尿中乙胺基代谢物和极度早产婴儿的临床结果
Miguel Guardado1, Dara Torgerson2, Cheryl Chapin3
1Department of Biological and Medical Informatics, University of California, San Francisco, San Francisco, California.
American journal of perinatology
|January 9, 2025
概括
研究了在早产婴儿中使用乙氨基 (APAP) 的情况. 测量了尿液中的APAP代谢物水平,但没有发现与支气管肺功能障碍症或早产风险视网膜病变的相关性.
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 毒理学 毒理学 毒理学
背景情况:
- 乙氨基 (APAP) 用于极度早产婴儿的疼痛和专利性动脉管.
- 高剂量的APAP对成年人有毒,之前的研究表明,母乳中的APAP代谢物可能与婴儿BPD和ROP有关.
- 在这个脆弱人群中,APAP的安全性和代谢物水平需要进一步调查.
研究的目的:
- 为了确定极度早产婴儿尿液中APAP代谢物的水平,这些婴儿有BPD和ROP的高风险.
- 检查APAP代谢物水平与这些婴儿BPD和ROP发展之间的关联.
主要方法:
- 来自TOLSURF和PROP研究的314名婴儿 (妊娠29周以下) 的尿液样本使用非向的UHPLC:MS/MS.进行了分析.
- 使用多变量逻辑回归和元分析来评估APAP代谢物水平与临床结果之间的关系.
主要成果:
- 在95%的样本中检测到尿中主要的APAP代谢物4-APAP硫酸盐,并与其他代谢物相关联.
- 在从亲肠道到肠道营养过渡的婴儿中,4-APAP硫酸盐水平和持续时间较高.
- 在第10天和第28天,APAP代谢物水平和BPD或ROP之间没有发现显著的关联.
结论:
- 尿中的APAP代谢物水平与极早产婴儿BPD或ROP风险增加无关.
- 在这一群体中,APAP的安全性尚未完全确定.
- 需要进一步的研究来了解APAP代谢及其对新生儿的长期影响.
相关概念视频
Factors Affecting Drug Response: Overview
1.8K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.8K
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
80
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
80
Phase II Reactions: Acetylation Reactions
174
Acetylation, a phase II biotransformation reaction, introduces an acetyl group to drugs or their metabolites. Acetyltransferase enzymes facilitate this reaction, which resembles α-amino acid conjugation due to the addition of a functional group to the drug molecule.
The substrates for acetylation are typically drugs or their metabolites with an amino, sulfonamide, or hydrazine functional group. Acetylation can occur at several points in the drug molecule, including primary, secondary, and...
The substrates for acetylation are typically drugs or their metabolites with an amino, sulfonamide, or hydrazine functional group. Acetylation can occur at several points in the drug molecule, including primary, secondary, and...
174
Drug Elimination by Renal Route: Tubular Reabsorption
3.2K
During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
3.2K
Enhanced Elimination of Poison
473
Poison can be effectively removed from the gastrointestinal (GI) tract through various decontamination procedures.
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
Antidotes serve a crucial role in counteracting the effects of poison by inhibiting enzymes responsible for producing harmful drug metabolites. In some cases, these toxic metabolites can be neutralized by endogenous cosubstrates, which are maintained at specific concentrations to prevent interaction with cellular macromolecules and subsequent cell death.
Renal excretion is the...
473
Factors Influencing Drug Absorption: Presystemic Elimination
176
The pharmacokinetic journey of oral drugs begins with a crucial first pass through the hepatic portal system, called the first-pass effect. This first pass significantly impacts bioavailability — the proportion of a drug that enters systemic circulation and is available for therapeutic action. The primary route sees the drug absorbed by intestinal membranes and then shunted to the liver via the hepatic portal vein. Here, pre-systemic elimination occurs as drugs face metabolism or biliary...
176


