2016, Number 2
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Rev Cubana Pediatr 2016; 88 (2)
Drug interactions in children with respiratory diseases in the pediatric unit of a teaching hospital in Brazil
Yuriko MM, Batalho VG, Vianello RMH, Linardi A
Language: English
References: 51
Page: 166-181
PDF size: 277.28 Kb.
ABSTRACT
Introduction: the pharmacokinetic and pharmacodynamic responses to drugs can
change during childhood, with children being more susceptible to adverse drug
reactions than adults. The frequency of adverse reactions and length of hospitalization
generally increase as the number of drugs administered increases.
Objective: evaluating the drug associations used in children hospitalized with
respiratory disorders in the pediatric unit of a teaching hospital in Brazil.
Methods: this retrospective study was based on the quantitative analysis of data
collected from medical records of hospitalized children aged 7-12 years with
diagnoses for respiratory diseases and cystic fibrosis with pulmonary exacerbation.
The descriptive analyses of data were done using SPSS
® v.13.0 software.
The Micromedex database was used to identify drug interactions and to determine the
classification based on severity.
Results: there were 111 possible drug interactions for respiratory diseases
(25 major, 75 moderate, 10 minor and one contraindicated drug association) in
49 medical records. For cystic fibrosis, there were five possible drug interactions
(four major and one minor) in 18 medical records.
Conclusions: these findings indicate that pediatric prescription should be confined to
essential drugs. The prescription should contain the smallest possible number of medications to prevent possible drug interactions. The availability of a
multidisciplinary team combined with a program of active pharmacovigilance can help
to prevent the occurrence of drug. interactions.
REFERENCES
Therapeutic National Formulary. Ministério da Saúde, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Departamento de Assistência Farmacêutica e Insumos Estratégicos. 2th ed. Brasília (DF) [Internet]. 2010 [cited 2014 April 14]. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/formulario_terapeutico_nacional_2010.pdf
Cruciol-Souza JM, Thomson JC. A pharmacoepidemiologic study of drug interactions in a Brazilian teaching hospital. Clinics. 2006;61:515-20.
Carleton BC, Smith MA, Gelin MN, Heathcote SC. Paediatric adverse drug reaction reporting: understanding and future directions. Can J Clin Pharmacol. 2007;14(1):e45-57.
Lobo MG, Pinheiro SM, Castro JG, Momenté VG, Pranchevicius MC. Adverse drug reaction monitoring: support for pharmacovigilance at a tertiary care hospital in northern Brazil. BMC Pharmacol Toxicol. 2013;14(5):1-7.
Hartshorn EA. Evolution of drug-drug interactions: a personal viewpoint. Ann Pharmacother. 2006;40:112-3.
Kearns GL, Abdel-Rahman SM, Blander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology – drug disposition, action, and therapy in infants and children. N Engl J Med. 2003;349(12):1157-67.
Barterlink IH, Rademaker CMA, Schobben AF, van den Anker JN. Guidelines on pediatric dosing on the basis of developmental physiology and pharmacokinetic considerations. Clin Pharmacokinet. 2006;45(11):1077-97.
Morselli PL, Franco-Morselli R, Bossi L. Clinical pharmacokinetics in newborns and infants. Age-related differences and therapeutic implications. Clin Pharmacokinet. 1980;5(6):485-527.
Johnson TN. The development of drug metabolising enzymes and their influence on the susceptibility to adverse drug reactions in children. Toxicology. 2003;192(1):37-48.
Hayton WL. Maturation and growth of renal function: dosing renally cleared drugs in children. AAPS Pharm Sci. 2000;2(1):22-8.
Sweet DH, Bush KT, Nigam SK. The organic anion transporter family: from physiology to ontogeny and the clinic. American Journal of Physiology. Renal Physiology. 2001;281:F197-F205.
Strolin BM, Baltes EL. Drug metabolism and disposition in children. Fundam Clin Pharmacol. 2003;17(3):281-99.
Anderson GD. Developmental pharmacokinetics. Semin Pediatr Neurol. 2010;17(4):208-13.
Turner MA, Catapano M, Hirschfeld S, Giaquinto C. Paediatric drug development: the impact of evolving regulations. Adv Drug Deliv Rev. 2014;73C,2-13.
International Classification of Diseases (ICD-10) [Internet]. 2015 [cited 2015 May 14]. Available from: http://apps.who.int/classifications/icd10/browse/2015/en
Peterlini MA, Chaud MN, Pedreira, ML. Drug therapy orphans: the administration of intravenous drugs in hospitalized children. Rev Lat Am Enfermagem. 2003;11(1):88-95.
Jasiecka A, Máslanka T, Jaroszewski JJ. Pharmacological characteristics of metamizole. Pol J Vet Sci. 2014;17(1):207-14.
Rosenkranz, B, Lehr KH, Mackert G, Seyberth HW. Metamizole-furosemide interaction study in healthy volunteers. Eur J Clin Pharmacol. 1992;42(6):593-8.
Hinz B, Cheremina O, Bachmakov J, Renner B, Zolk O, Fromm MF, et al. Dipyrone elicits substantial inhibition of peripheral cyclooxygenases in humans: new insights into the pharmacology of an old analgesic. FASEB J. 2007;21(10):2343-51.
Kraul H, Pasanen M, Saguache H, Stenbäck F, Park SS, Gelboin HV, et al. Immunohistochemical properties of dipyrone-induced cytochromes P450 in rats. Hum Exp Toxicol. 1996;15(1):45-50.
Saussele T, Burk O, Blievernicht JK, Klein K, Nussler A, Nussler, et al. Selective induction of human hepatic cytochromes P450 2B6 and 3A4 by metamizole. Clin Pharmacol Ther. 2007;82(3):265-74.
Qin WJ, Zhang W, Liu ZQ, Chen XP, Tan ZR, Hu DL, et al. Rapid clinical induction of bupropion hydroxylation by metamizole in healthy Chinese men. Br J Clin Pharmacol. 2012;74(6):999-1004.
Von Moltke LL, Greenblatt DJ, Schmider J, Harmatz JS, Shader RI. Metabolism of drugs by P450, 3A isoforms. Implications for drug interactions in psychopharmacology. Clin Pharmacokinet. 1995;29(1):33-44.
Czock D, Keller F, Rasche FM, Häussler U. Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids. Clinical Pharmacokinetics Journal. 2005;44(1):61-98.
Bergmann TK, Barraclough KA, Lee KJ, Staatz CE. Clinical pharmacokinetics and pharmacodynamics of prednisolone and prednisone in solid organ transplantation. Clin Pharmacokinet. 2012;51(11):711-41.
Skerjanec A, Wang J, Maren K, Rojkjaer L. Investigation of the pharmacokinetic interactions of deferasirox, a once-daily oral iron chelator, with midazolam, rifampin, and repaglinide in healthy volunteers. J Clin Pharmacol. 2010;50(2):205-13.
Rendić S. Drug interactions of H2-receptor antagonists involving cytochrome P450 (CYPs) enzymes: from the laboratory to the clinic. Croat Med J. 1999;40(3):357-67.
Westphal JF. Macrolide-induced clinically relevant drug interactions with cytochrome P-450A (CYP) 3A4: an update focused on clarithromycin, azithromycin and dirithromycin. Br J Clin Pharmacol. 2000;50(4):285-95.
Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol. 2006;61(3):246-55.
Gonzalez FJ, Coughtrie M, Tukey RH. Metabolismo dos fármacos. In: Brunton LL, Chabner BA, Knollmann BC, eds. As bases farmacológicas da terapêutica de Goodman & Gilman. 12 ed. Porto Alegre: AMGH Publisher Ltda./MacGraw-Hill Education; 2012. p. 123-43.
Borowitz D, Robinson KA, Rosenfeld M, Davis SD, Sabadosa KA, Spear SL, et al. Cystic Fibrosis Foundation evidence-based guidelines for management of infants with cystic fibrosis. Journal of Pediatrics. 2009;155(6):S73-93.
Filho LVRFS, Damaceno N, Reis FJC, Hira AY. Registro brasileiro de fibrose cística [Internet]. 2010 [cited 2014 March 22]. Avaible from: http://www.cysticfibrosisdata.org/LiteratureRetrieve.aspx?ID=135160
Adde FV, Marostica PJC, Ribeiro MAGO, Santos CIS, Sol D, Vieira SE. Fibrose cística: diagnóstico e tratamento [Internet]. 2014 [cited 2014 April 20] Avaible from: http://www.projetodiretrizes.org.br/ans/diretrizes/fibrose_cisticadiagnostico_ e_tratamento.pdf
Prayle A, Smyth AR. Aminoglycoside use in cystic fibrosis: therapeutic strategies and toxicity. Curr Opin Pulm Med. 2010;16(6):604-10.
Liangos O. Drugs and AKI. Minerva Urol Nefrol. 2012;64(1):51-62.
Khalili H, Bairam S, Kargar M. Antibiotics induced acute kidney injury: incidence, risk factors, onset time and outcome. Acta Med Iran. 2013;51(12):871-8.
Barza M, Loannidis JPA, Capelleri JC, Lau J. Single or multiple daily doses of aminoglycosides: a meta-analysis. Br Med J. 1996;312(7027):338-45.
Flume PA, Mogayzel PJJr, Robinson KA, Goss, CH, Rosenblatt, RL, Kuhn RJ, et al. Clinical Practice Guidelines for Pulmonary Therapies committee. Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations. Am J Respir Crit Care Med. 2009;180(9):802-8.
Smyth AR, Bhatt J. Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis. Cochrane Database Syst Rev. 2014;2:CD002009.
Bhatt JM. Treatment of pulmonary exacerbations in cystic fibrosis. Eur Respir Rev. 2013;22:205-16.
Castro MCS, Firmida MC. O tratamento na fibrose cística e suas complicações. HUPE. 2011;10:82-108.
Geller DE. Aerosol antibiotics in cystic fibrosis. Respir Care. 2009;54(5):658-70.
Levy CE. Microbiologia no trato respiratório na fibrose cística. In: Paschoal IA, Pereira MC, eds. Fibrose Cística. São Paulo: Yends; 2010. p. 201-12.
Promoting Rational Use of Medicines: Core Components-WHO Policy perspectives on medicine, No. 005, September 2002. Essential medicines and Health Products Information Portal. A World Health Organization Resource [internet]. 2015 [cited 2015 October 23]. Available from: http://www.who.int/medicines/publications/policyperspectives/ppm05en.pdf
Jain S, Upadhyaya P, Goyal J, Kumar A, Jain P, Seth V, et al. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspect Clin Res. 2015;6(2):86-90.
Bergqvist M, Ulfvarson J, Andersen Karlsson E, von Bahr C. A nurse-led intervention for identification of drug-related problems. Eur J Clin Pharmacol. 2008;64:451–56.
Morrison-Griffiths S, Walley TJ, Park BK, Breckenridge AM, Pirmohamed M. Reporting of adverse drug reactions by nurses. Lancet. 2003;361(9366):1347-8.
Ulfvarson J, Mejyr S, Bergman U. Nurses are increasingly involved in pharmacovigilance in Sweden. Pharmacoepidemiol Drug Safety. 2007;16(5):532-7.
Johansson-Pajala RM, Martin L, Fastbom J, Jorsäter Blomgren K. Nurses' selfreported medication competence in relation to their pharmacovigilant activities in clinical practice. J Eval Clin Pract. 2015;21(1):145-52.
Mendes D, Alves C, Batel Marques F. Nurses’ spontaneous reporting of adverse drug reactions: expert review of routine reports. J Nurs Man. 2014;22:322-30.
King RL. Nurses’ perceptions of their pharmacology educational needs. J Adv Nurs.2004;45(4):392-400.