Journal of Pediatric Pharmacology and Therapeutics最新文献_第3页

The Role of Pediatric Pharmacists in the Prevention and Treatment of Congenital Syphilis. 儿科药剂师在预防和治疗先天性梅毒中的作用。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.429

Taylor Barnes, Jennifer E Girotto

引用次数: 0

Characterization of Awareness and Depth of Blockade During Neuromuscular Blockade Infusions in Critically Ill Children. 重症儿童神经肌肉阻滞输液过程中的意识和阻滞深度特征。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.368

Kelly M Bodine, Elizabeth J Beckman

{"title":"Characterization of Awareness and Depth of Blockade During Neuromuscular Blockade Infusions in Critically Ill Children.","authors":"Kelly M Bodine, Elizabeth J Beckman","doi":"10.5863/1551-6776-29.4.368","DOIUrl":"10.5863/1551-6776-29.4.368","url":null,"abstract":"Objective: The Society of Critical Care Medicine released the first guideline for the prevention and -management of pain, agitation, neuromuscular blockade, and delirium in critically ill pediatric patients but offered conditional recommendations for sedation practices and monitoring during neuromuscular blockade. This study aimed to characterize sedation practices, patient awareness, and depth of blockade with neuromuscular blocking agent (NMBA) infusion administration in a single pediatric and cardiac intensive care unit.Methods: This retrospective chart review of critically ill pediatric patients queried orders for continuous infusion NMBA. Analgosedation agent(s), dose, and dose changes were assessed, along with depth of blockade monitoring via Train of Four (TOF) and awareness via Richmond Agitation and Sedation Scale (RASS).Results: Thirty-one patients were included, of which 27 (87%) had a documented sedation agent infusing at time of NMBA initiation and 17 patients (54%) were receiving analgesia. The most common agents used were rocuronium (n = 28), dexmedetomidine (n = 23), and morphine (n = 14). RASS scores were captured in all patients; however, 9 patients (29%) had recorded positive scores and 1 patient (3%) never achieved negative scores. TOF was only captured for 11 patients (35%), with majority of the scores being 0 or 4.Conclusions: Majority of the study population did not receive recommended depth of blockade monitoring via TOF. Similarly, RASS scores were not consistent with deep sedation in half of the patients. The common use of dexmedetomidine as a single sedation agent calls into question the appropriateness of current sedation practices during NMBA continuous infusions.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983478","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

Evaluation of Hyponatremia in Infants on Vasopressin Therapy. 评估接受血管加压素治疗的婴儿的低钠血症。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.385

Caitlin Hawkins, Brianna Hemmann, Trina Hemmelgarn

{"title":"Evaluation of Hyponatremia in Infants on Vasopressin Therapy.","authors":"Caitlin Hawkins, Brianna Hemmann, Trina Hemmelgarn","doi":"10.5863/1551-6776-29.4.385","DOIUrl":"10.5863/1551-6776-29.4.385","url":null,"abstract":"Objective: Vasopressin has systemic vasoconstrictive yet pulmonary vasodilatory effects, making it an ideal agent for hypotension management in infants with congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension. The side effects of vasopressin in this population, such as hyponatremia, are understudied. This study aims to characterize the effect of vasopressin on sodium concentrations in infants with and without CDH.Methods: This was a retrospective review of patients who received vasopressin while admitted to a level IV neonatal intensive care unit. The primary outcome was the incidence of hyponatremia (blood sodium <135 mmol/L) during vasopressin therapy. Secondary outcomes included time to hyponatremia, dose and duration of vasopressin, incidence of severe hyponatremia (blood sodium <125 mmol/L), and hypertonic saline use. Both blood serum and blood gas sample sodium concentrations were used to compare CDH vs non-CDH patients.Results: The average difference between baseline and lowest blood sodium was significant for both CDH and non-CDH patients for all samples (p < 0.001). There was no significant difference in the primary outcome, nor in the secondary outcomes of time to hyponatremia or duration of vasopressin infusion. The average dose of vasopressin was higher in the CDH vs non-CDH group (p = 0.018). The incidences of severe hyponatremia and hypertonic saline use were greater in the CDH vs non-CDH group for patients who had blood serum sodium samples collected (p = 0.049 and p = 0.033, respectively).Conclusions: This study showed that severe hyponatremia occurred more frequently in CDH vs non-CDH patients. Extreme caution is necessary when managing total body sodium in patients with CDH.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983481","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

AI-Assisted Academia: Navigating the Nuances of Peer Review With ChatGPT 4. 人工智能辅助学术界：利用 ChatGPT 解决同行评审中的细微差别 4.

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.441

Som S Biswas

引用次数: 0

Parenteral Beta-Lactam/Beta-Lactamase Inhibitor Ordering in Hospitals That Provide Care for Pediatric Patients. 为儿科患者提供护理的医院的肠外β-内酰胺/β-内酰胺酶抑制剂订购。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.391

Kristen R Nichols, Emily N Israel, Nicolette A Gordon, Darcie D Streetman, Nathan S Walleser, Chad A Knoderer

{"title":"Parenteral Beta-Lactam/Beta-Lactamase Inhibitor Ordering in Hospitals That Provide Care for Pediatric Patients.","authors":"Kristen R Nichols, Emily N Israel, Nicolette A Gordon, Darcie D Streetman, Nathan S Walleser, Chad A Knoderer","doi":"10.5863/1551-6776-29.4.391","DOIUrl":"https://doi.org/10.5863/1551-6776-29.4.391","url":null,"abstract":"Objectives: The purpose of this study was to define current practices related to beta-lactam/beta-lactamase inhibitor (BL/BLI) dose descriptions in hospitals that provide care for pediatric patients and to identify perceived implications of standardizing BL/BLI dose communication and ordering to a total drug-based strategy.Methods: A 27-item electronic survey was distributed via 4 pediatric pharmacy and infectious diseases listservs. Survey questions pertained to hospital demographics, dosing communication practices, BL/BLI ordering and labeling practices, obstacles to safe BL/BLI use, and the effects of potential standardization to a total drug communication strategy. SPSS was used for quantitative analysis and MAXQDA was used for qualitative analysis.Results: A total of 140 unique survey responses were analyzed after exclusion of incomplete responses and reconciliation of multiple responses from the same institution. Overall, 56.2% of institutions order BL/BLIs by BL component for pediatric patients, and 22% of institutions order by BL component for adult patients. Approximately half (51.8%) of respondents felt that standardizing to total drug would have a negative effect at their institution; perception of potential effect varied based on the institution's ordering strategy.Conclusion: Communication and ordering of BL/BLIs is inconsistent across institutions and between pediatric and adult patients. In the short term, the perception is that standardization would compound institutional challenges.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983487","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 Retrospective Analysis of Micafungin Prophylaxis in Children Under 12 Years Undergoing Chemotherapy or Hematopoietic Stem Cell Transplantation. 对接受化疗或造血干细胞移植的 12 岁以下儿童使用米卡芬净预防的回顾性分析。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.379

Breana K Goscicki, Shirley Q Yan, Sherry Mathew, Audrey Mauguen, Nina Cohen

{"title":"A Retrospective Analysis of Micafungin Prophylaxis in Children Under 12 Years Undergoing Chemotherapy or Hematopoietic Stem Cell Transplantation.","authors":"Breana K Goscicki, Shirley Q Yan, Sherry Mathew, Audrey Mauguen, Nina Cohen","doi":"10.5863/1551-6776-29.4.379","DOIUrl":"10.5863/1551-6776-29.4.379","url":null,"abstract":"Objectives: Literature is limited regarding ideal micafungin dosing in pediatric patients with hematologic malignancies receiving chemotherapy or hematopoietic stem cell transplantation. Micafungin is an intravenous echinocandin with activity against Candida and Aspergillus species and has a favorable safety profile compared with other antifungal classes. Our objective was to evaluate the breakthrough invasive fungal infection (IFI) rate in pediatric patients who received a prophylactic micafungin course at our institution.Methods: A single-center, retrospective study was conducted between January 1, 2011, and July 31, 2017, to determine the IFI rate in patients receiving micafungin prophylaxis. Patients with suspected IFI were evaluated for probable or proven infection based on European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group invasive fungal disease definitions. Statistical analyses were descriptive.Results: A total of 170 prophylactic micafungin courses from 129 unique patients ages <12 years at a median dose of 3 mg/kg daily were identified. The rate of probable or proven breakthrough IFIs was 2.4% as determined by clinical, radiologic, microbiologic, and histopathologic criteria.Conclusions: A low rate of breakthrough IFI was seen with micafungin prophylaxis that is consistent with prior published adult hematopoietic stem cell transplantation studies. Micafungin was well tolerated, with liver function test elevations being transient in most cases and thought to be related to alternative factors.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983474","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

Controlled Substance Liquid Waste Management Systems As Potential Reservoirs for Nosocomial Infection in a Pediatric Hospital. 将受控物质液体废物管理系统作为儿科医院非医院感染的潜在贮藏室。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.399

Margaret Morales, Brittany Asaban, Sarah Parsons, Michael Chicella

{"title":"Controlled Substance Liquid Waste Management Systems As Potential Reservoirs for Nosocomial Infection in a Pediatric Hospital.","authors":"Margaret Morales, Brittany Asaban, Sarah Parsons, Michael Chicella","doi":"10.5863/1551-6776-29.4.399","DOIUrl":"10.5863/1551-6776-29.4.399","url":null,"abstract":"Objective: The purpose of this study was to determine if controlled substance waste management systems (CSWMS) demonstrate microbial growth, and therefore present a potential infection risk to pediatric hospital patients.Methods: Twenty CSWMS, either Smart Sink or Pharma Lock systems, located in patient care areas were sampled. Twelve were located in critical care areas. Cultures were obtained by swabbing the drain grate with a sterile swab. Swabs were then transported to the microbiology lab for culture. Each sample was labeled with the location of the CSWMS and each system was photographed.Results: Of the CSWMS sampled, 50% demonstrated bacterial or fungal growth with a total of 15 microorganisms isolated, including 3 systems with Micrococcus luteus, 2 with Aspergillus species, and 2 with -Bacillus cereus. Nine of the 15 microorganisms isolated were from systems in the pediatric intensive care unit (PICU) followed by 2 microorganisms in the neonatal intensive care unit (NICU). Of the 12 systems sampled in critical care areas, 8 (66%) had positive cultures. Of the 10 systems which demonstrated growth, 9 were Pharma Lock and 1 was Smart Sink.Conclusion: Controlled substance waste management systems harbor potential pathogens and may serve as reservoirs of infectious agents in pediatric hospitals. Microbial growth was identified in more than half of sampled CSWMS located in critical care areas, where the most vulnerable patients are located. Based on this study, a cleaning procedure for CSWMS should be implemented. Further investigation on the relationship between CSWMS and nosocomial infections is warranted.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983479","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

Evaluation of Serum Acetaminophen Concentration Utility for Closure of Patent Ductus Arteriosus. 评估血清对乙酰氨基酚浓度对关闭动脉导管未闭的作用

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.404

Jennifer M Giulietti, Alexandra D Sharpe

{"title":"Evaluation of Serum Acetaminophen Concentration Utility for Closure of Patent Ductus Arteriosus.","authors":"Jennifer M Giulietti, Alexandra D Sharpe","doi":"10.5863/1551-6776-29.4.404","DOIUrl":"10.5863/1551-6776-29.4.404","url":null,"abstract":"Objective: Acetaminophen for patent ductus arteriosus (PDA) closure has gained popularity over the last decade; however, therapeutic drug monitoring for this indication remains uncertain. The exact timing and goal trough serum acetaminophen concentration ranges are not well defined. The purpose of our study is to evaluate the impact of therapeutic drug monitoring on both PDA closure rates and identify real-world risk of hepatotoxicity.Methods: Retrospective single-center chart review of neonates admitted to the neonatal intensive care unit (NICU) between April 2016 and August 2022 with at least 1 serum acetaminophen concentration to monitor for PDA closure. Acetaminophen was initiated at 15 mg/kg administered intravenously every 6 hours and a trough serum concentration was obtained prior to the sixth or seventh dose. PDA closure was confirmed radiographically with corresponding provider documentation. Associations of efficacy to closure were -analyzed using descriptive statistics.Results: Thirty-eight neonates were included in the analysis, of which 18 (47%) achieved PDA closure. First serum acetaminophen trough concentration was obtained before the seventh dose [IQR, 6-8] and ranged from undetectable (< 5 mg/L) to 30.8 mg/L. Subgroup analysis of first concentrations revealed therapeutic trough, defined as 10 to 20 mg/L, did not correlate to PDA closure (no closure median concentration = 14.7 [IQR, 13-15.6] vs closure median concentration = 15.4 [IQR, 11.4-18.5], p = 0.42), or duration of treatment. No neonate experienced acetaminophen-associated toxicity.Conclusions: PDA closure did not correlate to serum acetaminophen trough concentration. The regimen of 15 mg/kg every 6 hours appears safe as no neonate experienced acetaminophen toxicity or discontinued treatment early.","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11321801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983482","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

Management of Pediatric Parenteral Fluids. 小儿肠外输液管理。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.346

Rachel Meyers

引用次数: 0

Iron Pill-Induced Gastritis in a Pediatric Patient Taking Ferrous Sulfate Tablets. 一名服用硫酸亚铁片的儿童患者因铁丸引发胃炎。

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-08-01 Epub Date: 2024-08-13 DOI: 10.5863/1551-6776-29.4.425

Charles B Chen, Shreeya Chugh, Deepthi Rao

引用次数: 0