Assuntos
Cateteres de Demora/efeitos adversos , Perfuração Intestinal/etiologia , Diálise Peritoneal/instrumentação , Rim Policístico Autossômico Recessivo/terapia , Anastomose Cirúrgica , Remoção de Dispositivo , Falha de Equipamento , Evolução Fatal , Humanos , Lactente , Perfuração Intestinal/cirurgia , Nefrectomia , Rim Policístico Autossômico Recessivo/diagnóstico por imagem , Rim Policístico Autossômico Recessivo/cirurgia , RadiografiaRESUMO
An open-label study was conducted to characterize the pharmacokinetics and antihypertensive response to irbesartan in children (1-12 years) and adolescents (13-16 years) with hypertension. Patients received single once-daily oral doses of irbesartan 2 mg/kg (maximum of 150 mg once daily) for 2 to 4 weeks (+/- nifedipine or hydrochlorothiazide). Plasma irbesartan concentrations were determined by a validated high-performance liquid chromatography/fluorescence method from blood samples taken predose, up to 24 hours after dosing on Day 1, and up to 48 hours after the final dose. The plasma concentration-time profiles were similar between the 6- to 12-year and the 13- to 16-year age groups and to that previously determined from a study of adult subjects receiving approximately 2 mg/kg (i.e., 150 mg) oral irbesartan once daily. Mean reductions in systolic/diastolic blood pressure were 16/10 mmHg at Day 28 with irbesartan monotherapy (n = 8). Irbesartan was well tolerated and may be a treatment option for pediatric hypertensive patients.
Assuntos
Anti-Hipertensivos/farmacocinética , Compostos de Bifenilo/farmacocinética , Tetrazóis/farmacocinética , Administração Oral , Adolescente , Anti-Hipertensivos/sangue , Anti-Hipertensivos/uso terapêutico , Área Sob a Curva , Compostos de Bifenilo/sangue , Compostos de Bifenilo/uso terapêutico , Criança , Pré-Escolar , Feminino , Meia-Vida , Humanos , Hipertensão/tratamento farmacológico , Lactente , Absorção Intestinal , Irbesartana , Masculino , Taxa de Depuração Metabólica , Tetrazóis/sangue , Tetrazóis/uso terapêuticoRESUMO
The incidence of CMV infection in pediatric renal transplant recipients has increased as immunosuppression levels deepen following the use of newer immunosuppressive agents. It has been thought that 3-5 months of anti-CMV prophylaxis offers sufficient protection for these patients. We present a case of late-onset fatal CMV disease in a pediatric renal transplant recipient who received prolonged anti-CMV prophylaxis while on "quadruple" immunosuppression with daclizumab, mycophenolate, tacrolimus, and prednisone. Our case has prompted us to reassess CMV surveillance, prophylaxis, and immunosuppression levels in our pediatric renal transplant patients.
Assuntos
Infecções por Citomegalovirus/etiologia , Transplante de Rim , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Pré-Escolar , Infecções por Citomegalovirus/prevenção & controle , Daclizumabe , Quimioterapia Combinada , Evolução Fatal , Feminino , Humanos , Imunoglobulina G/uso terapêutico , Imunossupressores/uso terapêutico , Ácido Micofenólico/uso terapêutico , Cuidados Pós-Operatórios , Prednisona/uso terapêutico , Fatores de Risco , Tacrolimo/uso terapêuticoRESUMO
Nicardipine is the first dihydropyridine calcium channel blocker capable of intravenous administration. Seven pediatric patients with hypertensive emergencies attributable to various pathological processes were treated with intravenous nicardipine, starting at 1 microg/kg/min. Nicardipine appeared to be safe and effective in controlling hypertension in these patients. Two patients who received nicardipine through peripheral lines developed superficial thrombophlebitis. None of the five patients receiving nicardipine through a central line experienced phlebitis, and no other adverse effects were noted.