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The role of therapeutic drug monitoring in childhood. 儿童治疗药物监测的作用。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
L O Boréus
{"title":"The role of therapeutic drug monitoring in childhood.","authors":"L O Boréus","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Therapeutic drug monitoring (TDM) can greatly improve the precision of drug therapy, provided 1) the analytical technique is sensitive, selective, and reproducable enough, 2) the pharmacokinetics of the drug is reasonably well known, and 3) the quantitative relation between kinetics and clinical effect is not too complicated. The TDM service must be supervised and further developed by a responsible group of experts, for example, a section or department of clinical pharmacology that should also provide service to help the physicians to take full advantage of the system. The appearance of active drug metabolites (for some drugs) and the considerable fluctuations in blood levels (in some patients) may complicate the interpretation. A cost-benefit analysis should continuously be made of the system; small, peripheral units for TDM may be too expensive to run.</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"145-8"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17732398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of beta-receptor-agonists and glucocorticoids on alpha- and beta-adrenoceptors of isolated blood cells from asthmatic children. 受体激动剂和糖皮质激素对哮喘患儿分离血细胞α和β肾上腺素受体的影响。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
D Reinhardt, B Becker, M Nagel-Hiemke, R Schiffer, T Zehmisch
{"title":"Influence of beta-receptor-agonists and glucocorticoids on alpha- and beta-adrenoceptors of isolated blood cells from asthmatic children.","authors":"D Reinhardt,&nbsp;B Becker,&nbsp;M Nagel-Hiemke,&nbsp;R Schiffer,&nbsp;T Zehmisch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The most attractive \"adrenergic theory\" has proposed that in asthmatic patients the bronchial hyperreactivity might be caused by a decreased beta-receptor and an increased alpha-receptor responsiveness. Based upon the assumption that an abnormality of adrenergic receptors might be a general phenomenon, we have performed receptor-binding studies on lymphocytes and thrombocytes from asthmatic children who had and had not undergone treatment with beta-receptor agonists and/or glucocorticoids. Iodo-cyano-pindolol and tritium-labeled yohimbine were used as beta- and alpha-receptor ligands. The following results have been obtained: 1) The number and affinity of alpha- and beta-adrenoceptors on thrombocytes and lymphocytes showed no significant differences in asthmatic children and their age-matched controls. 2) In vivo treatment of asthmatic children with beta-receptor agonists immediately reduced the number of beta-receptors (\"down regulation\"). A reversal of the number of beta-receptors occurred within 1 day after cessation of the therapy. Although it appeared that some asthmatics with severe asthma have a reduced number of beta-receptors, in vivo treatment with beta-receptor agonists thus might mimic a beta-receptor blockade. 3) High-dose treatment with glucocorticoids increased the number of beta-receptors but left the alpha-receptors unaffected.</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"293-302"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17391115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Midtrimester thyroidectomy in the ovine fetus. 妊娠中期绵羊胎儿甲状腺切除术。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
J Ayromlooi, P D Berg, E Valderrama, M D Tobias
{"title":"Midtrimester thyroidectomy in the ovine fetus.","authors":"J Ayromlooi,&nbsp;P D Berg,&nbsp;E Valderrama,&nbsp;M D Tobias","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Six lamb fetuses at 63-101 days gestation had thyroidectomy (Thx) and were investigated at term for weights, radiologic study, serum thyroxine (T4), and thyroid-stimulating hormone concentrations (TSH), electron-microscopic lung examination, acid base, blood flow, EEG, and brain metabolism. Compared to age-matched controls, body weight was significantly reduced (P less than .025). Brain and lung weights were reduced but not significantly. Brain weight as a percent of body weight was significantly increased in Thx fetuses (Thx = 1.85% +/- 0.18; control = 1.41% +/- 0.08; P less than .025). Hemoglobin was reduced (P less than .025), as was O2 content (P less than .005) and cerebral blood flow (P less than .05). Fetal T4 was low (Thx = 4.1 +/- 1.7 microgram %, control = 9.4 +/- 1.3 microgram %); (P less than .05). Fetal Thx cortisol, calcium, phosphate, glucose, lactate, pH, pO2, pCO2, O2 saturation, heart rate, and blood pressure remained unchanged. Thx-fetal brain O2 consumption and glucose consumption, as well as lactate production, were unchanged. EEG showed no consistent pattern of change regarding maturity, but did show immaturity with the two lowest T4 levels. Bone microradiographs showed growth and maturity retardation, specifically delayed epiphyseal closure, endochrondral ossification, and lack of secondary ossification centers in Thx fetuses. Electron-microscopic examination of lung showed Thx fetuses had fewer lamellar bodies in type II cells, fewer type II cells, and more glycogen granules. Thx causes fetal reduction of T4 and anemia, delays lung maturation and bone growth and maturation.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 1","pages":"15-28"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17702178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of German and American law concerning clinical trials. 德国与美国临床试验法律之比较。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
E Deutsch
{"title":"Comparison of German and American law concerning clinical trials.","authors":"E Deutsch","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In German and American law, clinical trials require a positive benefit-risk evaluation, free and informed consent, medical and scientific qualification of the doctor, and a written research protocol. American law requires a written consent, which is free of undue influence, the subject being instructed that he is free to withdraw from the trial. In German law, an orally given consent is sufficient for therapeutic trials. With minor or incompetent research subjects, informed consent to therapeutic clinical experimentation has to be given by their parents or guardians, the permissibility of which, in other trials, is controversial. In non-therapeutic trials, blind studies, double-bind studies, and trials involving placebos, special attention has to be paid to the risk-benefit analysis and to informed consent, which in these cases, even in Germany, must be written. The most outstanding feature of American law of clinical trial is that the experimentation is subject to previous control and approval by institutional review boards. The most interesting difference in German law is the investigator's duty to effect an insurance against the risks of the research subject's death or invalidity.</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"353-9"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17732303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oral phenytoin in infancy: dose requirement, absorption, and elimination. 婴儿口服苯妥英:剂量需求、吸收和消除。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
M Albani, I Wernicke
{"title":"Oral phenytoin in infancy: dose requirement, absorption, and elimination.","authors":"M Albani,&nbsp;I Wernicke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Oral phenytoin therapy in infants required unexpectedly high doses of about 18 mg/kg body weight to achieve and to maintain serum concentrations between 8 and 25 micrograms/ml. Plasma half-life determined in 12 infants aged 6 weeks to 12 months ranged between 7.9 to 24.9 hours (mean 12.8 +/- 3.6 hours). Measurement of phenytoin metabolite excretion in urine during steady state revealed that only about 30% of the daily given phenytoin is eliminated through the kidneys. Studying the bioavailability of phenytoin in different age groups (infants, children, and adolescents) before and after ingestion of age-appropriate food showed an age-dependent absorption rate and extent, and an influence of the food upon the absorption pattern could be demonstrated. Mechanisms for this phenomenon of an impaired bioavailability of phenytoin in infancy are discussed.</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"229-36"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17732295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
T4 levels in methylxanthine-treated premature newborns. 甲基黄嘌呤治疗的早产儿T4水平。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
H Sourgens, A H Staib, M Bielicki, V von Loewenich
{"title":"T4 levels in methylxanthine-treated premature newborns.","authors":"H Sourgens,&nbsp;A H Staib,&nbsp;M Bielicki,&nbsp;V von Loewenich","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The respiratory stimulants caffeine and theophylline are able to control apneic spells in premature newborns. However both substances have goitrogenic properties in rats on low-iodine diet. They lower T4 serum levels and inhibit TSH- and GH-release probably by enhancing hypothalamic somatostatin secretion. The retrospective study described here was carried out in an attempt to clarify whether treatment of premature children with methylxanthines has adverse effects on thyroid function. The results are as follows: 1) There is no significant correlation between caffeine- and theophylline-concentrations and circulating T4 levels in single blood specimen of unselected premature infants. 2) In none of the infants was a low T4-serum value accompanied by a rise in serum TSH during methylxanthine treatment. Thus methylxanthines are not associated with the induction of primary hypothyroidism but the possibility of tertiary hypothyroidism cannot be excluded. In order to avoid adverse effects on thyroid function the lowest therapeutically active dose should be chosen.</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"267-72"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17732298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gustav-Adolf von Harnack. 古斯塔夫·阿道夫·冯·哈纳克。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
D Reinhardt, G Heimann
{"title":"Gustav-Adolf von Harnack.","authors":"D Reinhardt,&nbsp;G Heimann","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"v-vi"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17436587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The benefits of drug monitoring in patients with bacterial meningitis, eg, chloramphenicol monitoring. 细菌性脑膜炎患者药物监测的益处，如氯霉素监测。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
H Rosin, A Crea, J Forster
{"title":"The benefits of drug monitoring in patients with bacterial meningitis, eg, chloramphenicol monitoring.","authors":"H Rosin,&nbsp;A Crea,&nbsp;J Forster","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Regular drug monitoring during therapy with chloramphenicol sodium succinate is actually recommended by expert centers. In this report a case of meningitis due to Salmonella typhimurium is described, which underlines the necessity of examining both the chloramphenicol and the chloramphenicol succinate concentrations. It is suggested that medical microbiologists and clinicians should be encouraged to take advantage of new, quick, and sensitive methods for drug monitoring in order to achieve optimal therapy.</p>","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 3-4","pages":"175-80"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17436588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serum digoxin levels in neonates under 1500 grams. 1500克以下新生儿血清地高辛水平。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
G G Sandor, G Reid, M W Patterson
{"title":"Serum digoxin levels in neonates under 1500 grams.","authors":"G G Sandor,&nbsp;G Reid,&nbsp;M W Patterson","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 1","pages":"57"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17702181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The accuracy of amikacin administration in neonates. 新生儿阿米卡星给药的准确性。
Pediatric pharmacology (New York, N.Y.) Pub Date : 1983-01-01
J B Philips, M Geerts, A Dew, G Cassady
{"title":"The accuracy of amikacin administration in neonates.","authors":"J B Philips,&nbsp;M Geerts,&nbsp;A Dew,&nbsp;G Cassady","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77932,"journal":{"name":"Pediatric pharmacology (New York, N.Y.)","volume":"3 2","pages":"127-30"},"PeriodicalIF":0.0,"publicationDate":"1983-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"17729604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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