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.
Mechanically Ventilated Neonates,
Painful Procedures in Newborns
|Study Design:||Endpoint Classification: Pharmacokinetics Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Absorption and Metabolism of Oral Codeine in Mechanically Ventilated Neonates|
- 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. [ Time Frame: 2 hours ] [ Designated as safety issue: No ]
- Secondary outcomes include the additional PK parameters elimination half life, area under the curve and mean residence time. [ Time Frame: 2 hours ] [ Designated as safety issue: No ]
|Study Start Date:||August 2008|
|Estimated Primary Completion Date:||July 2012 (Final data collection date for primary outcome measure)|
Neonates 0-30 days, no more than 2,000 grams, receiving mechanical ventilation.
One single oral dose of 1 mg/kg of codeine
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.
|Contact: Jacob V Aranda, MD, PhDfirstname.lastname@example.org|
|Contact: Jeffrey L Blumer, MD, PhDemail@example.com|
|United States, New York|
|State University of New York Downstate||Recruiting|
|Brookyln, New York, United States, 11203|
|Principal Investigator:||Jacob V Aranda, MD, PhD||State University of New York Downstate|