Paracetamol and morphine for infant and neonatal pain; still a long way to go?. Issue 1 (2nd January 2017)

• Record Type: Journal Article
• Authors: Baarslag, Manuel A.; Allegaert, Karel; Van Den Anker, John N.; Knibbe, Catherijne A.J.; Van Dijk, Monique; Simons, Sinno H.P.; Tibboel, Dick
• Is Part Of: Expert review of clinical pharmacology. Volume 10:Issue 1(2017)
• Page Start: 111
• Page End: 126
• Publication Date: 2017-01-02
• Subjects: Pain -- pediatrics -- neonates -- infants -- analgesia -- pharmacokinetics -- pharmacodynamics -- opioids -- paracetamol -- acetaminophen; Clinical pharmacology -- Periodicals; 615.105
• DOI: 10.1080/17512433.2017.1254040
• Languages: English
• ISSNs: 1751-2433

Abstract

ABSTRACT: Introduction : Pharmacologic pain management in newborns and infants is often based on limited scientific data. To close the knowledge gap, drug-related research in this population is increasingly supported by the authorities, but remains very challenging. This review summarizes the challenges of analgesic studies in newborns and infants on morphine and paracetamol (acetaminophen). Areas covered : Aspects such as the definition and multimodal character of pain are reflected to newborn infants. Specific problems addressed include defining pharmacodynamic endpoints, performing clinical trials in this population and assessing developmental changes in both pharmacokinetics and pharmacodynamics. Expert commentary : Neonatal and infant pain management research faces two major challenges: lack of clear biomarkers and very heterogeneous pharmacokinetics and pharmacodynamics of analgesics. There is a clear call for integral research addressing the multimodality of pain in this population and further developing population pharmacokinetic models towards physiology-based models.