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Journal articles on the topic 'Drugs and infants'

Author: Grafiati

Published: 4 June 2021

Last updated: 3 February 2022

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1

McIlleron, Helen, and Hermien Gous. "Pharmacokinetics of antiretroviral drugs in infancy." Southern African Journal of HIV Medicine 10, no. 4 (December 14, 2009): 54. http://dx.doi.org/10.4102/sajhivmed.v10i4.260.

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Infancy (from birth until 1 year of age) is a time of rapid changes within the body of a child. These changes affect pharmacokinetics in many ways. The CHER study1 showed that early antiretroviral treatment reduces mortality and disease progression amongst infants acquiring HIV infection before 12 weeks of age. As a result the World Health Organization has recently revised treatment initiation recommendations in children less than one year of age: all infants under 12 months of age with confirmed HIV infection should be started on antiretroviral therapy, irrespective of clinical or immunological stage2. Dosing in infants is challenging because drug concentrations are highly variable, there is frequently scant pharmacokinetic information in young children, and few suitable drug formulations are available. Furthermore, adherence to treatment is reliant on the caregiver, rather than the patient. Peri- and postnatal HIV transmission are reduced by maternal highly active antiretroviral treatment (HAART). However, the benefits and risks to breast fed infants of exposure to maternal antiretroviral drugs during lactation are poorly understood. In this article we review the pharmacokinetics of antiretroviral drugs relevant to South African infants, and highlight some of the challenges to delivering antiretroviral treatment in safe and effective doses.

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2

Mayes, Linda C., Marc H. Bornstein, Katarzyna Chawarska, O. Maurice Haynes, and Richard H. Granger. "Impaired regulation of arousal in 3-month-old infants exposed prenatally to cocaine and other drugs." Development and Psychopathology 8, no. 1 (1996): 29–42. http://dx.doi.org/10.1017/s0954579400006957.

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AbstractThis study investigated relations between drug exposure, particularly cocaine, and infants' regulation of arousal in response to novelty. Sixty-three infants — 36 cocaine exposed and 27 non-cocaine exposed — participated at 3 months of age in a novel-repeat stimulus presentation procedure. Arousal was operationalized in terms of infant behavioral state, affective expressiveness, and attention to the stimulus. Infants were tested and infant behaviors were scored by experimenters blind to the drug exposure status of the infant. There were no differences between the two groups in baseline behavioral state or affective expression before the presentation of novel stimuli. Compared to the non-cocaine-exposed group, infants exposed prenatally to cocaine and other drugs were more likely to exhibit a crying state and to display negative affect on novel stimulus presentations. There were no group differences in the amount of looking toward the stimulus. Both groups showed less crying and negative affect when stimuli were presented a second time, but decrements were consistently greater for the cocaine-exposed group. These results obtained when group differences were controlled for sociodemographic and perinatal variables. Sources of differences in the regulation of arousal in cocaine-exposed and non-cocainc-exposed infants are discussed, and impairments in the regulation of arousal in cocaine-exposed infants are considered in a framework of predictive implications for children's social and cognitive development.

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3

WINK, DIANE M. "Giving Infants and Children Drugs." MCN, The American Journal of Maternal/Child Nursing 16, no. 6 (November 1991): 317???322. http://dx.doi.org/10.1097/00005721-199111000-00006.

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4

Iqbal Bhutta, Tariq, and OmarS Khwaja. "Anti-motility drugs for infants." Lancet 336, no. 8710 (August 1990): 314. http://dx.doi.org/10.1016/0140-6736(90)91850-a.

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5

Pellock, Jack. "Antiepileptic drugs trials: Neonates and infants." Epilepsy Research 68, no. 1 (January 2006): 42–45. http://dx.doi.org/10.1016/j.eplepsyres.2005.09.017.

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6

Hans, Sydney L., and Sandra S. Snook. "Sudden Infant Death in infants exposed to opioid drugs in utero." Infant Behavior and Development 9 (April 1986): 161. http://dx.doi.org/10.1016/s0163-6383(86)80163-1.

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7

Lima, Roberta Elian de, Andrezza Aparecida Aleixo, Lúcio Borges Araújo, Camila Piqui Nascimento, and Vivian Mara Gonçalves de Oliveira Azevedo. "Neuropsychomotor development characteristics of the infants who born from women who abused drugs during pregnancy." Journal of Human Growth and Development 28, no. 1 (March 12, 2018): 27. http://dx.doi.org/10.7322/jhgd.134374.

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Introduction: The use of street drugs during pregnancy, due to their deleterious effects on the health of the infant, may have clinical implications for neuropsychomotor development. Objective: The aim of this study was to analyse the characteristics of the neuropsychomotor development of infants born from women who used street drugs during pregnancy. Methods: A cross-sectional retrospective study was carried out. A total of 51 medical records of infants weighing less than 1.500 grams, who were born in the Hospital de Clínicas da Universidade Federal de Uberlândia (HC/UFU), Minas Gerais, Brazil, from January 2014 to December 2015 were analysed. Using the Development Screening test Denver II at 6 or 9 months of corrected age performed the neuropsychomotor development evaluation. Statistical analysis included quantitative variables that were described by means of average, medians and standard deviation. Groups were compared by the t test or Mann-Whitney test. The associations of the qualitative variables were evaluated by means of the likelihood ratio test. Results: Of the 51 records analysed, 39.2% belong to the group of children of mothers who used street drugs and 60.8% belong to the group of children of nonuser mothers. The neuropsychomotor development was predominantly abnormal and with a significant difference in the general performance classification (p<0.001) and, specifically, in the coarse motor area (p = 0.003) in the group of infants born to mothers who used street drugs. Conclusion: Infants of mothers who used street drugs had a greater delay in neuropsychomotor development.

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8

van den Berg, Hendrik, John N. van den Anker, and Jos H. Beijnen. "Cytostatic drugs in infants: A review on pharmacokinetic data in infants." Cancer Treatment Reviews 38, no. 1 (February 2012): 3–26. http://dx.doi.org/10.1016/j.ctrv.2011.03.005.

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9

Schramm, Diana B., Fiona Anthony, Busani Mathebula, Gayle Sherman, Ashraf Coovadia, Glenda E. Gray, Louise Kuhn, and Caroline T. Tiemessen. "Effect of Maternal HIV-1 Status and Antiretroviral Drugs on Haematological Profiles of South African Infants in Early Life." Open AIDS Journal 4, no. 1 (August 12, 2010): 156–65. http://dx.doi.org/10.2174/1874613601004010156.

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Maternal HIV-1 status and antiretroviral drug exposure may influence the haematological profiles of infants. We recruited infants from 118 uninfected control women and from 483 HIV-1 infected women who received no antiretroviral drugs (n=28), or received single-dose Nevirapine (sdNVP) (n=424) or triple-drug combination therapy (n=31) to reduce HIV-1 transmission. Blood was drawn from infants within 24 hours of delivery or 6-12 weeks post-delivery and full blood counts performed using a fully automated AcT-5-diff haematology analyser and reference controls. Exposed uninfected (EU; no NVP) differed from control infants only in having lower basophil counts and percentages. In all infant groups, leukocyte profiles showed characteristic quantitative changes with age in the first 6 weeks of life. HIV-1 infected infants displayed by 6 weeks elevations in white blood cells, lymphocyte, monocyte and basophil counts, and monocyte and basophil percentages, when compared to EU infants. At birth EU NVP-treated infants exhibited elevated monocyte percentages and counts and basophil counts that did not persist at 6 weeks. Interestingly, EU newborns of mothers with high CD4 counts (> 500 cells/μl) that had taken sdNVP had significantly elevated white blood cell, monocyte and basophil counts when compared to newborn infants of mothers with similar CD4 counts that had not taken sdNVP; this was not evident in infants of mothers with CD4 counts <200 cells/μl. These previously undescribed features may affect immune response capability in early life and clinical consequences of such changes need to be further investigated.

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10

Kohane, Daniel S., Wudbhav N. Sankar, Maria Shubina, Delphine Hu, Rifai Nader, and Charles B. Berde. "Sciatic Nerve Blockade in Infant, Adolescent, and Adult Rats." Anesthesiology 89, no. 5 (November 1, 1998): 1199–208. http://dx.doi.org/10.1097/00000542-199811000-00021.

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Background Ropivacaine is a newly introduced local anesthetic. No data are available regarding its safety, efficacy, or sensory-selectivity in children. The sciatic block duration and systemic toxicity of bupivacaine and ropivacaine were compared among infant, adolescent, and adult rats. Methods Infant, adolescent, and adult rats received blocks with ropivacaine or bupivacaine. Nociceptive, proprioceptive, and motor blockade were assessed. Systemic effects (contralateral leg analgesia, seizures, respiratory distress, apnea) were quantified. Plasma local anesthetic concentrations were measured at terminal apnea. Results Nerve blockade for a given absolute dose lasted longer in infants than in older rats for both drugs. Block duration from ropivacaine generally was the same as or slightly shorter than bupivacaine. There was no difference in sensory-selectivity between the drugs. Doses required to induce all systemic toxicity indices were inversely related to age (e.g., the lethal dose in 50% of animals [LD50] of ropivacaine in infants is 155 mg/kg; in adults it is 54 mg/kg). All indices of toxicity occurred at higher doses per kilogram for ropivacaine than bupivacaine, at all ages (e.g., the LD50 of bupivacaine in infants is 92 mg/kg; in adults it is 30 mg/kg). Plasma concentrations at terminal apnea were higher for ropivacaine than for bupivacaine at all ages, and were higher in infants than in older rats. Conclusions Ropivacaine resembles bupivacaine in its local anesthetic effects but has a greater margin of safety. For a given absolute dose, sciatic blockade in infant rats lasts longer than in adolescents or adults. Although the doses (in milligrams per kilogram) causing toxicity were much higher in infants than in adults, this probably does not correspond to a wider therapeutic index.

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11

Gronert, Brian J., and Barbara W. Brandom. "Neuromuscular Blocking Drugs in Infants and Children." Pediatric Clinics of North America 41, no. 1 (February 1994): 73–91. http://dx.doi.org/10.1016/s0031-3955(16)38708-9.

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12

Meakin, George H. "Neuromuscular blocking drugs in infants and children." Continuing Education in Anaesthesia Critical Care & Pain 7, no. 5 (October 2007): 143–47. http://dx.doi.org/10.1093/bjaceaccp/mkm032.

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13

Meakin, George H. "Neuromuscular blocking drugs in infants and children." Continuing Education in Anaesthesia Critical Care & Pain 8, no. 2 (April 2008): 76. http://dx.doi.org/10.1093/bjaceaccp/mkn009.

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14

Brandom, B. W. "Neuromuscular blocking drugs in infants and children." Current Opinion in Anaesthesiology 1, no. 1 (May 1988): 24–30. http://dx.doi.org/10.1097/00001503-198805000-00006.

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15

Rylance, G. W. "New Drugs: Prescribing for infants and children." BMJ 296, no. 6627 (April 2, 1988): 984–86. http://dx.doi.org/10.1136/bmj.296.6627.984.

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16

Pulley, Keri R., and Mary Beth Flanders-Stepans. "Smoking Hygiene: An Educational Intervention to Reduce Respiratory Symptoms in Breastfeeding Infants Exposed to Tobacco." Journal of Perinatal Education 11, no. 3 (July 2002): 28–37. http://dx.doi.org/10.1891/1058-1243.11.3.28.

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The American Academy of Pediatrics recently removed nicotine from the category of drugs contraindicated during breastfeeding. Little evidence demonstrates that infants exposed to nicotine through breastfeeding experience increased health risks beyond the airborne risks associated with passive smoking. The purpose of this longitudinal, five-week, quasi-experimental pilot study was to determine whether “smoking hygiene,” an educational intervention, reduces the frequency of respiratory symptoms experienced by infants whose mothers both smoke and breastfeed. Twenty-nine mother-infant pairs entered the study with 28% dropping out. Of the 21 mother-infant pairs who completed the study, 66% of the nine infants in the control group experienced respiratory illness, compared to 42% of the 12 infants in the intervention group (x2 = .814; p mt .05). Thus, the difference was statistically nonsignificant in this small sample, but the trend worsened the anticipated direction. The study demonstrates some of the difficulties of intervening with this group of mothers.

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17

YOSHIDA, K., B. SMITH, M. CRAGGS, and R. KUMAR. "Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants." Psychological Medicine 28, no. 1 (January 1998): 81–91. http://dx.doi.org/10.1017/s0033291797005965.

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Background. Very little is known about the pharmacokinetics of neuroleptic drugs in breast-feeding mothers and their infants or about possible adverse effects in the infants.Method. Twelve mothers who breast-fed their infants were prescribed haloperidol, chlorpromazine or trifluoperazine. Two methods, enzyme immunoassay (EIA) and high performance liquid chromatography (HPLC) were used to assay these drugs in samples from mothers, but infants' samples were assayed only by the more sensitive EIA. Repeated clinical and developmental assessments of the breast-fed infants were carried out up to 30 months of age. The control subjects were 18 bottle-fed infants whose mothers were also prescribed neuroleptic or mood-stabilizing drugs.Results. The total concentrations of neuroleptic drugs and their principal metabolites in maternal plasma were correlated with concentrations in fore-milk. Infants were ingesting up to 3% of the maternal daily dose per kg body weight and small amounts of the drugs were detected in infants' plasma and urine. Concentrations of haloperidol in the adult range were found in plasma from 2 of 5 infants assayed by EIA but there was no evidence of any acute or delayed adverse effects. Three other breast-fed infants whose mothers were prescribed both haloperidol and chlorpromazine showed a decline in their developmental scores from the first to the second assessment at 12–18 months.Conclusion. More extensive longitudinal studies are needed but, in the meantime, there appears to be grounds for caution if breast-feeding mothers are prescribed doses of single or two neuroleptic drugs at the upper end of their recommended ranges.

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18

Ravisankar, Srikanth, Devon Kuehn, Reese H. Clark, Rachel G. Greenberg, P. Brian Smith, and Christoph P. Hornik. "Antihypertensive drug exposure in premature infants from 1997 to 2013." Cardiology in the Young 27, no. 5 (October 17, 2016): 905–11. http://dx.doi.org/10.1017/s1047951116001591.

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AbstractBackgroundSystemic hypertension is increasingly recognised in premature infants. There is limited evidence regarding treatment, and most published treatment recommendations are based solely on expert opinions.MethodsWe identified all infants born ⩽32 weeks of gestation and ⩽1500 g birth weight discharged from one of 348 neonatal ICUs managed by the Pediatrix Medical Group between 1997 and 2013. We defined antihypertensive drugs as vasodilators, angiotensin-converting enzyme inhibitors, β receptor blockers, calcium channel blockers, and central α2 receptor agonists. We compared characteristics between infants who were treated with at least one antihypertensive drug during their initial hospitalisation and infants who were not prescribed antihypertensive drugs using Wilcoxon’s ranked sum test or Pearson’s χ2-test.ResultsWe identified 2504/119,360 (2.1%) infants who required at least one antihypertensive drug. The median postnatal age of first exposure was 48 days (25th, 75th percentile 15, 86), and the median length of therapy was 6 days (1, 16). Hydralazine was the most commonly prescribed antihypertensive with 1280/2504 (51.1%) treated infants exposed to the drug. More than two antihypertensive drugs were administered in 582/2504 (23.2%) infants, and 199/2097 (9.5%) of the treated infants were discharged home on antihypertensive therapy. Infants who received antihypertensive drugs were of lower gestational age (p<0.001) and birth weight (p<0.001) compared with infants not prescribed antihypertensive drugs.ConclusionsOur study is the largest to describe current antihypertensive drug exposure in a cohort of exclusively premature infants born ⩽32 weeks of gestation. We found wide variations in practice for treating hypertension in premature infants.

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Locke, Robin L., Linda L. Lagasse, Ronald Seifer, Barry M. Lester, Seetha Shankaran, Henrietta S. Bada, and Charles R. Bauer. "Effects of prenatal substance exposure on infant temperament vary by context." Development and Psychopathology 28, no. 2 (June 3, 2015): 309–26. http://dx.doi.org/10.1017/s0954579415000504.

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AbstractThis was a prospective longitudinal multisite study of the effects of prenatal cocaine and/or opiate exposure on temperament in 4-month-olds of the Maternal Lifestyle Study (N= 958: 366 cocaine exposed, 37 opiate exposed, 33 exposed to both drugs, 522 matched comparison). The study evaluated positivity and negativity during The Behavior Assessment of Infant Temperament (Garcia Coll et al., 1988). Parents rated temperament (Infant Behavior Questionnaire; Rothbart, 1981). Cocaine-exposed infants showed less positivity overall, mainly during activity and threshold items, more negativity during sociability items, and less negativity during irritability and threshold items. Latent profile analysis indicated individual temperament patterns were best described by three groups:low/moderate overall reactivity, high social negative reactivity,andhigh nonsocial negative reactivity. Infants with heavy cocaine exposure were more likely in high social negative reactivity profile, were less negative during threshold items, and required longer soothing intervention. Cocaine- and opiate-exposed infants scored lower on Infant Behavior Questionnaire smiling and laughter and duration of orienting scales. Opiate-exposed infants were rated as less respondent to soothing. By including a multitask measure of temperament we were able to show context-specific behavioral dysregulation in prenatally cocaine-exposed infants. The findings indicate flatter temperament may be specific to nonsocial contexts, whereas social interactions may be more distressing for cocaine-exposed infants.

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Kuhn, Louise. "Maternal and infant health is protected by antiretroviral drug strategies that preserve breastfeeding by HIV-positive women." Southern African Journal of HIV Medicine 13, no. 1 (March 13, 2012): 6–13. http://dx.doi.org/10.4102/sajhivmed.v13i1.151.

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The South African Department of Health is justified in withdrawing support for free infant formula. By so doing, it recognises that any intervention that might detract from breast feeding poses a serious threat to infant survival. Since evidence is now strong that antiretroviral drugs used during lactation prevent transmission of infection from a seropositive mother, strategies that promote breastfeeding can now be recommended for enhancing the health of mothers and infants.

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21

Marcellus, Lenora. "Foster Families Who Care for Infants with Prenatal Drug Exposure: Support During the Transition from NICU to Home." Neonatal Network 23, no. 6 (November 2004): 33–41. http://dx.doi.org/10.1891/0730-0832.23.6.33.

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Infants exposed prenatally to drugs and alcohol tend to enter the child welfare system at a younger age than many other foster children and often directly from the hospital following birth. This article examines three concepts from the postpartum family adaptation literature: transition to parenthood, maternal and paternal role identities, and attachment. It applies these concepts to the experiences of foster parents who care for infants with prenatal drug and alcohol exposure. Also reviewed are recommended strategies to promote development of the foster parent–infant relationship and to increase parental knowledge within the NICU setting and during the period of transition from hospital to home. Nurses within the NICU have a unique knowledge and experience of caring for infants in withdrawal. This knowledge needs to be shared beyond the hospital with community professionals, who may have limited training in infant health, mental health, or development.

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22

Newham, James J., Simon H. Thomas, Karine MacRitchie, Patricia R. McElhatton, and R. Hamish McAllister-Williams. "Birth weight of infants after maternal exposure to typical and atypical antipsychotics: Prospective comparison study." British Journal of Psychiatry 192, no. 5 (May 2008): 333–37. http://dx.doi.org/10.1192/bjp.bp.107.041541.

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BackgroundThe effects of in utero exposure to atypical antipsychotics on infant birth weight are unknown.AimsTo determine whether atypical and typical antipsychotics differ in their effects on birth weight after maternal exposure during pregnancy.MethodProspective data on gestational age and birth weight collected by the National Teratology Information Service for infants exposed to typical (n=45) and atypical (n=25) antipsychotics was compared with data for a reference group of infants (n=38).ResultsInfants exposed to atypical antipsychotics had a significantly higher incidence of large for gestational age (LGA) than both comparison groups and a mean birth weight significantly heavier than those exposed to typical antipsychotics. In contrast those exposed to typical antipsychotics had a significantly lower mean birth weight and a higher incidence of small for gestational age infants than the reference group.ConclusionsIn utero exposure to atypical antipsychotic drugs may increase infant birth weight and risk of LGA.

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23

Vita, Gian Luca, and Giuseppe Vita. "Is it the right time for an infant screening for Duchenne muscular dystrophy?" Neurological Sciences 41, no. 7 (February 28, 2020): 1677–83. http://dx.doi.org/10.1007/s10072-020-04307-7.

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Abstract Newborn screening (NBS) is an essential, preventive public health programme for early identification of disorders whose early treatment can lead to significant reduction in morbidity and mortality. NBS for Duchenne muscular dystrophy (DMD) has been a controversial matter for many years, because of false positives, the lack of effective drugs and the need of more data about screening efficacy. The still high diagnostic delay of DMD and the current availability of drugs such as steroid, ataluren, eteplirsen, golodirsen and forthcoming new drugs, improving the clinical conditions if early started, make appropriate to begin a concrete discussion between stakeholders to identify best practice for DMD screening. A two-step system CK/DNA screening programme is presented to be performed in male infants aged between 6 months and 42 months involving more than 30,000 male infants. Five to eight DMD subjects are believed to be diagnosed. The pilot project would give the opportunity to test in a small population the feasibility of an infant screening programme, which in the near future could be applicable to an entire country.

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24

Bae, Chong-Woo. "New Medical Drugs for Care of Premature Infants." Journal of the Korean Medical Association 52, no. 2 (2009): 191. http://dx.doi.org/10.5124/jkma.2009.52.2.191.

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25

Eyler, Fonda Davis, and Marylou Behnke. "Early Development of Infants Exposed to Drugs Prenatally." Clinics in Perinatology 26, no. 1 (March 1999): 107–50. http://dx.doi.org/10.1016/s0095-5108(18)30075-7.

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26

&NA;. "Recommendations for OTC cough/cold drugs in infants." Reactions Weekly &NA;, no. 1174 (October 2007): 1. http://dx.doi.org/10.2165/00128415-200711740-00001.

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27

Roll, Claudia, Patrizia Kutz, and Christoph Bührer. "Sex-specific actions of drugs in preterm infants." Acta Paediatrica 108, no. 3 (December 5, 2018): 398–400. http://dx.doi.org/10.1111/apa.14638.

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28

Källén, Bengt, and Elisabeth Robert-Gnansia. "Maternal Drug Use, Fertility Problems, and Infant Craniostenosis." Cleft Palate-Craniofacial Journal 42, no. 6 (November 2005): 589–93. http://dx.doi.org/10.1597/04-031.1.

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Objective To test the hypothesis that maternal drug use or treatment for infertility is related to the occurrence of infant craniostenosis. Design and Material Maternal drug use and infertility treatment were studied in 398 cases of craniostenosis, identified from various Swedish health registers. Exposure information was ascertained in early pregnancy, and comparisons after adjustment for some confounders were made with all infants born. In order to validate some findings, data from the Central-East France Registry were studied for first trimester drug exposure in 235 infants, and use of ovarian stimulation in 315 infants with craniostenosis. Results A statistically significant association between maternal use of anticonvulsants and infant craniostenosis was found (risk ratio [Swedish data], 6.9; 95% confidence interval, 1.10 to 7.94). With the Swedish data, an association was found with three nitrosatable drugs (risk ratio, 3.4; 95% confidence interval, 1.10 to 7.94), previously associated with the occurrence of craniostenosis, but this was based on only five exposures, and no such exposure occurred in the French data set. No association with subfertility (odds ratio, 0.72; 95% confidence interval, 0.60 to 1.86) or infertility treatment (odds ratio, 1.06; 95% confidence interval, 0.60 to 1.87) was found in the Swedish data and no statistically significant increase in the use of ovulation stimulation in the French data. Conclusions A strong association was found between the maternal use of anticonvulsants and infant craniostenosis, and a tentative association was found with the use of nitrofurantoin and two other nitrosatable drugs. There was no association with maternal subfertility or infertility treatment.

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De Rose, Domenico Umberto, Sara Cairoli, Marco Dionisi, Alessandra Santisi, Luca Massenzi, Bianca Maria Goffredo, Carlo Dionisi-Vici, Andrea Dotta, and Cinzia Auriti. "Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age." International Journal of Molecular Sciences 21, no. 16 (August 17, 2020): 5898. http://dx.doi.org/10.3390/ijms21165898.

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Therapeutic drug monitoring (TDM) should be adopted in all neonatal intensive care units (NICUs), where the most preterm and fragile babies are hospitalized and treated with many drugs, considering that organs and metabolic pathways undergo deep and progressive maturation processes after birth. Different developmental changes are involved in interindividual variability in response to drugs. A crucial point of TDM is the choice of the bioanalytical method and of the sample to use. TDM in neonates is primarily used for antibiotics, antifungals, and antiepileptic drugs in clinical practice. TDM appears to be particularly promising in specific populations: neonates who undergo therapeutic hypothermia or extracorporeal life support, preterm infants, infants who need a tailored dose of anticancer drugs. This review provides an overview of the latest advances in this field, showing options for a personalized therapy in newborns and infants.

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Yoshida, K., B. Smith, M. Craggs, and R. Channi Kumar. "Fluoxetine in breast-milk and developmental outcome of breast-fed infants." British Journal of Psychiatry 172, no. 2 (February 1998): 175–79. http://dx.doi.org/10.1192/bjp.172.2.175.

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BackgroundSelective serotonin reuptake inhibitors are currently the most widely prescribed antidepressant drugs. There are only four published studies of breast-feeding mothers and their infants in which the mothers were taking fluoxetine.MethodFour mothers who took fluoxetine and their breast-fed infants were studied. Samples of plasma, breast-milk and urine were taken from the mothers and of plasma and urine from infants for assays of drug and metabolite concentrations. Bayley Scales of Infant Development were repeatedly used to assess cognitive and psychomotor development of the infants.ResultsFluoxetine and norfluoxetine were detected in all samples of maternal plasma (range of total concentration 138–427 ng/ml) and in breast-milk (range 39–177 ng/ml). Amounts of both fluoxetine and norfluoxetine in infants' plasma and urine were below the lower limit of detection. All infants were observed to be developing normally and showed no abnormal findings on neurological examination.ConclusionsMuch larger databases are needed but these four cases do not provide any evidence to suggest that women who are maintained on therapeutic doses of fluoxetine should discontinue breast-feeding their infants if they wish to breast-feed.

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31

Shadrin, O. H., A. P. Volokha, N. H. Chumachenko, V. M. Fysun, and V. V. Zaiets. "Modern diagnostic and treatment approaches of congenital cytomegalovirus infection: a clinical case." UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS, no. 4(84) (December 30, 2020): 48–54. http://dx.doi.org/10.15574/pp.2020.84.48.

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Cytomegalovirus infection (CMV) is one of the most common causes of fetal infection. Recently fetal infections cause from 11% to 45% of perinatal losses, according to various authors, and are considered to be one of the most likely causes of congenital malformations, which lead to infants disability and reduce quality of life. CMV-infection clinical picture is very diverse, disguised as other diseases. There may be clinical manifestations of both generalized infection and single organ damage, because the virus has tropism to various organs and tissues. Timely diagnosis and treatment are the key to successful therapy of even severe manifestations of congenital CMV-infection in infants. Antiviral drugs usage can be sufficiently justified in patients with severe infection and can prevent complications. A clinical case of a manifest form of cytomegalovirus infection with severe hepatitis in an infant is presented and the therapeutic efficacy and safety of the ganciclovir and valganciclovir antiviral drugs are shown. The study is performed in accordance with principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the article. Informed consent of parents was obtained for the research. The authors declare no conflict of interest. Key words: infants, congenital cytomegalovirus infection, ganciclovir, valganciclovir, clinical case.

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32

Blunt, Brenda. "Supporting Mothers in Recovery: Parenting Classes." Neonatal Network 28, no. 4 (July 2009): 231–35. http://dx.doi.org/10.1891/0730-0832.28.4.231.

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Drug addiction is a serious issue in today’s society. Women are giving birth to infants who are born addicted to illicit drugs, and these mothers are not able to care for their infants safely and competently without training and support. This article examines the prevalence of the problem. It also discusses the possible impact of parenting skills classes, as part of recovery efforts, for women seeking recovery who have recently given birth. Several programs already in place in the U.S have shown positive results for these mothers and their infants. Infants exposed in utero to illicit drugs need to be given all of the resources society can provide in an effort to stop the intergenerational cycle of drug addiction.

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Hiramatsu, Y., S. Yoshida, T. Kotani, E. Nakamura, Y. Kimura, D. Fujita, Y. Nagayasu, et al. "Changes in the blood level, efficacy, and safety of tacrolimus in pregnancy and the lactation period in patients with systemic lupus erythematosus." Lupus 27, no. 14 (November 4, 2018): 2245–52. http://dx.doi.org/10.1177/0961203318809178.

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Objectives We investigated the efficacy and safety of tacrolimus (TAC) by monitoring its serum concentration for mothers and infants in pregnant patients with systemic lupus erythematosus (SLE). Methods We measured trough concentrations of TAC in 25 pregnant patients with SLE to assess influence of TAC on the disease activity. Additionally, we measured the concentrations of TAC in umbilical arterial blood, breast milk, and breastfed infants to investigate the safety of TAC for the mothers and infants. Results The trough concentrations of TAC in the mothers significantly decreased in the second trimester as compared with those before pregnancy. However, the decrease in the trough concentrations of TAC did not lead to the deterioration of SLE. When examined, the doses of TAC were significantly lower in the second trimester and postpartum in the deteriorating group than those in the non-deteriorating group. There were no adverse events by TAC in mothers and fetuses. The concentrations of TAC in the umbilical cord blood were lower than those in the maternal blood. The relative infant dose in breastfed infants of TAC was < 1%. The level of TAC in infant bloods was below detectable limits. Conclusion These findings suggest that TAC is one of the most effective and safest immunosuppressive drugs for use in pregnant patients with SLE.

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Aranda, Jacob V., Fabrizio Salomone, Gloria B. Valencia, and Kay D. Beharry. "Non-steroidal Anti-inflammatory Drugs in Newborns and Infants." Pediatric Clinics of North America 64, no. 6 (December 2017): 1327–40. http://dx.doi.org/10.1016/j.pcl.2017.08.009.

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van der Heide, Agnes, Paul J. van der Maas, Gerrit van der Wal, Louis A. A. Kollée, and Richard de Leeuw. "Using potentially life-shortening drugs in neonates and infants." Critical Care Medicine 28, no. 7 (July 2000): 2595–99. http://dx.doi.org/10.1097/00003246-200007000-00069.

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Brown, Raeford E. "Evaluation of Drugs for Use in Infants and Children." Anesthesia & Analgesia 129, no. 4 (October 2019): 1170–74. http://dx.doi.org/10.1213/ane.0000000000004094.

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Young, Guy. "Old and new antithrombotic drugs in neonates and infants." Seminars in Fetal and Neonatal Medicine 16, no. 6 (December 2011): 349–54. http://dx.doi.org/10.1016/j.siny.2011.07.002.

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Parikh, Tapan, Dharmendra Goyal, Jonathan R. Scarff, and Steven Lippmann. "Antipsychotic Drugs and Safety Concerns for Breast-Feeding Infants." Southern Medical Journal 107, no. 11 (November 2014): 686–88. http://dx.doi.org/10.14423/smj.0000000000000190.

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&NA;. "Overdosing of high-risk drugs among infants a concern." Reactions Weekly &NA;, no. 1352 (May 2011): 3. http://dx.doi.org/10.2165/00128415-201113520-00007.

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Hayes, Monique, and Helen Puusepp-Benazzouz. "Exposure of Infants Who Are Breastfed to Antiepileptic Drugs." JAMA Neurology 77, no. 12 (December 1, 2020): 1577. http://dx.doi.org/10.1001/jamaneurol.2020.3030.

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Al-Turkait, Asma, Lisa Szatkowski, Imti Choonara, and Shalini Ojha. "Review of Drug Utilization Studies in Neonatal Units: A Global Perspective." International Journal of Environmental Research and Public Health 17, no. 16 (August 5, 2020): 5669. http://dx.doi.org/10.3390/ijerph17165669.

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Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

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Weidle, Paul J., Clement Zeh, Amy Martin, Richard Lando, Frank Angira, Joseph Osoga, Paul Ogindo, Sonali Girde, Timothy D. Minniear, and Timothy K. Thomas. "Nelfinavir and Its Active Metabolite, Hydroxy-t-Butylamidenelfinavir (M8), Are Transferred in Small Quantities to Breast Milk and Do Not Reach Biologically Significant Concentrations in Breast-Feeding Infants Whose Mothers Are Taking Nelfinavir." Antimicrobial Agents and Chemotherapy 55, no. 11 (August 29, 2011): 5168–71. http://dx.doi.org/10.1128/aac.05273-11.

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ABSTRACTAntiretroviral drugs cross from maternal plasma to breast milk and from breast milk to the infant in different concentrations. We measured concentrations of nelfinavir and its active metabolite (M8) in maternal plasma and breast milk from women and in dried blood spots collected from their infants at delivery and postnatal weeks 2, 6, 14, and 24 in the Kisumu Breastfeeding Study, Kisumu, Kenya. Nelfinavir-based antiretroviral regimens given to mothers as prevention of mother-to-child HIV transmission (PMTCT) do not expose the breast-feeding infant to biologically significant concentrations of nelfinavir or M8.

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Slater, Rebeccah, Caroline Hartley, Fiona Moultrie, Eleri Adams, Ed Juszczak, Richard Rogers, Jane E. Norman, et al. "A blinded randomised placebo-controlled trial investigating the efficacy of morphine analgesia for procedural pain in infants: Trial protocol." Wellcome Open Research 1 (November 15, 2016): 7. http://dx.doi.org/10.12688/wellcomeopenres.10005.1.

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Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia. 156 infants between 34 and 42 weeks’ gestational age who require a clinical heel lance and ROP screening on the same test occasion will be included in the trial. Infants will be randomised to receive either a single dose of morphine sulphate (100 μg/kg) or placebo. Each infant will be monitored for 48 hours and safety data will be collected during the 24 hours following drug administration. The primary outcome will be the Premature Infant Pain Profile–revised (PIPP-R) score 30 seconds after ROP screening. The co-primary outcome will be the magnitude of nociceptive-specific brain activity evoked by a clinically-required heel lance. Infant clinical stability will be assessed by comparing the number of episodes of bradycardia, tachycardia, desaturation and apnoea, and changes in respiratory support requirements in the 24-hour periods before and after the clinical intervention. In addition, drug safety will be assessed by considering the occurrence of apnoeic and hypotensive episodes requiring intervention in the 24-hour period following drug administration. This study has been published as an Accepted Protocol Summary by The Lancet.

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Slater, Rebeccah, Caroline Hartley, Fiona Moultrie, Eleri Adams, Ed Juszczak, Richard Rogers, Jane E. Norman, et al. "A blinded randomised placebo-controlled trial investigating the efficacy of morphine analgesia for procedural pain in infants: Trial protocol." Wellcome Open Research 1 (January 26, 2017): 7. http://dx.doi.org/10.12688/wellcomeopenres.10005.2.

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Infant pain has both immediate and long-term negative consequences, yet in clinical practice it is often undertreated. To date, few pain-relieving drugs have been tested in infants. Morphine is a potent analgesic that provides effective pain relief in adults, but there is inconclusive evidence for its effectiveness in infants. The purpose of this study is to establish whether oral morphine provides effective analgesia for procedural pain in infants. A blinded, placebo-controlled, parallel-group randomized, phase II, clinical trial will be undertaken to determine whether morphine sulphate administered orally prior to clinically-required retinopathy of prematurity (ROP) screening and heel lancing provides effective analgesia. 156 infants between 34 and 42 weeks’ gestational age who require a clinical heel lance and ROP screening on the same test occasion will be included in the trial. Infants will be randomised to receive either a single dose of morphine sulphate (100 μg/kg) or placebo. Each infant will be monitored for 48 hours and safety data will be collected during the 24 hours following drug administration. The primary outcome will be the Premature Infant Pain Profile–revised (PIPP-R) score during the 30 second periods after ROP screening. The co-primary outcome will be the magnitude of nociceptive-specific brain activity evoked by a clinically-required heel lance. Infant clinical stability will be assessed by comparing the number of episodes of bradycardia, tachycardia, desaturation and apnoea, and changes in respiratory support requirements in the 24-hour periods before and after the clinical intervention. In addition, drug safety will be assessed by considering the occurrence of apnoeic and hypotensive episodes requiring intervention in the 24-hour period following drug administration. This study has been published as an Accepted Protocol Summary by The Lancet.

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Corvaglia, Luigi, Caterina Monari, Silvia Martini, Arianna Aceti, and Giacomo Faldella. "Pharmacological Therapy of Gastroesophageal Reflux in Preterm Infants." Gastroenterology Research and Practice 2013 (2013): 1–12. http://dx.doi.org/10.1155/2013/714564.

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Although gastroesophageal reflux (GER) is a very common phenomenon among preterm infants, its therapeutic management is still an issue of debate among neonatologists. A step-wise approach should be advisable, firstly promoting nonpharmacological interventions and limiting drugs to selected infants unresponsive to the conservative measures or who are suffering from severe GER with clinical complications. Despite of this, a concerning pharmacological overtreatment has been increasingly reported. Most of the antireflux drugs, however, have not been specifically assessed in preterm infants; moreover, serious adverse effects have been noticed in association to their administration. This review mainly aims to draw the state of the art regarding the pharmacological management of GER in preterm infants, analyzing the best piecies of evidence currently available on the most prescribed anti-reflux drugs. Although further trials are required, sodium alginate-based formulations might be considered promising; however, data regarding their safety are still limited. Few piecies of evidence on the efficacy of histamine-2 receptor blockers and proton pump inhibitors in preterm infants with GER are currently available. Nevertheless, a significantly increased risk of necrotizing enterocolitis and infections has been largely reported in association with their use, thereby leading to an unfavorable risk-benefit ratio. The efficacy of metoclopramide in GER’s improvement still needs to be clarified. Other prokinetic agents, such as domperidone and erythromycin, have been reported to be ineffective, whereas cisapride has been withdrawn due to its remarkable cardiac adverse effects.

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Härtel, Christoph, Kirsten Glaser, and Christian P. Speer. "The Miracles of Surfactant: Less Invasive Surfactant Administration, Nebulization, and Carrier of Topical Drugs." Neonatology 118, no. 2 (2021): 225–34. http://dx.doi.org/10.1159/000516106.

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Surfactant replacement therapy (SRT) has long become the standard of care in the treatment of neonatal respiratory distress syndrome (RDS), significantly decreasing acute pulmonary morbidity and mortality in preterm infants. For decades, this beneficial replacement therapy has been administered via endotracheal tube. Despite significantly improving the outcome of RDS, however, the burden of bronchopulmonary dysplasia remains, in particular, in very immature preterm infants. Acknowledging the direct relationship between exposure to and duration of invasive mechanical ventilation and chronic lung disease, the latter has been gradually replaced by noninvasive ventilation strategies in neonatal RDS. This replacement is strongly related to the demand for similarly noninvasive modes of surfactant administration. Alternative techniques in spontaneously breathing infants have evolved, including less invasive techniques using thin catheters (less invasive surfactant administration and minimally invasive surfactant treatment) as well as nebulization of surfactant, although the latter is not ready for clinical application yet. In addition, given their therapeutic delivery to the lungs and subsequent alveolar distribution, surfactant preparations represent an attractive vehicle for pulmonary deposition of drugs in preterm infants. Further improvement of SRT and expansion of the field of application of lung surfactant may hold additional benefits, especially in the treatment of the most immature preterm infants.

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Purdy, Isabell, and Dorothy Wiley. "Perinatal Corticosteroids: A Review of Research Part I: Antenatal Administration." Neonatal Network 23, no. 2 (March 2004): 15–30. http://dx.doi.org/10.1891/0730-0832.23.2.15.

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The premature infant may receive therapeutic glucocorticoid drugs while in utero or in the postnatal period. This article (part I of a two-part series) discusses the benefits and risks of in utero, or antenatal, corticosteroids (ACS) for the premature infant. Part II addresses the benefits and risks of postnatal corticosteroid (PCS) use. There are numerous clinical studies on the therapeutic use of these steroids for the prevention of respiratory distress syndrome and chronic lung disease in the premature infant, although research results on the efficacy of repeated steroid exposure among premature infants vary. Premature infants who are exposed to repeated courses of ACS and/or highcumulative- dose PCS may show no neurologic side effects until later in life. Research in newborn animal models focused on the timing, duration, and amounts of ACS and PCS. Current clinical research includes examination of the neurodevelopment of infants who are therapeutically exposed to perinatal corticosteroids, to identify safer minimal dose protocols. Over the past 30 years, corticosteroids have been increasingly prescribed before and after birth. Understanding the potential treatment benefits and risks to human fetuses and neonates is vital to clinical practice. This review presents historic and pharmacokinetic information about prenatal use of corticosteroids. It also offers scientific evidence of the benefits and risks identified in animal models and clinical trials, to stimulate thought that guides neonatal clinical practice.

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Blokhin, B. M., A. D. Prokhorova, I. P. Lobushkova, A. S. Suyundukova, G. I. Gordiyenko, V. Yu Steshin, Z. R. Kagirova, T. Kh Mirzoev, M. A. Melnikova, and N. V. Antipova. "Pharmacoepidemiology of the probiotics use in infants." Russian Journal of Woman and Child Health 3, no. 4 (2020): 309–18. http://dx.doi.org/10.32364/2618-8430-2020-3-4-309-318.

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Aim: to obtain clinical data on the use of probiotic drugs in infants with functional gastrointesti-nal disorders (FGIDs). Patients and Methods: a retrospective cohort study was conducted on the basis of 7 medical in-stitutions in Moscow. Database of 502 case histories of children with diagnosed disorders of in-testinal microbiocenosis was formed. The children were divided into three groups depending on the probiotic agents and other medications for GI: group 1 — medications containing up to two probiotic strains in a composition; group 2 — medications containing more than two probiotic strains in a composition; group 3 — other medications for symptomatic treatment of FGIDs. Results: 259 case histories of infants were included in the study to analyze the data of the group with FGIDs. The ratio of boys and girls was 50%. In infants on artificial nutrition, the duration of the main symptoms (abdominal pain, flatulence, diarrhea, and changes in stool consistency) was significantly longer (p=0.0002). There was the lowest indicator of the symptoms’ maximum duration in the group of symptomatic treatment for GI without probiotic products. At the same time, the symptoms’ duration in this group differed from multicomponent probiotic medications (p=0.0031), but did not differ from the group of single- and two-component drugs (p=0.15). Adding that, there was a tendency to have differences between single- and two-component drugs and multicomponent ones (p=0.08). Conclusion: multicomponent probiotic medications do not always have the predominance over the single-component. It is necessary to provide a more rational approach to the targeted probi-otic therapy prescription with a possible preference for single-component drugs to avoid a num-ber of effects associated with the multicomponent probiotics use, such as antigenic load on the gastrointestinal mucosa, competitive interaction of strains. KEYWORDS: probiotics, functional gastrointestinal disorders, baby colic, retrospective study. FOR CITATION: Blokhin B.M., Prokhorova A.D., Lobushkova I.P. et al. Pharmacoepidemiology of the probiotics use in infants . Russian Journal of Woman and Child Health. 2020;3(4):309–317. DOI: 10.32364/2618-8430-2020-3-4-309-318.

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&NA;. "Assess risks of exposing infants to drugs in breast milk." Reactions Weekly &NA;, no. 811 (July 2000): 4. http://dx.doi.org/10.2165/00128415-200008110-00006.

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Dunin-Waogon;sowicz, D., S. Jóźwiak, and J. Kasprzyk-Obara. "Antiepileptic drugs withdrawal in infants with epilepsy and cytomegalovirus infection." European Journal of Paediatric Neurology 12 (May 2008): S43. http://dx.doi.org/10.1016/s1090-3798(08)70142-9.

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