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Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
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GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics01:23

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Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla.  Benzonatate operates peripherally within the respiratory tract by...
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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...
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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...
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Drug Delivery: Enteral Route01:18

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The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Updated: Oct 15, 2025

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
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Anti-reflux medication use in preterm infants.

Haslina Binti Abdul Hamid1,2, Lisa Szatkowski1, Helen Budge1

  • 1Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, UK.

Pediatric Research
|October 30, 2021
PubMed
Summary

Anti-reflux medications are commonly given to very preterm infants, despite lacking evidence of effectiveness. Clearer guidelines are needed for managing gastro-oesophageal reflux disease (GORD) in this vulnerable population.

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Area of Science:

  • Neonatal medicine
  • Pharmacology
  • Gastroenterology

Background:

  • Current guidelines do not recommend anti-reflux medications for gastro-oesophageal reflux disease (GORD) in preterm infants.
  • Despite this, these medications are frequently prescribed to very preterm infants.

Purpose of the Study:

  • To determine the prevalence of GORD and anti-reflux medication use in very preterm infants (<32 weeks' gestational age) in England and Wales.
  • To analyze trends in the types of anti-reflux medications used over time.

Main Methods:

  • Retrospective cohort study utilizing the National Neonatal Research Database.
  • Inclusion of 58,108 infants with analysis of gestational age, birth weight, and medication prescriptions.

Main Results:

  • 15.8% of infants had a GORD diagnosis, and 36.9% received anti-reflux medications.
  • Infants receiving medications were more preterm and had lower birth weights.
  • Gaviscon and Histamine-2 Receptor Antagonists (H2RAs) were most common; prokinetic use decreased, while PPI use increased.

Conclusions:

  • Anti-reflux medications are frequently prescribed to very preterm infants, often without a GORD diagnosis.
  • Evidence suggests these medications are ineffective and potentially harmful.
  • There is a need for clear guidelines to rationalize the pharmacological management of GORD in preterm infants.