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先天性心脏病儿童的药物不良反应:系统评价。

Adverse Drug Reactions in Children with Congenital Heart Disease: A Scoping Review.

机构信息

Medical Informatics, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.

Medical Informatics, Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Paediatr Drugs. 2024 Sep;26(5):519-553. doi: 10.1007/s40272-024-00644-8. Epub 2024 Jul 23.

Abstract

BACKGROUND

Congenital heart disease (CHD) is one of the leading causes of death. Safe and timely medical interventions, especially in children, can prolong their survival. The drugs prescribed for children with CHD are mainly based on the outcomes of drug therapy in adults with cardiovascular diseases, and their adverse drug reactions (ADRs) might be different. Therefore, the aim of this study was to investigate ADRs in children with CHD.

METHODS

This was a scoping review conducted in 2023. PubMed, Web of Science, Scopus, the Cochrane Library, Ovid, ProQuest, and Google Scholar databases were searched. All studies that reported ADRs for children with CHD and were published in English by 1 November 2023 were included in this study. Finally, the results were reported using a content analysis method.

RESULTS

A total of 87 articles were included in the study. The results showed that symptoms/signs/clinical findings, and cardiovascular disorders were the most common ADRs reported in children with CHD. The results also showed that most of the ADRs were reported for prostaglandin E1, amiodarone, prostaglandin E2, dexmedetomidine, and captopril, respectively.

CONCLUSION

The review underscores the wide array of ADRs in children with CHD, particularly in antiarrhythmics, diuretics, beta-blockers, anticoagulants, and vasodilators, which affected cardiovascular, respiratory, endocrine, metabolic, genitourinary, gastrointestinal, and musculoskeletal systems. Tailored treatment is imperative, considering individual patient characteristics, especially in the vulnerable groups. Further research is essential for optimizing dosing, pharmacogenetics, and alternative therapies to enhance patient outcomes in CHD management.

摘要

背景

先天性心脏病 (CHD) 是导致死亡的主要原因之一。安全且及时的医疗干预,特别是在儿童中,可以延长他们的生存时间。为 CHD 儿童开的药物主要基于心血管疾病成人的药物治疗结果,其不良反应 (ADR) 可能不同。因此,本研究旨在调查 CHD 儿童的 ADR。

方法

这是 2023 年进行的范围综述。检索了 PubMed、Web of Science、Scopus、Cochrane 图书馆、Ovid、ProQuest 和 Google Scholar 数据库。本研究纳入了所有报告 CHD 儿童 ADR 并于 2023 年 11 月 1 日之前以英文发表的研究。最后,使用内容分析法报告结果。

结果

共纳入 87 篇文章。结果表明,症状/体征/临床发现和心血管疾病是报告的 CHD 儿童最常见的 ADR。结果还表明,大多数 ADR 分别报告了前列腺素 E1、胺碘酮、前列腺素 E2、右美托咪定和卡托普利。

结论

该综述强调了 CHD 儿童 ADR 的广泛性,特别是在抗心律失常药、利尿剂、β受体阻滞剂、抗凝剂和血管扩张剂中,这些 ADR 影响了心血管、呼吸、内分泌、代谢、泌尿生殖、胃肠道和肌肉骨骼系统。考虑到个体患者的特点,特别是在脆弱群体中,需要进行个体化治疗。进一步的研究对于优化剂量、药物遗传学和替代疗法至关重要,以改善 CHD 管理中的患者结局。

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