Personalized Pediatric Anesthesia and Pain Management: Problem-Based Review

Packiasabapathy, Senthil; Rangasamy, Valluvan; Horn, Nicole; Hendrickson, Michele; Renschler, Janelle S; Sadhasivam, Senthilkumar

doi:10.2217/pgs-2019-0108

Cited by 2 publications

(4 citation statements)

References 150 publications

(162 reference statements)

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“…Fatalities have been reported in infants breastfed by mothers taking codeine, in children following adenotonsillectomy and other surgeries, particularly in the presence of apnea and obesity [49]. A review of adverse effects in children taking codeine-containing products found cases of severe respiratory depression and death [50]. This has led to the development of guidelines and clinical practice guidelines for the use of codeine by the World Health Organization, the FDA, the European Medicines Agency (EMA), and Health Canada, as well as the Medicines and Healthcare products Regulatory Agency Great Britain [50].…”

Section: Data On the Pediatric Populationmentioning

confidence: 99%

“…A review of adverse effects in children taking codeine-containing products found cases of severe respiratory depression and death [50]. This has led to the development of guidelines and clinical practice guidelines for the use of codeine by the World Health Organization, the FDA, the European Medicines Agency (EMA), and Health Canada, as well as the Medicines and Healthcare products Regulatory Agency Great Britain [50]. Restrictions have been established for the use of codeine in children under 12 years of age after adenotonsillectomy procedures [51].…”

Section: Data On the Pediatric Populationmentioning

confidence: 99%

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Pharmacogenetics of Anesthesiological Support

Skavinska,

Fishchuk,

Cherniavska

et al. 2024

Neonatol. hìr. perinat. med.

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Pharmacogenetics studies the relationship between a person’s individual genetic characteristics and the human body’sresponse to the action of various drugs, particularly the occurrence of undesirable side eff ects. Thanks to the development of the latest technologies and methods, this branch of medical genetics and clinical pharmacology is developing very actively. Data are being accumulated, special databases are being created with the aim of creating individual genetic passports in the future, which will allow the selection of personalized treatment schemes.Anesthesiology is a special area of pharmacogenetic research because, more than any other medical specialty, it ischaracterized by polypharmacy-the simultaneous or sequential administration of many drugs. The same dose of a drug may be inadequate for some patients and may be life-threatening or cause unwanted side eff ects for others. Today, information about genetic factors is being used by clinicians to prescribe drugs to tailor drug therapy to a patient’s genome. In anesthesiology, the principles of pharmacogenetics have been explained for neuromuscular blocking agents, opioid metabolism, different types of anesthetics, and postoperative nausea and vomiting. On the other hand, a large number of anesthetics have a narrow therapeutic index.This review summarizes the most recent data from the scientifi c literature on the pharmacogenetics of diff erent types ofanesthetics. Inhalational anesthetics are halogenated derivatives of methyl ethyl ether, the exact mechanism of action of which is not yet fully understood. One of the rare but very serious side eff ects of all halogenated anesthetics is malignant hyperthermia, a genetically determined autosomal dominant disorder that manifests as a hypermetabolic response to drug administration. The dosage of intravenous anesthetics should also be carefully determined, taking into account the patient’s age, cardiovascular, hepatic, and renal status, concomitant drug therapy, and genetic factors. Ontogeny and genetic variability of drug-metabolizing enzymes are interrelated because genetic variability in drug-metabolizing enzyme expression cannot be assessed until the required protein is suffi ciently expressed. Pharmacogenetic variants may contribute to unpredictable drug exposure at the same weight- based drug dose.There are a number of potentially clinically applicable pharmacogenetic data in newborns, but more research is needed toconfi rm these fi ndings and understand how to incorporate them into clinical care.The selection of drugs and dosing regimens based on a patient’s pharmacogenomic profi le may be an important part of thefuture of medicine. Personalized treatment based on the specifi c variants in the genome will ultimately reduce the incidence of side eff ects and length of hospital stay for patients and save healthcare costs. Although pharmacogenomics and its application in clinical practice are still in their infancy, different variants and their implications for many clinical areas, including anesthesiology, are emerging every day.

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Section: Data On the Pediatric Populationmentioning

confidence: 99%

Section: Data On the Pediatric Populationmentioning

confidence: 99%

Pharmacogenetics of Anesthesiological Support

Skavinska,

Fishchuk,

Cherniavska

et al. 2024

Neonatol. hìr. perinat. med.

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“…Agencja odradza także zastosowanie tych leków wśród kobiet karmiących piersią ze względu na możliwe szkody dla niemowląt. [8] Zastosowanie morfiny, najczęściej stosowanego leku z grupy agonistów μ-receptorów, uznawanie jest obecnie za złoty standard. [1] Farmakokinetyka morfiny u dzieci nie jest obecnie dokładnie przeanalizowana, dlatego też jej zastosowanie w populacji pediatrycznej powinno być dokładnie monitorowane przez doświadczony personel.…”

Section: Leczenie Farmakologiczneunclassified

“…Wykazano jego dużą skuteczność w zwalczaniu bólu u dzieci. [8] [10] W Polsce jego używanie jest popularne podczas występowania tzw. bóli przebijających u dzieci z procesem nowotworowym.…”

Section: Leczenie Farmakologiczneunclassified

Pain therapy in the pediatric population

Białowąs

Mazurek²,

Aghadi³

et al. 2023

J Educ Health Sport

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Introduction: The assessment and treatment of pain in the pediatric population is a huge challenge for doctors and medical staff dealing with this group of patients. It is also one of the most important elements of pediatric care practice. There are many factors that contribute to the difficulty of assessing and managing pain in children, but the most important seems to be the lack of unified standards of care. In pain therapy, both pharmacotherapy and behavioral methods and psychological care are used. Purpose of the work: The aim of this work is to systematize the current state of knowledge in the field of pain therapy in the pediatric population, focusing particular attention on pharmacotherapy Materials and Evidence: We reviewed the literature available in the PubMed database using the following keywords: pediatric; pain therapy; analgesia Summary: Pain therapy in the pediatric population, despite the fact that it is often underestimated and insufficiently managed, is crucial both in terms of avoiding health complications and in the overall therapeutic process. Despite the presence of many drugs for pain therapy on the market, many of them are not approved for use in this group of patients. Knowledge of their mechanisms of action and predicting the impact on metabolism in a pediatric patient compared to an adult is crucial for the management of both acute and chronic pain syndromes. Despite the current knowledge, there is still a need for broader research on the possibility of the drugs used, their impact on the therapy process and side effects in the youngest patients.

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Personalized Pediatric Anesthesia and Pain Management: Problem-Based Review

Cited by 2 publications

References 150 publications

Pharmacogenetics of Anesthesiological Support

Pharmacogenetics of Anesthesiological Support

Pain therapy in the pediatric population

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