Related Experiment Videos

Increased injection pain with darbepoetin-alpha compared to epoetin-beta in paediatric dialysis patients

Claus Peter Schmitt1, Barbara Nau, Christiane Brummer

  • 1Division of Paediatric Nephrology, University Hospital for Paediatric and Adolescent Medicine, Im Neuenheimer Feld 153, 69120 Heidelberg, Germany. claus.peter.schmitt@med.uni-heidelberg.de

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 29, 2006
PubMed

Insights

Subcutaneous darbepoetin-alpha injections cause more pain in children than epoetin-beta. This difference in injection pain may limit darbepoetin-alpha

Area of Science:

  • Pediatric Nephrology
  • Pharmacology
  • Pain Management

Background:

  • Darbepoetin-alpha offers longer injection intervals compared to epoetin-beta.
  • Early observations in pediatric patients on peritoneal dialysis suggested increased injection pain with darbepoetin-alpha.

Purpose of the Study:

  • To compare the inherent painfulness of darbepoetin-alpha and epoetin-beta in pediatric patients.
  • To evaluate patient, parent, and nurse perceptions of injection pain.

Main Methods:

  • A prospective, randomized, double-blind trial was conducted in 13 pediatric end-stage renal disease patients.
  • Patients received equivalent doses of darbepoetin-alpha or epoetin-beta in saline via 27G needles.
  • Pain was assessed immediately and 30 minutes post-injection using a visual analogue scale (VAS).

Main Results:

  • Immediate injection pain was significantly higher with darbepoetin-alpha (5.4) compared to epoetin-beta (2.3) as reported by patients (P < 0.05).
  • Parents and nurses also reported significantly greater pain with darbepoetin-alpha injections.
  • A majority of patients reported markedly higher pain scores with darbepoetin-alpha, with pain inversely related to patient age.

Conclusions:

  • Subcutaneous injections of darbepoetin-alpha are perceived as more painful than epoetin-beta in most pediatric patients.
  • The difference in painfulness is attributed to the properties of the injected compounds.
  • This increased pain may restrict the subcutaneous use of darbepoetin-alpha in children.
Abstract

Related Concept Videos

Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
Drug Accumulation During Multiple Dosing: Repetitive IV Injections01:21

Drug Accumulation During Multiple Dosing: Repetitive IV Injections

Calculating drug dosage and accumulation in multiple-dose regimens is crucial for achieving therapeutic efficacy while avoiding toxicity. This involves determining the plasma drug concentrations over time to optimize dosing schedules. The principle of superposition is fundamental in this process, allowing for the prediction of drug concentration in plasma following multiple doses based on single-dose data.The principle of superposition asserts that the plasma concentration-time curves from...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions01:24

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...