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Abedin S, Adeleke OA. State of the art in pediatric nanomedicines. Drug Deliv Transl Res 2024:10.1007/s13346-024-01532-x. [PMID: 38324166 DOI: 10.1007/s13346-024-01532-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
In recent years, the continuous development of innovative nanopharmaceuticals is expanding their biomedical and clinical applications. Nanomedicines are being revolutionized to circumvent the limitations of unbound therapeutic agents as well as overcome barriers posed by biological interfaces at the cellular, organ, system, and microenvironment levels. In many ways, the use of nanoconfigured delivery systems has eased challenges associated with patient differences, and in our opinion, this forms the foundation for their potential usefulness in developing innovative medicines and diagnostics for special patient populations. Here, we present a comprehensive review of nanomedicines specifically designed and evaluated for disease management in the pediatric population. Typically, the pediatric population has distinguishing needs relative to those of adults majorly because of their constantly growing bodies and age-related physiological changes, which often need specialized drug formulation interventions to provide desirable therapeutic effects and outcomes. Besides, child-centric drug carriers have unique delivery routes, dosing flexibility, organoleptic properties (e.g., taste, flavor), and caregiver requirements that are often not met by traditional formulations and can impact adherence to therapy. Engineering pediatric medicines as nanoconfigured structures can potentially resolve these limitations stemming from traditional drug carriers because of their unique capabilities. Consequently, researchers from different specialties relentlessly and creatively investigate the usefulness of nanomedicines for pediatric disease management as extensively captured in this compilation. Some examples of nanomedicines covered include nanoparticles, liposomes, and nanomicelles for cancer; solid lipid and lipid-based nanostructured carriers for hypertension; self-nanoemulsifying lipid-based systems and niosomes for infections; and nanocapsules for asthma pharmacotherapy.
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Affiliation(s)
- Saba Abedin
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Oluwatoyin A Adeleke
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
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Newland DM, Pak JL, Ali R, Herzog T, Nemeth TL, Tressel W, Kronmal RA, Knorr LR, Albers EL, Friedland-Little JM, Ahmed H, Kemna MS, Hong BJ, Spencer K, Law YM. Mycophenolic acid therapeutic drug monitoring using area under the curve in pediatric heart transplant recipients. Clin Transplant 2023; 37:e15087. [PMID: 37526562 DOI: 10.1111/ctr.15087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 06/10/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION Pharmacokinetics of mycophenolic acid (MPA) display substantial interpatient variability, with up to 10-fold difference of exposure in individual patients under a fixed-dose regimen. MPA trough level (C0) monitoring is common in clinical practice but has not proven sufficiently informative in predicting MPA exposure or patient outcomes, especially in children. No limited sampling strategies (LSSs) have been generated from pediatric heart transplant (HTx) recipients to estimate MPA AUC. METHODS Single-center, observational analysis of 135 de novo pediatric HTx recipients ≤21 years old who underwent MPA AUC between 2011 and 2021. RESULTS Median age was 4 years (IQR .6-12.1). Median time from transplant to MPA AUC sampling was 15 days (IQR 11-19). MMF doses (mg or mg/day) had low, negative Pearson correlation coefficients (r) while doses adjusted for weight or body surface area had low correlation with Trapezoidal MPA AUC0-24 h (r = .3 and .383, respectively). MPA C0 had weak association (r = .451) with Trapezoidal MPA AUC0-24 h . LSS with two pharmacokinetic sampling time points at 90 (C3 ) and 360 (C5 ) min after MMF administration (estimated AUC0-24 h = 32.82 + 4.12 × C3 + 11.53 × C5 ) showed strong correlation with Trapezoidal MPA AUC0-24 h (r = .87). CONCLUSION MMF at fixed or weight-adjusted doses, as well as MPA trough levels, correlate poorly with MPA AUC0-24 h . We developed novel LSSs to estimate Trapezoidal MPA AUC from a large cohort of pediatric HTx recipients. Validation of our LSSs should be completed in a separate cohort of pediatric HTx recipients.
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Affiliation(s)
- David M Newland
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA
- School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - Jennifer L Pak
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA
- School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - Reda Ali
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA
- School of Pharmacy, University of Washington, Seattle, Washington, USA
| | | | - Thomas L Nemeth
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA
- School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - William Tressel
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Richard A Kronmal
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Lisa R Knorr
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA
- School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - Erin L Albers
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Joshua M Friedland-Little
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Humera Ahmed
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Mariska S Kemna
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Borah J Hong
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Kathryn Spencer
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Yuk M Law
- Pediatric Cardiology, Seattle Children's Hospital, Seattle, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
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Formulation development and optimization of taste-masked azithromycin oral suspension with ion exchange resins: Bioanalytical method development and validation, in vivo bioequivalence study, and in-silico PBPK modeling for the paediatric population. J Drug Deliv Sci Technol 2023. [DOI: 10.1016/j.jddst.2022.104048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Development of Physiologically Based Pharmacokinetic Model for Pregabalin to Predict the Pharmacokinetics in Pediatric Patients with Renal Impairment and Adjust Dosage Regimens: PBPK Model of Pregabalin in Pediatric Patients with Renal Impairment. J Pharm Sci 2021; 111:542-551. [PMID: 34706283 DOI: 10.1016/j.xphs.2021.10.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 12/17/2022]
Abstract
Pregabalin (PGB) is widely used clinically; however, its pharmacokinetics (PK) has not been studied in pediatric patients with renal impairment (RI). To design optimized PGB regimens for pediatric patients with varying degrees of RI and predict exposure to PGB, physiologically based pharmacokinetic (PBPK) models of PGB were developed and verified, and its disposition was simulated in the healthy population and adults with RI. The simulated results from the PBPK models after single-dose and multi-dose administrations of PGB were consistent with the corresponding observed data based on the fold error values of less than 2. The area under curve ratios were 1.23 ± 0.06, 2.02 ± 0.10, 3.86 ± 0.21, and 9.92 ± 0.79 in pediatric patients with mild, moderate, severe, and end-stage RI, respectively. Based on the predictions for pediatric patients with moderate, severe, and end-stage RI, the maximum dose should not exceed 7, 3.5, and 1.4 mg/kg/day, respectively, among those weighing < 30 kg, and it should not exceed 5, 2.5, and 1 mg/kg/day, respectively, among those weighing > 30 kg. In conclusion, the developed PBPK model is a valuable tool for predicting PGB dosage for pediatric patients with RI.
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Kandel SE, Lampe JN. Inhibition of CYP3A7 DHEA-S Oxidation by Lopinavir and Ritonavir: An Alternative Mechanism for Adrenal Impairment in HIV Antiretroviral-Treated Neonates. Chem Res Toxicol 2021; 34:1150-1160. [PMID: 33821626 PMCID: PMC8058764 DOI: 10.1021/acs.chemrestox.1c00028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
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Prophylactic antiretroviral
therapy (ART) in HIV infected pregnant
mothers and their newborns can dramatically reduce mother-to-child
viral transmission and seroconversion in the neonate. The ritonavir-boosted
lopinavir regimen, known as Kaletra, has been associated with premature
birth and transient adrenal insufficiency in newborns, accompanied
by increases in plasma dehydroepiandrosterone 3-sulfate (DHEA-S).
In the fetus and neonates, cytochrome P450 CYP3A7 is responsible for
the metabolism of DHEA-S into 16α-hydroxy DHEA-S, which plays
a critical role in growth and development. In order to determine if
CYP3A7 inhibition could lead to the adverse outcomes associated with
Kaletra therapy, we conducted in vitro metabolic
studies to determine the extent and mechanism of CYP3A7 inhibition
by both ritonavir and lopinavir and the relative intrinsic clearance
of lopinavir with and without ritonavir in both neonatal and adult
human liver microsomes (HLMs). We identified ritonavir as a potent
inhibitor of CYP3A7 oxidation of DHEA-S (IC50 = 0.0514
μM), while lopinavir is a much weaker inhibitor (IC50 = 5.88 μM). Furthermore, ritonavir is a time-dependent inhibitor
of CYP3A7 with a KI of 0.392 μM
and a kinact of 0.119 min–1, illustrating the potential for CYP3A mediated drug–drug
interactions with Kaletra. The clearance rate of lopinavir in neonatal
HLMs was much slower and comparable to the rate observed in adult
HLMs in the presence of ritonavir, suggesting that the addition of
ritonavir in the cocktail therapy may not be necessary to maintain
effective concentrations of lopinavir in neonates. Our results suggest
that several of the observed adverse outcomes of Kaletra therapy may
be due to the direct inhibition of CYP3A7 by ritonavir and that the
necessity for the inclusion of this drug in the therapy may be obviated
by the lower rate of lopinavir clearance in the neonatal liver. These
results may lead to a reconsideration of the use of ritonavir in neonatal
antiretroviral therapy.
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Affiliation(s)
- Sylvie E Kandel
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy, University of Colorado, Aurora, Colorado 80045, United States
| | - Jed N Lampe
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy, University of Colorado, Aurora, Colorado 80045, United States
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Lavan M, Wang X, McCain R, Jannasch A, Cooper B, Hostetler S, Byrn S, Knipp G. Development of a Pediatric Mini-Tablet Formulation for Expedited Preclinical Studies. AAPS PharmSciTech 2021; 22:40. [PMID: 33417081 DOI: 10.1208/s12249-020-01891-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/27/2020] [Indexed: 12/12/2022] Open
Abstract
Multiple considerations are essential to address the main challenges of dose flexibility and patient adherence in pediatric drug development, particularly for oncology. Mini-tablets, 2 mm in diameter, were manufactured using a rotary tablet press at a set weight and compression force level. The physical characteristics were consistent for mini-tablets throughout multiple batches. Polymeric amorphous solid dispersion (ASD) was used as a solubility enhancing technique to increase solubility and exposure of lapatinib. The effects of the polymeric excipient and disintegrant on drug release properties were investigated. While having a lower apparent solubility and shorter storage stability, hydroxypropyl methylcellulose E3 (HPMCE3) formulation provided a higher percentage of drug release compared to hydroxypropyl methylcellulose phthalate (HPMCP). The intermolecular interaction within the ASD system plays a role in the level of apparent solubility, physical stability, and concentration of free drug available in an aqueous environment. Juvenile porcine models at two different weight groups (10 and 20 kg) were used to obtain the pharmacokinetic parameters of lapatinib. While the dose-normalized exposure of drug was found to be lower in the pig study, the dose flexibility of mini-tablets enabled a constant dose level to be administered to achieve equivalent plasma concentration-time profiles between the two groups. This linear scaling in the amount of drug in pediatric and adult population has also been observed in human clinical studies.
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Matlock MK, Tambe A, Elliott-Higgins J, Hines RN, Miller GP, Swamidass SJ. A Time-Embedding Network Models the Ontogeny of 23 Hepatic Drug Metabolizing Enzymes. Chem Res Toxicol 2019; 32:1707-1721. [PMID: 31304741 DOI: 10.1021/acs.chemrestox.9b00223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Pediatric patients are at elevated risk of adverse drug reactions, and there is insufficient information on drug safety in children. Complicating risk assessment in children, there are numerous age-dependent changes in the absorption, distribution, metabolism, and elimination of drugs. A key contributor to age-dependent drug toxicity risk is the ontogeny of drug metabolism enzymes, the changes in both abundance and type throughout development from the fetal period through adulthood. Critically, these changes affect not only the overall clearance of drugs but also exposure to individual metabolites. In this study, we introduce time-embedding neural networks in order to model population-level variation in metabolism enzyme expression as a function of age. We use a time-embedding network to model the ontogeny of 23 drug metabolism enzymes. The time-embedding network recapitulates known demographic factors impacting 3A5 expression. The time-embedding network also effectively models the nonlinear dynamics of 2D6 expression, enabling a better fit to clinical data than prior work. In contrast, a standard neural network fails to model these features of 3A5 and 2D6 expression. Finally, we combine the time-embedding model of ontogeny with additional information to estimate age-dependent changes in reactive metabolite exposure. This simple approach identifies age-dependent changes in exposure to valproic acid and dextromethorphan metabolites and suggests potential mechanisms of valproic acid toxicity. This approach may help researchers evaluate the risk of drug toxicity in pediatric populations.
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Affiliation(s)
- Matthew K Matlock
- Department of Pathology and Immunology , Washington University in St. Louis , Saint Louis , Missouri 63110 , United States
| | - Abhik Tambe
- Department of Pathology and Immunology , Washington University in St. Louis , Saint Louis , Missouri 63110 , United States
| | - Jack Elliott-Higgins
- Department of Pathology and Immunology , Washington University in St. Louis , Saint Louis , Missouri 63110 , United States
| | - Ronald N Hines
- National Health and Environmental Effects Research Laboratory , United States Environmental Protection Agency , Research Triangle Park , North Carolina 27709 , United States
| | - Grover P Miller
- Department of Biochemistry and Molecular Biology , University of Arkansas for Medical Sciences , Little Rock , Arkansas 72205 , United States
| | - S Joshua Swamidass
- Institute for Informatics , Washington University in St. Louis , Saint Louis , Missouri 63110 , United States
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8
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Pediatric Review and Perioperative Considerations. J Perianesth Nurs 2018; 33:265-274. [PMID: 29784255 DOI: 10.1016/j.jopan.2016.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/14/2016] [Accepted: 03/20/2016] [Indexed: 11/24/2022]
Abstract
Perioperative management of pediatric patients demands knowledge of the relevant ways in which pediatric physiology and physiological regulation differs from the adult. This article will outline some of these most pertinent differences, and also present current recommendations for perioperative management.
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9
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Nicolas JM, Bouzom F, Hugues C, Ungell AL. Oral drug absorption in pediatrics: the intestinal wall, its developmental changes and current tools for predictions. Biopharm Drug Dispos 2017; 38:209-230. [PMID: 27976409 PMCID: PMC5516238 DOI: 10.1002/bdd.2052] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 11/21/2016] [Accepted: 11/30/2016] [Indexed: 12/14/2022]
Abstract
The dissolution, intestinal absorption and presystemic metabolism of a drug depend on its physicochemical characteristics but also on numerous physiological (e.g. gastrointestinal pH, volume, transit time, morphology) and biochemical factors (e.g. luminal enzymes and flora, intestinal wall enzymes and transporters). Over the past decade, evidence has accumulated indicating that these factors may differ in children and adults resulting in age-related changes in drug exposure and drug response. Thus, drug dosage may require adjustment for the pediatric population to ensure the desired therapeutic outcome and to avoid side-effects. Although tremendous progress has been made in understanding the effects of age on intestinal physiology and function, significant knowledge gaps remain. Studying and predicting pharmacokinetics in pediatric patients remains challenging due to ethical concerns associated with clinical trials in this vulnerable population, and because of the paucity of predictive in vitro and in vivo animal assays. This review details the current knowledge related to developmental changes determining intestinal drug absorption and pre-systemic metabolism. Supporting experimental approaches as well as physiologically based pharmacokinetic modeling are also discussed together with their limitations and challenges. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jean-Marie Nicolas
- Non-Clinical Development Department, UCB Biopharma sprl, Braine-l'Alleud, Belgium
| | - François Bouzom
- Non-Clinical Development Department, UCB Biopharma sprl, Braine-l'Alleud, Belgium
| | - Chanteux Hugues
- Non-Clinical Development Department, UCB Biopharma sprl, Braine-l'Alleud, Belgium
| | - Anna-Lena Ungell
- Non-Clinical Development Department, UCB Biopharma sprl, Braine-l'Alleud, Belgium
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Murphy JL, Fenn N, Pyle L, Heizer H, Hughes S, Nomura Y, Child J, Parker SK. Adverse Events in Pediatric Patients Receiving Long-term Oral and Intravenous Antibiotics. Hosp Pediatr 2016; 6:330-8. [PMID: 27220835 DOI: 10.1542/hpeds.2015-0069] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Children receiving long-term antibiotic therapy (LTAT) at Children's Hospital Colorado (CHCO) are treated with both oral and intravenous (i.v.) agents and often experience complications not comprehensively described by the literature. We sought to describe adverse drug events (ADEs) and venous access complications (VACs) in pediatric patients managed with oral and i.v. antibiotics so as to inform clinical decision-making, drug monitoring, and patient counseling at CHCO. METHODS We conducted a retrospective review of children receiving LTAT through the CHCO infectious disease service from 2006 to 2012. Demographic, microbiologic, diagnostic data, ADEs, and VACs were recorded for each patient. RESULTS From 2006 to 2012, 521 patients received 1876 courses, accounting for 71,306 days of antimicrobial therapy. A total of 219 patients (42%) developed an ADE with discontinuation of the offending agent in 65% of courses associated with an ADE. The most common ADEs were neutropenia, rash, and diarrhea. Central lines were placed in 376 patients with 106 (28%) experiencing ≥1 VACs. I.v. agents were associated with a fourfold increase in the rate of ADEs compared with oral agents, and a fivefold increase when VACs were included. CONCLUSIONS Practitioners may make more informed decisions and risk assessments by using descriptive ADE information for specific agents and mode of drug delivery to mitigate risk, thereby improving the quality of care. Patients should be counseled regarding risks of LTAT, including increased risk with i.v. therapy, and actively monitored for side effects.
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Affiliation(s)
| | - Norman Fenn
- Department of Pediatrics, University of Arizona, Tuscan, Arizona; and
| | | | | | | | - Yosuke Nomura
- Department of Pediatrics, and Departments of Pediatrics and
| | - Jason Child
- Pharmacy, Children's Hospital Colorado, Aurora, Colorado
| | - Sarah K Parker
- Section of Infectious Diseases and Section of Infectious Diseases, School of Medicine and
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Mitchell A, Hall RW, Erickson SW, Yates C, Lowery S, Hendrickson H. Systemic Absorption of Cyclopentolate and Adverse Events After Retinopathy of Prematurity Exams. Curr Eye Res 2016; 41:1601-1607. [PMID: 27159349 DOI: 10.3109/02713683.2015.1136419] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Preterm infants undergoing Retinopathy of Prematurity Eye Exams (ROPEE) may experience adverse events, possibly from systemic absorption of cyclopentolate. The purpose of this study was to analyze the association between adverse events and drug levels found in neonates undergoing ROPEE. MATERIALS AND METHODS 25 infants were randomized into two groups during routine ROP screening: 5 infants for blood collection before mydriatic drops and 20 for blood collection 1 h after eye drops. Blood was collected onto dried blood spot cards, extracted, and analyzed for cyclopentolate and phenylephrine using liquid chromatography and mass spectrometry. Relationships between drug levels and adverse events were assessed. RESULTS Cyclopentolate (range 6-53 ng/ml) was observed in 15 of 18 infants, while phenylephrine was not detected. Levels of cyclopentolate were significantly higher in infants who were on oxygen (p = 0.01). There was a significant association between cyclopentolate levels and gastric residuals in tube-fed infants not receiving oxygen (p = 0.01). CONCLUSIONS Cyclopentolate levels varied among preterm infants after ROPEE. Cyclopentolate was positively associated with increased gastric residuals. Underlying medical conditions requiring oxygen administration may affect absorption and metabolism of cyclopentolate. There is a need to predict infants at risk for high blood levels of cyclopentolate in order to prevent or treat adverse events after ROPEE.
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Affiliation(s)
- Anita Mitchell
- a Department of Nursing Science , College of Nursing, University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Richard W Hall
- b Department of Pediatrics , College of Medicine, University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Stephen W Erickson
- c Department of Biostatistics , University of Arkansas for Medical Sciences , Little Rock , AR , USA
| | - Charlotte Yates
- d Department of Physical Therapy , University of Central Arkansas , Conway , AR , USA
| | | | - Howard Hendrickson
- e Department of Pharmaceutical Sciences , College of Pharmacy, University of Arkansas for Medical Sciences , Little Rock , AR , USA
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Burgess KS, Philips S, Benson EA, Desta Z, Gaedigk A, Gaedigk R, Segar MW, Liu Y, Skaar TC. Age-Related Changes in MicroRNA Expression and Pharmacogenes in Human Liver. Clin Pharmacol Ther 2015; 98:205-15. [PMID: 25968989 PMCID: PMC4512918 DOI: 10.1002/cpt.145] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/07/2015] [Accepted: 05/07/2015] [Indexed: 11/10/2022]
Abstract
Developmental changes in the liver can significantly impact drug disposition. Due to the emergence of microRNAs (miRNAs) as important regulators of drug disposition gene expression, we studied age-dependent changes in miRNA expression. Expression of 533 miRNAs was measured in 90 human liver tissues (fetal, pediatric [1-17 years], and adult [28-80 years]; n = 30 each). In all, 114 miRNAs were upregulated and 72 were downregulated from fetal to pediatric, and 2 and 3, respectively, from pediatric to adult. Among the developmentally changing miRNAs, 99 miRNA-mRNA interactions were predicted or experimentally validated (e.g., hsa-miR-125b-5p-CYP1A1; hsa-miR-34a-5p-HNF4A). In human liver samples (n = 10 each), analyzed by RNA-sequencing, significant negative correlations were observed between the expression of >1,000 miRNAs and mRNAs of drug disposition and regulatory genes. Our data suggest a mechanism for the marked changes in hepatic gene expression between the fetal and pediatric developmental periods, and support a role for these age-dependent miRNAs in regulating drug disposition.
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Affiliation(s)
- K S Burgess
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - S Philips
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - E A Benson
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Z Desta
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - A Gaedigk
- Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Hospital, Kansas City, and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - R Gaedigk
- Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Hospital, Kansas City, and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - M W Segar
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Y Liu
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - T C Skaar
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Medeiros M, Castañeda-Hernández G, Ross CJD, Carleton BC. Use of pharmacogenomics in pediatric renal transplant recipients. Front Genet 2015; 6:41. [PMID: 25741362 PMCID: PMC4332348 DOI: 10.3389/fgene.2015.00041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/28/2015] [Indexed: 12/17/2022] Open
Abstract
Transplant recipients receive potent immunosuppressive drugs in order to prevent graft rejection. Therapeutic drug monitoring is the current approach to guide the dosing of calcineurin inhibitors, mammalian target of rapamycin inhibitors (mTORi) and mofetil mycophenolate. Target concentrations used in pediatric patients are extrapolated from adult studies. Gene polymorphisms in metabolizing enzymes and drug transporters such as cytochromes CYP3A4 and CYP3A5, UDP-glucuronosyl transferase, and P-glycoprotein are known to influence the pharmacokinetics and dose requirements of immunosuppressants. The implications of pharmacogenomics in this patient population is discussed. Genetic information can help with achieving target concentrations in the early post-transplant period, avoiding adverse drug reactions and drug-drug interactions. Evidence about genetic studies and transplant outcomes is revised.
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Affiliation(s)
- Mara Medeiros
- Laboratorio de Investigación en Nefrología y Metabolismo Mineral, Hospital Infantil de México Federico Gómez México, México ; Departamento de Farmacología, Facultad de Medicina UNAM México, México ; Pharmaceutical Outcomes Programme, Pediatrics, BC Children's Hospital, University of British Columbia Vancouver, BC, Canada
| | - Gilberto Castañeda-Hernández
- Departamento de Farmacología, Centro de Investigacion y Estudios Avanzados del Instituto Politecnico Nacional México, México
| | - Colin J D Ross
- Pharmaceutical Outcomes Programme, Pediatrics, BC Children's Hospital, University of British Columbia Vancouver, BC, Canada ; Division of Translational Therapeutics, Department of Paediatrics, Faculty of Medicine, University of British Columbia Vancouver, BC, Canada ; Child and Family Research Institute, University of British Columbia Vancouver, BC, Canada
| | - Bruce C Carleton
- Pharmaceutical Outcomes Programme, Pediatrics, BC Children's Hospital, University of British Columbia Vancouver, BC, Canada ; Division of Translational Therapeutics, Department of Paediatrics, Faculty of Medicine, University of British Columbia Vancouver, BC, Canada ; Child and Family Research Institute, University of British Columbia Vancouver, BC, Canada
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