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Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments
In this paper, we review the management of neonatal opioid withdrawal syndrome (NOWS) and clinical pharmacology of primary treatment agents in NOWS, including morphine, methadone, buprenorphine, clonidine, and phenobarbital. Pharmacologic treatment strategies in NOWS have been mostly empirical, and...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301571/ https://www.ncbi.nlm.nih.gov/pubmed/33650314 http://dx.doi.org/10.1111/cts.12994 |
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author | Tang, Fei Ng, Chee M. Bada, Henrietta S. Leggas, Markos |
author_facet | Tang, Fei Ng, Chee M. Bada, Henrietta S. Leggas, Markos |
author_sort | Tang, Fei |
collection | PubMed |
description | In this paper, we review the management of neonatal opioid withdrawal syndrome (NOWS) and clinical pharmacology of primary treatment agents in NOWS, including morphine, methadone, buprenorphine, clonidine, and phenobarbital. Pharmacologic treatment strategies in NOWS have been mostly empirical, and heterogeneity in dosing regimens adds to the difficulty of extrapolating study results to broader patient populations. As population pharmacokinetics (PKs) of pharmacologic agents in NOWS become more well‐defined and knowledge of patient‐specific factors affecting treatment outcomes continue to accumulate, PK/pharmacodynamic modeling and simulation will be powerful tools to aid the design of optimal dosing regimens at the patient level. Although there is an increasing number of clinical trials on the comparative efficacy of treatment agents in NOWS, here, we also draw attention to the importance of optimizing the dosing regimen, which can be arguably equally important at identifying the optimal treatment agent. |
format | Online Article Text |
id | pubmed-8301571 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83015712021-07-27 Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments Tang, Fei Ng, Chee M. Bada, Henrietta S. Leggas, Markos Clin Transl Sci Reviews In this paper, we review the management of neonatal opioid withdrawal syndrome (NOWS) and clinical pharmacology of primary treatment agents in NOWS, including morphine, methadone, buprenorphine, clonidine, and phenobarbital. Pharmacologic treatment strategies in NOWS have been mostly empirical, and heterogeneity in dosing regimens adds to the difficulty of extrapolating study results to broader patient populations. As population pharmacokinetics (PKs) of pharmacologic agents in NOWS become more well‐defined and knowledge of patient‐specific factors affecting treatment outcomes continue to accumulate, PK/pharmacodynamic modeling and simulation will be powerful tools to aid the design of optimal dosing regimens at the patient level. Although there is an increasing number of clinical trials on the comparative efficacy of treatment agents in NOWS, here, we also draw attention to the importance of optimizing the dosing regimen, which can be arguably equally important at identifying the optimal treatment agent. John Wiley and Sons Inc. 2021-05-01 2021-07 /pmc/articles/PMC8301571/ /pubmed/33650314 http://dx.doi.org/10.1111/cts.12994 Text en © 2021 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Reviews Tang, Fei Ng, Chee M. Bada, Henrietta S. Leggas, Markos Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
title | Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
title_full | Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
title_fullStr | Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
title_full_unstemmed | Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
title_short | Clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
title_sort | clinical pharmacology and dosing regimen optimization of neonatal opioid withdrawal syndrome treatments |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301571/ https://www.ncbi.nlm.nih.gov/pubmed/33650314 http://dx.doi.org/10.1111/cts.12994 |
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