Home
Search
Study Topics
Glossary
|
|
|
|
|
|
Sponsored by: |
Johns Hopkins University |
---|---|
Information provided by: | Johns Hopkins University |
ClinicalTrials.gov Identifier: | NCT00330343 |
This is an investigator initiated dose finding study designed to determine the optimal dose of naloxone to prevent or minimize the most common side effects induced by opioids, namely itching, nausea, and vomiting. Male and female inpatients of the Children’s Center of the Johns Hopkins Hospital, who are greater than 6 and less than 18 years of age with acute, moderate to severe pain, and who are to be treated with IVPCA morphine will be eligible for inclusion in this study. Patients will be recruited by a study investigator prior to the initiation of IVPCA therapy. The majority of patients will be post operative patients, and will start therapy and the investigational drug in the Post Anesthesia Care Unit or the Pediatric Intensive Care Unit. We plan on studying between 10 and 99, male and female patients over a 2 year period.
Condition | Intervention |
---|---|
Pain Nausea Pruritus |
Drug: naloxone |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Dose Comparison, Single Group Assignment, Pharmacokinetics/Dynamics Study |
Official Title: | The Optimal Dose of Prophylactic Naloxone in Ameliorating Opioid Induced Side Effects in Children and Adolescents Receiving IVPCA Morphine for Moderate to Severe Pain: A Pharmacodynamic, Pharmacokinetic, and Pharmacogenetic Study |
Estimated Enrollment: | 99 |
Study Start Date: | May 2004 |
Estimated Study Completion Date: | May 2005 |
In patients of all ages, opioids are the cornerstone of management of moderate to severe pain. Regardless of method of administration, all opioids produce unwanted side effects, including pruritus, nausea and vomiting, constipation, urinary retention, cognitive impairment, tolerance, dependence, and (rarely) respiratory depression. Based on the results of a previously completed randomized controlled trial, children and adolescents with moderate to severe pain, are now routinely treated in the Children’s Center of the Johns Hopkins Hospital with a low dose naloxone infusion (0.25 mcg/kg/HOUR) whenever morphine intravenous patient controlled analgesia (IVPCA) or parent/nurse controlled analgesia (IVPNCA) is initiated. Although the previous study showed a marked reduction in the incidence and severity of pruritus and nausea, approximately a third of our patients still experience these side effects. The primary purpose of this study is to reduce this failure rate by determining if there is an optimal dose of naloxone to prevent opioid induced side effects as determined by a dose finding classic up down dose escalation method. Our second aim is to detemine the pharmacokinetics of morphine and naloxone and their metabolites at each of the naloxone infusion rates attempted. We will measure morphine, naloxone, and their metabolites using a liquid chromatographic-electrospray ionization-tandem mass spectrometric method (LC/MS/MS). Our final aim is to determine the pharmacogenetics of responders and non-responders using DNA isolated from patient blood. To accomplish this we will need a single blood collection from patients currently being treated with IVPCA morphine and low dose intravenous naloxone.
Ages Eligible for Study: | 7 Years to 17 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Myron Yaster, MD | 410-955-2393 | myaster@jhmi.edu |
United States, Maryland | |
John Hopkins Hospital | Recruiting |
Baltimore, Maryland, United States, 21287 | |
Contact: Myron Yaster, MD 410-955-2393 myaster@jhmi.edu | |
Principal Investigator: Myron Yaster, MD |
Principal Investigator: | Myron Yaster, MD | Johns Hopkins University |
Study ID Numbers: | 04-03-31-02 |
Study First Received: | May 24, 2006 |
Last Updated: | May 25, 2006 |
ClinicalTrials.gov Identifier: | NCT00330343 |
Health Authority: | United States: Institutional Review Board |
morphine naloxone pediatrics adverse effects pain |
Pruritus Morphine Nausea Pain Naloxone |
Sensory System Agents Therapeutic Uses Physiological Effects of Drugs Narcotic Antagonists |
Peripheral Nervous System Agents Central Nervous System Agents Pharmacologic Actions |