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K Hoppu

Publications and source records attributed to K Hoppu.

52 records · Page 3Linked to original sources
PubMed1989

Changes in trimethoprim pharmacokinetics after the newborn period.

The pharmacokinetics of trimethoprim administered orally or intravenously were investigated in six infants aged 1.7 months to 1.1 years. In these infants trimethoprim had a mean half life of 4.6 hours; this was comparable with the values found in young and school age children (3.8 and 5.4 hours respectively) and about a quarter of the half life in newborns. The volume of distribution (1.5 l/kg) was smaller than in newborns but larger than in young or school age children (0.9 and 1.1 l/kg respectively). The plasma clearance in these infants (3-3 ml/min/kg) was slightly larger than in newborns or in either group of older children (2.9 and 2.4 ml/min/kg respectively). Thus the most dramatic changes in trimethoprim pharmacokinetics seem to occur during the first two months of life. A reduced daily dose of trimethoprim is necessary during the first two months only. An increased daily dose, by addition of a third dose each day, is recommended from two months.

Age Factors↗
PubMed1988

Trimethoprim in the treatment of acute urinary tract infections in children.

In the first study to assess the effect of trimethoprim in the treatment of acute urinary tract infections in children, we compared it with sulphisoxazole. Eighteen girls, mean age 5.3 years, were treated with trimethoprim 6 mg/kg/day. Seventeen girls, mean age 5.0 years, treated with sulphisoxazole 150-200 mg/kg/day for 10 days served as controls. All infections were cured. Three patients in each group had reinfections during the 6 months of follow-up. In each group, one of the reinfections occurred within 2 weeks after the end of the treatment. One patient developed a rash from sulphisoxazole and so required drug change. No other adverse effects were observed. We conclude that trimethoprim is as effective as sulphisoxazole in the treatment of simple acute urinary tract infections of children and recommend it, in the dosage used, as an alternative first-choice drug, especially for patients who have had side effects from sulphonamides or nitrofurantoin.

Acute Disease↗
PubMed1987

Determination of trimethoprim in pediatric samples by high-performance liquid chromatography.

We describe and evaluate modifications to a known high-performance liquid chromatography assay of trimethoprim. The sensitivity, specificity and wide range of linearity (0.11-690 mumol/l) of this method make it suitable for analysing samples with large variations in volume and concentration. We have used it to study the pharmacokinetics of trimethoprim in children, including newborns. Automated injection is a useful option if the sample volume is not limited. The recovery (at 3.44 mumol/l) of the method was 99.8% with a coefficient of variation of 6.8% for manually injected samples. The corresponding results for automated injection were 97.9% and 12.8%.

Blood Specimen Collection↗
PubMed1987

Food and guar decrease absorption of trimethoprim.

Absorption of trimethoprim suspension 3 mg/kg has been studied in 12 healthy adult volunteers when given alone, with food or with food and guar, using a randomised Latin-squares study design. Serum and urine trimethoprim concentrations were followed for 24 h. The mean peak serum concentration was higher when fasting subjects were treated (mean: 2.35, 1.84 and 1.97 micrograms/ml for the fasting, food and food + guar groups, respectively; ANOVA p less than 0.001 for the difference between fasting and non-fasting values). The times of the peak serum concentrations did not differ. Food ingestion decreased the area under the curve by 22.2%, as did food + guar. For maximal efficacy trimethoprim should be administered between meals.

Absorption↗
PubMed1987

Inositol supplementation in respiratory distress syndrome: relationship between serum concentration, renal excretion, and lung effluent phospholipids.

Inositol or placebo was given to 48 small preterm infants with respiratory distress syndrome (mean birth weight 1365 g, gestational age 30.1 weeks) between 48 hours and 10 days of age. The dose of inositol, 40 mg/kg every 6 hours, was at least as high as amounts received in full preterm human milk feedings. Serum inositol concentration increased between days 2 and 3 from a mean of 566 mumol/L to 823 mumol/L in the infants given supplement and fell from 451 mumol/L to 292 mumol/L in the controls. On day 16, serum inositol values remained higher in the infants given supplement than in those given placebo (mean 334 mumol/L vs 146 mumol/L, P = 0.014). The infants who developed bronchopulmonary dysplasia had significantly higher renal inositol clearance, lower inositol intake, and lower serum inositol concentrations. Inositol supplementation increased the saturated phosphatidylcholine/sphingomyelin ratio in tracheal aspirates. According to these results, supplementation with inositol in preterm infants leads to a rise in serum inositol concentration and improvement in the surfactant phospholipids. Inositol deserves further study as a dietary supplement for immature preterm infants who do not receive full human milk feeds.

Double-Blind Method↗
PubMed1987

Trimethoprim pharmacokinetics in children with renal insufficiency.

We studied the pharmacokinetics of trimethoprim in 14 children (two neonates) with renal insufficiency. They were 1 week to 16.4 years old and had glomerular filtration rates (GFR) between 10.8 to 72.3 ml/min/1.73 m2. The half-life (t1/2) of trimethoprim was inversely related to the GFR. The relation followed a power curve (correlation of t1/2 with GFR: r = -0.86; P less than 0.001). The slower elimination rate was mainly the result of lowered renal clearance of trimethoprim. The volume of distribution (Varea) was, in most patients, in the upper normal range for children. In some of the patients, chiefly infants with severe renal insufficiency, the Varea was larger than normal. In some individuals the pharmacokinetics of trimethoprim deviated from that to be expected from the GRF. We recommend reduced daily doses of trimethoprim if the GFR is less than 30 ml/min/1.73 m2. The reduction should be proportional to the reduction in GFR and primarily take the form of a prolonged dose interval.

Absorption↗
PubMed1987

Age differences in trimethoprim pharmacokinetics: need for revised dosing in children?

The pharmacokinetics of trimethoprim was studied in children (nine girls 1.05 to 3.57 years old and nine girls 7.55 to 9.70 years old) with urinary tract infections and 12 healthy adults (27.07 to 44.62 years old) to investigate any age-related changes. Serum and urine concentrations were measured during 24 hours. The groups did not differ in the time or the height of the peak serum concentration. Thereafter the children had lower serum concentrations. They had a shorter elimination half-life (means: 1 to 3 years, 3.7 hours; 8 to 10 years, 5.4 hours; adults, 11.2 hours), because of the smaller volume of distribution (0.86 l/kg; 1.08 l/kg; 1.31 l/kg) and higher total clearance (2.8 ml/min/kg; 2.4 ml/min/kg; 1.4 ml/min/kg). The higher clearance in children was mainly nonrenal (metabolism). Calculation of the pharmacokinetic variables per unit of body surface area modified the age differences considerably. Compared with present dosage recommendations, trimethoprim in larger daily doses per kilogram of body weight for the children is suggested. The daily dose should be increased primarily by shortening the dose interval.

Adult↗
PubMed1984

Difference in trimethoprim pharmacokinetics between children and adults.

We used a new micromethod, an application of a previously published high-performance liquid chromatography assay, to investigate trimethoprim (TMP) pharmacokinetics in children. The subjects were 5 girls who were treated for urinary tract infection with a TMP suspension, 6 mg/kg/day, twice daily for 10 days. Elimination studies were done after the last dose. The girls were 1.08-9.71 years old. 3 healthy adult males, aged 26.35-37.31 served as controls. The half-life (t 1/2) of TMP in the children was 3.0-5.5 versus 9.3-13.6 h in the adults. The volume of distribution (Vd) was 0.7-1.1 1/kg in the children and 0.5-0.9 1/kg in the adults. Plasma clearance (Clp) was 2.1-2.8 ml/min/kg for the children. The adults had a smaller Clp of 0.4-1.2 ml/min/kg. From this and previous studies we conclude that the t 1/2 of TMP is much shorter in children than in adults.

Adult↗
PubMed1983

Causes of neonatal deaths in a pediatric hospital neonatal unit. An autopsy study of a ten-year period.

A study is presented of 1020 consecutive autopsies on newborn infants who died during the first 28 days of life at the Children's Hospital, University of Helsinki, during 1969-1978. The infants were grouped into four categories according to their weight at birth and into early (0-7 days) and late (8-28 days) neonatal groups according to their age at death. 77.5% of the cases fell into the early neonatal group. The most common causes of death were hyaline membrane disease (HMD) and cerebral haemorrhage (CH), which together accounted for 41.9% of all the deaths. Congenital anomaly was the second most common group of causes, comprising 35.3% of the cases. A gradual fall in the total number of deaths was conspicuous during the ten-year period. There was a statistically significant decrease in the number of deaths from HMD and CH in the weight categories 1001-1500 g and 1501-2500 g. The fall is considered to reflect improvement in both obstetrics and neonatal medicine.

Autopsy↗
PubMed1981

Diazepam rectal solution for home treatment of acute seizures in children.

To gain clinical experience of treating acute convulsions in children with diazepam rectal solution, 17 epileptic children with prolonged convulsions were treated at home. The drug was used 65 times. On 2/3 of all occasions the seizure was interrupted in less than 15 min. A starting dose of 0.5 mg/kg is recommended, with a maximum of 20 mg per single dose. One patient had respiratory difficulties, one dizziness and two skin reactions.

Adolescent↗