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儿科急诊医学中的药物不良反应

Adverse Drug Reactions in Pediatric Emergency Medicine.

作者信息

Darnis Domitille, Mahé Julien, Vrignaud Bénédicte, Guen Christèle Gras-Le, Veyrac Gwenaelle, Jolliet Pascale

机构信息

University Hospital, Nantes, France.

University Hospital, Nantes, France

出版信息

Ann Pharmacother. 2015 Dec;49(12):1298-304. doi: 10.1177/1060028015602904. Epub 2015 Aug 31.

Abstract

BACKGROUND

The pediatric population displays its own pharmacological characteristics, making children vulnerable to adverse drug reactions (ADRs).

OBJECTIVE

To determine the incidence of ADRs among the pediatric emergency department (PED) population.

METHODS

This is a descriptive, noncontrolled, prospective, and single-center study, during 4 consecutive months in the PED of Nantes University Hospital.

RESULTS

Setting up active gathering of data on ADRs enabled 121 reports of 11 095 consultations at the emergency department, which corresponds to an ADR incidence of 1.09%. Digestive and cutaneous reactions made up the majority of reactions judged as being nonserious (53%) and were mainly found in children between 2 -11 years old. Of the serious ADRs, 25% were found in the 12-15-year-old age range because of the drug overdose. The main medications administered, which were responsible for the majority of the ADRs, were an equimolar mix of oxygen and nitrogen monoxide, amoxicillin, and acetaminophen. Three means of collecting data were possible: collecting files data, oral communication, or filling a form, the last being the most used method.

CONCLUSIONS

This active data gathering shows the incidence and nature of the adverse effects as well as the age distribution in the PED population. It highlights the considerable misuse of medications among young teenagers and the high incidence of overmedication in the younger age group. This work also revealed the need for a better reporting system. Future joint studies should be carried out between clinical and pharmacological departments to optimize communication and the correct use of medications in children.

摘要

背景

儿科人群具有自身的药理学特征,这使得儿童易发生药物不良反应(ADR)。

目的

确定儿科急诊科(PED)人群中药物不良反应的发生率。

方法

这是一项描述性、非对照、前瞻性单中心研究,在南特大学医院儿科急诊科连续进行4个月。

结果

建立药物不良反应数据的主动收集机制后,在急诊科的11095次会诊中得到了121份报告,药物不良反应发生率为1.09%。消化和皮肤反应构成了大多数被判定为不严重的反应(53%),主要发生在2至11岁的儿童中。在严重药物不良反应中,25%发生在12至15岁年龄组,原因是药物过量。导致大多数药物不良反应的主要用药是等摩尔混合的氧气和一氧化氮、阿莫西林和对乙酰氨基酚。有三种收集数据的方式:收集病历数据、口头交流或填写表格,最后一种是最常用的方法。

结论

这种主动的数据收集显示了儿科急诊科人群中不良反应的发生率、性质以及年龄分布。它突出了青少年中药物的大量误用以及较年轻年龄组中用药过量的高发生率。这项工作还揭示了需要一个更好的报告系统。未来临床和药理部门应开展联合研究,以优化沟通并正确使用儿童药物。

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