613 results match your criteria Journal of Pediatric Pharmacology and Therapeutics[Journal]


Opioid Use in Children.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):72-75

Limited guidance on opioid use exists in the pediatric population, causing medication safety concerns for pain management in children and adolescents. Opioid misuse and use disorder continue to greatly affect adolescents and young adults in the United States, furthering the apprehension of their use. Pediatric Pharmacy Advocacy Group (PPAG) recommends pharmacists contribute their knowledge to pain management in children, including the discussion of appropriate use of non-opioid alternatives for pain and when to recommend coprescribing of naloxone. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-24.1.72
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http://dx.doi.org/10.5863/1551-6776-24.1.72DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397009PMC
March 2019
14 Reads

Ranitidine-induced Thrombocytopenia in a Neonate - A Case Report and Review of Literature.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):66-71

Thrombocytopenia (platelet count <150 × 10/L) regularly occurs in newborns but is especially observed in critically ill neonates. We describe the case of a small for gestational age (SGA) neonate, who showed an unexpected, severe thrombocytopenia (8 × 10/L) at day 5 of life. The thrombocytopenia recovered completely after cessation of ranitidine (0. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.66DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397013PMC
March 2019
2 Reads

Trimethoprim/Sulfamethoxazole and Moxifloxacin Therapy for a Pediatric Stenotrophomonas Maltophilia Ventriculoperitoneal Shunt Infection.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):61-65

Stenotrophomonas maltophilia is an increasingly prevalent cause of nosocomial infections. This report describes a 5-month-old male diagnosed with a S maltophilia ventriculoperitoneal shunt infection after a neurosurgical procedure. Intravenous trimethoprim/sulfamethoxazole and moxifloxacin successfully treated the patient. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.61DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397010PMC

Implementation of a Palivizumab Order Panel to Decrease Inappropriate Use.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):58-60

Objective: Palivizumab is a monoclonal antibody used to prevent infection from respiratory syncytial virus (RSV) in certain patients who are at high risk for complications. A previous medication use evaluation (MUE) demonstrated 12% of our palivizumab use did not meet criteria for use. Prior to the start of the 2016-2017 RSV season, an order panel was implemented requiring prescribers to select the approved criterion for each patient prescribed palivizumab. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.58DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397003PMC
March 2019
5 Reads

Sterility and Stability Testing of Preservative-free Albuterol.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):53-57

Background: Continuous albuterol administration (CAA) is commonly used in hospitalized patients for treatment of asthma exacerbations. Due to higher dose requirements, CAA requires large volumes of albuterol obtained from multidose vials containing benzalkonium chloride (BAC). BAC is a common pharmaceutical preservative and potent bronchoconstrictor, which may antagonize the bronchodilation effects of albuterol. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.53DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397012PMC

Calcium/Phosphate Solubility Curves for Premasol and Trophamine Pediatric Parenteral Nutrition Formulations.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):45-52

Objectives: Calcium and phosphate incompatibility in parenteral nutrition formulations remains a critical concern for patient safety. This study examined calcium phosphate solubility for 2-in-1 admixtures prepared using 2 commercially available pediatric amino acid solutions (Premasol, Baxter Healthcare Corp; or Trophamine, B. Braun Medical Inc), applying identical test methods, storage conditions, and acceptance criteria. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.45DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397015PMC
March 2019
2 Reads

Uncomplicated Urinary Tract Infection in Ambulatory Primary Care Pediatrics: Are We Using Antibiotics Appropriately?

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):39-44

Objectives: Antimicrobial stewardship programs target antimicrobial use within the inpatient care setting. However, most antimicrobials are prescribed at ambulatory sites. We aim to determine the appropriateness of the diagnosis and treatment of uncomplicated urinary tract infection (UTI) in children within the outpatient setting at our institution, and to evaluate the cost of antibiotic treatment in our patient cohort. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.39DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397004PMC

Safety and Tolerability of Lidocaine Infusions as a Component of Multimodal Postoperative Analgesia in Children.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):34-38

Objectives: Use of lidocaine as part of a multimodal approach to postoperative pain management has increased in adults; however, limited information is available regarding safety and tolerability in pediatrics. This study's primary objective was to evaluate the incidence of adverse effects related to lidocaine infusions in a sample of pediatric patients.

Methods: A retrospective analysis was conducted in pediatric patients receiving lidocaine infusion for the management of postoperative analgesia at the University of Virginia Health System. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397014PMC
March 2019
3 Reads

Evaluation of Calcium Homeostasis and Dietary Supplementation for Pediatric and Neonatal Patients Receiving Extracorporeal Membrane Oxygenation Support.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):27-33

Objectives: Although the use of extracorporeal membrane oxygenation (ECMO) significantly improves survival in patients with persistent respiratory or cardiovascular failure, it also induces physiologic stress and disrupts homeostatic mechanisms. Patients undergoing ECMO support at our institution have required widely variable quantities of calcium supplementation for maintenance of normal calcium levels. Our primary objective was to assess the frequency of calcium abnormalities in pediatric and neonatal ECMO patients. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.27DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397005PMC
March 2019
1 Read

Comparison of Morphine- and Hydromorphone-Containing Patient-Controlled Epidural Analgesia Solutions in Pediatric Postoperative Patients.

Authors:
Jesse Cramer

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):22-26

Objective: The use of patient-controlled epidural analgesia (PCEA) in pediatric patients has been shown to be safe and effective in managing postoperative pain in children. However, the optimal opioid to use in the epidural regimen remains undetermined. Morphine, hydromorphone, and fentanyl have been the agents most often used, but comparison of effectiveness across studies is difficult. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397006PMC

Survey of the Current Use of Dexmedetomidine and Management of Withdrawal Symptoms in Critically Ill Children.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):16-21

Objectives: Dexmedetomidine use for sedation in the pediatric intensive care units (PICUs) has increased since its initial US Food and Drug Administration (FDA) approval in adults. However, there is limited evidence to direct providers regarding current usage, dosing, and monitoring for withdrawal symptoms in pediatric patients. This study sought to determine the utilization of dexmedetomidine and management of dexmedetomidine withdrawal symptoms among PICU physicians. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397011PMC
March 2019
2 Reads

Efficacy of Bifidobacterium Species in Prevention of Necrotizing Enterocolitis in Very-Low Birth Weight Infants. A Systematic Review.

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):10-15

Necrotizing enterocolitis (NEC) is one of the most common and serious gastrointestinal diseases in preterm infants. The aim of this systematic review examines the effects of probiotics on preventing NEC in very-low birth weight (VLBW) infants with a focus on the Bifidobacterium species and its strains. A systematic review of randomized trials and retrospective studies analyzing the use of probiotics to prevent NEC in VLBW infants was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (1996-2016). Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397007PMC
March 2019
8 Reads

Adverse Drug Reactions in Children: Pediatric Pharmacy and Drug Safety.

Authors:
Michael Rieder

J Pediatr Pharmacol Ther 2019 Jan-Feb;24(1):4-9

An underappreciated problem in child health is the risk for adverse drug reactions (ADRs). While there is an impression that children are at a lower risk than adults for ADRs, in fact a number of factors germane to pediatric therapy place certain groups of children at a high risk for adverse events associated with therapy. Given the importance of drug safety, an understanding of a diagnostic classification for ADRs and of how to approach a possible ADR clinically are key skills for pediatric pharmacists. Read More

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http://dx.doi.org/10.5863/1551-6776-24.1.4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397008PMC
March 2019
4 Reads

Pediatric Pharmacists' Participation in Cardiopulmonary Resuscitation Events.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):502-506

The Pediatric Pharmacy Advocacy Group (PPAG) understands the dilemma and varying factors that many institutions face concerning the routine participation of pharmacists in emergency resuscitation events. Acknowledging these obstacles, the PPAG encourages all institutions to strongly consider creating, adopting, and upholding policies to address pharmacists' participation in cardiopulmonary resuscitation (CPR) as evidenced by the impact pharmacist participation has shown on the reduction of hospital medication error and mortality rates in children. The PPAG advocates that pharmacists be actively involved in the institution's CPR, medical emergency team committees, and preparation of emergency drug kits and resuscitation trays. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.502DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336177PMC
January 2019
2 Reads

The Role of the Pediatric Pharmacist in Precision Medicine and Clinical Pharmacogenomics for Children.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):499-501

With the initiatives by the National Institutes of Health and the US Food and Drug Administration, pharmacogenomics is transitioning from the laboratory to patient care. Nearly 200 drug products now contain pharmacogenomic information as part of their labeling; many of these products are commonly used in the pediatric population. Because pharmacogenomic testing can provide patient-specific predictors for drug response, pharmacists are positioned to assume a leadership role in pharmacogenomic testing, clinical interpretation of results, and recommendations for individualization of drug therapy. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.6.499
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http://dx.doi.org/10.5863/1551-6776-23.6.499DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336182PMC
January 2019
6 Reads

Tolvaptan Use to Treat SIADH in a Child.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):494-498

Hyponatremia is one of the most common electrolyte abnormalities encountered in the clinical setting in hospitalized patients. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the leading cause of hyponatremia in most of these cases. While fluid restriction, hypertonic saline infusion, diuretics, and the treatment of underlying conditions constitute the first line of treatment of SIADH, in refractory cases, and especially for pediatric patients, there seems not to be any other choice for treatment. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.6.494
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http://dx.doi.org/10.5863/1551-6776-23.6.494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336180PMC
January 2019
16 Reads

Ceftaroline Plus Daptomycin for Refractory Methicillin- Resistant Staphylococcus aureus Bacteremia in a Child.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):490-493

Persistent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia can be difficult to treat, with growing adult literature supporting the combination of ceftaroline and daptomycin for these patients. Here, we report a pediatric patient with persistent MRSA bacteremia with associated cellulitis, fasciitis, myositis, and a deep venous thrombosis causing septic pulmonary emboli. After being unable to clear the bacteremia on vancomycin and then daptomycin monotherapy, the bacteremia cleared quickly with rapid clinical improvement after the addition of ceftaroline to daptomycin. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.490DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336175PMC
January 2019
3 Reads

Dexmedetomidine-Associated Fever in a Critically Ill Obese Child.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):486-489

Dexmedetomidine use in the pediatric intensive care unit has increased in recent years. Reports of dexmedetomidine-associated drug fever have been described in adult patients; however, this has not been reported in the pediatric population. We report a case of persistent fever that resolved with the discontinuation of dexmedetomidine and successful transition to clonidine. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.6.486
Publisher Site
http://dx.doi.org/10.5863/1551-6776-23.6.486DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336172PMC
January 2019
8 Reads

Identification of Factors Associated With the Desire to Participate in a Pediatric Pharmacy Practice-Based Research Network.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):479-485

Objectives: To evaluate the practice-based research network (PBRN) potential within the Pediatric Pharmacy Advocacy Group (PPAG) membership and to identify characteristics associated with member willingness to join a PPAG PBRN.

Methods: In October 2016, a 21-question survey was sent by email to approximately 900 PPAG pharmacist members (excluding students) using contact information contained in the PPAG membership database. The survey elucidated information regarding training, clinical and research experience, practice site information, and willingness to participate in a PPAG PBRN. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336176PMC
January 2019

Evaluation of the Cardiovascular Effects of Clonidine in Neonates Treated for Neonatal Abstinence Syndrome.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):473-478

Objectives: Neonatal abstinence syndrome (NAS) is characterized by withdrawal symptoms in neonates exposed to legal or illegal substances , and it is often managed with medications such as opiates, phenobarbital, and clonidine. Clonidine use is increasing, but further safety data regarding its use in neonates are warranted. This study evaluated the effects of clonidine on heart rate and blood pressure in neonates treated for NAS at doses up to 24 mcg/kg/day. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336178PMC
January 2019
2 Reads

Association of Procalcitonin Value and Bacterial Coinfections in Pediatric Patients With Viral Lower Respiratory Tract Infections Admitted to the Pediatric Intensive Care Unit.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):466-472

Objective: Our primary objective was to determine the utility of procalcitonin (PCT) in detection of bacterial coinfection in children < 5 years admitted to the pediatric intensive care unit with viral lower respiratory tract infection (LRTI).

Methods: Electronic medical record review of children < 5 years admitted to the pediatric intensive care unit with a viral LRTI who also had at least 1 PCT concentration measurement.

Results: Seventy-five patients were admitted to the intensive care unit and met the inclusion criteria for this investigation. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336174PMC
January 2019
1 Read

Is Orally Administered Pentobarbital a Safe and Effective Alternative to Chloral Hydrate for Pediatric Procedural Sedation?

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):460-465

Objectives: Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336170PMC
January 2019
3 Reads

Pharmacologic Management of Agitation and Aggression in a Pediatric Emergency Department - A Retrospective Cohort Study.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):455-459

Background: Benzodiazepine and antipsychotic use for acute management of agitation and aggression in the pediatric emergency department (ED) setting has not been well described.

Objectives: To describe medication utilization in the management of agitation and aggression in a pediatric ED and to assess the safety of their use.

Methods: This was a retrospective observational study. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336173PMC
January 2019
1 Read

Safety and Utility of Continuous Ketamine Infusion for Sedation in Mechanically Ventilated Pediatric Patients.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):447-454

Objectives: The selection of sedative medications for mechanically ventilated pediatric patients remains an ongoing clinical challenge. Although continuous ketamine infusion has been used in this population, support for its use remains largely anecdotal. This study describes a single institution's use of ketamine infusions as part of a sedation protocol in the pediatric intensive care unit (PICU). Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.447DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336171PMC
January 2019

An Introduction to Pharmacotherapy for Inborn Errors of Metabolism.

Authors:
Aaron A Harthan

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):432-446

Inborn errors of metabolism comprise a wide array of diseases and complications in the pediatric patient. The rarity of these disorders limits the ability to conduct and review robust literature regarding the disease states, mechanisms of dysfunction, treatments, and outcomes. Often, treatment plans will be based on the pathophysiology associated with the disorder and theoretical agents that may be involved in the metabolic process. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336179PMC
January 2019
2 Reads

Glomerular Filtration Rate Estimation Formulas for Pediatric and Neonatal Use.

J Pediatr Pharmacol Ther 2018 Nov-Dec;23(6):424-431

Renal function assessment is of the utmost importance in predicting drug clearance and in ensuring safe and effective drug therapy in neonates. The challenges to making this prediction relate not only to the extreme vulnerability and rapid maturation of this pediatric subgroup but also to the choice of renal biomarker, covariates, and glomerular filtration rate (GFR) estimating formula. In order to avoid burdensome administration of exogenous markers and/or urine collection in vulnerable pediatric patients, estimation of GFR utilizing endogenous markers has become a useful tool in clinical practice. Read More

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http://dx.doi.org/10.5863/1551-6776-23.6.424DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336181PMC
January 2019
2 Reads

Severe Neuropathic Pain With Concomitant Administration of Vincristine and Posaconazole.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):417-420

Vincristine is a chemotherapeutic agent with a potential toxicity of sensorimotor peripheral neuropathy. Patients receiving chemotherapy are in an immunocompromised state and may require antifungal agents. Triazole antifungals are known inhibitors of cytochrome P450 (CYP) enzymes. Read More

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http://dx.doi.org/10.5863/1551-6776-23.5.417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213623PMC
November 2018
18 Reads

Assessment of Outcomes With a Sedation Protocol During Laser Photocoagulation in Preterm Infants With Retinopathy of Prematurity.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):410-416

Objectives: To evaluate the success of a sedation protocol of fentanyl and midazolam infusions for infants undergoing laser photocoagulation for retinopathy of prematurity.

Methods: This retrospective study included infants receiving a sedation protocol for laser photocoagulation during a 4-year period. The primary objective was protocol success, defined as completion without interruption, absence of protocol dose deviations, and absence of interventions. Read More

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http://dx.doi.org/10.5863/1551-6776-23.5.410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213621PMC
November 2018
1 Read

Effectiveness of Antimicrobial Preservation of Extemporaneous Diluted Simple Syrup Vehicles for Pediatrics.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):405-409

Objectives: Extemporaneous or magistral formulation of active pharmaceutical ingredients using traditional compounding techniques is a common practice when no commercial form is available for pediatrics. For this vulnerable group of patients, the formulation must be prepared with the minimum quantity and lowest proportion of excipients approved for pediatrics, avoiding the use of preservatives. Often the vehicles used for these preparations are dilutions of simple syrup with water. Read More

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http://dx.doi.org/10.5863/1551-6776-23.5.405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213630PMC
November 2018
15 Reads

Use of Intravenous Acetaminophen in Children for Analgesia After Spinal Fusion Surgery: A Randomized Clinical Trial.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):395-404

Objectives: Opioid pharmacotherapy is the cornerstone of postoperative analgesia. Despite its effectiveness, it has a variety of potential adverse effects. Therefore, a multimodal approach with non-opioid analgesics would be optimal. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.5.395
Publisher Site
http://dx.doi.org/10.5863/1551-6776-23.5.395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213625PMC
November 2018
15 Reads

Azithromycin Induces Migrating Motor Complexes in Pediatric Patients Undergoing Antroduodenal Motility Studies.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):390-394

Objective: Erythromycin (ERY) is used in the treatment of gastroparesis; however, this medication is associated with serious side effects, such as cardiac arrhythmias and consequent cardiorespiratory arrest. Azithromycin (AZM) has been suggested as an alternative to ERY as a result of its improved safety profile. Intravenous ERY (1 mg/kg) is administered during antroduodenal motility studies to induce migrating motor complexes (MMCs), the presence or absence of which helps diagnose motility disorders like gastroparesis and gastrointestinal dysmotility. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.5.390
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http://dx.doi.org/10.5863/1551-6776-23.5.390DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213627PMC
November 2018
14 Reads

Relationship of Pulmonary Outcomes, Microbiology, and Serum Antibiotic Concentrations in Cystic Fibrosis Patients.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):379-389

Objectives: To determine the frequency of subtherapeutic exposure to intravenously administered β-lactam antibiotics in a cohort of cystic fibrosis (CF) patients who were treated for a pulmonary exacerbation, and its impact on pulmonary function.

Methods: Nineteen CF patients between the ages of 5 and 21 years treated at Children's National Health System for a pulmonary exacerbation were followed between March 2015 and August 2016 in a prospective, longitudinal study. Pharmacokinetic modeling and minimum inhibitory concentrations (MICs) of the involved pathogens were used to determine therapeutic or subtherapeutic β-lactam antibiotic exposure based on the time the antibiotic concentration was above the MIC. Read More

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http://dx.doi.org/10.5863/1551-6776-23.5.379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213626PMC
November 2018
2 Reads

Pediatric Antiviral Stewardship: Defining the Potential Role of Ribavirin in Respiratory Syncytial Virus-Associated Lower Respiratory Illness.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):372-378

Objectives: Although no longer included in the American Academy of Pediatrics guideline, ribavirin was shown to be beneficial in a subset of adult patients with severe respiratory syncytial virus (RSV)-associated bronchiolitis. This study aimed to investigate risk factors for progression to severe acute respiratory tract infections in hospitalized pediatric patients with RSV-associated bronchiolitis to identify which patients may benefit from inhaled ribavirin therapy, despite its substantial cost, diffcult administration, and potential complications.

Methods: Patients were identified by ICD-9 codes for RSV bronchiolitis and were only included if they had a confirmed positive result for RSV via polymerase chain reaction for detection and typing of respiratory viruses. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.5.372
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http://dx.doi.org/10.5863/1551-6776-23.5.372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213624PMC
November 2018
18 Reads

Poractant Alfa Versus Beractant for Neonatal Respiratory Distress Syndrome: A Retrospective Cost Analysis.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):367-371

Objectives: The objectives of this study were to determine the average medication cost per patient of poractant alfa and beractant, and to compare the outcomes of treatment with these agents.

Methods: We conducted a retrospective, observational, cohort study of patients who received surfactant, before and after an institutional formulary change from beractant to poractant alfa. The primary outcome was the average medication cost per case. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.5.367
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http://dx.doi.org/10.5863/1551-6776-23.5.367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213622PMC
November 2018
17 Reads

Assessing the Understanding of Pediatric-Oriented Medication Education Materials Versus Standard Available Education Materials.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):362-366

Objectives: The objective of this study was to determine if education material targeting children would improve understanding of medication indication, administration, and common side effects in pediatric subjects.

Methods: This cross-sectional pilot study included students 7 to 11 years old from a suburban elementary school. Study participants were read either the US Food and Drug Administration-approved adult medication leaflet or a pediatric medication leaflet created at a first-grade reading level for levetiracetam (Keppra, UCB, Inc, Atlanta, GA). Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.5.362
Publisher Site
http://dx.doi.org/10.5863/1551-6776-23.5.362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213628PMC
November 2018
7 Reads

Evolving Pharmacotherapeutic Strategies for Type 1 Diabetes Mellitus.

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):351-361

Despite pharmacotherapeutic advancements in the management of type 1 diabetes mellitus during the past several decades, patients struggle to achieve glycemic goals. Additionally, hypoglycemia, especially in extremes of age, decreases quality of life. The lack of optimal glycemic control and risk for hypoglycemia are multifactorial. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.5.351
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http://dx.doi.org/10.5863/1551-6776-23.5.351DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213629PMC
November 2018
17 Reads

Pediatric News.

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J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):347

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http://dx.doi.org/10.5863/1551-6776-23.4.347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117807PMC
September 2018
1 Read

Position Paper: Pharmacists and Childhood Vaccines.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):343-346

Vaccination rates of children in the United States remain below the target coverage levels identified in the Healthy People 2020 objectives. Given the success of pharmacists in providing adult vaccinations and the accessibility of pharmacists to the public, expanding pharmacists' authority to vaccinate children may improve vaccination rates of children, particularly in key disease states. This article serves as a Position Statement of the Pediatric Pharmacy Advocacy Group (PPAG), who supports the expansion of pharmacists' authority to vaccinate children. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.4.343
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http://dx.doi.org/10.5863/1551-6776-23.4.343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117813PMC
September 2018
4 Reads

Intravenous Ribavirin for Parainfluenza and Respiratory Syncytial Virus in an Infant Receiving Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):337-342

Background: Viral bronchiolitis remains a significant cause of hospitalization as well as morbidity and mortality during the first year of life, with treatment options beyond supportive care being limited. In cases of severe illness, ribavirin may offer therapeutic benefit.

Objective: We report the use of intravenous (IV) ribavirin in an infant requiring concomitant venovenous extracorporeal membrane oxygenation (VV-ECMO) and continuous venovenous hemofiltration (CVVH) for respiratory syncytial virus (RSV) and parainfluenza virus (PIV) coinfection. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.337DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117812PMC
September 2018
9 Reads

Impact of Two Educational Modules on Practitioner Knowledge of Pediatric Delirium.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):329-336

Objectives: The purpose of this study was to evaluate the efficacy of education modules in preparing staff before the implementation of a pediatric delirium screening protocol.

Methods: After consenting participants began phase 1 of the study, which covered general information on pediatric delirium. It comprised a 21-question assessment administered as a pretest followed by an education module and then the same 21-question assessment administered as a posttest. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117815PMC
September 2018
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Development of an Interprofessional Pharmacist-Nurse Navigation Pediatric Discharge Program.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):320-328

Objectives: Numerous challenges face clinically complex patients as they transition from hospital to home. The purpose of this project was to add pharmacy discharge services to an existing nurse-led discharge service (patient navigation program) to facilitate the transition of care process for clinically complex pediatric patients.

Methods: For select patients referred to the service, a pharmacist resolved medication discrepancies, provided discharge counseling, and conducted follow-up telephone encounters on days 1, 7, and 14 post discharge. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117806PMC
September 2018
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Effect of Exogenous Antithrombin Administration on Anti-Xa Levels in Infants Treated With Enoxaparin.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):315-319

Objectives: Determine the effect of exogenous antithrombin III administration on low molecular weight heparin anti-Xa levels in the context of enoxaparin dosing in infants.

Methods: A retrospective chart review of infants receiving concomitant antithrombin III and enoxaparin. The primary objective of this study was to determine the median change in anti-Xa level with antithrombin III supplementation. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117808PMC
September 2018
1 Read

Sterility Duration of Preprimed Extracorporeal Membrane Oxygenation Circuits.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):311-314

Objectives: There is a lack of standardization and supporting data regarding the duration preassembled and preprimed extracorporeal membrane oxygenation (ECMO) circuits are expected to be sterile. Therefore, the purpose of this study was to prospectively evaluate whether preassembled and preprimed ECMO circuits could maintain sterility for a period up to 65 days.

Design: Four ECMO circuits (2 neonatal/pediatric¼" and 2 adolescent/adult ⅜ ") were assembled and primed under sterile conditions and maintained at room temperature. Read More

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http://www.jppt.org/doi/10.5863/1551-6776-23.4.311
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http://dx.doi.org/10.5863/1551-6776-23.4.311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117816PMC
September 2018
11 Reads

Therapeutic Drug Monitoring of Vancomycin in Pediatric Patients With Extracorporeal Membrane Oxygenation Support.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):305-310

Objectives: Determine pharmacokinetic (PK) parameters and optimal dosage of vancomycin for children on extracorporeal membrane oxygenation (ECMO).

Methods: Retrospective PK study of vancomycin in pediatric patients on ECMO who received IV vancomycin 40 to 60 mg/kg/day every 6 hours. Patients were analyzed according to the presence of acute kidney injury (AKI) and requirement of renal replacement therapy (RRT). Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117811PMC
September 2018
4 Reads

A Report of an Asthma Pathway Leading to Improved Resource Use.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):298-304

Objectives: Asthma pathways have been shown to improve resource use and decrease length of stay (LOS). A tertiary care hospital implemented an asthma pathway in May 2015 to standardize inpatient care. We predicted that the pathway would increase the use of albuterol metered-dose inhalers (MDIs) and steroids; decrease use of albuterol nebulizer, antibiotics, chest radiograph (CXR), and respiratory viral panel (RVP); and decrease LOS. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117809PMC
September 2018
1 Read

Pharmacist and Pediatrician Knowledge of Codeine Use in Children.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):293-297

Objectives: In 2011, approximately 1.7 million pediatric patients had a codeine-containing prescription filled at a US retail pharmacy. Numerous cases involving serious adverse effects or fatalities have been reported in children who have been prescribed codeine. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117814PMC
September 2018
4 Reads

A Clinician's Guide to Oral Extended-Release Drug Delivery Systems in Epilepsy.

J Pediatr Pharmacol Ther 2018 Jul-Aug;23(4):277-292

Epilepsy is one of the most common chronic neurologic disorders that affects individuals of all ages. It is primarily managed with antiepileptic drugs (AEDs), with the goal of maintaining complete seizure control combined with minimal or no adverse effects. Oral administration is the mainstay of AED delivery for patients with chronic epilepsy and consists essentially of immediate-release (IR) and modified-release (delayed-release and extended-release [ER]) dosage formulations. Read More

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http://dx.doi.org/10.5863/1551-6776-23.4.277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6117810PMC
September 2018
15 Reads

Pediatric News.

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J Pediatr Pharmacol Ther 2018 May-Jun;23(3):271-273

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http://dx.doi.org/10.5863/1551-6776-23.3.271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027973PMC
July 2018
2 Reads

Angioedema Associated With Nebulized Recombinant Human DNase in a Preterm Infant: Case Report.

J Pediatr Pharmacol Ther 2018 May-Jun;23(3):219-222

Pulmonary atelectasis leads to difficulties in weaning of the neonates from mechanical ventilation. The management of persistent atelectasis in neonates constitutes a common challenge for physicians. Several reports suggested Recombinant human DNase (rhDNase) as a beneficial therapy for neonates with persistent atelectasis by reducing mucous viscosity. Read More

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http://dx.doi.org/10.5863/1551-6776-23.3.219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027972PMC
July 2018
25 Reads