Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

1.0K
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...
1.0K
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

1.5K
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
1.5K
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

400
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...
400
Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

597
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
597
Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

387
Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
387
Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

271
Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
271

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Prospective economic evaluation ancillary to a trial of higher versus lower hemoglobin transfusion thresholds for preterm infants.

Neonatology·2026
Same author

Correlation of Oxygen Saturation Index with Oxygenation Index in Congenital Diaphragmatic Hernia: in A Secondary Analysis of a Randomized Clinical Trial.

The Journal of pediatrics·2026
Same author

Budesonide and Surfactant Therapy Versus Surfactant Alone on Incidence of Lung Disease in Preterm Infants (BEST Lung): Study Protocol for a Systematic Review and Individual Participant Data Meta-Analysis With Nested Prospective Meta-Analysis.

Acta paediatrica (Oslo, Norway : 1992)·2026
Same author

Parent-reported quality of life at school age among children born extremely preterm is associated with non-medical determinants of health and developmental outcomes.

Early human development·2026
Same author

Standardised reporting framework for nutrition and growth in preterm nutrition studies: the NutriGrow Delphi study.

Pediatric research·2026
Same author

Why leave neonatal therapies up to chance?

Pediatric research·2026

Related Experiment Video

Updated: Apr 27, 2026

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
09:29

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods

Published on: August 4, 2022

1.8K

Symptom-Based Dosing for Neonatal Opioid Withdrawal: The OPTimize NOW Randomized Clinical Trial.

Lori A Devlin1, Denise C Babineau2, Stephanie L Merhar3,4

  • 1Norton Children's Neonatology, affiliated with the University of Louisville School of Medicine, Louisville, Kentucky.

JAMA
|April 25, 2026
PubMed
Summary

Symptom-based dosing significantly reduced hospital stays for infants with neonatal opioid withdrawal syndrome (NOWS) compared to traditional scheduled opioid tapers. This approach may improve care for newborns experiencing withdrawal symptoms.

More Related Videos

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

90.5K
Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits
06:46

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits

Published on: February 28, 2025

866

Related Experiment Videos

Last Updated: Apr 27, 2026

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods
09:29

Investigating Drivers of Antireward in Addiction Behavior with Anatomically Specific Single-Cell Gene Expression Methods

Published on: August 4, 2022

1.8K
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

90.5K
Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits
06:46

Implantation of Electroencephalogram and Electrocardiogram Telemetry Devices in Neonatal Rabbit Kits

Published on: February 28, 2025

866

Area of Science:

  • Neonatal care
  • Pharmacology
  • Clinical trials

Background:

  • Neonatal Opioid Withdrawal Syndrome (NOWS) is typically managed with scheduled opioid tapers.
  • An alternative, symptom-based dosing approach may better match treatment intensity to withdrawal severity.

Purpose of the Study:

  • To compare the time to medical readiness for discharge between symptom-based dosing and scheduled opioid taper for infants with moderate to severe NOWS.
  • To evaluate the effectiveness of two different treatment strategies for NOWS.

Main Methods:

  • A cluster crossover randomized clinical trial involving 23 US hospitals.
  • Infants were treated using either the Eat, Sleep, Console (ESC) approach or Finnegan-based care, with opioid dosing guided by site-specific algorithms.
  • Sites were randomized to administer symptom-based dosing first, followed by scheduled opioid taper, or vice versa.

Main Results:

  • Symptom-based dosing significantly reduced the mean time to medical readiness for discharge (9.18 days) compared to scheduled opioid taper (11.61 days) in the ESC cohort.
  • No significant differences in time to discharge or length of stay were observed in the Finnegan cohort.
  • The risk for initiating pharmacologic treatment and length of stay did not differ significantly between the two approaches in the ESC cohort.

Conclusions:

  • Symptom-based dosing, particularly within the ESC framework, can decrease the time to medical readiness for discharge for infants with NOWS.
  • This approach offers a potentially more efficient treatment strategy for NOWS, aligning care with infant withdrawal severity.