1989
DOI: 10.1213/00000539-198905000-00006
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Effects of Cholestatic Hepatic Disease and Chronic Renal Failure on Alfentanil Pharmacokinetics in Children

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Cited by 22 publications
(8 citation statements)
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“…In a study assessing 9 children with cholestatic liver disease and 10 children with chronic renal failure undergoing organ transplantation, no significant difference was found in alfentanil clearance or half-life 6 (Level III evidence), suggesting the drug is safe to use in these groups.…”
Section: Alfentanilmentioning
confidence: 99%
“…In a study assessing 9 children with cholestatic liver disease and 10 children with chronic renal failure undergoing organ transplantation, no significant difference was found in alfentanil clearance or half-life 6 (Level III evidence), suggesting the drug is safe to use in these groups.…”
Section: Alfentanilmentioning
confidence: 99%
“…The decrease in alfentanil protein binding observed in adults with cirrhosis as well as in children with end-stage liver disease may be related to quantitative or qualitative changes in the plasma proteins or to the presence of binding inhibitors (Marshall & Williams 1978). Although we did not determine the cause for the decrease in protein binding in children with liver disease, the increase in the free or unbound fraction of a highly bound drug with a low-tointermediate extraction coefficient would account for some of alfentanil's phamacokinetic and pharmacodynamic variability (Davis et al 1989).…”
Section: Discussionmentioning
confidence: 88%
“…Dr Cook's team studied the pharmacokinetics of alfentanil in children with cholestatic liver disease during liver transplantation. They found that except for the period immediately following liver transplantation, volume of distribution, elimination half‐life, and clearance were unchanged for alfentanil and required no dose adjustments when compared to children without cholestatic liver disease . Immediately following liver transplantation, these values were found to be increased and the recommendation was that the dose may need to be decreased.…”
Section: Era Of Clinical Pharmacologymentioning
confidence: 99%
“…7 In addition to neuromuscular antagonists, Dr Cook and his team helped define the pharmacology of opioids like alfentanil in the pediatric population. [17][18][19][20][21] Alfentanil has a rapid onset of analgesia and has a shorter elimination half-life than fentanyl and sufentanil, but these parameters had not previously been defined in neonates. Dr…”
Section: During Dr Cook's Third Year Of Medical School He Was Hired mentioning
confidence: 99%
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