在儿童医院为患有状细胞病的青少年增加胺的管理
Ashley Jenkins1, Erin Hendry1, Alexandra Power-Hays2
1University of Rochester, Rochester, New York, United States.
Blood advances
|December 3, 2025
概括
在患有状细胞病 (SCD) 的住院青少年中,胺的使用从2016年至2023年增加. 早期服用胺与住院时间缩短和阿片类药物使用减少有关,这表明需要进一步研究.
科学领域:
- 儿科血液学 儿科血液学
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 胺是治疗状细胞疾病 (SCD) 疼痛的阿片类药物缓解剂.
- 对于住院儿科SCD患者使用胺的数据有限.
研究的目的:
- 描述住院患有SCD的年轻人中胺的使用趋势.
- 为了检查胺使用和患者的结果之间的关联.
主要方法:
- 美国儿童医院入院的跨截面,多中心研究 (2016-2023年).
- 使用ICD-10代码识别了患有SCD的年轻人 (≥6个月).
- 分析了胺剂的使用和相关的结果,包括停留时间和阿片类药物的使用日.
主要成果:
- 在儿科SCD入院中,胺的使用率从2.3% (2016) 增加到5.7% (2023).
- 青少年 (≥12岁) 和晚年 (≥2019) 显示胺的几率增加.
- 早期服用胺类药物与逗留时间缩短和阿片类药物服用日数减少相关.
结论:
- 在住院的儿科SCD患者中,胺的使用正在增加.
- 早期服用胺类药物可能会改善停留时间和阿片类药物暴露等结果.
- 随机对照试验是必要的,以确认胺的好处和最佳时间.
相关概念视频
Pharmacokinetics in Pediatric Patients: Drug Excretion
195
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...
195
Pharmacokinetics in Pediatric Patients: Drug Metabolism
176
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...
176
Drug Dosing: Infants and Children
234
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...
234
Pharmacokinetics in Pediatric Patients: Drug Distribution
244
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,...
244
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
231
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...
231
Parenteral Anesthetics: Overview
546
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
546


