Perinatal Pharmacology: Individualized Neonatal Therapy

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“Perinatal Pharmacology: Individualized Neonatal Therapy” edited by Jacob V. Aranda, Vassilios Fanos, John N. van den Anker

ISBN 9788890651434, book series: Systems Medicine, 352 pages, Hardcover, € 90, 1st edition: October 2012

Authors: Massimo Agosti, Karel Allegaert, Jacob V. Aranda, Salvatore Aversa, Caterina Silvia Barbàra, Ignazio Barberi, Pier Paolo Bassareo, Kay Beharry, Paolo Biban, Giuseppe Buonocore, Daniel Canal-Tristancho, Maria Grazia Capretti, Virgilio P. Carnielli, Elio Castagnola, Massimo Castagnola, Carla Cerasaro, Francesca Ciuffini, Paola E. Cogo, Mariarosa Colnaghi, Giovanni Corsello, Laura Cuzzolin, Roosmarijn De Cock, Sahera Dirajlal-Fargo, Gavino Faa, Daniela Fanni, Vassilios Fanos, Daniele Farina, Monica Fumagalli, Bruna Gabriele, Clara Gerosa, Yukio Gibo, Eloisa Gitto, Mario Giuffrè, Maria Beatriz Guedes, Hercília Guimarães, Nicoletta Iacovidou, Eveline Jacqz-Aigrain, Spyros Kloudas, Catherijne Knibbe, Amir Lahav, Marcello Lanari, Douglas R. Lazarro, Tiziana Lazzarotto, Paolo Manzoni, Lucia Marseglia, Giuseppe Mercuro, Fabio Midulla, Corrado Moretti, Fabio Mosca, Sonia Nemolato, Stefano Nobile, Eren Özek, Paola Papoff, Serafina Perrone, Valentina Polimeni, Natella Y. Rakhmanina, Gustavo Rocha, Serena Salvadei, Davide Silvagni, Henrique Soares, Paulo Soares, Paola Sogno Valin, Gemma Stazzoni, Mauro Stronati, Aggeliki Syggelou, Maria Luisa Tataranno, Gloria B. Valencia, John N. van den Anker, Bart Van Overmeire, Theodoros Xanthos, Murat Yurdakök, Emily Zimmerman

The origin of this book lies on the awareness that we have to do more for identifying unmet needs and improving a tailor-made treatment for each newborn.

After a large introduction on developmental pharmacology, this book analyses in detail new advances on antibiotics (aminoglycosides), antifungals, antivirals (CMV, RSV, HIV), analgosedatives, steroids, caffeine, and cardiovascular drugs. An updated pharmacologic treatment of respiratory diseases (respiratory distress syndrome, meconium aspiration syndrome, chronic lung disease, persistent pulmonary hypertension) is presented, as well as for persistent patent ductus arteriosus and retinopathy of prematurity. Finally, neuroprotection is considered, with special emphasis on antioxidants and melatonin.

A special part is devoted to drug-induced renal toxicity and liver toxicity and completes the volume, also quoting the so-called ‘-omics sciences such as genomics and metabolomics.

The topics are covered by international experts in the field and the subtle red line that links all the chapters together is the perspective of individualized treatments to reach our ultimate goal: the right therapy for each newborn without any side effects.

Main topics

AminoglycosidesAnalgosedativesAntifungalsAntioxidantsAntivirals (CMV, RSV, HIV) – CaffeineCardiovascular drugsChronic lung diseaseDrug-induced liver
toxicityDrug-induced renal toxicityGenomicsMeconium aspiration syndromeMelatoninMetabolomicsNeuroprotectionPersistent patent ductus arteriosusPersistent pulmonary hypertensionRespiratory distress syndromeRetinopathy of prematuritySteroids





1. Developmental pharmacology
John N. van den Anker, Natella Y. Rakhmanina, Karel Allegaert
Drug absorption • Drug distribution • Drug metabolism • Phase I enzymes • Drug excretion • Other factors influencing the absorption, distribution, metabolism and excretion of drugs in neonates and young infants • Pharmacogenomics: impact for pediatric populations • Developmental pharmacodynamics • Conclusions • References

2. Drug-induced liver injury in neonates: a developmental approach
Gavino Faa, Daniela Fanni, Clara Gerosa, Sonia Nemolato, Yukio Gibo, Massimo Castagnola, Vassilios Fanos
Pharmacokinetics in neonates • Drug-induced liver injury in neonates • Liver disease due to widely utilized drugs in newborns • Conclusions and future challenges • References

3. Influence of prenatal drug treatments on kidney function during fetal and neonatal life
Laura Cuzzolin, Vassilios Fanos
Pathophysiological mechanisms and renal syndromes • Prenatal exposure to drugs • Conclusions • References

4. Excipients in neonatal drug formulations: friend and foe?
Roosmarijn De Cock, Catherijne Knibbe, Karel Allegaert
About the compounds we routinely administer, but never prescribe • The STEP database • The ESNEE research initiative • The Leuven propylene glycol research project to illustrate feasibility and limitations • Perspectives • References

5. Pharmacotoxic effects of aminoglycosides and loud environmental noise: an overlooked risk for hearing loss in preterm infants
Amir Lahav, Emily Zimmerman
The prevalence of hearing loss in preterm neonates • From the protected environment of the womb to the ototoxic environment in the neonatal intensive care unit • Aminoglycosides-induced ototoxicity • Synergistic ototoxicity induced by aminoglycoside and noise exposure • Implications for clinical care •

6. Clinical pharmacology of analgosedatives in neonates: between the hammer and the anvil?
Karel Allegaert, John N. van den Anker
On the relevance of (in)adequate analgesia in neonates • Clinical pharmacology of analgesics: from pharmacokinetics towards pharmacodynamics • New compounds: new tools or new toys? • Clinical practice: between the hammer and the anvil? • References

7. New treatments of persistent pulmonary hypertension of the newborn
Nicoletta Iacovidou, Aggeliki Syggelou, Spyros Kloudas, Theodoros Xanthos
Definitions • Pulmonary vasculature physiology – Pathophysiology of PPHN • Etiology of PPHN – Classification – Predisposing factors • Diagnosis of PPHN • Management of PPHN • References

8. Inotropic and vasopressor drugs in the newborn
Hercília Guimarães, Gustavo Rocha, Paulo Soares, Henrique Soares, Maria Beatriz Guedes
Inotropic agents • Epinephrine • Norepinephrine • Dopamine • Dobutamine • Isoproterenol • Milrinone • Levosimendan • References

9. Role of vasopressin and terlipressin in newborns and infants with hypotension and shock
Paolo Biban, Davide Silvagni
Biology of endogenous vasopressin • Role of endogenous vasopressin in shock • Pharmacology of vasopressin and terlipressin • Exogenous vasopressin and terlipressin in neonatal and pediatric shock • Safety and adverse effects of vasopressin and terlipressin • Conclusions • References

10. Pharmacological treatment of patent ductus arteriosus: the last days of indomethacin?
Bart Van Overmeire
Indomethacin • Ibuprofen, the preferred drug? • Gastrointestinal effects of NSAIDs • Renal adverse effects of NSAIDs • Pulmonary hypertension • Bilirubin and ibuprofen • Appropriate NSAIDs dosing • Adapted ibuprofen dosing • Oral administration • Paracetamol? • Conclusion • References

11. The role of caffeine in neonatology
Pier Paolo Bassareo, Vassilios Fanos, Giuseppe Mercuro
Caffeine: short-term effects • Caffeine: long-term effects • Conclusions • References

12. Pulmonary surfactant in newborn infants
Virgilio P. Carnielli, Stefano Nobile, Paola E. Cogo
Background and history • Composition and pharmacodynamics • Methods for pharmacokinetic studies • Surfactant therapy • References

13. Meconium aspiration syndrome: do we know the treatment?
Murat Yurdakök
Pathophysiology of meconium aspiration syndrome • Prophylaxis of meconium aspiration • Management of infants with meconium aspiration • Conclusions • References

14. Treatment of chronic lung disease
Fabio Mosca, Valentina Polimeni, Francesca Ciuffini, Massimo Agosti, Monica Fumagalli, Mariarosa Colnaghi
Caffeine • Diuretics • Postnatal corticosteroids • Surfactant • Bronchodilators • Inhaled nitric oxide • Pulmonary vasodilators • Anti-oxidants • Stem cells • Conclusion • References

15. Postnatal steroids for the prevention and treatment of bronchopulmonary dysplasia
Eren Özek
Postnatal corticosteroids for bronchopulmonary dysplasia • Background • Current evidence of postnatal steroid use • Choice of glucocorticoids • Timing, dosage and duration of corticosteroids • Other systemic or inhaled glucocorticoids • Summary of current evidence based recommendations • References

16. Molecular and clinical pharmacology of retinopathy of prematurity
Kay D. Beharry, Jacob V. Aranda, Daniel Canal-Tristancho, Gloria B. Valencia, Douglas R. Lazarro
Epidemiology and clinical considerations • Pharmacologic interventions in ROP • Caffeine • NSAIDs and COX blockade in ROP • Antioxidant use in ROP • Long chain polyunsaturated fatty acids (LCPUFA) • Growth factors, IGF-1, VEGF and VEGF-antibodies • Beta-blockers • Other pharmacologic interventions • Summary • References

17. How to treat hypoxic-ischemic encephalopathy with drugs
Serafina Perrone, Gemma Stazzoni, Maria Luisa Tataranno, Giuseppe Buonocore
Pathophysiology of HIE • Promising pharmacological interventions • Combined therapies • Conclusions • References

18. Does the best antioxidant come from the brain? Melatonin for the newborn: present and future
Ignazio Barberi, Salvatore Aversa, Lucia Marseglia, Eloisa Gitto
Utility of melatonin in newborns • Future prospectives • References

19. Invasive fungal infections in the nursery: the state of the art
Paolo Manzoni, Elio Castagnola, Eveline Jacqz-Aigrain, Mauro Stronati, Daniele Farina
Risk factors • Prevention • Treatment of neonatal invasive fungal disease: antifungal drugs • References

20. News on management of Cytomegalovirus infections
Marcello Lanari, Maria Grazia Capretti, Paola Sogno Valin, Tiziana Lazzarotto
Prenatal strategies to prevent CMV congenital infection • Neonatal diagnosis of CMV congenital infection • Postnatal CMV infection transmitted via mother’s milk • Neuroimaging of CMV congenital infected newborns • CMV and antiviral therapy • Conclusions • References

21. Global (pharmacological and non pharmacological) prevention of RSV infection
Giovanni Corsello, Bruna Gabriele, Mario Giuffrè
Respiratory syncytial virus infections • Non pharmacological prophylaxis • Pharmacological prophylaxis • Conclusions • References

22. Clinical review of pharmacologic agents for infants with severe viral bronchiolitis
Corrado Moretti, Paola Papoff, Carla Cerasaro, Caterina Silvia Barbàra, Serena Salvadei, Fabio Midulla
Antibiotics • Beta agonists, epinephrine and hypertonic saline • Corticosteroids • DNase • Caffeine • Surfactant • Anesthetics • Conclusions • References

23. Perinatal antiretroviral therapy
Natella Y. Rakhmanina, Sahera Dirajlal-Fargo, John N. van den Anker
Antiretroviral therapy during pregnancy and delivery • Neonatal antiretroviral prophylaxis • Safety of perinatal antiretroviral therapy • Conclusions • References


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