Wagner Jonathan, Abdel-Rahman Susan M
Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri ; Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Hospital, Kansas City, Missouri ; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Division of Clinical Pharmacology, Toxicology and Therapeutic Innovation, Children's Mercy Hospital, Kansas City, Missouri ; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
J Pediatr Pharmacol Ther. 2016 Sep-Oct;21(5):380-403. doi: 10.5863/1551-6776-21.5.380.
Increasingly, children and adolescents with dyslipidemia qualify for pharmacologic intervention. As they are for adults, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) are the mainstay of pediatric dyslipidemia treatment when lifestyle modifications have failed. Despite the overall success of these drugs, the magnitude of variability in dose-exposure-response profiles contributes to adverse events and treatment failure. In children, the cause of treatment failures remains unclear. This review describes the updated guidelines for screening and management of pediatric dyslipidemia and statin disposition pathway to assist the provider in recognizing scenarios where alterations in dosage may be warranted to meet patients' specific needs.
越来越多的血脂异常儿童和青少年符合药物干预的条件。与成人一样,当生活方式改变无效时,3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂(他汀类药物)是儿童血脂异常治疗的主要药物。尽管这些药物总体上取得了成功,但剂量-暴露-反应曲线的变异性程度会导致不良事件和治疗失败。在儿童中,治疗失败的原因尚不清楚。本综述描述了儿童血脂异常筛查和管理的最新指南以及他汀类药物处置途径,以帮助医疗服务提供者识别可能需要调整剂量以满足患者特定需求的情况。