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并非全是吸入治疗:儿科呼吸医学中口服疗法面临的挑战。

It's not all about inhaled treatment: challenges with oral therapy in paediatric respiratory medicine.

作者信息

Sareen Anneka, Ramphul Manisha, Bhatt Jayesh Mahendra

机构信息

Pharmacy Dept, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK.

Paediatric Respiratory Medicine, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK.

出版信息

Breathe (Sheff). 2021 Mar;17(1):210005. doi: 10.1183/20734735.0005-2021.

Abstract

UNLABELLED

Advances in therapies and management of conditions encountered by paediatric respiratory specialists have led to improved outcomes and improved survival rates dramatically in chronic diseases such as cystic fibrosis. However, this has also meant an increase in treatment burden. A variety of inhaled treatments are crucial in managing paediatric respiratory diseases, but these patients also have to take many oral medications. It is widely recognised that developing oral formulations appropriate for the paediatric population can affect how well a product is received by patients and their families. Consideration should be given to palatability and the number of medicines to be administered as these can all contribute to treatment adherence. Polypharmacy specifically in the context of management of patients with cystic fibrosis is not a new concept, but the recently introduced cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies and their potential for interactions and adverse reactions create novel challenges. There are some strategies that families and healthcare professionals can implement to reduce treatment burden. This review will also provide some insight into the life of a teenager with cystic fibrosis and the relative complexities of her treatment and the impacts on daily life.

EDUCATIONAL AIMS

To describe the difficulties faced by children with long-term respiratory conditions having to take oral medication.To discuss oral drug interactions that may exist within paediatric respiratory medicine and to consider issues with polypharmacy.To highlight strategies that may be used to reduce the burden of care for children on oral medication.

摘要

未标注

儿科呼吸科专家所治疗疾病的疗法和管理方面的进展,已使诸如囊性纤维化等慢性疾病的治疗效果得到改善,存活率显著提高。然而,这也意味着治疗负担增加。多种吸入治疗对于管理儿科呼吸道疾病至关重要,但这些患者还必须服用许多口服药物。人们普遍认识到,开发适合儿科人群的口服制剂会影响产品被患者及其家人接受的程度。应考虑口感以及要服用的药物数量,因为这些都会影响治疗依从性。特别是在囊性纤维化患者管理背景下的多药联用并非新概念,但最近引入的囊性纤维化跨膜传导调节因子(CFTR)调节剂疗法及其相互作用和不良反应的可能性带来了新的挑战。家庭和医疗保健专业人员可以实施一些策略来减轻治疗负担。本综述还将深入了解一名患有囊性纤维化的青少年的生活,以及她治疗的相对复杂性及其对日常生活的影响。

教育目标

描述患有长期呼吸道疾病的儿童在服用口服药物时面临的困难。讨论儿科呼吸医学中可能存在的口服药物相互作用,并考虑多药联用问题。强调可用于减轻服用口服药物儿童护理负担的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f29/8291910/48ec74466905/EDU-0005-2021.01.jpg

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