlusive painful crises. Pain control in these patients is often difficult and requires a multimodal approach. In patients with uncontrolled pain after traditional pain control methods, ketamine infusi...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0000000000000978
更新日期:2019-01-01 00:00:00
abstract::The etiology of acute liver failure varies widely in children, but the most common causes are viral hepatitis, drugs, and toxins. We report herein a case of autoimmune hepatitis and acute liver failure caused by leptospirosis, which is involved rarely in etiology. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182309e79
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Radiographic survey of the entire aerodigestive tract (nares to anus) is common practice in children presenting to the emergency department following coin ingestion. The purpose of our study was to determine the optimal protocol for radiographic survey post-coin ingestion. We hypothesized that for children p...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001688
更新日期:2018-11-19 00:00:00
abstract::The delayed presentation of a congenital diaphragmatic hernia may include symptoms of acute respiratory distress or gastrointestinal obstruction. We review the presentation and management of the different types of diaphragmatic hernias. In addition, we present a case of twins with a left-sided congenital diaphragmatic...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200108000-00013
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Somatization is associated with increased health care use in adults. Whether mothers with somatic symptoms use more health care resources for their children has not been investigated. OBJECTIVE:This study aimed to explore the association of maternal somatic symptoms and emergency department (ED) use. DESIG...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182809a10
更新日期:2013-02-01 00:00:00
abstract::Primary tumors of the esophagus are extremely rare in children. A common periesophageal mass in children is duplication. It constitutes only 0.5 to 2.5% of all esophageal lesions usually diagnosed in infancy or early childhood. Duplication of the esophagus may be diagnosed on examination by the emergency department (E...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVES:The purposes of the study were (1) to assess the acceptability of mental health screening in the pediatric emergency department (ED) for children and their parents; (2) to measure providers' perceptions on whether screening has an impact on patient care; and (3) to determine the impact of screening status on...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318222554e
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:The Emergency Severity Index version 4 (ESI v.4) is the most recently implemented 5-level triage system. The validity and reliability of this triage tool in the pediatric population have not been extensively established. The goals of this study were to assess the validity of ESI v.4 in predicting hospital ad...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182621813
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between mothers' use of prenatal care and pediatric emergency department (ED) use by their infants in the first 3 months of life. METHODS:This is a retrospective, cohort-control study of well, full-term infants who use a children's hospital ED. Using logistic regression, the lik...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-200006000-00004
更新日期:2000-06-01 00:00:00
abstract::Pediatric skin diseases are a common presenting complaint to emergency medicine physicians but often pose a significant diagnostic challenge. Skin eruptions that are unusually severe for the diagnosis in question, lasting beyond the typical time of resolution, or not responding to conventional therapy should raise con...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001218
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES AND METHODS:The aim of the present retrospective, cross-sectional, descriptive study was to determine the characteristics of febrile 3- to 36-month-old children who were admitted to the emergency department (ED) with the chief complaint of fever and returned with the same complaint within 72 hours (returning...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31823a3e86
更新日期:2011-12-01 00:00:00
abstract::Atypical manifestations of acute hepatitis A virus (HAV) infection include ascites, pleural effusion, acute renal failure, aplastic anemia, and neurological manifestations. Although association of HAV and acute cholecystitis is known, presentation of hepatitis A infection with acute cholecystitis has not been reported...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318258bdda
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:To develop the infrastructure and demonstrate the feasibility of conducting microarray-based RNA transcriptional profile analyses for the diagnosis of serious bacterial infections in febrile infants 60 days and younger in a multicenter pediatric emergency research network. METHODS:We designed a prospective ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,多中心研究
doi:10.1097/PEC.0000000000000324
更新日期:2015-01-01 00:00:00
abstract::We undertook a prospective study of 377 children (two to 16 years old) presenting with abdominal pain to determine: 1) common discharge diagnoses; 2) what signs and symptoms are associated with appendicitis; and 3) follow-up of patients discharged from the emergency department (ED). Nine diagnoses accounted for 86% of...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199206000-00003
更新日期:1992-06-01 00:00:00
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journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181c33109
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:Enterocolitis remains the most significant cause of morbidity and mortality in Hirschsprung disease (HD). It could progress into toxic megacolon (TM)-acute dilatation of the colon as accompanying toxic complication of Hirschsprung enterocolitis. It is a devastating complication, especially in infants with so...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000444
更新日期:2016-11-01 00:00:00
abstract::Since its introduction into clinical practice, it has been known that fentanyl and other synthetic opioids may cause skeletal muscle rigidity. Involvement of the respiratory musculature, laryngeal structures, or the chest wall may impair ventilation, resulting in hypercarbia and hypoxemia. Although most common with th...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3182535a2a
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVES:To examine attitudes toward the use of oral rehydration therapy (ORT) by pediatric emergency medicine physicians before and after being given recent data that might affect their practice and to see if there is a difference in responses based upon year of graduation from medical school. METHODS:A national su...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318149f66f
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:Since 1987 the average length of stay for infants following hospital delivery has decreased 1.8 days. This study was undertaken to evaluate the null hypothesis that early discharge of newborns from nurseries does not result in increased emergency department (ED) utilization during the first 10 days of life...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199712000-00001
更新日期:1997-12-01 00:00:00
abstract::Sexually transmitted infection as the result of child sexual abuse in prepubertal children is uncommon. Chlamydia trachomatis conjunctivitis is an even less common entity in prepubertal children outside the newborn period. This report details the presentation of 2 children with conjunctivitis who were subsequently dia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001449
更新日期:2020-08-01 00:00:00
abstract::Omeprazole; the first proton pump inhibitor (PPI) showing an effective acid inhibitory ability, provides the satisfactory therapy either in gastro-esophageal reflux symptom relief or in healing of erosive esophagitis. It's also effective in peptic ulcer disease. Up to date, omeprazole efficacy and safety are well esta...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000173350.45648.9b
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:The aims of the study were to determine the frequency at which each emergency medicine evaluation and management (E/M) code is used, to identify factors associated with their use by academic pediatric emergency departments (PEDs), and to compare PED E/M code utilization rates with rates reported by Centers fo...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000177193.60784.c2
更新日期:2005-09-01 00:00:00