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Codeine in Mechanically Ventilated Neonates

Absorption and Metabolism of Oral Codeine in Mechanically Ventilated Neonates

The purpose of this study is to determine the absorption and bioavailability of codeine in relation to postnatal (PNA) and postconceptional (PCA) age; determine the parent drug (codeine), its active metabolites, their formation rates and their ratios in relation with PCA and PNA; and identify relevant genetic polymorphisms of opioid metabolism in the study population and their potential relationship to the biodisposition and pharmacodynamic effects of codeine. The study population is intubated and mechanically ventilated infants equal to or greater than 26 weeks gestational age at birth and less than 4 weeks postnatal age.

Studieoversigt

Status

Afsluttet

Intervention / Behandling

Detaljeret beskrivelse

This proposal has its origins in a larger initiative to elucidate the pharmacological basis for the interindividual differences observed in opioid responsiveness. Gaps in our knowledge related to opioid disposition in newborns need to be addressed to complete the design of the required overarching initiative in which age could be treated as a continuous variable within a context of PK, PD and PG determinants.This proposal is designed to generate preliminary data that addresses two issues. First, can newborns absorb enterally administered codeine and is this ability determined by PCA or PNA age? The second relates to the ability of newborn infants to catalyze those reactions required to metabolically activate both codeine and morphine. The latter will also be evaluated within the context of PCA versus PNA age.

These data will not only fill an information gap that must be addressed before the larger initiative moves forward, but they also provide a platform for serious study of the ontogeny of certain pharmacokinetic processes that may prove critical to our understanding of newborn drug disposition. In this way, codeine can provide important insights concerning the ontogeny of drug disposition and permit the determination of the relative importance of PCA versus PNA ages to the functional expression of these processes.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

6

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • New York
      • Brooklyn, New York, Forenede Stater, 11203
        • State University of New York Downstate

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

Ikke ældre end 1 måned (Barn)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Neonates ≥ 26 weeks PCA receiving mechanical ventilation and painful procedure will be eligible for participation in the study
  • Subject's parent/legal guardian must give written informed consent prior to study participation
  • Subject is receiving opioid analgesia therapy based on caregiver determination. The ideal patient will not be receiving morphine.
  • Must be able to receive an enteral dose of codeine.

Exclusion Criteria:

  • Known hypersensitivity to morphine, fentanyl, or codeine
  • Patients with ALT concentrations >2x upper limit of normal for age or clinical evidence of hepatic failure
  • Patients with serum creatinine concentrations >2x upper limit of normal for age or clinical evidence of renal failure
  • Patients who are NPO
  • Babies born to maternal drug abuse.
  • Total serum bilirubin level of > 10 mg/dl or 170 umol/L.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: 1
Neonates 0-30 days, no more than 2,000 grams, receiving mechanical ventilation.
One single oral dose of 1 mg/kg of codeine

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
The rate and extent of absorption of oral codeine, the ratios of the observed concentration of each metabolite to the observed concentration of parent drug and the formation and clearances of the metabolites.
Tidsramme: 2 hours
2 hours

Sekundære resultatmål

Resultatmål
Tidsramme
Secondary outcomes include the additional PK parameters elimination half life, area under the curve and mean residence time.
Tidsramme: 2 hours
2 hours

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Jacob V Aranda, MD, PhD, State University of New York Downstate

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. august 2008

Primær færdiggørelse (Faktiske)

6. marts 2013

Studieafslutning (Faktiske)

6. marts 2013

Datoer for studieregistrering

Først indsendt

22. marts 2011

Først indsendt, der opfyldte QC-kriterier

22. marts 2011

Først opslået (Skøn)

24. marts 2011

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

27. august 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. august 2018

Sidst verificeret

1. august 2018

Mere information

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Codeine

Abonner