ArticleBritish journal of clinical pharmacology2016
Pragmatic pharmacology: population pharmacokinetic analysis of fentanyl using remnant samples from children after cardiac surgery.
Article in British journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 33 citations in OpenAlex.
- Advances in pharmacokinetic-pharmacodynamic modeling for anesthesia, 1987-2024: a review.Frontiers in pharmacology · 2026Review
- Escitalopram and Sertraline Population Pharmacokinetic Analysis in Pediatric Patients.Clinical pharmacokinetics · 2023Article
- A point-of-care pharmacokinetic/pharmacodynamic trial in critically ill children: Study design and feasibility.Contemporary clinical trials communications · 2023Article
- Variant-based heritability assessment of dexmedetomidine and fentanyl clearance in pediatric patients.Clinical and translational science · 2023Article
- An individualized digital twin of a patient for transdermal fentanyl therapy for chronic pain management.Drug delivery and translational research · 2023Article
- Integrating real-world data to accelerate and guide drug development: A clinical pharmacology perspective.Clinical and translational science · 2022Review
- Population pharmacokinetic analysis of dexmedetomidine in children using real-world data from electronic health records and remnant specimens.British journal of clinical pharmacology · 2022Article
- Effect of CYP3A5 and CYP3A4 Genetic Variants on Fentanyl Pharmacokinetics in a Pediatric Population.Clinical pharmacology and therapeutics · 2022Article
- Analysis Approaches to Identify Pharmacogenetic Associations With Pharmacodynamics.Clinical pharmacology and therapeutics · 2021Review
- Towards Evidence-Based Weaning: a Mechanism-Based Pharmacometric Model to Characterize Iatrogenic Withdrawal Syndrome in Critically Ill Children.The AAPS journal · 2021Article
- Dosing of Continuous Fentanyl Infusions in Obese Children: A Population Pharmacokinetic Analysis.Journal of clinical pharmacology · 2020Article
- Development of a System for Postmarketing Population Pharmacokinetic and Pharmacodynamic Studies Using Real-World Data From Electronic Health Records.Clinical pharmacology and therapeutics · 2020Article
- Characterizing Fentanyl Variability Using Population Pharmacokinetics in Pediatric Burn Patients.Journal of burn care & research : official publication of the American Burn Association · 2020Observational
- Factors Contributing to Fentanyl Pharmacokinetic Variability Among Diagnostically Diverse Critically Ill Children.Clinical pharmacokinetics · 2019Article
- Real-World Data for Pediatric Pharmacometrics: Can We Upcycle Clinical Data for Research Use?Clinical pharmacology and therapeutics · 2019Article
- Opportunities and Challenges in Cardiovascular Pharmacogenomics: From Discovery to Implementation.Circulation research · 2018Review
- Correction to: Pharmacokinetics of Fentanyl and Its Derivatives in Children: A Comprehensive Review.Clinical pharmacokinetics · 2018Article
- Pharmacokinetics of Fentanyl and Its Derivatives in Children: A Comprehensive Review.Clinical pharmacokinetics · 2018Review
- Pragmatic pharmacology: population pharmacokinetic analysis of fentanyl using remnant samples from children after cardiac surgery.British journal of clinical pharmacology · 2016Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
aimsOne barrier contributing to the lack of pharmacokinetic (PK) data in paediatric populations is the need for serial sampling. Analysis of clinically obtained specimens and data may overcome this barrier. To add evidence for the feasibility of this approach, we sought to determine PK parameters for fentanyl in children after cardiac surgery using specimens and data generated in the course of clinical care, without collecting additional blood samples.
methodsWe measured fentanyl concentrations in plasma from leftover clinically-obtained specimens in 130 paediatric cardiac surgery patients and successfully generated a PK dataset using drug dosing data extracted from electronic medical records. Using a population PK approach, we estimated PK parameters for this population, assessed model goodness-of-fit and internal model validation, and performed subset data analyses. Through simulation studies, we compared predicted fentanyl concentrations using model-driven weight-adjusted per kg vs. fixed per kg fentanyl dosing.
resultsFentanyl clearance for a 6.4 kg child, the median weight in our cohort, is 5.7 l h(-1) (2.2-9.2 l h(-1) ), similar to values found in prior formal PK studies. Model assessment and subset analyses indicated the model adequately fit the data. Of the covariates studied, only weight significantly impacted fentanyl kinetics, but substantial inter-individual variability remained. In simulation studies, model-driven weight-adjusted per kg fentanyl dosing led to more consistent therapeutic fentanyl concentrations than fixed per kg dosing.
conclusionsWe show here that population PK modelling using sparse remnant samples and electronic medical records data provides a powerful tool for assessment of drug kinetics and generation of individualized dosing regimens.
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