Journal of Pediatric Pharmacology and Therapeutics最新文献

{"title":"Sweet or Salty: Comparing Dextrose and Sodium Acetate Umbilical Arterial Catheter Fluids.","authors":"Rachel Qian, Purnahamsi V Desai, Aashish Shah, Joanna Tracy, Ferras Bashqoy","doi":"10.5863/JPPT-25-00071","DOIUrl":"10.5863/JPPT-25-00071","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate safety and clinical benefit of sodium acetate umbilical arterial catheter (UAC) fluid in neonates.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included neonates receiving dextrose 5% or sodium acetate 77 mEq/L heparinized fluid for UAC patency. The primary outcome was the potential number of capillary heel sticks avoided. Secondary outcomes included hypernatremia, intraventricular hemorrhage, metabolic acidosis, acute kidney injury, chronic lung disease, and parenteral nutrition optimization. Subgroup analysis was performed for patients undergoing therapeutic hypothermia and preterm infants.</p><p><strong>Results: </strong>There were 202 patients (dextrose n = 100; sodium acetate n = 102) included. The sodium acetate group demonstrated a greater number of potential heel sticks avoided per UAC line day (0 vs 2.2; p < 0.001). Despite a higher incidence of hypernatremia (sodium > 145 mEq/L) with sodium acetate, hypernatremia with sodium > 150 mEq/L were not significant between groups and there were no significant differences in other clinical outcomes.</p><p><strong>Conclusions: </strong>Using sodium acetate for UAC patency is safe and may decrease the number of painful capillary heel sticks.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 3","pages":"390-398"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212819","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}

{"title":"A Case of Prolonged Serotonin Toxicity After Fluoxetine Ingestion in an Adolescent Patient.","authors":"Merritt Tuttle, Madison Allen, Austin Cummings, Jillian Theobald","doi":"10.5863/JPPT-25-00049","DOIUrl":"10.5863/JPPT-25-00049","url":null,"abstract":"<p><p>Selective serotonin reuptake inhibitors (SSRIs), indicated for many disorders, have nuanced pharmacology. Half-lives of fluoxetine and its active metabolite, norfluoxetine, are 7 days and up to 17.5 days, respectively. Norfluoxetine inhibits CYP2D6, which metabolizes fluoxetine. A single substance ingestion could cause prolonged serotonin toxicity. CYP2D6 genotyping may identify patients at increased risk. In fluoxetine overdose, clinicians can expect prolonged hospitalization requiring aggressive sedation as in this case. A 16-year-old female with anxiety, depression, and headaches on no prescribed medications presented to emergency care after ingesting fluoxetine, benztropine, trimethoprim-sulfamethoxazole (TMP-SMX), gabapentin, omeprazole, and atorvastatin. She was intubated, sedated with propofol and fentanyl, and transported to higher-level care. In the pediatric intensive care unit (PICU), she had examination findings suggestive of serotonin toxicity. She was extubated hospital day (HD) 2 but required sedation for persistent agitation. Her mental status improved 24 hours after receiving cyproheptadine HD8, but she remained hyperthermic until HD10. She was externally cooled for maximum temperature 40.1°C. Peak creatine kinase level was 827 international units/L (reference, 27-140 units/L). Fluoxetine and norfluoxetine concentrations obtained HD8 were 350 ng/mL and 280 ng/mL (therapeutic steady-state range, 72-258 ng/mL for norfluoxetine and 91-302 ng/mL for fluoxetine). CYP2D6 metabolizer phenotype was normal. The patient was discharged home at neurologic baseline HD19.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 3","pages":"427-431"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212775","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}

{"title":"Commentary on \"Examining the Evidence Around Acetaminophen and Autism Risk\".","authors":"Kate Myers, Gregory L Kearns","doi":"10.5863/JPPT-26-X0111","DOIUrl":"10.5863/JPPT-26-X0111","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 3","pages":"453-455"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212853","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}

{"title":"The Role of the Pediatric Pharmacist in Precision Medicine and Clinical Pharmacogenomics for Children.","authors":"Kelsey J Cook, Benjamin Q Duong, Hyun Kim, Nathan Lamb, Jenny Q Nguyen","doi":"10.5863/JPPT-25-00118","DOIUrl":"10.5863/JPPT-25-00118","url":null,"abstract":"<p><p>For years, pharmacogenomics (PGx) has been transitioning from the laboratory to patient care. Utilization of PGx data in patient care is greater than ever, with over 80 institutions in the United States offering PGx services, including at least 12 in pediatric patient populations. There are over 300 drug products with PGx information in their labeling; many of which are commonly used in pediatric populations. Additionally, the increased use of next-generation sequencing (NGS) has led to increased availability of PGx data. Because PGx testing can provide patient-specific predictors for drug response, pharmacists are well positioned to assume a leadership role in PGx testing, clinical interpretation of results, and recommendations for individualization of drug therapy. Opportunities for pharmacists exist in both inpatient and outpatient settings, such as pharmacist-managed clinical PGx consultation services and educating patients about PGx testing. Given the potential for genetic and age-dependent factors to influence drug selection and dosing, pediatric pharmacists should be involved in the development of dosing recommendations and interprofessional practice guidelines regarding PGx testing in pediatric patients. Opportunities to become knowledgeable and competent in PGx extend from coursework as part of the pharmacy curriculum to postgraduate education (e.g., residencies, fellowship, continuing education). The Pediatric Pharmacy Association (PPA) acknowledges a need for pediatric pharmacists to have a working knowledge of PGx and recognizes the importance of PGx education for both students and practicing pharmacists with consideration for infants and children. This group also supports the need to have a subset of pharmacists specially trained in PGx with a pediatric focus.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 3","pages":"437-443"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212801","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}

{"title":"Neonatal Opioid Withdrawal Syndrome: 2 Years Later…Where Are We NOWS?","authors":"Morgan C Sanders-Preziosi, Parvesh M Garg, Ricardo J Rodriguez","doi":"10.5863/JPPT-26-00110","DOIUrl":"10.5863/JPPT-26-00110","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 3","pages":"449-452"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212828","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}

{"title":"Assessment of Enteral Baclofen Prescribing Practices for Infants With Hypertonia.","authors":"Hope E DiTaranto, Astrela Moore, Rebecca Kendsersky, Jessica Zook, Elana Katz, Sarah H Evans, J Michael King","doi":"10.5863/JPPT-25-00052","DOIUrl":"10.5863/JPPT-25-00052","url":null,"abstract":"<p><strong>Objective: </strong>Baclofen is used for hypertonia in infants despite limited dosing guidance. This study describes enteral baclofen prescribing in patients 12 months of age and younger.</p><p><strong>Methods: </strong>This single-center, retrospective review evaluated infants receiving enteral baclofen from January 2013 to December 2022. Regimen information, including dose, frequency, age, weight, and duration of treatment for up to 1 year following initiation, was assessed. Other outcomes included place in therapy, safety, and tolerability.</p><p><strong>Results: </strong>This study included 108 patients with 423 total regimens. At initiation, the median baclofen dose was 1.3 mg, corresponding to a weight-based dose (WBD) of 0.2 mg/kg, a total daily dose (TDD) of 3 mg, and a weight-based total daily dose (wTDD) of 0.5 mg/kg/day. Sixty-one patients (56.5%) received baclofen 3 times daily at initiation. The patients' longest-tolerated regimen had a median dose of 2.8 mg, corresponding to a WBD of 0.4 mg/kg, a TDD of 9 mg, and a wTDD of 1.3 mg/kg/day. Hypoxemic-ischemic encephalopathy and brain injury were the most common etiologies of hypertonia. Baclofen was the first antispastic agent for 37 patients (34.3%). Twenty-four patients (22.2%) discontinued baclofen within 1 year. Four patients (3.7%) stopped baclofen due to adverse effects (sedation and emesis).</p><p><strong>Conclusions: </strong>The median initiation dose of baclofen in infants was lower than the recommended dose for patients aged younger than 2 years, highlighting variability in practice. The baclofen regimens used in this study were safe and well-tolerated. These findings provide insight into baclofen prescribing for infants with hypertonia.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 3","pages":"372-379"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13245406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212794","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}

{"title":"Medication Barriers and Challenges Experienced/Perceived by Caregivers in Pediatric Medication Management: A Scoping Review.","authors":"Anmol Toor, Tapanga Brooks, Andrea W Tang","doi":"10.5863/JPPT-25-00055","DOIUrl":"10.5863/JPPT-25-00055","url":null,"abstract":"<p><p>The objective of this scoping review was to identify the challenges and barriers non-professional caregivers such as parents, experience/perceive when managing the medications for pediatric patients with chronic disease states in an outpatient setting. Embase and Ovid Medline databases were searched for articles published from inception to May 18, 2024. The search was limited to English language articles. Studies conducted in countries with a developing or transitioning economy, or those based in an institutional setting were excluded. This review was conducted as per the Joanna Briggs Institute Manual for Evidence Synthesis scoping review methodology and adhered to the PRISMA-SCr 2020 Checklist. Evidence selection and data extraction was completed independently by 2 reviewers (AT and TB) and then combined. Medication barriers were identified, grouped and themed using thematic analysis. Eight articles were included in this review. After extraction, 20 medication barriers were identified and themed into the following categories: drug factors, drug burden/regimen, access to medications, caregiver factors, child factors, health care system challenges, and fear and stigma. Drug factor medication barriers were highly endorsed by non-professional caregivers (25% of total barriers), followed by caregiver factors (20% of total barriers). To increase the likelihood of pediatric medication administration success, research focused on improving these barriers should be identified, especially those related to drug formulation and caregiver medication knowledge and forgetfulness.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"184-195"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692836","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}

{"title":"Administration of Intravenous Ferric Carboxymaltose in a Patient With Iron-Deficiency Anemia and Allergy to 2 Oral Iron Preparations.","authors":"Jordan Wallace, Adriana Trabal","doi":"10.5863/JPPT-26-00105","DOIUrl":"10.5863/JPPT-26-00105","url":null,"abstract":"<p><p>Iron deficiency is a common occurrence in the pediatric population, often leading to the development of anemia. The first line of treatment is oral iron administration for the resolution of anemia and replenishment of iron stores. Although rare, patients may present with allergic reactions to iron, which can limit treatment modalities. We present the case of a 14-month-old boy who presented with iron-deficiency anemia and demonstrated allergy to 2 oral iron formulations. Our institution developed a treatment plan that includes adding premedications and slowly titrating of the infusion rate for the administration of intravenous iron. The patient successfully tolerated 2 infusions without developing allergic reactions and experienced resolution of his iron-deficiency anemia. When patients with iron-deficiency anemia are allergic to oral iron formulations, their treatment options are limited. There are a few reports of effective desensitizations with intravenous ferric carboxymaltose in pediatric patients. Our successful experience may help guide other institutions with similar patients.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692847","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}

{"title":"Analysis of US Pediatric Pharmacists Incomes: A Gender Comparison Survey Study by the Pediatric Pharmacy Association, Practice-Based Research Network.","authors":"Ioana Popovici, Manuel J Carvajal, Tara Higgins, Emily C Benefield, Michelle Condren","doi":"10.5863/JPPT-25-00095","DOIUrl":"10.5863/JPPT-25-00095","url":null,"abstract":"<p><strong>Objectives: </strong>While gender disparities in the US workforce have received substantial attention, income inequalities among subspecialty pharmacists remain understudied. This study aimed to develop a professional profile of pediatric pharmacists in the United States, construct and test gender-specific income-determination models, and identify and compare factors influencing income among male and female pediatric pharmacists.</p><p><strong>Methods: </strong>Data were collected via a national survey targeting pediatric pharmacists. The survey included human-capital, job-related, and demographic variables. Separate income-determination models were estimated between genders, using ordinary least-squares with logged annual income as the dependent variable. Key covariates included hours worked, years of experience, administrative role, salary negotiation history, and work location.</p><p><strong>Results: </strong>A total of 285 responses were analyzed from a 29.3% response rate. Women outnumbered men 3:1. The average annual income difference between male and female pharmacists was $10,294 (6.4%, not significant); however, regression estimates showed significant differences in annual income determinants by gender (p ≤ 0.05). Work input and experience positively influenced income for both genders, but job-related covariates were significant only for women. Working more hours and having more years of experience led to bigger pay increases for men than for women. Projected annual earnings based on model estimates revealed a statistically significant gender income gap of $10,745.</p><p><strong>Conclusions: </strong>The study highlights a nuanced gender disparity in income among pediatric pharmacists, with income determinants functioning differently across genders. Although the average gender pay gap was not statistically significant, regression-based projections suggest potential underlying inequities. These findings call for further research and institutional dialogue to address gender-based income disparities in specialized pharmacy fields.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"206-213"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692893","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}

{"title":"Bacterial Resistance Associated With Inhaled Tobramycin for Prevention of Ventilator-Associated Tracheitis in Mechanically Ventilated Neonates and Children Without Cystic Fibrosis: An Observational Pilot Study.","authors":"Avery Parman, Maura Shrestha, Jamie L Miller, Misty M Oldham, Stephen Neely, Peter N Johnson","doi":"10.5863/JPPT-25-00068","DOIUrl":"10.5863/JPPT-25-00068","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"274-278"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692839","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}