Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children

Title

Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children

Creator

Olkkola KT; Hamunen K; Maunuksela EL

Publisher

Clinical Pharmacokinetics

Date

1995

Subject

Child; Humans; Analgesics; Preschool; infant; Opioid/administration & dosage/pharmacokinetics/pharmacology

Description

Pain in childhood has not always been managed as actively as that in adults because of the limited amount of research available to provide guidelines for the management of paediatric pain. However, for many years now the pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children have been studied intensively. Morphine is the standard for opioid analgesics and its pharmacology is the best studied in paediatric patients. During the neonatal period, the volume of distribution (Vd) appears to be smaller in neonates than in adults, but adult values are reached soon after the neonatal period. Although morphine is absorbed both orally and rectally, there is little information on the pharmacokinetics of morphine administered by these routes. The bioavailability of morphine after rectal administration appears to be highly variable. For all the opioid analgesics studied, the elimination of the opioids is slower in neonates than in adults. However, the rate of elimination usually reaches and even exceeds adult values within the first year of life. The high rate of drug metabolism means higher dosage requirements. In regard to the pharmacodynamics of opioid analgesics, infants and children do not appear to be more sensitive to the effects of opioids than adults. Thus, except for the neonatal period, the pharmacokinetics and pharmacodynamics of opioid analgesics are not markedly different from those of adults, and the risk of using opioids in infants and children is not higher.
1995

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Citation

Olkkola KT; Hamunen K; Maunuksela EL, “Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children,” Pediatric Palliative Care Library, accessed October 6, 2022, https://pedpalascnetlibrary.omeka.net/items/show/11770.

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