Use of Intravenous Iron Dextran Injection in Children Receiving Total Parenteral Nutrition

Reed, Michael D.

doi:10.1001/archpedi.1981.02130330039012

Cited by 11 publications

(9 citation statements)

References 16 publications

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“…Circulating free iron is rapidly distributed and taken up by cells of the reticulo-endothelial system (Proudfoot et at. 1986;Reed et al 1981), resulting in multicompartmental kinetic properties with a rapid distribution phase followed by an extremely long terminal elimination phase (Banner & Tong 1986). Because of the iron's pharmacokinetic profile, serum concentrations can be deceptively low within a few hours of a substantial ingestion (Robotham & Lietman 1980) and fall with an apparent serum half-life of approximately 3 to 5 58 hours in children (Kearns et at.…”

Section: Forensic Applicationsmentioning

confidence: 99%

Clinical Pharmacokinetics in Infants and Children A Reappraisal

Kearns

Reed

1989

Clinical Pharmacokinetics

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174

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A significant increase in the knowledge base in paediatric clinical pharmacology has occurred over the past 2 decades and has largely been the result of important scientific and sociological advancements pertaining to paediatric therapeutics. Although the data on drug disposition in infants and children have increased considerably over the past few years, pharmacokinetic-pharmacodynamic interactions, particularly the effect of development on pharmacodynamics, remain poorly understood.The impact of developmental physiology on drug absorption, distribution, metabolism and elimination in infants and children is reviewed and contrasted to the determinants of clinical pharmacokinetics in neonates. The most notable differences in drug disposition between in/ants and children when compared with neonates and young adults centre around alterations in body water and serum protein composition and the affinity/capacity for hepatic biotransformation of xenobiotics.As opposed to examining the effect of age on the disposition of specific compounds, the differences in developmental pharmacology are highlighted by the review of important and/or emerging pharmacokinetic-pharmacodynamic controversies in infants and children. These include the issues of altered drug distribution and metabolism in cysticjibrosis, pharmacokinetic determinants of successful antimicrobial therapy in bacterial meningitis and the pharmacokinetic determinants of immunosuppression treatment with cyclosporin. The pharmacological differences which are characteristic of development in both infants and children are also reviewed by examination of considerations for clinical pharmacokinetic evaluations such as specific routes and techniques for both drug administration and determination of sampling strategies.Clinical pharmacokinetics will continue to function as a bridge between the generation of new information and the practical application of this knowledge. Consequently, pharmacokinetics provides a pharmacological tool for use in research and clinical care. The clinical application of this tool is examined by a review of the pertinent assumptions and limitations, as well as useful mathematical techniques for use in paediatric patients. Additionally, 'non-traditional' uses of clinical pharmacokinetics (forensic application and use to evaluate organ function) in infants and children are discussed as are considerations for research use of clinical pharmacokinetic data.

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Section: Forensic Applicationsmentioning

confidence: 99%

Clinical Pharmacokinetics in Infants and Children A Reappraisal

Kearns

Reed

1989

Clinical Pharmacokinetics

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174

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“…Iron sucrose has been used increasingly for therapeutic iron replacement because of a lower rate of adverse effects than iron dextran. [13][14][15][16] The purpose of this study was to determine the physical and chemical stability of iron sucrose in PN. The pH of iron sucrose ranges from 10.5 to 11.1.…”

Section: Discussionmentioning

confidence: 99%

Physical and Chemical Stability of Iron Sucrose in Parenteral Nutrition

et al. 2009

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“…Hypersensitivity reactions associated with irondextran therapy range from less than 1 % to nearly 50% [9][10][11][12]. The most dangerous complication is an anaphylactoid (anaphylactic-like) reaction.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to contrast media reactions, the anaphylactoid reaction manifests itself during the first few minutes of infu sion and resembles a type I (IgE-mediated) allergic reaction [13][14][15][16]. The most common hypersensitivity reaction, occurring in over 30% of patients given iron dextran, is the development of arthralgias and fever within 24-48 h after initiation of the intravenous ther apy [9][10][11][12], Other rare systemic hypersensitivity reac tions that occur 1 -2 weeks after initiation of iron-dex tran therapy have been reported. These reactions in clude generalized lymphadenopathy, general malaise, fever, elevated erythrocyte sedimentation rates, leu kocytosis with neutrophilia, splenomegaly and arthralgia/arthritis -similar to that reported in human serum sickness to heterologous proteins [4,[17][18][19][20][21][22], There is only one citation o f 'allergic purpura' to irondextran, but the lesions appeared within 24-48 h, and no biopsy was performed [23].…”

Section: Discussionmentioning

confidence: 99%