An update on the safety of prescribing opioids in pediatrics.

An update on the safety of prescribing opioids in pediatrics. Expert Opin Drug Saf. 2019 Jan 16;: Authors: Parikh JM, Amolenda P, Rutledge J, Szabova A, Chidambaran V Abstract INTRODUCTION: The opioid abuse epidemic and its toll on the adolescent population has heightened awareness for safer opioid prescribing practices in pediatric pain management. Opioids remain the mainstay of therapy for severe pain, although there is an emphasis on multimodal therapy. Areas covered: In this update, the authors present information on parenteral/oral opioids commonly used in pediatrics. Recommendations for opioid use in special circumstances including neonates and developmental pharmacokinetic concerns are discussed. Due to noticeable interindividual variability, pharmacogenomics may be important for tailoring pain regimens. In particular, the role of CYP2D6 phenotypes on opioid selection/dosing and clinical implications are discussed. A summary of adverse effects and opioid safety data, and the role of regulations, risk assessment, CDC guidelines, follow up and monitoring for compliance in opioid prescribing, are detailed. Expert opinion: "One size does not fit all" describes the need for public policies focused on pediatric pain and opioid use, as children are not "little adults". Clinical trials to evaluate pharmacokinetic-pharmacodynamics of opioids are currently lacking. Development of novel biased opioid agonists, clinical integration of gen...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research