Subject(s)
Anti-Infective Agents , Lactams , Leucine , Nitriles , Proline , Ritonavir , Cytochrome P-450 CYP3A , Anti-Infective Agents/therapeutic useABSTRACT
INTRODUCTION: Achieving optimal clinical responses and minimizing side effects through precision dosing of antipsychotics in children and adolescents with psychiatric disorders remains a challenge. Identifying patient characteristics (covariates) that affect pharmacokinetics can inform more effective dosing strategies and ultimately improve patient outcomes. This review aims to provide greater insight into the impact of covariates on the clinical pharmacokinetics of antipsychotics in pediatric populations. AREAS COVERED: A comprehensive literature search was conducted, and the main findings regarding the effects of the covariates on the pharmacokinetics of antipsychotics in children and adolescents are presented. EXPERT OPINION: Our study highlights significant covariates, including age, sex, weight, CYP2D6 phenotype, co-medication, and smoking habits, which affect the pharmacokinetics of antipsychotics. However, the findings were generally limited by the small sample sizes of naturalistic, open-label, observational studies, and the homogeneous subgroups. Dosing based on weight and preemptive genotyping could prove beneficial for optimizing the dosing regimen in pediatric populations. Future research is needed to refine dosing recommendations and establish therapeutic reference ranges critical for precision dosing and Therapeutic Drug Monitoring (TDM). The integration of individual patient characteristics with TDM can further optimize the efficacy and safety of antipsychotics for each patient.
Subject(s)
Antipsychotic Agents , Mental Disorders , Adolescent , Humans , Child , Antipsychotic Agents/adverse effects , Antipsychotic Agents/pharmacokinetics , Mental Disorders/drug therapy , Mental Disorders/chemically induced , PhenotypeABSTRACT
Polymyxin B and colistin are considered the last therapeutic option to treat infections caused by highly drug-resistant bacteria. However, their administration may lead to various adverse effects such as nephrotoxicity, neurotoxicity, and allergic reactions. The current case report presents the clinical manifestation of polymyxin B-associated neurotoxicity in a female patient with no chronic illness history. The patient was rescued from under rubble during an earthquake. She was diagnosed with an intra-abdominal infection caused by Acinetobacter baumannii (A. baumannii) After the initiation of the polymyxin B infusion, the patient developed numbness and tingling sensations in her hands, face, and head. On discontinuing polymyxin B and starting colistimethate, the patient's symptoms improved. Therefore, healthcare professionals should be aware of the potential risk factors associated with neurotoxicity in patients receiving polymyxin B. On identifying such symptoms treatment should be discontinued promptly to prevent further neurological damage.
Subject(s)
Acinetobacter baumannii , Polymyxin B , Humans , Female , Polymyxin B/adverse effects , Anti-Bacterial Agents , Drug Resistance, Multiple, Bacterial , Microbial Sensitivity TestsABSTRACT
Background: The COVID-19 pandemic has captured the mental health discussion worldwide. Examining countries' representation in this discussion could prove instrumental in identifying potential gaps in terms of ensuring a truly global conversation in times of global crisis. Methods: We collected mental health and COVID-19-related journal articles published in PubMed in 2020. We focused on the corresponding authors' countries of affiliation to explore countries' representation. We also examined these articles' academic impact and correlations with their corresponding authors' countries of affiliation. Additional journals and countries' indicators were collected from the Web of Science and World Bank websites, respectively. Data were analyzed using the IBM SPSS Statistics and the VOSviewer software. Results: In total, 3492 publications were analyzed. Based on the corresponding author, high-income countries produced 61.9% of these publications. Corresponding authors from Africa, Latin America and the Caribbean, and the Middle East combined accounted for 11.8% of the publications. Europe hosted corresponding authors with the most publications and citations, and corresponding authors from North America had the largest mean journal impact factor. Conclusions: The global scientific discussion during the COVID-19 pandemic saw an increased contribution of academics from developing countries. However, authors from high-income countries have continued to shape this discussion. It is imperative to ensure the active participation of low- and middle-income countries in setting up the global mental health research agenda, particularly in situations of global crisis, such as the ongoing pandemic.
