26 research outputs found
Personalized Medicine in Pediatrics:The Clinical Potential of Orodispersible Films
textabstractChildren frequently receive medicines that are designed for adults. The dose of commercially available products is adapted, mostly based on the childâs bodyweight, thereby neglecting differences in pharmacokinetic and pharmacodynamics parameters. If commercial products are unsuitable for administration to children or are unavailable, extemporaneous pharmacy preparations are a good alternative. For this particular population, orodispersible films (ODFs) can be a highly attractive dosage form for the oral administration of drugs. ODFs are relatively easy to prepare in a hospital setting, create dose flexibility, and may suit an individual approach, especially for patients having difficulties in swallowing tablets or being fluid restricted. In this article, various aspects related to pharmacy preparations, clinical application, and preparation of ODFs for pediatric patients are highlighted and discussed
Oral lorazepam can be substituted for intravenous midazolam when weaning paediatric intensive care patients off sedation
Aim: Intravenous sedatives used in the paediatric intensive care unit (PICU) need to be tapered after prolonged use to prevent ia
Impact of Dose Adaptations Following Voriconazole Therapeutic Drug Monitoring in Pediatric Patients
This manuscript was derived from chapter 9 of the PhD thesis by Vincent Lempers done at Radboudumc, which can be found at: https://repository.ubn.ru.nl/bitstream/handle/2066/157075/157075.pdf?sequence=1 AW is supported by the Wellcome Trust Strategic Award (grant 097377), and the MRC Centre for Medical Mycology (grant MR/N006364/1) at the University of Aberdeen. Funding: this study was funded by the Department of Pharmacy RadboudumcPeer reviewedPostprin
Pharmacokinetic Targets for Therapeutic Drug Monitoring of Small Molecule Kinase Inhibitors in Pediatric Oncology
In recent years new targeted small molecule kinase inhibitors have become available for pediatric patients with cancer. Relationships between drug exposure and treatment response have been established for several of these drugs in adults. Following these exposureâresponse relationships, pharmacokinetic (PK) target minimum plasma rug concentration at the end of a dosing interval (Cmin) values to guide therapeutic drug monitoring (TDM) in adults have been proposed. Despite the fact that variability in PK may be even larger in pediatric patients, TDM is only sparsely applied in pediatric oncology. Based on knowledge of the PK, mechanism o
Increased risk of errors in children parenterals - Balance scale:Accurate drug preparation and administration for the child
Een weegbalans kan medicatiefouten bij voor toediening gereedmaken (VTGM) van parenterale geneesmiddelen voor kinderen voorkomen. Deze extra stap in het VTGM-proces kost relatief weinig tijd en zorgt voor een betere kwaliteitsborging
Increased risk of errors in children parenterals - Balance scale:Accurate drug preparation and administration for the child
Een weegbalans kan medicatiefouten bij voor toediening gereedmaken (VTGM) van parenterale geneesmiddelen voor kinderen voorkomen. Deze extra stap in het VTGM-proces kost relatief weinig tijd en zorgt voor een betere kwaliteitsborging
Oral lorazepam can be substituted for intravenous midazolam when weaning paediatric intensive care patients off sedation
Potential prediction of formulation performance in paediatric patients using biopharmaceutical tools and simulation of clinically relevant administration scenarios of nifedipine and lorazepam
AIMS: This study explores the impact of paediatric patient related factors and choice of formulation on the dissolution characteristics of nifedipine and lorazepam, 2 drug substances regularly applied in very young patients and in compounded formulations. METHODS: Dissolution experiments were designed to reflect clinical practice in a paediatric hospital, with respect to dosage forms, feeding regimens and methods of administration. Solubility studies addressed the influence of age and prandial state. Drug solubility and dissolution experiments were conducted in biorelevant media and adapted age-specific (neonate and infant) media. Dissolution studies were performed with the mini-paddle apparatus and the flow-through cell apparatus. RESULTS: Dissolution of nifedipine formulations was not affected by age-related changes of the fasted state simulated gastrointestinal fluids, and by disintegration of the formulation before administration. However, a significant difference in nifedipine's dissolution rate from commercial tablets and compounded capsules was observed. The dissolution of lorazepam tablets was affected by fasted- vs fed-state media, but it was deemed less likely to be clinically relevant. The significant effect of fed-state media on nifedipine's solubility was considered to have possible clinical relevance since very young patients are almost continuously in a fed state. CONCLUSION: The in vitro results obtained from these studies reveal the potential of biorelevant solubility and dissolution studies reflecting clinical practice to predict drug performance in paediatric patients.status: publishe