Evaluation of Different Methods Used to Calculate Ideal Body Weight in the Pediatric Population.

Objectives: Accurate determination of ideal body weight (IBW) in pediatric patients is important for the proper dosing of many medications and the classification of nutritional status. There is no consensus on the best method to calculate IBW. The purpose of this study is to evaluate and compare 7 different methods used to calculate IBW in the pediatric population.

A Review on the Use of Cystic Fibrosis Transmembrane Conductance Regulator Gene Modulators in Pediatric Patients.

The literature surrounding the use of cystic fibrosis transmembrane conductance regulator-targeted pharmacotherapies in pediatric patients continues to evolve. These therapies represent a departure from symptom management and infection prevention, which have been the mainstay of cystic fibrosis management in pediatrics, to targeting the genetic defect present within these patients. This article reviews the clinical studies evaluating the safety and efficacy of ivacaftor, ivacaftor/lumacaftor, and ivacaftor/tezacaftor.

The Use of Codeine and Tramadol in the Pediatric Population-What is the Verdict Now?

Codeine and tramadol are opioid analgesics approved for the management of pain in the United States. Both agents are metabolized in the liver to active compounds via the cytochrome P450 2D6 enzyme. Case reports of pediatric patients with overactive CYP2D6 enzymes have been reported.

Treatment of pediatric infection: a review on treatment efficacy and economic value.

The incidence of infection (CDI) in pediatric patients continues to rise. Most of the pediatric recommendations for CDI treatment are extrapolated from the literature and guidelines for adults. The American Academy of Pediatrics recommends oral metronidazole as the first-line treatment option for an initial CDI and the first recurrence if they are mild to moderate in severity.

Evaluation of the Efficacy of a Onetime Injectable Dexamethasone Administered Orally in the Pediatric Emergency Department for Asthma Exacerbation.

Objective: This study assessed the efficacy of injectable dexamethasone administered orally in pediatric patients who presented to the emergency department with asthma exacerbation.

Methods: This was a retrospective study of patients 0 to 18 years of age who presented to and who were directly discharged from the emergency department at Moses H. Cone Memorial Hospital between September 1, 2012, and September 30, 2015, for the diagnosis of asthma or asthma exacerbation.

Primary Immunization of Human Papillomavirus Vaccine in the Pediatric Population: What Is the Verdict Now?

The safety and efficacy of a 2-dose series for the human papillomavirus vaccines rather than a 3-dose series in older children has not been well defined. This article reviews the literature summarizing the use of all 3 HPV vaccines (2vHPV, 4vHPV, 9vHPV) as a 2-dose series for females and 4vHPV and 9vHPV for males younger than 15 years. Six prospective trials evaluating immunogenicity of a 2-dose series of 2vHPV and/or 4vHPV, as well as an ongoing prospective clinical trial for 9vHPV, are discussed.

Current Clinical Trials on the Use of Ceftaroline in the Pediatric Population.

The rate of antibiotic resistance in children continues to rise requiring the use of new antibiotics. Ceftaroline fosamil, a newer-generation cephalosporin, was recently approved for the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia in children aged >2 months. Ceftaroline provides coverage against staphylococcal and streptococcal infections, including methicillin-resistant Staphylococcus aureus and penicillin-resistant Streptococcus pneumoniae.

Attention Deficit Hyperactive Disorder and Occurrence of Tic Disorders in Children and Adolescents-What is the Verdict.

The United States Food and Drug Administration currently states that the use of stimulants in patients with tic disorders and/or family history of tic disorders including Tourette's syndrome is contraindicated. Patients with attention deficit hyperactivity disorder (ADHD), however, are at increased risk of tics regardless of stimulants use. After evaluating the most recent literature on the incidence of tic disorders in pediatric patients treated with stimulants for ADHD, it is reasonable to say that the incidence of tics and the severity of tics are not increased by the use of these medications.

Transitioning antimicrobials from intravenous to oral in pediatric acute uncomplicated osteomyelitis.

Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention. If left untreated, acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis. Early treatment is necessary to prevent complications, and the standard of care is progressing to a shorter duration of intravenous (IV) antibiotics and transitioning to oral therapy for the rest of the treatment course.

Hypersensitivity Reaction to Insulin Glargine and Insulin Detemir in a Pediatric Patient: A Case Report.

Allergy to human insulin or its analogs is rare, but it is still a significant issue in current diabetes care. Allergic reactions can range from localized injection site reactions to generalized anaphylaxis, and they can be caused by excipients or the insulin molecules themselves. We presented a case of a 14-year-old male patient with generalized allergic reactions to insulin glargine and insulin detemir.

Current Clinical Trials on the Use of Direct Oral Anticoagulants in the Pediatric Population.

Common treatment options for deep vein thrombosis and venous thromboembolism in the pediatric population include unfractionated heparin, low molecular weight heparin, and warfarin. Other alternatives are bivalirudin, argatroban, and fondaparinux. Warfarin is the only approved oral option, but an oral agent without frequent monitoring would be optimal for pediatric patients.

Overview of Pharmacological Treatment Options for Pediatric Patients with Refractory Kawasaki Disease.

Kawasaki disease is an autoimmune disease found predominantly in children under the age of 5 years. Its incidence is higher in those who live in Asian countries or are of Asian descent. Kawasaki disease is characterized as an acute inflammation of the vasculature bed affecting mainly the skin, eyes, lymph nodes, and mucosal layers.

Tramadol use in pediatric sickle cell disease patients with vaso-occlusive crisis.

Aim: To evaluate whether the addition of scheduled oral tramadol to intravenous morphine and intravenous ketorolac reduces morphine requirements.

Methods: This single-centered, Institutional Review Board-approved, retrospective study at Moses Cone Memorial Hospital included pediatric patients who were ≥ 2 years old with vaso-occlusive crisis (VOC) caused by sickle cell disease (SCD), were on morphine patient-controlled analgesia (PCA), and had scheduled oral tramadol added to their standard pain regimen. The study population was admitted between March 2008 and March 2011.

A review on vitamin d deficiency treatment in pediatric patients.

Vitamin D is essential for calcium absorption and for maintaining bone health in the pediatric population. Vitamin D deficiency may develop from nutritional deficiencies, malabsorption, enzyme-inducing medications, and many other etiologies. It may present as hypocalcemia before bone demineralization at periods of increased growth velocity (infancy and adolescence) because the increased calcium demand of the body cannot be met.

Revisiting the safety of over-the-counter cough and cold medications in the pediatric population.

Increased reports of serious adverse events in young children have led to numerous investigations of its therapeutic role in the pediatric population. A review of the literature has shown limited support of its use in young children, with the majority of randomized controlled trials showing no difference in endpoints when compared to placebo. Because of the recent recommended changes to pediatric cough and cold medication use, studies have suggested a decline in ingestion misuses, health care referrals, and reports of adverse events.

The use of ketogenic diet in pediatric patients with epilepsy.

A ketogenic diet is a nonpharmacologic treatment strategy to control refractory epilepsy in children. Although this diet has been used successfully to reduce seizures since the 1920s, the anticonvulsant mechanism of ketosis remains unknown. The initiation of the diet requires an average four-day hospitalization to achieve ketosis in the patient as well as to provide thorough education on diet maintenance for both the patient and the caregivers.

Use of anticoagulation therapy for jugular vein thrombus in pediatric patients with Lemierre's syndrome.

Background: Lemierre's syndrome is a rare condition involving septic thrombophlebitis of the internal jugular vein secondary to an acute oropharyngeal infection. The low incidence and prevalence of Lemierre's syndrome contribute to the many controversies pertaining to its therapeutic management, one of which is the use of anticoagulation for associated internal jugular vein thrombus.

Case Description: A previously healthy 5-year-old male admitted with left internal jugular vein thrombosis associated with Lemierre's syndrome was placed on appropriate antibiotics and anticoagulation therapy with enoxaparin.

First-line disease-modifying therapies in paediatric multiple sclerosis: a comprehensive overview.

Paediatric multiple sclerosis (MS) is defined as the onset of MS before the age of 18 years. Immunomodulatory disease-modifying therapies (i.e.

An evaluation of initial vancomycin dosing in infants, children, and adolescents.

Background. The pharmacokinetics of many medications change as we age, thus most would assume dosing strategies would adjust for these changes. The objective of this study is to evaluate the initial vancomycin dosing in three pediatric age groups based on measured serum trough concentrations.

Fidaxomicin for the Treatment of Clostridium Difficile Infection in the Pediatric Population - Not Quite So Soon Yet.

Fidaxomicin is a new narrow spectrum macrocyclic antibiotic. It inhibits bacterial RNA polymerase and eradicates with minimal effect on normal intestinal flora. The US FDA granted orphan drug designation for all formulations of fidaxomicin for the treatment of infections in pediatric patients on January 10, 2011.

Rufinamide for pediatric patients with Lennox-Gastaut syndrome: a comprehensive overview.

Rufinamide is a triazole derivative with broad-spectrum antiepileptic effects that is unrelated to any antiepileptic drug currently on the market. The European Commission and the US FDA approved rufinamide in 2007 and 2008, respectively, for adjunctive treatment of seizures associated with Lennox-Gastaut syndrome in children 4 years of age or older and adults. The mechanism of action of rufinamide is not completely understood but it is believed to prolong the inactive state of sodium channels, therefore limiting excessive firing of sodium-dependent action potentials.

Cognitive pharmacy services at a pediatric nephrology and hypertension clinic.

Purpose: Pediatric patients require special attention from pediatric pharmacists. This is particularly true for pediatric patients with chronic kidney disease (CKD) as the number of their medications and the complexity of their treatment increase with disease progression. However, there is paucity of information describing pediatric cognitive pharmacy services in this setting.