Rational Analgesic Drug Use in Children

Yıl 2024, Cilt: 33 Sayı: 2, 91 - 97, 30.06.2024

Olcay Kıroğlu , Mahmut Köylü , Nursel Surmelioglu

https://doi.org/10.17827/aktd.1460525

Öz

The use of medication in children differs from that in adults. The significant role of the physiological differences between children and adults, especially in the early stages of childhood, contributes to these distinctions. Variations in body surface area and weight according to age, changes in organ functions, and issues related to drug administration and dosing are among the primary differences. Frequent pain and fever symptoms in children lead to excessive use of analgesic drugs. Failure to use analgesic drugs in accordance with the individual characteristics of patients, in sufficient time to meet their clinical needs, in the most accurate dose and at the most affordable cost leads to irrational use of analgesics. The irrational use of analgesics can result in their ineffectiveness or significant side effects. When using analgesics in children, rational drug use approaches should adhere to the drugs pharmacodynamic-pharmacokinetic differences specific to children and the requirements of their developmental stages.

Anahtar Kelimeler

Child, pain, analgesics, rational drug use.

Çocuklarda Akılcı Analjezik İlaç Kullanımı

Öz

Çocuklarda ilaç kullanımı erişkinlere göre farklılık göstermektedir. Çocukların erken evrelerde fizyolojik özelliklerinin erişkinlerden farklı olmasının bu değişkenlikte önemli rolü bulunmaktadır. Yaşa göre değişen vücut yüzey alanı ve ağırlık, organ fonksiyonlarındaki değişimler, ilaç uygulama ve uyunç problemleri bu farklıların başında gelmektedir. Çocuklarda ağrı ve ateş bulgularının sık görülmesi, analjezik ilaçların çok kullanılmasına neden olmaktadır. Analjezik ilaçların hastaların bireysel özelliklerine uygun, klinik gereksinimlerini karşılamak amacıyla yeterli sürede, en doğru dozda ve en uygun maliyetle kullanılmaması akılcı olmayan analjezik kullanımına yol açmaktadır. Analjeziklerin akılcı kullanılmaması ilaçların tedavideki etkilerinin azalmasına veya önemli yan etkilere neden olmaktadır. Çocuklarda analjezik kullanırken çocuklara özgü ilaçların farmakodinamik-farmakokinetik farklılıklarına, çocukların gelişim dönemlerinin gerekliliklerine uygun akılcı ilaç kullanım yaklaşımlarının yapılması gerekmektedir

Anahtar Kelimeler

Çocuk, ağrı, analjezik, akılcı ilaç kullanımı.

Kaynakça

• 1. Aslan R. Ağrı duygusu ve tarihçesi. Ayrıntı Dergisi.2020;7(84).
• 2. Aydın ON. Ağrı ve ağrı mekanizmalarına güncel bakış. ADÜ Tıp Fakültesi Dergisi. 2002; 3(2) : 37-48.
• 3. Perquin CW, Hazebroek-Kampschreu AAJM, Hunfeld JAM, Bohnen AM, van Suijlekom-Smit LWA, Passchier J et al. Pain in children and adolescents: a common experience. Pain 2000; 87: 51-58.
• 4. Oster J, Nielsen A. Growing pains: a clinical investigation of a school population. Acta Pediatr Scan 1972; 61: 329-34.
• 5. Zuckerman B, Stevenson J, Bailey V. Stomaches and headaches in a community sample of preschool children. Pediatrics 1987; 79: 677-82.
• 6. Kristjansdottir G. Prevalence of self-reported back pain in school children: a study of sociodemographic differences. Eur J Pediatr 1996; 155: 984-86.
• 7. Goldschneider KR, Mancuso TJ, Berde CB. Pain and Its Management in Children. In: Loeser JD, Butler SH, Chapman CR, Turk DC. Bonica’s Management of Pain. USA: Lea & Fabiger. 2001; 797-812.
• 8. Desparmet-Sheridan JF. Pain in Children, Practical Management of pain, Bernad M. Abrams, Honorlo T.Benzon, Marc B. Hahn, James E. Heavner, David Niv, Winston C.V. Parris, Richard Rauck, Michael stanton-Hicks. 2000; 295-315.
• 9. World Health Organization (WHO). Promoting Rational Use of Medicines: Core Components. WHO Policy Perspectives on Medicines no: 5. Geneva, WHO/EDM/2002.3.
• 10. Maxwell S. Rational prescribing: the principles of drug selection. Clinical Medicine 2009; 9:481-85.
• 11. Bedre CB, Sethna NF. Analgesics for the treatment of pain in children. N Engl J Med. 2002; 347: 1094- 1103.
• 12. Krauss B, Gren SM. Sedation and analgesia for procedures in children. N Engl J Med. 2000; 342: 938-45.
• 13. Golianu B, Krane EJ, Galloway KS, Yaster M. Pediatric acute pain management. Pediatr Clin North Am 2000; 47: 559-87.
• 14. Cancer pain relief and palliative care in children. Published by World Health Organization, 1998.
• 15. Yaster M, Hardart RA. Pediatric pain management. In PP Raj (Ed) Text book of Regional Anesthesia Churchill Livingstone. 2002; 1009-32.
• 16. Desparmet- Sheridan JF. Pain in Children, In: PP Raj (ed) Practical Management of Pain. 2000; 295-315.
• 17. Mazur A, Radziewicz Winnicki I, Szczepański T. Pain management in children. Ann Agric Environ Med. 2013; 1(1), 28-34.
• 18. Holdcroft A, Power I. Management of pain. Bmj.2023; 326(7390), 635-39.
• 19. Verghese ST, Hannallah RS. Acute pain management in children. Journal of pain research. 2010; 3, 105.
• 20. Twycross A. Managing pain in children: where to from here? Journal of clinical nursing. 2010; 19(15,16), 2090-99.
• 21. Malviya S, Voepel‐Lewis T, Tait AR, Merkel S, Lauer A, Munro H et al. Pain management in children with and without cognitive impairment following spine fusion surgery. Pediatric Anesthesia. 2001; 11(4), 453-58.
• 22. Brennan F, Carr DB, Cousins M. Pain management: a fundamental human right. Anesthesia & Analgesia. 2007; 105(1), 205-21.
• 23. Hasçelik Z. Nonsteroid antiinflamatuvar ilaçlar. Sürekli Tıp Eğitimi Dergisi. 2001; 10(1).
• 24. Karaman H. Opioid kullanımına bağlı yan etkiler ve tedavileri. Ağrı, 2017; 1, 1-11.
• 25. Aktay G, Hancı İ, Balseven A. İlaç etkileşimleri ve hekim sorumluluğu. Sürekli tıp eğitimi dergisi, 2003; 12(7), 261-4.
• 26. Tannenbaum C, Sheehan NL. Understanding and preventing drug–drug and drug–gene interactions. Expert Rev. Clin. Pharmacol, 2014; 7(4), 533-44 .
• 27. Done AK. Aspirin overdosage: incidence, diagnosis and management. Pediatrics. 1978; 62(5), 890-97.
• 28. Vearrier D, Grundmann O. Clinical Pharmacology, Toxicity and Abuse Potential of Opioids. The Journal of Clinical Pharmacology. 2021; 61(2) 70-88.
• 29. Le Grand A, Hogerzeil HV, Haaijer-Ruskamp FM. Intervention research in rational use of drugs: a review. Health Policy and Planning. 1999; 14(2), 89-102,
• 30. Utli H, Turan M. 0-12 yaş arası çocuğa sahip ebevenlerin akılcı ilaç kullanımına yönelik tutumlarının incelenmesi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi. 2020; 36(2), 87-95.
• 31. Rahwan GL, Rahwan RG. Aspirin and Reye's syndrome: the change in prescribing habits of health professionals. Drug Intell Clin Pharm. 1986; 20(2):143-45.
• 32. Goulding, R. Acetaminophen poisoning. Pediatrics, 1973; 52(6), 883-84.
• 33. Beringer RM, Thompson JP, Parry S, Stoddart PA. Intravenous paracetamol overdose: two case reports and a change to national treatment guidelines. Archives of disease in childhood. 2011; 96(3), 307-308.
• 34. Done AK. Aspirin overdosage: incidence, diagnosis, and management. Pediatrics. 1978; 62(5s), 890-97.
• 35. Obu HA, Chinawa JM, Ubesie AC, Eke CB, Ndu IK. Paracetamol use (and/or misuse) in children in Enugu, South-East, Nigeria. BMC pediatrics. 2012; 12(1), 1-5.
• 36. Reisner A, Hayes LL, Holland CM, Wrubel DM, Kebriaei MA, Geller RJ et al. Opioid overdose in a child: case report and discussion with emphasis on neurosurgical implications. Journal of Neurosurgery: Pediatrics.2015; 16(6), 752-57.
• 37. Anand KJS, Willson DF, Berger J, Harrison R, Meert KL, Zimmerman J et al. Tolerance and with drawal from prolonged opioid use in critically ill children. NIH Public Access, Pediatrics. 2010; 125(5): 1208-25.