Journal of Pediatric Pharmacology and Therapeutics最新文献_第2页

Assessment of the Effective Dose of Isavuconazole, Itraconazole, Posaconazole, and Voriconazole to Achieve Goal Serum Concentrations in Pediatric Patients at a Single Center.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.112

KaShena L Kennedy, Elizabeth H Ristagno, Linda K Marshall, Kristin C Mara, Grace Lee, Laura M Dinnes

{"title":"Assessment of the Effective Dose of Isavuconazole, Itraconazole, Posaconazole, and Voriconazole to Achieve Goal Serum Concentrations in Pediatric Patients at a Single Center.","authors":"KaShena L Kennedy, Elizabeth H Ristagno, Linda K Marshall, Kristin C Mara, Grace Lee, Laura M Dinnes","doi":"10.5863/1551-6776-30.1.112","DOIUrl":"10.5863/1551-6776-30.1.112","url":null,"abstract":"Objective: The optimal dose for triazoles in pediatric patients may substantially vary given the dynamic changes in pharmacokinetics and pharmacodynamics, based on disease severity. Therapeutic drug monitoring has been a valuable tool to help guide management and avoid potential toxicities associated with treatment of invasive fungal infections (IFIs). Goal azole serum concentrations are based on specific drug, indication, and minimum inhibitory concentration when known. This study aimed to determine the optimal pediatric azole doses needed to achieve targeted serum concentrations of isavuconazole, itraconazole, posaconazole, and voriconazole.Methods: This is a single center, retrospective chart review of pediatric patients who received isavuconazole, itraconazole, posaconazole, or voriconazole between January 1, 2011, and August 31, 2021.Results: A total of 273 pediatric patients received isavuconazole, itraconazole, posaconazole, or voriconazole in the inpatient or outpatient setting during the study period. Of the 273 patients, only 122 met criteria for inclusion in the analysis. Eighty-three percent of patients reached a goal serum concentration. Patients younger than 12 years required a higher dose (mg/kg/day) to achieve goal serum concentrations. Patients who received an azole in the form of an oral tablet or intravenously were more likely to reach a goal concentration than those not receiving these formulations. Median time to goal concentration occurred at 20 days for isavuconazole, 34 days for itraconazole, 11 days for posaconazole, and 10 days for voriconazole.Conclusions: Higher starting azole doses are needed to obtain goal concentrations quickly, especially for children younger than 12 years.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"30 1","pages":"112-122"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retrospective Cohort Analysis of 1-Hour Infliximab Infusions in Pediatric Patients. 儿科患者 1 小时英夫利西单抗输注的回顾性队列分析

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.65

Drew Goodrich, Alyssa George, Jennifer Stein, Robert Koziol, Brienne Costigan

{"title":"Retrospective Cohort Analysis of 1-Hour Infliximab Infusions in Pediatric Patients.","authors":"Drew Goodrich, Alyssa George, Jennifer Stein, Robert Koziol, Brienne Costigan","doi":"10.5863/1551-6776-30.1.65","DOIUrl":"10.5863/1551-6776-30.1.65","url":null,"abstract":"Objective: This study aimed to characterize and assess the safety of a 1-hour infliximab infusion in a cohort of pediatric patients.Methods: A retrospective chart review of pediatric patients that received a 1-hour infliximab or its biosimilar infusion for a gastrointestinal or rheumatologic condition was conducted. Infusions were included if the patient had at least 3 infusions for rheumatology patients and 4 for gastroenterology patients. Patients who were not transitioned to the rapid, 1-hour infusion were excluded. Baseline characteristics, including age, weight, indication, dose, the use of premedications or combination therapy, and the development of anti-infliximab antibodies were analyzed along with any reported safety outcomes related to infusion administration.Results: A total of 69 pediatric patients were screened for inclusion, of which 41 patients received 159 infusions. The median age of the population was 15 years, and the sex distribution was nearly equal, with 48.8% of the population representing females. Most patients received infliximab treatment by the pediatric gastroenterology service (87.8%), with Crohn's disease being the lead indication (75.6%). A small number of patients were managed with combination therapy or premedicated before their infusion. Forty-one patients were routinely monitored for infliximab antibodies, but only 4 developed them (9.8%). Doses ranged from 150 to 1000 mg, depending on patient weight. One patient (0.6%) experienced an adverse reaction during the 1-hour infusion, which resulted in cessation of the infusion, but continued 1-hour infusions at a later date.Conclusions: This study showcases that 1-hour infliximab infusions are well-tolerated and appear safe in pediatric patients.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"30 1","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Survey of Diabetes Technology in the Pediatric Inpatient Setting.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.123

Abby B Hamilton, Nitya Rajagopal, Chloe Ngo, Amy D Hendrix-Dicken, Shelly Mercer, Michelle Condren

{"title":"Survey of Diabetes Technology in the Pediatric Inpatient Setting.","authors":"Abby B Hamilton, Nitya Rajagopal, Chloe Ngo, Amy D Hendrix-Dicken, Shelly Mercer, Michelle Condren","doi":"10.5863/1551-6776-30.1.123","DOIUrl":"10.5863/1551-6776-30.1.123","url":null,"abstract":"Objective: Advances in diabetes technology have led to increasing use of insulin pumps and continuous glucose monitors (CGMs) to improve the quality of life for children with diabetes. The objective of this study was to assess the percentage of hospitals that had policies regarding the use of diabetes technology in the pediatric inpatient setting and assess the content of policies to identify specific areas for improvement.Methods: A diabetes technology survey was developed by a multidisciplinary research team, consisting of 3 domains including CGM use/policies, insulin pump use/policies, and demographics. It was distributed to the pharmacist membership of the Pediatric Pharmacy Association in August 2022. Descriptive statistics were conducted to describe current practices/policies.Results: Seventeen of the 31 responding hospitals (55%) allowed CGM use in the pediatric inpatient setting with 77% (n = 13) having written policies. Primary barriers to use included lack of policy (n = 11, 79%), knowledgeable staff (n = 10, 71%), and electronic health record (EHR) integration (n = 6, 43%). More than half reported not using CGM alarms for high and low blood sugar levels (n = 10, 59%). More hospitals allowed insulin pump use (n = 29, 94%) with 97% (n = 28) reporting written policies. Less than half had specific policies for suspected pump site failure (n = 13, 46%). Only 60% reported that nurses verify insulin pump doses given.Conclusion: This study demonstrates there is room to improve both the existence and content of policies related to CGM and insulin pump use in hospitals.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"30 1","pages":"123-128"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incorporating Pediatrics in Clinical Education: A Call to Action in Inpatient Pharmacy Practice.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.4

Caroline M Sierra, Amanda C Capino, Cober M Petrea, Lea S Eiland, Norman E Fenn Iii, Nicholas M Fusco, Lucas E Orth

引用次数: 0

Monogenic Familial Neonatal Diabetes in Preterm Infant With ABCC8 Gene Mutation: Transition to Oral Sulfonylurea Therapy. ABCC8基因突变早产儿的单基因家族性新生儿糖尿病：过渡到口服磺脲类药物治疗。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.129

Elizabeth Behre, Sierra S Donnell, Nicole Larsen, Guido Mora, Kousiki Patra

引用次数: 0

A Pediatric Research Imperative: Addressing Neonates in Drug Development Through Understanding Neonatal Clinical Pharmacology.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.8

An N Massaro, Elimika Pfuma Fletcher, Rajanikanth Madabushi, Gerri Baer, Dionna Green

引用次数: 0

Impact of Arginine Hydrochloride Supplementation on Diuretic Effectiveness in Critically Ill Children.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.93

Matthew Ballweg, Laura A Ortmann

{"title":"Impact of Arginine Hydrochloride Supplementation on Diuretic Effectiveness in Critically Ill Children.","authors":"Matthew Ballweg, Laura A Ortmann","doi":"10.5863/1551-6776-30.1.93","DOIUrl":"10.5863/1551-6776-30.1.93","url":null,"abstract":"Objective: Hypochloremia is common in children receiving diuretics and may contribute to diuretic -resistance. This study's objective was to investigate whether arginine hydrochloride supplementation for -hypochloremia was associated with a change in urine output (UOP) or fluid balance (FB) in children -receiving diuretics.Methods: This was an observational retrospective study of children admitted to the pediatric, cardiac, or neonatal intensive care unit. Patients were included if they received at least 3 days of loop or thiazide diuretics then supplemented with arginine hydrochloride during ongoing diuresis. Data collected included diagnosis category, electrolyte supplementation and serum concentrations, weights, and all fluid input and output. UOP and FB were compared in the 48 hours before and after supplementation.Results: Of the 345 children studied, 60% had underlying cardiac disease and 97% received furosemide. Median arginine hydrochloride dose was 0.9 mEq/kg, most often given every 6 hours for 4 doses. Serum chloride concentrations rose from 91.6 to 96.4 mmol/L (p < 0.001). There was no difference in UOP (4.6 vs 4.4 mL/kg/hr, p = 0.06) or FB (1.5 vs 2.7 mL/kg/day, p = 0.13) when comparing the 48 hours before supplementation with the 48 hours after. Analyses of patients with stable diuretic dosing, those with a serum chloride concentration ≤90 mmol/L, those with an increase in serum chloride ≥8 mmol/L, and those with cardiac disease had no improvement in UOP or FB after chloride supplementation.Conclusions: Arginine hydrochloride supplementation was not associated with an improvement in diuretic effectiveness in children as demonstrated by lack of improvement in UOP or FB.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"30 1","pages":"93-99"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence of Fever Associated With Dexmedetomidine in Critically Ill Children.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.78

Matthew P Naden, Lindsay Schray, Ankit Shukla, Jessica Parker

{"title":"Incidence of Fever Associated With Dexmedetomidine in Critically Ill Children.","authors":"Matthew P Naden, Lindsay Schray, Ankit Shukla, Jessica Parker","doi":"10.5863/1551-6776-30.1.78","DOIUrl":"10.5863/1551-6776-30.1.78","url":null,"abstract":"Objective: To evaluate the incidence of fever in critically ill pediatric patients receiving continuously infused dexmedetomidine.Methods: This was a retrospective study of pediatric patients admitted to the pediatric or neonatal intensive care unit (PICU or NICU) between November 2017 and December 2021 who received dexmedetomidine. The primary endpoint was defined as a fever ≥38°C while receiving dexmedetomidine. Patient- and drug-specific characteristics between the fever and non-fever groups were compared to identify possible trends.Results: A total of 151 patients were included, with a median age of 15.8 months (IQR, 2.9-48.1). Thirteen patients (8.6%) met the criteria for the primary endpoint, with a mean maximum temperature of 38.2°C ± 0.2°C. Median time of fever onset was 9.7 hours (IQR, 2.0-29.3) into their dexmedetomidine infusion with a median dose of 0.4 mcg/kg/hr (IQR, 0.2-0.6). Patients within the fever group were younger (1.7 months [IQR, 1.1-8.6] vs 17.3 months [IQR, 3.3-65.5], p = 0.0006), reached a higher maximum infusion rate (0.8 mcg/kg/hr [IQR, 0.6-0.9] vs 0.6 mcg/kg/hr [IQR, 0.4-0.8], p = 0.0343), and received dexmedetomidine for longer durations (83.2 hours [IQR, 64.2-128.3] vs 35.2 hours [IQR, 17.6-55.7], p < 0.0001) than the non-fever group.Conclusions: Fever ≥38°C was observed in 8.6% of PICU and NICU patients receiving dexmedetomidine. Younger patients or those exposed to higher doses or longer durations of dexmedetomidine may be at increased risk. Prospective studies will be required to further validate these findings.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"30 1","pages":"78-83"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Critical Juncture for Drug Information and Evidence-Based Voices.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.143

Karen Kier

引用次数: 0

23andYOU: How Pharmacogenomics Is Important to You and Your Patients.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2025-02-01 Epub Date: 2025-02-10 DOI: 10.5863/1551-6776-30.1.146

Bruce C Carleton

引用次数: 0