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Related Concept Videos

Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating 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...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...

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Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain
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Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain

Published on: May 12, 2018

Medication neurotoxicity in children.

Ramesh S Iyer1, Apeksha Chaturvedi, Sumit Pruthi

  • 1Department of Radiology, Seattle Children's Hospital, Seattle, WA 98105, USA. riyer@uw.edu

Pediatric Radiology
|July 26, 2011
PubMed
Summary

Medication neurotoxicity in children presents with distinct brain imaging patterns, primarily posterior reversible encephalopathy syndrome (PRES) and acute toxic leukoencephalopathy (ATL). Prompt diagnosis via MRI and neurological assessment aids treatment and recovery.

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Published on: May 12, 2018

Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
07:42

Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity

Published on: April 26, 2012

Area of Science:

  • Pediatric Neurology
  • Neuroradiology
  • Toxicology

Background:

  • Medication-induced neurotoxicity is a significant concern in pediatric patients, presenting diverse neurological symptoms.
  • Distinct imaging patterns, such as posterior reversible encephalopathy syndrome (PRES) and acute toxic leukoencephalopathy (ATL), are recognized.
  • Specific medications can cause characteristic central nervous system toxicities beyond these common patterns.

Purpose of the Study:

  • To review common and distinct neuroimaging manifestations of medication neurotoxicity in children.
  • To discuss proposed etiologies, imaging features, and differential diagnostic strategies for PRES and ATL.
  • To highlight specific medications and their unique neurotoxic appearances on imaging.

Main Methods:

  • Pictorial essay format reviewing established literature and imaging findings.
  • Discussion of proposed etiologies and clinical presentations.
  • Analysis of magnetic resonance imaging (MRI) characteristics for diagnosis.

Main Results:

  • Posterior reversible encephalopathy syndrome (PRES) and acute toxic leukoencephalopathy (ATL) are the most common patterns of medication-induced brain injury.
  • Certain agents like methotrexate, cyclosporine A, tacrolimus, metronidazole, and vigabatrin exhibit characteristic neurotoxic effects.
  • Diagnosis relies on new-onset neurological deficits, recent medication initiation, and characteristic MRI findings.

Conclusions:

  • Medication neurotoxicity in children has identifiable imaging patterns, aiding diagnosis.
  • Distinct imaging findings are crucial for differentiating PRES, ATL, and other medication-specific toxicities.
  • Discontinuation of the offending agent often leads to clinical and radiological improvement.