Cough Remedies for Children and Adolescents: Current and Future Perspectives
AbstractCough is a widespread symptom in children and adolescents. Despite advances in scientific knowledge about the neurophysiological mechanisms underlying the cough reflex, the best therapeutic approaches for children and adolescents who cough remain unclear, and many needs are still unmet. Many remedies for cough are self-prescribed, reflecting strong demand, but significant evidence of their efficacy and safety is missing in pediatric populations. Moreover, as most coughs are part of self-limited illnesses, treatment could be considered unnecessary in some patients. Drug therapy to relieve cough and other symptoms is...
Source: Pediatric Drugs - September 14, 2020 Category: Pediatrics Source Type: research
Practical Challenges —Use of Paracetamol in Children and Youth Who are Overweight or Obese: A Narrative Review
AbstractWorldwide,> 380 million children and adolescents are overweight or obese, including 41 million children aged< 5 years. Obesity can change the pharmacokinetic properties of drugs by altering their distribution, metabolism, and elimination. Thus, children who are overweight or obese are at increased risk for receiving inappropriate doses of commonly used drugs, which can result in treatment failure, adverse events, and/or drug toxicity. This review analyzes available data on paracetamol dosing for pain and fever in children and adolescents who are overweight or obese to identify gaps and challenges in optim...
Source: Pediatric Drugs - September 10, 2020 Category: Pediatrics Source Type: research
Adherence to Medication During Transition to Adult Services
AbstractThe transition from childhood and adolescence to adulthood is often tumultuous. For individuals with a chronic medical condition, this progression also includes a gradual transition to independence in healthcare management as well as a transfer in care location at some set point. As adolescents navigate these sometimes challenging processes, there is a significant risk for a decline in adequate health behaviors, which can have dire consequences. One of the most vital components of the transfer to adult care is medication adherence. Poor medication adherence puts patients at risk for worse outcomes, with the most pr...
Source: Pediatric Drugs - September 4, 2020 Category: Pediatrics Source Type: research
Management of Chronic Migraine in Children and Adolescents: A Brief Discussion on Preventive Therapies
AbstractPediatric migraine is a debilitating disease that affects about 10% of school-aged children. Like other pain disorders, migraines can be accompanied with sleep, mood, and cognitive difficulties, leading to interruptions in daily tasks required at both school and home. This paper serves as a review of the most current pharmacological treatments available for managing migraine in the pediatric population. Because the management of migraine is complex, we discuss the importance of multidisciplinary care involving pharmacological and non-pharmacological measures, behavioral modifications, and a shared treatment plan be...
Source: Pediatric Drugs - September 4, 2020 Category: Pediatrics Source Type: research
Anakinra for Treatment-Resistant Kawasaki Disease: Evidence from a Literature Review
AbstractKawasaki disease (KD) is one of the most common vasculitides of childhood and the main cause of acquired heart disease in developed countries. Intravenous immunoglobulin (IVIG) in association with aspirin represents the main treatment for KD. However, 10 –20% of patients fail to respond to standard treatment and have an increased risk of cardiac complications. There is currently no accepted protocol for treatment of resistant cases. Several authors highlighted the role of interleukin-1 (IL-1) as a mediator of inflammation in KD and suggested the p ossibility of using IL-1 or its receptor as a target of therapy. T...
Source: Pediatric Drugs - September 2, 2020 Category: Pediatrics Source Type: research
Treatment of Juvenile Spondyloarthritis: Where We Stand
AbstractJuvenile spondyloarthritis is a subset of juvenile idiopathic arthritis (JIA) with onset in late childhood and adolescence and a strong association with human leukocyte antigen (HLA) B-27 positivity and familial aggregation that has the potential for axial involvement, potentially leading to ankylosing spondylitis. Current therapy for severe disease relies heavily on tumor necrosis factor inhibitors (TNFi). Treatment paradigms in children largely consist of extrapolation from studies on adults with spondyloarthritis. Additional therapies studied in adults include non-steroidal anti-inflammatory drugs (NSAIDs), bloc...
Source: Pediatric Drugs - September 2, 2020 Category: Pediatrics Source Type: research
Immunotherapy in Pediatric B-Cell Acute Lymphoblastic Leukemia: Advances and Ongoing Challenges
AbstractLeukemia, most commonly B-cell acute lymphoblastic leukemia (B-ALL), accounts for about 30% of childhood cancer diagnoses. While there have been dramatic improvements in childhood ALL outcomes, certain subgroups —particularly those who relapse—fare poorly. In addition, cure is associated with significant short- and long-term side effects. Given these challenges, there is great interest in novel, targeted approaches to therapy. A number of new immunotherapeutic agents have proven to be efficacious in rel apsed or refractory disease and are now being investigated in frontline treatment regimens. Blinatumomab (a b...
Source: Pediatric Drugs - August 28, 2020 Category: Pediatrics Source Type: research
Efficacy of Milrinone Plus Sildenafil in the Treatment of Neonates with Persistent Pulmonary Hypertension in Resource-Limited Settings: Results of a Randomized, Double-Blind Trial
ConclusionDual therapy using sildenafil and milrinone was superior to monotherapy with either drug in neonates with severe PPHN and is recommended for use in resource-constrained settings.RegistrationPan African Clinical Trial Registry identifier number PACTR201902691230243. (Source: Pediatric Drugs)
Source: Pediatric Drugs - August 27, 2020 Category: Pediatrics Source Type: research
Thiopurines in Pediatric Inflammatory Bowel Disease: Current and Future Place
AbstractThiopurines have been widely used to maintain steroid-free remission in children with inflammatory bowel disease (IBD). However, within the expanding treatment armamentarium, the role of these non-selective immunomodulators has been questioned, especially in pediatric patients, who often present with a more aggressive disease course, which can impact growth and development. The less favorable safety but also inferior efficacy profile associated with thiopurines, in contrast to the newer biological therapies, has interfered with their use. The future place of thiopurines in the management of childhood IBD, therefore...
Source: Pediatric Drugs - August 13, 2020 Category: Pediatrics Source Type: research
A Pharmacokinetic Study of Methylphenidate Hydrochloride Multilayer Extended-Release Capsules (Aptensio XR ® ) in Preschool-Aged Children with Attention-Deficit/Hyperactivity Disorder
ConclusionThe PK of MPH-MLR in preschool children demonstrated the biphasic absorption profile described earlier in older children, and the PK profile in children with ADHD aged 4 to < 6 years was similar to the profile in those aged 6–11 years, apart from a lowerVd and relatively higher systemic MPH levels for children in the preschool group.Trial registrationClinicaltrials.gov Identifier: NCT02470234. (Source: Pediatric Drugs)
Source: Pediatric Drugs - August 9, 2020 Category: Pediatrics Source Type: research
The Role of Probiotics in the Prevention and Treatment of Atopic Dermatitis in Children: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials
ConclusionOur updated meta-analysis demonstrates that interventions with probiotics potentially lower the incidence of AD and relieve AD symptoms in children, particularly when treating infants and children aged ≥ 1 year with AD. Interventions with mixed-strain probiotics tended to have better preventive and curative effects. Probiotics administered solely to infants appeared to produce negative preventive effects. Different intervention durations might also affect clinical outcomes. However, given the insignificant subgroup differences, except for treatment by participant age, and the moderate heterogeneity among ...
Source: Pediatric Drugs - August 3, 2020 Category: Pediatrics Source Type: research
Recent Advances in the Pharmacological Management of Behavioral Disturbances Associated with Autism Spectrum Disorder in Children and Adolescents
AbstractAutism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition affecting an estimated one in 36 children. Youth with ASD may have severe behavioral disturbances including irritability, aggression, and hyperactivity. Currently, there are only two medications (risperidone and aripiprazole) approved by the US Food and Drug Administration (FDA) for the treatment of irritability associated with ASD. Pharmacologic treatments are commonly used to target ASD-associated symptoms including irritability, mood lability, anxiety, and hyperactivity. However, evidence for the efficacy of many commonly used treatment...
Source: Pediatric Drugs - July 19, 2020 Category: Pediatrics Source Type: research
Characteristics of Reported Pediatric Medication Errors in Northern Ireland and Use in Quality Improvement
ConclusionsIncident reports identified neonates, a shortlist of drugs, and specific error types, associated with modifiable behaviors, as priority improvement targets. These findings direct further study and inform intervention development, such as specific training in calculations to prevent dosing errors. Involving experienced practitioners both endorsed the findings and engaged the practice community in their future implementation. The utility of incident reports to direct improvement efforts may offset the limitations in their representativeness. (Source: Pediatric Drugs)
Source: Pediatric Drugs - July 5, 2020 Category: Pediatrics Source Type: research
Treat-to-Target in Pediatric Inflammatory Bowel Disease: What Does the Evidence Say?
AbstractThe traditional management of inflammatory bowel disease, based on treatment intensification guided by clinical activity alone, has been revised in the last 10 years and a treat-to-target approach has been proposed and is currently under evaluation as a disease-modifying strategy. Treat-to-target focuses on objective and scheduled measures to monitor intestinal damage, with consequent therapeutic adjustments in case of failure to achieve pre-defined targ ets. Identification of targets has been set out by the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) committee in 2015. Mucosal healing is...
Source: Pediatric Drugs - June 22, 2020 Category: Pediatrics Source Type: research
Analysis of Reporting Adverse Drug Reactions in Paediatric Patients in a University Hospital in the Netherlands
ConclusionsThe results of the present study show that a large number of ADRs are not registered in the medical records and are not reported to the national pharmacovigilance system. Furthermore, it is shown that the number of ADRs occurring at our centre is much higher than the number reported to the national pharmacovigilance centre. Only an average of 513 ADRs in paediatric patients are reported per year nationwide, suggesting that there is extensive underreporting. (Source: Pediatric Drugs)
Source: Pediatric Drugs - June 17, 2020 Category: Pediatrics Source Type: research
