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Titre du document / Document title

Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children

Auteur(s) / Author(s)

OLKKOLA K. T. (1) ; HAMUNEN K. (2) ; MAUNUKSELA E.-L. (2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Univ. Helsinki, dep. anaesthesia, 00290 Helsinki, FINLANDE
(2) Helsinki univ. eye hosp., Helsinki, FINLANDE

Résumé / Abstract

Pain in childhood has not always been managed as actively as that in adults because of the limited amount of research available to provide guidelines for the management of paediatric pain. However, for many years now the pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children have been studied intensively. Morphine is the standard for opioid analgesics and its pharmacology is the best studied in paediatric patients. During the neonatal period, the volume of distribution (Vd) appears to be smaller in neonates than in adults, but adult values are reached soon after the neonatal period. Although morphine is absorbed both orally and rectally, there is little information on the pharmacokinetics of morphine administered by these routes. The bioavailability of morphine after rectal administration appears to be highly variable. For all the opioid analgesics studied, the elimination of the opioids is slower in neonates than in adults. However, the rate of elimination usually reaches and even exceeds adult values within the first year of life. The high rate of drug metabolism means pharmacodynamics of opioid analgesics, infants and children do not appear to be more sensitive to the effects of opioids than adults. Thus, except for the neonatal period, the pharmacokinetics and pharmacodynamics of opioid analgesics are not markedly different from those of adults, and the risk of using opioids in infants and children is not higher

Revue / Journal Title

Clinical pharmacokinetics    ISSN  0312-5963   CODEN CPKNDH 

Source / Source

1995, vol. 28, no5, pp. 385-404 (153 ref.)

Langue / Language

Anglais

Editeur / Publisher

Adis International, Auckland, NOUVELLE-ZELANDE  (1976) (Revue)

Mots-clés anglais / English Keywords

Opiates

;

Narcotic analgesic

;

Biological activity

;

Pharmacokinetics

;

Newborn

;

Infant

;

Child

;

Review

;

Route of administration

;

Activity concentration relation

;

Analgesia

;

Human

;

Mots-clés français / French Keywords

Opiacés

;

Analgésique narcotique

;

Activité biologique

;

Pharmacocinétique

;

Nouveau né

;

Nourrisson

;

Enfant

;

Article synthèse

;

Voie administration

;

Relation concentration activité

;

Analgésie

;

Homme

;

Mots-clés espagnols / Spanish Keywords

Opiados

;

Analgésico narcotico

;

Actividad biológica

;

Farmacocinética

;

Recién nacido

;

Lactante

;

Niño

;

Artículo síntesis

;

Vía administración

;

Relación concentración actividad

;

Analgesia

;

Hombre

;

Localisation / Location

INIST-CNRS, Cote INIST : 15599, 35400005666327.0040

Nº notice refdoc (ud4) : 3511976



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