Abstract
The development of new, sensitive techniques for assaying drugs and drug metabolites together with progress in computer technology have made possible remarkable advances in pharmacokinetics studies. Pharmacokinetics is the mathematical description of drug disposition over time. In other words, it is what the body does to the drug over time. Pharmacokinetics deals with the fate of the drugs in the body, including the mechanisms and kinetics of drug absorption, distribution, elimination (excretion and metabolism), and transport to the site of action (biophase). The latter process can be considered as a link between pharmacokinetics and pharmacodynamics; fundamentally, however, it is a pharmacokinetic process. The volume of pharmacokinetic drug evaluations in children falls considerably behind that performed in the adult population, with the exception of a few limited areas. There are some appropriate reasons for the limited availability of pharmacokinetics data in children. The thalidomide tragedy led to more stringent regulations. Consequently, manufacturers began omitting drug studies in infants and children, creating a population of “therapeutic orphans”. Performing research in children is not only problematic for ethical reasons but also due to logistic difficulties. Patient and parent cooperation may be poor and phlebotomy is typically more difficult to perform in children. Limited patient populations present a problem even in large centers.
Keywords
- Epidural Morphine
- Intravenous Morphine
- Remarkable Advance
- Total Plasma Concentration
- Acute Postoperative Pain
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References
Upton RN, Semple TJ, Macintyre PE (1997) Pharmacokinetic optimisation of opioid treatment in acute pain therapy. Clin Pharmacokinet 33:225–244
Kart T, Christrup LL, Rasmussen M (1997) Recommended use of morphine in neonates, infants and children based on a literature review. Part 1: Pharmacokinetics. Paediatr Anaesth 7:5–11
Hartley R, Green M, Quinn M, Levene MI (1993) Pharmakokinetics of morphine infusion in premature neonates. Arch Dis Child 69:55–58
Lynn AM, Slattery JT (1987) Morphine pharmakokinetics in early infancy. Anaesthesiology 66:136–139
Olkkola KT, Munuksela EL, Korpela R, Rosemberg PH (1988) Kinetics and dynamics of postoperative intravenous morphine in children. Clin Pharmacol Ther 44:128–136
Kart T, Christrup LL, Rasmussen M (1997) Recommended use of morphine in neonates, infants and children based on a literature review. Part 2: Clinical use. Paediatr Anaesth 7:93–101
Attia J, Ecoffey C, Sandouk P, Gross JB, Samii K (1986) Epidural morphine in children: pharmacokinetics and CO2 sensivity. Anaesthesiology 65:590–594
Mazoit JX, Denson DO, Samii K (1988) Pharmacokinetics of bupivacaine following caudal anaesthesia in infants. Anaesthesiology 68:387–391
Luz G, Innerhofer P, Fishhut B et al (1996) Bupivacaine plasma concentrations during continuous infusion epidural anaesthesia in infants and children. Anaesth Analg 82:231–234
Ecoffey C, Desparmet AM, Maury M et al (1985) Bupivacaine in children: pharmacokinetics following caudal anaesthesia. Anaesthesiology 63:447–448
Tucker GT (1986) Pharmacokinetics of local anaesthetics. Br J Anaesth 58:717–731
Berde CB (1992) Convulsions associated with pediatric regional anesthesia. Anesth Analg 75:164–166
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© 1999 Springer-Verlag Italia
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Calamandrei, M., Busoni, P. (1999). Models of pharmacokinetics in the treatment of acute postoperative pain in paediatrics. In: Salvo, I., Vidyasagar, D. (eds) Anaesthesia and Intensive Care in Neonates and Children. Topics in Anaesthesia and Critical Care. Springer, Milano. https://doi.org/10.1007/978-88-470-2282-9_17
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DOI: https://doi.org/10.1007/978-88-470-2282-9_17
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-0043-8
Online ISBN: 978-88-470-2282-9
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