MODERN APPROACHES TO PHARMACOTHERAPY IN CHILDREN
DOI:
https://doi.org/10.11603/24116-4944.2022.1.13254Keywords:
pain in children, opioid analgesics, non-opioid analgesics, pharmacology of analgesics, pharmacotherapy of painAbstract
The aim of the study – to summarize the latest available data on the clinical pharmacology of analgesics and pharmacocorrection of pain in children.
Materials and Methods. A bibliographic search for results of the study of the analgesics use for pain relief in children was conducted using PubMed EMBASE databases as the main search engines.
Results and Discussion. The main scales for assessing pain in children, adapted to those developed in the USA and Great Britain, are presented. Opioid analgesics are quite often used for acute pain, in particular, morphine at a dose of 50–200 μg/kg; methadone orally at a dose of 50–200 μg/kg; fentanyl (0.5–4 μg/kg); alfentanil (10–20 μg/kg); sufentanil (10–15 μg/kg) and remifentanil (5 μg/kg) intravenously. Short-acting opioid analgesics fentanyl, alfentanil, sufentanil, and remifentanil are used for very severe and unbearable pain. Non-opioid analgesics are prescribed for moderate pain. Paracetamol (acetaminophen at a dose of 12–15 mg/kg), midazolam (50–150 μg/kg), which is not recommended for newborns, and propafol (2.5 mg/kg) can be used.
Conclusions. In recent years, preference is given to non-opioid analgesics for non-acute pain relief in pediatric patients.
References
Saarenmaa, E., Huttunen, P., Leppäluoto, J., & Fellman, V. (1996). Alfentanil as procedural pain relief in newborn infants. Arch Dis Child Fetal Neonatal Ed., 75(2), 103-107.
Barrington, K.J., & Byrne, P.J. (1998). Premedication for neonatal intubation. Am. J . Perinatol, 15(4), 213-216.
Schmidt, B., Adelmann, C., & Stützer, H. [et al.]. (2010). Comparison of sufentanil versus fentanyl in ventilated term neonates. Klin Padiatr., 222(2), 62-66.
Davis, J.M., Shenberger, J., & Terrin, N. [et al.]. (2018). Comparison of Safety and Efficacy of Methadone vs Morphine for Treatment of Neonatal Abstinence Syndrome: A Randomized Clinical Trial. JAMA Pediatr., 172(8). 741-748. DOI: 10.1001/jamapediatrics.2018.1307.
Cuzzolin, L., Antonucci, R., & Fanos, V. (2013). Paracetamol (acetaminophen) efficacy and safety in the newborn. Curr Drug Metab., 14(2), 178-185.
Dewhirst, E., Naguib, A., & Tobias, J.D. (2012). Chest wall rigidity in two infants after low-dose fentanyl administration. Pediatr Emerg Care, 28(5), 465-468.
Palmer, G.M., Atkins, M., & Anderson, B.J. (2008). I.V. acetaminophen pharmacokinetics in neonates after multiple doses. Br. J. Anaesth., 101(4), 523-530.
Ivanova, S.V., & Galiyash, N.B. (2017). Metody` ocinyuvannya bolyu v dy`tyachomu vici. Medsestry`nstvo, 4, 38-41.
Lundeberg, S., & Roelofse, J.A. (2011). Aspects of pharmacokinetics and pharmacodynamics of sufentanil in pediatric practice. Paediatr Anaesth., 21(3), 274-279.
Neonatal Formulary. “Morphine”. Oxford University Press. 8th Edition, Great Clarendon Street, Oxford, OX2, 6DP, UK, 2020. – P. 530-533.
Andriishyn, L.I., & Bratsiun, O.P. (Eds.). (2016). Nastanovy VOOZ shсhodo farmakolohichnoho likuvannia stiikoho boliu v ditei iz medychnymy zakhvoriuvanniamy [WHO guidelines regarding pharmacological treatment]. Kyiv: TOV “Vydavnychyi dim “Kalyta” [in Ukrainian].
Czynski, A.J., Davis, J.M., & Dansereau, L.M. [et al.]. (2020). Neurodevelopmental Outcomes of Neonates Randomized to Morphine or Methadone for Treatment of Neonatal Abstinence Syndrome. J. Pediatr., 219, 146-151. DOI: 10.1016/j.jpeds.2019.12.018. Epub 2020 Jan 24.
Pacifici G.M. (2021). Clinical pharmacology of morphine in infants and children. J. Pharmaceutics and Pharmacology Research., 4(5). DOI: 10.31579/2693-7247/053.
Pacifici G.M. (2014). Clinical pharmacology of analgesics in infants and the pharmacologic management of pain in neonates. Clinical pharmacology of analgesics in neonates, 1(3), 105-115.
Peeters, M.Y., Allegaert, K., & Blussé van Oud-Alblas, H.J. (2010). Prediction of propofol clearance in children from an allometric model developed in rats, children and adults versus a 0.75 fixed-exponent allometric model. Clin. Pharmacokinet, 49(4), 269-275.
Shaheen, S.O., Newson, R.B., & Ring, S.M. (2010). Prenatal and infant acetaminophen exposure, antioxidant gene polymorphisms, and childhood asthma. J. Allergy Clin. Immunol., 126(6), 1141-1148.
Walter-Nicolet, E., Annequin, D., Biran, V., Mitanchez, D., & Tourniaire, B. (2010). Pain management in newborns: from prevention to treatment. Paediatr Drugs., 12(6), 353-365.
Penido, M.G., Garra, R., Sammartino, & M., Pereira e Silva Y. (2010). Remifentanil in neonatal intensive care and anaesthesia practice. Acta Paediatr., 99(10),1454-1463.
Ream, Al-Hasani, & Michael, R., Bruchas (2011). Molecular mechanisms of opioid receptor-dependent signaling and behavior. Anesthesiology, 115, 1363-1381. https://doi.org/10.1097/ALN.0b013e318238bba6
Welzing, L., Oberthuer, A., Junghaenel, S., Harnischmacher, U., Stützer, H., & Roth, B. (2012). Remifentanil/midazolam versus fentanyl/midazolam for analgesia and sedation of mechanically ventilated neonates and young infants: a randomized controlled trial. Intensive Care Med., 38 (6), 1017-1024.
The British national formulary for children. “Morphine”. Macmillan, 78th Edition, Hampshire International Business Park, Hampshire, Lime Three Way, Basingstoke, Hampshire, UK, 2019-2020.
Wong, D.L., & Baker, C.M. (1988). Pain in children: comparison of assessment scales. Pediatr. Nurs., 14 (1), 9-17.
Yaksh, T., & Wallace, M. “Opioid, Analgesia, end Pan Managment” In The Goodman & Gilman’s. The Pharmacological Basis of the Therapeutics, Brunton Hilaldandan I.I., Knoollmann B.C. Eds Mc Graw Hill, 13th Edition, USA, New York.
Young, T.E., Mangum, B., & Neofax, A. (2010). A manual of drugs used in neonatal care. 23rd. Montvale 07645, New Jersey, USA: Thomson Reuters;
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