Journal of Pediatric Pharmacology and Therapeutics最新文献

{"title":"Evaluation of Moderate-Course Hydrocortisone for the Prevention of Bronchopulmonary Dysplasia in Premature Infants: A Pilot Study.","authors":"Chyna Sical, Melody Hernandez, Genevra Galura","doi":"10.5863/JPPT-25-00091","DOIUrl":"10.5863/JPPT-25-00091","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"270-273"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692898","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":"Stability Study of Compounded Ethanol-Free Buprenorphine Oral Syringes for the Treatment of Neonatal Opioid Withdrawal Syndrome.","authors":"Viren Soni, Samarth A Shah, Walter K Kraft, Gagan Kaushal","doi":"10.5863/JPPT-25-00058","DOIUrl":"10.5863/JPPT-25-00058","url":null,"abstract":"<p><strong>Objective: </strong>Buprenorphine (BUP) is advantageous in the management of neonatal opioid withdrawal syndrome (NOWS). A widely used BUP formulation for the treatment of NOWS contains 30% ethanol. This study aimed to investigate the stability of BUP in compounded ethanol-free oral syringes.</p><p><strong>Methods: </strong>A 75-mcg/mL BUP solution was prepared by diluting the commercial injectable solution with water for irrigation, transferred into amber oral syringes, and stored at either room temperature (n = 3) and refrigerated (n = 3) conditions. Microbial testing of the compounded oral syringes was performed to determine microbial growth for 24 and 48 hours at 37°C. The stability of BUP was assessed in the compounded syringes was conducted by pH and liquid chromatography-mass spectrometry (LC-MS) analysis after compounding and at 7, 30, and 60 days of storage.</p><p><strong>Results: </strong>The concentration of BUP at all time points was between 90% and 110% of the baseline on day 0. Concentration increased slightly in the oral syringes after day 30, likely due to moisture loss, as there were no degradation peaks observed in chromatograms. There was no microbial growth or visual change observed for the compounded ethanol-free BUP oral syringes. The pH of the oral syringes was consistent through 60 days for both room-temperature and refrigerated samples.</p><p><strong>Conclusion: </strong>Buprenorphine in an ethanol-free formulation is stable and can be easily compounded in pediatric pharmacies. This formulation is appealing for the treatment of NOWS.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"233-237"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692961","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":"Optimizing Pediatric Drug Therapy: Pediatric Pharmacokinetics and Administration Routes.","authors":"Nokwanda Nhlanzeko Ngcobo","doi":"10.5863/JPPT-24-00144","DOIUrl":"10.5863/JPPT-24-00144","url":null,"abstract":"<p><p>Optimizing pediatric drug therapy requires a comprehensive understanding of the unique pharmacokinetic characteristics in pediatrics, alongside appropriate drug administration routes. This review explores the impact of age-related pharmacokinetic variations, including enzymatic maturation and organ function, on drug absorption, distribution, metabolism, and excretion. The challenges and advantages of various drug administration routes, evaluating their effect on drug efficacy and safety in pediatric populations are also addressed. A multidisciplinary framework is proposed, integrating pharmacokinetic principles with customized drug administration routes and adherence strategies, such as simplified dosing and digital health interventions. Our findings highlight the necessity of a personalized approach to pediatric drug therapy that combines pharmacokinetic insights with practical administration considerations.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"196-205"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692850","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":"State of Vancomycin Dosing in Neonates: An Overview.","authors":"Amanda L Wilkins, Xiao Zhu, Noel Cranswick, Nigel Curtis, Amanda Gwee","doi":"10.5863/JPPT-25-01214","DOIUrl":"10.5863/JPPT-25-01214","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 2","pages":"284-291"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692994","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":"Concomitant Enalapril and Spironolactone-Induced Hyperkalemia in a Pediatric Patient.","authors":"Sarah Mae Rogado, Jamie M Pinto, Liliana Cruz Hernandez, Stephanie Chin, Anita Siu","doi":"10.5863/JPPT-25-00009","DOIUrl":"10.5863/JPPT-25-00009","url":null,"abstract":"<p><p>Spironolactone is a mineralocorticoid receptor antagonist with potassium-sparing effects used in the management of heart failure to minimize morbidity and mortality. It is typically given in combination with an angiotensin-converting enzyme inhibitor (ACEI) as part of standard management of pediatric heart failure but has limited literature regarding safety and efficacy in this population. We report a case of probable concomitant enalapril and spironolactone-induced hyperkalemia in a 2-month old female. The patient presented with Class III congestive heart failure and was initiated on enalapril and spironolactone. New hyperkalemia (serum potassium concentration 8.9 mEq/L) developed on day 7 after initiation and persisted despite decreases in the spironolactone dose. Persistent hyperkalemia and hyponatremia with a metabolic acidosis led to the discontinuation of spironolactone by day 12 of admission. The hyperkalemia resolved within 72 hours of discontinuation without further interventions. Based on our patient's course, hyperkalemia in a pediatric patient may occur when spironolactone and an ACEI are given concomitantly and resolve upon discontinuation of spironolactone.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 1","pages":"83-87"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12889005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167104","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":"Clopidogrel Dosing Scheme in Pediatric Cardiac Patients 0-24 Months Old Using P2Y₁₂ Reaction Unit Monitoring.","authors":"Pilar Anton-Martin, Carli Coalter, Kathryn DeAvilla, Meredith Ray, Benjamin W Kozyak, Mario Briceno-Medina, Mark Rayburn","doi":"10.5683/JPPT-25-00024","DOIUrl":"10.5683/JPPT-25-00024","url":null,"abstract":"<p><strong>Objective: </strong>The use of clopidogrel for postprocedural primary thromboprophylaxis in pediatric cardiac patients is becoming more common. This study aimed to explore, using P2Y12 reaction unit (PRU) values, whether the currently recommended static low clopidogrel dose of 0.2 mg/kg/day for patients under 24 months is optimal, or if a gradual dosage escalation would be more appropriate; and to propose a hypothetical dosing scheme for clopidogrel thromboprophylaxis in these patients.</p><p><strong>Methods: </strong>Exploratory, retrospective cohort study in cardiac patients 0-24 months old receiving clopidogrel for thromboprophylaxis between 2018 and 2021. Data collected from medical records included patient demographics and diagnoses, clopidogrel dosing and duration, PRU values, concomitant anticoagulant and antiplatelet therapies, adverse events, and outcomes. Exponential and linear regression analyses were employed to model dosage as a function of time using therapeutic PRU values and to identify the best-fit dosing scheme for clopidogrel.</p><p><strong>Results: </strong>Forty-four cardiac patients on clopidogrel for thromboprophylaxis were included. No statistically significant difference was observed between the predicted dosing from the fitted and the referent regressions, indicating that the observed clopidogrel doses that achieved a therapeutic PRU followed a dosing gradient inconsistent with the static low dose (0.2 mg/kg/day) recommended by the Platelet Inhibition in Children On cLOpidogrel (PICOLO) trial during the first 24 months of age.</p><p><strong>Conclusions: </strong>Pediatric cardiac patients may require a gradual escalation of clopidogrel dosing with age, in contrast to the static low dose recommended by the PICOLO trial during the first 24 months of life. An age-based dosing scheme may prove beneficial for this age group. Prospective studies evaluating age-based clopidogrel dosing in this patient population could offer further insight into this relationship.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 1","pages":"30-36"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167116","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":"Systematic Review of Pharmacologic Treatments for Hypochloremic Metabolic Alkalosis in Critically Ill Children.","authors":"Taylor McLarty, Angela Giglione, Jamie L Miller, Teresa V Lewis, Peter N Johnson","doi":"10.5863/JPPT-25-00038","DOIUrl":"10.5863/JPPT-25-00038","url":null,"abstract":"<p><p>Metabolic alkalosis, characterized by an increase in serum bicarbonate (>28 mEq/L) and serum pH (>7.45), is associated with clinical complications including arrhythmias, mental confusion, and seizures. Non-pharmacologic measures are recommended first-line for treatment of hypochloremic metabolic alkalosis, but pharmacologic treatment may be needed. This review of the literature provides detailed descriptions of dosage regimens, efficacy, safety, and other considerations for use of pharmacologic agents. The literature search included published human studies in the English language from EMBASE and Ovid MEDLINE from 1946 to January 2025. A total of 11 studies representing 736 pediatric patients were included. Use of acetazolamide, hydrochloric acid, ammonium chloride, and arginine hydrochloride have been reported in the literature for pharmacologic management of hypochloremic metabolic alkalosis. Of these agents, acetazolamide and arginine hydrochloride are the only two available for use in the United States. Acetazolamide monotherapy was evaluated in 5 studies, representing 270 patients (36.6%). Arginine chloride monotherapy was evaluated in 2 studies, representing 427 critically ill patients (58.0%). Only 1 study compared the safety and efficacy of acetazolamide and arginine hydrochloride but was limited by variable dosing and undocumented routes of administration and duration of therapy. Adverse effects were reported in 7 patients (0.95%) in the studies included, all of which occurred with acetazolamide. Given that acetazolamide is a US Food and Drug Administration (FDA)-labeled commercially available medication for enteral and intravenous administration, it is the authors' opinion that it should be administered as a first-line pharmacologic agent for pediatric patients refractory to other interventions for hypochloremic metabolic alkalosis.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 1","pages":"4-17"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167162","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":"National Survey on Very Low Birth Weight Starter Parenteral Nutrition.","authors":"Ju Eun Jun, Molly Siver, Christine A Robinson, Anita Siu, Rachel S Meyers, Pooja Shah","doi":"10.5863/JPPT-25-00016","DOIUrl":"10.5863/JPPT-25-00016","url":null,"abstract":"<p><strong>Objective: </strong>Parenteral nutrition (PN) is initiated as early as possible in very-low-birth-weight (VLBW) neonates to prevent protein catabolism. Each institution takes a different approach to ensure that appropriate nutrition is administered as soon as possible after birth. This study aimed to describe the initial nutritional management for VLBW infants in various neonatal intensive care units.</p><p><strong>Methods: </strong>A 16-question electronic survey was distributed to Pediatric Pharmacy Association (PPA) members through PPA listservs. The primary outcome was to identify the most common macronutrients and micronutrients in starter PN and their concentrations. Secondary outcomes were starting concentrations of electrolytes in the VLBW starter PN, maximum osmolarity, dextrose and calcium concentration permitted in peripheral PN, and use of fat emulsion, including starting dose, start time, and type of fat emulsion.</p><p><strong>Results: </strong>Of 70 individual institutions included, 64 institutions (91%) stocked standardized starter PN, and 6 institutions (9%) stocked custom-compounded starter PN. The most common contents were amino acids (100%), dextrose (100%), calcium gluconate (73%), and heparin (74%), with mean (range) reported concentrations of 3.5% (1.8%-6%), 8.9% (5%-12.5%), 14 mEq/L (0.2-38 mEq/L), and 0.5 units/mL (0.2-1 units/mL), respectively. Among 66 institutions, the mean initial fat emulsion dose was 1.2 g/kg/day (0.5-3 g/kg/day). Mean maximum osmolarity for peripheral PN was 1016 mOsm/L (900-1250 mOsm/L).</p><p><strong>Conclusions: </strong>This study found that although there are common contents reported in VLBW starter PNs, there is wide variation in their concentrations. Future research on the nutritional needs of VLBW neonates may provide an opportunity to develop more widely accepted standardized starter PNs.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 1","pages":"50-55"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167134","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":"Pharmacoepidemiology of Antiviral Treatment for Congenital Cytomegalovirus in Neonates.","authors":"Haejung Yoon, Daniel K Benjamin, Reese H Clark, Matthew Laughon, Rachel G Greenberg, Ashley Stark","doi":"10.5863/JPPT-25-00149","DOIUrl":"10.5863/JPPT-25-00149","url":null,"abstract":"<p><strong>Objective: </strong>The objective was to assess the pharmacoepidemiology of ganciclovir and valganciclovir for treatment of congenital cytomegalovirus (cCMV), adverse events, and hearing screen outcomes in infants treated with antiviral therapy.</p><p><strong>Methods: </strong>We included infants discharged from Pediatrix Medical Group neonatal intensive care units (NICUs) between 2010 and 2020. We calculated the number of infants with cCMV and the proportion treated per year. We identified infants with cCMV treated with antivirals and used logistic regression models to compare adverse events (neutropenia, thrombocytopenia, and hepatic dysfunction) before and during treatment. Hearing screen outcomes were assessed using a logistic regression model as our primary analysis, with further sensitivity analyses to allow for the possibility of endogenous treatment.</p><p><strong>Results: </strong>A total of 465 infants from 144 sites met our inclusion criteria, of whom 262 received antiviral treatment. From 2010 to 2020, the annual number of infants with cCMV fell by one-third and the proportion of infants receiving antiviral treatment more than doubled. Neutropenia (absolute neutrophil count ANC <1000 μL) was significantly more common among infants receiving antiviral treatment after adjustment for gestational age and postnatal age (OR 3.2, 95% CI: 1.4-7.3). Neither thrombocytopenia nor hepatic dysfunction was associated with treatment. The primary logistic regression analysis and sensitivity analyses indicated that antiviral exposure was associated with elevated risk of hearing screen failure.</p><p><strong>Conclusions: </strong>Our data support previous studies identifying neutropenia as an adverse effect of antiviral treatment. In our cohort of infants with cCMV, treatment was associated with increased likelihood of failed hearing screen; this finding could be a result of unmeasured confounding variables or other limitations of retrospective analysis. Further studies should focus on identifying which infants with cCMV will most likely benefit from treatment, the optimal duration of treatment, and long-term outcomes.</p>","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 1","pages":"161-169"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167153","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":"Why the Birth Dose Matters for Hepatitis B Vaccination.","authors":"Jennifer E Girotto, J Hunter Fly, Selena Warminski, Jessica Forster, Tamara Oz","doi":"10.5863/JPPT-26-00107","DOIUrl":"10.5863/JPPT-26-00107","url":null,"abstract":"","PeriodicalId":37484,"journal":{"name":"Journal of Pediatric Pharmacology and Therapeutics","volume":"31 1","pages":"102-105"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166907","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}