Análisis de los factores pronósticos de la respuesta antipirética del ibuprofeno / Analysis of prognostic factors for the antipyretic response to ibuprofen

OBJETIVO: Analizar los factores que influyen en la respuesta antitérmica del ibuprofeno. PACIENTES Y MÉTODOS: Niños de entre 1y 10años que acudieron al servicio de urgencias con temperatura superior a 38ºC. Se les administró una dosis de 7mg/kg de ibuprofeno, anotándose después la temperatura a los 30, 60, 90, 120, 180y 240min. Se analizó la influencia de la edad, sexo, peso, superficie corporal, entidad nosológica, administración previa de antitérmicos y asociación de medidas físicas sobre la evolución de la temperatura. RESULTADOS: Se estudiaron 384 niños, con temperatura corporal comprendida entre 38y 42ºC (39,1 ñ 60,6ºC), en el 77,8 por ciento la fiebre duraba más de 6h y el 59,5 por ciento habían recibido al menos un antitérmico. El 93,5 por ciento de los niños redujeron su temperatura hasta 37,5ºC o menos, alcanzándose dicha temperatura en el 80,2 por ciento de los niños entre 1y 2horas después del tratamiento. El 95 por ciento de los pacientes alcanzó un descenso de la temperatura corporal de al menos 1ºC. La temperatura inicial más alta (odds ratio[OR] 0,008; intervalo de confianza [IC] 95 por ciento, 00,14) y la mayor superficie corporal (OR, 0,004; IC 95 por ciento, 00,89) facilitan la consecución de dicho objetivo, mientras que la mayor edad la dificulta (OR, 1,67; IC 95 por ciento, 1,032,7). CONCLUSIÓN: El ibuprofeno es un fármaco muy eficaz en el tratamiento de la fiebre infantil y la magnitud de su efecto antitérmico guarda cierta relación con la edad, el grado de temperatura inicial y la superficie corporal (AU)

Evaluación de la eficacia antipirética y seguridad de dos formulaciones pediátricas de ibuprofeno / Evaluation of the antipyretic safety and accuracy of two pediatric ibuprofen formulations

OBJETIVO: Comparar la eficacia y evaluar la bioequivalencia clínica de dos presentaciones de ibuprofeno para niños, suspensión y gránulos efervescentes, en el tratamiento de la fiebre. MÉTODOS: Ensayo clínico abierto, de distribución aleatoria y multicéntrico. Se administró a niños con pesos superiores a 25kg, que acudieron con temperatura axilar superior a38º C a servicios de urgencias hospitalarios, una dosis de ibuprofeno en suspensión de 7 mg/kg, o una dosis de gránulos efervescentes con la siguiente posología: 200 mg en niños con pesos entre 25 y 40 kg, o 400 mg si pesaban entre 35 y 40 kg y tenían una temperatura axilar superior a 39 ºC, así como en los niños de más de 40 kg. Se tomó la temperatura axilar antes del tratamiento y a los 30, 60, 90, 120, 180 y 240 min, y se registraron posibles efectos adversos. RESULTADOS: Se incluyeron 103 pacientes, 51 recibieron gránulos y 52 suspensión. La temperatura media se redujo en los dos grupos a lo largo del estudio (p < 0,005), sin diferencias entre ellos. Las diferencias medias de temperatura en cada momento del estudio se situó dentro del intervalo de bioequivalencia (60,5ºC). En un caso se alcanzó una temperatura axilar de 35,9 ºC, siendo el único acontecimiento adverso ocurrido. CONCLUSIÓN: Ambas formulaciones se mostraron eficaces en la reducción de la temperatura y pueden considerarse bioequivalentes clínicamente (AU)

[Analysis of prognostic factors for the antipyretic response to ibuprofen]. / Análisis de los factores pronósticos delarespuesta antipirética del ibuprofeno.

AIM: To assess the factors influencing the antipyretic activity of ibuprofen in children. PATIENTS AND METHODS: Children aged between 1 and 10 years attending the emergency department with a temperature of> 38 degrees C were given one dose of ibuprofen (7 mg/kg). Temperature was recorded before and 30, 60, 90, 120, 180 and 240 min after ibuprofen administration. The influence of age, sex, weight, body surface, nosologic entity, previous antipyretic administration, and the association between physical measurements and temperature evolution were assessed. RESULTS: A total of 384 children were studied. Baseline temperatures were between 38 degrees C and 42 degrees C (mean: 39.1 +/- 60.6). Most of the patients (77.8%) had been feverish for more than 6 hours and 59.5% had received antipyretic treatment. In 93.5% of the children temperature was lowered to 37.5 degrees C or less. In 80.2% of the children this temperature was reached 12 hours after treatment. In 95% of ther children a decrease of at least 1 degree C was achieved. Older age (OR 1.67; 95% CI: 1.032.7), smaller body surface (OR 0.004; 95% CI 00.89) and lower baseline temperature (OR 0.008; 95%CI 00.14) were associated with a smaller antipyretic response (decrease in body temperature lower than 1 degree C). CONCLUSIONS: Ibuprofen is effective in the treatment of fever in children. Its effectiveness is related to age, the degree of fever and body surface.

[Flubiprofen vs dipyrone combined with hyoscine: the analgesic efficacy in renal colic]. / Flubiprofeno vs dipirona asociada a hioscina: eficacia analgésica en el cólico nefrítico.

OBJECTIVE: We compared the efficacy of flurbiprofen (NSAID) versus dipirone + hyoscine N-butylbromide in the treatment of nephric colic. METHODS: The study comprised 135 patients, aged 18 to 75 yrs, with intense nephric colic. The patients were observed 60 min after a single IM dose of 150 mg flurbiprofen (n = 67) or 2 gm dipirone + 20 mg hyoscine N-butylbromide. RESULTS: Both treatment modalities were well-tolerated and afforded significant pain relief. Flurbiprofen, however, was faster-acting and superior to dipirone + hyoscine in the overall evaluation of good and excellent therapeutic response rates. CONCLUSION: The results of the study show that IM flurbiprofen is a useful alternative to dipirone + hyoscine N-butylbromide in the treatment of nephric colic.

[The efficacy of injectable flurbiprofen in the symptomatic treatment of biliary colic]. / Eficacia del flurbiprofeno inyectable en el tratamiento sintomático del cólico biliar.

BACKGROUND: To evaluate the efficacy of flurbiprofen (nonsteroidal anti-inflammatory drug) in the treatment of biliary colic pain as compared with the drugs commonly used (analgesics and/or spasmolytics). METHODS: Eighty-four patients aged between 21 and 86 affected by intense pain of simple hepatic colic participated in the study. Following a single intramuscular dose of 150 mg of flurbiprofen (FRI, n = 30), 20 mg of N-hyoscine butylbromide (HBB, n = 25) or 30 mg of pentazocine (PTZ, n = 29) the patients were observed during the 6 hours after administration. RESULTS: The evolution of the pain was significantly better in the patients treated with FRI with differences being detected between the three drugs after 30 minutes of administration. A greater number of adverse reactions were seen among the patients who received PTZ with the differences being statistically significant with the other 2 treatments (p less than 0.02). CONCLUSIONS: Intramuscular flurbiprofen was more effective and generally better tolerated than pentozocine and hyoscine butylbromide.

Cognitive effects of long-term treatment with phenobarbital and valproic acid in school children.

The Wechsler Intelligence Scales for Children was applied to 64 epileptic children and 60 healthy subjects; patients followed chronic treatment with valproic acid (n = 32) or phenobarbital (n = 32). None of the children suffered mental retardation or neurological abnormalities. The test was repeated after a 9-12 month interval: 26 of the valproate treated children and 23 of the phenobarbital-treated children performed the second evaluation. At baseline, total, verbal and performance IQ scores of children receiving phenobarbital were lower than those of controls. When the results of the first and the second tests were compared, a significant increase in IQ scores was detected among controls and patients treated with valproic acid, but not among phenobarbital-treated patients. It is concluded that long-term phenobarbital therapy induces a significant impairment in learning ability whereas long-term valproate therapy does not exert a noticeable noxious effect at this respect.

[Monitoring of three delayed-release preparations of theophylline in the plasma of children: pharmacokinetic parameters and therapeutic significance]. / Monitorización plasmática de tres preparados de teofilina de liberación retardada en la infancia: parámetros farmacocinéticos e interés terapéutico.

The pharmacokinetic and clinical efficacy of three theophylline slow-release formulations was studied in 29 children suffering chronic bronchial asthma. Theophylline loading dose was of 6 mg/kg; maintenance dose was adjusted according to therapeutic effect and drug plasma concentrations and ranged to 11.1 to 31.3 mg/kg/daily (means = 22.32 +/- 6.6 mg/kg/daily). Peak theophylline plasma levels were 13.38 +/- 4.83 micrograms/ml and through plasma levels were 8.73 +/- 3.78 micrograms/ml. No difference was found among theophylline formulations for clinical response nor kinetic parameters. Drug plasma half-life varied from 2.9 to 18.2 hr (means = 8.85 +/- 3.64 hr). Theophylline total body clearance and apparent volume of distribution exhibited a marked decrease during chronic drug administration in relation to the values observed after intake of the loading dose. Twenty three of the children reached a good degree of control of bronchospasm and did not require any associated medication.