新生儿和儿科患者涎泻的药物治疗。

Q2 Medicine
Caitlyn V Bradford, Avery M Parman, Peter N Johnson, Jamie L Miller
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引用次数: 0

摘要

唾液分泌过多是指唾液流出过多或分泌物过多,常见于脑瘫和其他神经系统疾病患者,与临床并发症有关,如局部皮肤反应、感染、吸入、肺炎和脱水的风险增加。在非药物治疗措施无效的情况下,临床医生有几种非侵入性药物可用于控制流涎。本文献综述详细介绍了非注射性药物的使用方法、疗效、安全性和实际注意事项。文献检索包括 1997 年至 2022 年期间在 PubMed 和 Google Scholar 上发表的英语人类研究。此外,还筛选了文章中的相关引文。共纳入了代表 719 名儿科患者的 15 项研究。甘草酸苷、阿托品、东莨菪碱和三苯氧胺均可用于治疗儿童咽峡炎;然而,甘草酸苷仍是研究最多的药物,在纳入系统综述的 719 例患者中,有 374 例(n = 52.0%)接受了该药物治疗。总体而言,在两项对比研究中,甘草酸苷的疗效相似,但耐受性高于同类药物,通常被视为一线药物。在开始一种新疗法或在治疗失败后转用另一种药物时,必须权衡患者的具体情况(年龄、给药途径)和药物的具体情况(剂量配方、药物强度)。由于所有药物的不良反应发生率都很高,临床医生应考虑从剂量范围的低端开始用药,因为之前的研究已经指出了剂量依赖关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmacologic Management of Sialorrhea in Neonatal and Pediatric Patients.

Sialorrhea, defined as an excess flow of saliva or excessive secretions, is common in patients with cerebral palsy and other neurologic disorders and is associated with clinical complications such as increased risk of local skin reactions, infections, aspiration, pneumonia, and dehydration. Upon failure of non-pharmacologic measures, clinicians have several noninvasive pharmacologic options available to manage sialorrhea. This review of the literature provides detailed descriptions of medications used, efficacy, safety, and practical considerations for use of non-injectable pharmacologic agents. The literature search included published -human studies in the English language in PubMed and Google Scholar from 1997 to 2022. Relevant citations within articles were also screened. A total of 15 studies representing 719 pediatric patients were included. Glycopyrrolate, atropine, scopolamine, and trihexyphenidyl all have a potential role for sialorrhea management in children; however, glycopyrrolate remains the most studied option with 374 (n = 52.0%) of the 719 patients included in the systematic review receiving this medication. Overall, glycopyrrolate showed similar efficacy but higher tolerability than its comparators in 2 comparative studies and is often considered the first-line agent. Patient-specific (age, route of administration) and medication-specific (dosage formulation, medication strength) considerations must be weighed when initiating a new therapy or switching to another medication upon treatment failure. Owing to the high propensity of adverse events with all agents, clinicians should consider initiating doses at the lower end of the dosage range, as previous studies have noted a dose-dependent relationship.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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