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Background: Buprenorphine (BPN) is a widely used analgesic in the pediatric population, although there are few studies on the pharmacokinetics and pharmacodynamics of this drug. Objective: The objective was to characterize the pharmacokinetics of BPN after intravenous administration and analyze the effect of age, gender, weight, height, body mass index (BMI), and drug-drug interactions as covariates. Methods: Ninety-nine children (2-10 years), who underwent orthopedic surgery under regional, general, or combined anesthesia were included. Patients evaluated according to the American Society of Anesthesiologists Physical Status Classification, who received intravenous BPN 2 μg/kg were enrolled. Blood was collected from 1-240 min. Drug plasma concentrations were determined by LC-MS/MS. Population pharmacokinetic parameters were obtained with Monolix 2021R1 software. Pearson's correlation and/or ANOVA were used for statistical analysis. Results: Age was associated with changes in clearance and central compartment volume and the female gender was associated with lower intercompartmental clearance, while BMI modified clearance, central and peripheral compartment volume. Concomitant administration of BPN with fentanyl and dexamethasone produced decreases in clearance. Conclusions: The covariates of sex, age, and BMI are directly related to the increase or decrease in BPN pharmacokinetic parameters. [ABSTRACT FROM AUTHOR]

The aim of the present study was to develop a simple, selective and reliable method to quantify acetaminophen and its toxic metabolite N-acetyl- p-benzoquinoneimine (NAPQI) for pediatric studies using 100 µL plasma samples, by reverse-phase HPLC and UV detection. The assay was performed using a C column and an isocratic elution with water-methanol-formic acid (70:30:0.15; v/v/v) as mobile phase. Linearity of the method was assayed in the range of 1-30 µg/mL for acetaminophen and 10-200 µg/mL for NAPQI, with a correlation coefficient r = 0.999 for both compounds, and inter- and intra-day coefficients of variation of less than 13%. Several commonly co-administered drugs were analyzed for selectivity and no interference with the determinations was observed. The detection and quantification limits for acetaminophen and NAPQI were 0.1 and 1 µg/mL, and 0.1 and 10 µg/mL respectively. The present method can be used to monitor acetaminophen levels using 100 µL plasma samples, which may be helpful when very small samples need to be analyzed, as in pharmacokinetics determination or drug monitoring in plasma in children. This assay is also able to detect the NAPQI for drug monitoring in patients diagnosed with acetaminophen intoxication. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Copyright of Acta Pediatrica de Mexico is the property of Instituto Nacional de Pediatria (INP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Boletín Médico del Hospital Infantil de México is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The lack of pediatric drug formulations is a problem that has limited the prescription in that population in the long term, resulting errors in drug administration by patients. Objetive: To determine the frequency of drug consumption at a National Pediatrics Institute in a six year-period, and identify those medications for which there is no available pediatric formulation. Methods: The frequency of consumption of medications was investigated, using the data base at the Pharmacy of the National Pediatrics Institute during the period from January 2001 to June 2006. Drugs were grouped according to their frequency, identifying those not available for pediatric use which are nevertheless prescribed. Results:. About 85 different drugs were used to attend hospital demands, which were prescribed on 7514 occasions within the period of study. The most frequently used drugs were: ranitidine (4.7%), paracetamol (3.8%) and midazolam (3.7%). Our results showed that midazolam, furosemide, phenobarbital, omeprazole, prednisone and captopril were the most prescribed drugs for which there are no pediatric formulations commercially available. Conclusion: This article reports the frequency of drug consumption at a pediatric hospital and discusses it in view of the lack of adequate formulations for pediatric patients in our country. [ABSTRACT FROM AUTHOR]

Copyright of Acta Pediatrica de Mexico is the property of Instituto Nacional de Pediatria (INP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archivos de Cardiología de México is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Suicide is a complex behavior with biological, psychological and social causes. It has predisposing family factors such as domestic violence, psychiatric disorders and parents' alcohol abuse. Suicides have increased in children and adolescents in the last decades and it is now the third leading cause of death. Mexico has the second place in mortality in adolescents between 10-14 years old, of which 21.9 % are suicides. This study aimed to determine the frequency of suicide attempts using drugs in children and adolescents in a tertiary care hospital and to identify the causes. A retrospective and descriptive study was performed considering socioeconomic, cultural and biological issues related to suicide attempts using drugs in children and adolescents who were attended at the National Institute of Pediatrics from January 1995 to March 2005. A total of 141 drug intoxication cases were detected including 47 suicide attempts; 25 girls and 22 boys, with a median of 13 years of age. The most frequently drug classes used were analgesics 21 of 47 cases and antidepressants 11 of 47 cases. Risk factors were parents' divorce and family dysfunction in 16 of 47 cases of the population. Suicidal behavior in children and adolescents can be a way to attract attention, as well as an alarm signal asking for help. Analgesics and antidepressants are drugs commonly used in suicide attempts.

Aim: The purpose of the present study is to determine the relationship between the anticonvulsant drug use during pregnancy and the presence of malformations in the newborns., Methods: The frequency of malformations in the neonates of epileptic mothers under anticonvulsant treatment was analyzed in two periods, one from 1988 to 1992, which included 76 epileptic mothers, and another from 1996 to 2003 with 170 patients., Results: In the first period, 51 (67.1%) of mothers received monotherapy and 25 (32.9%) received polytherapy of phenytoin with carbamazepine, valproic acid or phenobarbital. In this period, 4 newborns (16%) with congenital malformations were registered. In the second period, 159 (93.5%) of the epileptic mothers received monotherapy and 11 (6.5%) received polytherapy of valproic acid with carbamazepine or phenytoin. During this period only 3 newborns 27.3% with malformations were registered., Discussion: Clinical treatment should consider the risk of using polytherapy, mainly if phenytoin or valproic acid are combined with other anticonvulsants.

Cytochrome P4502D6 (CYP2D6) shows genetic polymorphism, which is clinically important in the metabolism of drugs and other xenobiotics. Dextrometorphan (DM) has been used as a test compound to evaluate the in vivo activity of CYP2D6. Phenotypical frequencies of CYP2D6 have been determined in some populations, but little is known about them in native populations. The object of this study was to characterize the phenotypical expression of CYP2D6 in Amerindian subjects of Tepehuano origin from the State of Durango, using DM as metabolic marker, as well as the effect of age, sex and nutritional status on this activity. Three hr after oral administration of a single 30 mg dose of DM, the plasma concentration of DM and its metabolite dextrophan (DX) were determined with HPLC in 55 Tepehuano subjects. All subjects were extensive metabolizers (metabolic ratio MR < 0.3). No correlation of age, sex or nutritional status was found with the DM/DX metabolic ratio. However, we found a monoexponential relationship between the metabolic ratio of DM and DX, and their concentrations respectively, which can have clinical applications, since metabolic ratio can be predicted from a known DM or DX concentration. Three hr after ingestion of DM, 18 individuals showed DM plasma concentrations of 5 to 10 ng/mL, 15 subjects of 11 to 20 ng/mL, 8 subjects of 21 to 50 ng/mL and 14 subjects >51 ng/mL pointing out that DM concentrations and MR must be determined to establish toxicity risk levels.

Unlabelled: Numerous reports in the literature have demonstrated changes in drug pharmacokinetics that result with age. Ranitidine is a drug commonly used in Mexico. However no reports on the pharmacokinetics of ranitidine in the Mexican population are available in the literature. The objective of this clinical trial was to evaluate the effect of age on the pharmacokinetics of ranitidine in healthy Mexican volunteers., Methods: Twenty-one healthy Mexican volunteers were included, who were divided into three groups G1 (18-30 y), G2 (31-50 y) and G3 (51-60 y). The volunteers were given a single oral dose of 300 mg of ranitidine and blood samples were obtained, and some pharmacokinetic parameters were correlated with age., Results: Statistically significant differences were noted in the distribution volume (4.00 +/- 1.11 L/kg in G1, vs 2.15 +/- 1.12 L/kg in G3) of the drug. Clearance was faster among the G1 (1.11 +/- 0.12 mL/hr) group compared to the G3 group (0.58 +/- 0.19 mL/hr). Differences for AUC, t1/2 and Cmax are more evident between G1 and G3., Discussion: The results of our study indicated that in patients over 50 years of age who are treated with ranitidine, the dosage of this agent should be appropriately adjusted in order to avoid adverse effects that may develop with prolonged use of the drug. However it is very important to consider that our result only reflect observations made from a single dose study, thus it is necessary to carry out study under chronic dosage treatment.

The present study was undertaken to determine if differences exist in the pharmacokinetic parameters of oral ranitidine caused by gender and stage of the menstrual cycle. The study was performed in two steps, in the first a pharmacokinetic study was performed on 10 men (average age 35.5 yrs) and 10 women (average age 34.7 yrs) during the follicular phase, and in the second the pharmacokinetic study was performed only on the same women in their luteal phase. Subjects received a tablet dose of 300 mg ranitidine, and blood samples were drawn at several times after its ingestion. Plasma ranitidine concentration was determined by high performance liquid chromatography. Comparison of the pharmacokinetic parameters of women and men revealed statistically significant differences both in distribution volume (Vd) with values of 2.0 and 6.3 l/kg, Area Under Curve (AUC) with values of 7312.15 and 11471.94 ng/ml/h, and clearance (CLt) with values of 0.65 and 0.59 l/kg/h, respectively. Several pharmacokinetic parameters in women were different in the follicular compared to the luteal phase; for example, Vd was 2.0 and 5.6 l/kg, AUC was 7312.15 and 5195.83 ng/ml/h, and CLt was 0.65 and 0.97 l/kg/h, in the respective phases. Moreover, the maximum concentration (Cmax) was 1086 ng/ml in the follicular vs. 864 ng/ml in the luteal phase. The first study detected differences between men and women in several pharmacokinetic parameters, mainly those indicative of drug availability, for example, Vd, AUC, and CLt. Comparison of data obtained in the follicular phase with those obtained in the luteal phase revealed differences in most pharmacokinetic parameters, which is seemingly indicative of the characteristic physiological changes associated with the luteal phase that largely affect the kinetics and availability of drugs such as ranitidine. Although it has been postulated that hormonal fluctuation within the menstrual cycle phase is the primary cause of documented gender differences in the pharmacokinetics and pharmacodynamics of drugs, further study of related factors is required to understand how gender and menstrual cycle rhythms affect the phannacokinetic process in their entirety.