Risk of se­ri­ous re­ac­tions for kids tak­ing mul­ti­ple drugs

The Borneo Post - Nature and health - - Front Page - By Linda Car­roll

NEARLY one in five Amer­i­can chil­dren use at least one pre­scrip­tion med­i­ca­tion, and roughly one in 13 kids takes more than one pre­scrip­tion drug, ac­cord­ing to a new study. And among the chil­dren tak­ing more than one med­i­ca­tion, one in 12 is at risk of a harm­ful drug in­ter­ac­tion, re­searchers re­port in Pe­di­atrics.

Ado­les­cent girls are most at risk of ad­verse re­ac­tions, in­clud­ing a po­ten­tially deadly heart con­di­tion, the re­searchers found. In fact, one in five of those tak­ing mul­ti­ple med­i­ca­tions were found to be at risk of a ma­jor drug-drug in­ter­ac­tion.

“Cur­rently, ad­verse drug events are the lead­ing cause of in­juries and death among chil­dren and ado­les­cents,” said the study’s lead au­thor, Dima Qato, of the Col­lege of Phar­macy at the Univer­sity of Illi­nois at Chicago.

“Par­ents need to ask their phar­ma­cist or pae­di­a­tri­cian about po­ten­tial side ef­fects and in­ter­ac­tions as­so­ci­ated with the med­i­ca­tions their chil­dren are tak­ing,” Qato said. “Pre­scribers also need to be aware and to be proac­tive and to ask their pa­tients and their pa­tients’ par­ents about the med­i­ca­tions be­ing taken.”

Qato and her col­leagues an­a­lysed the med­i­ca­tion use of 23,179 chil­dren and ado­les­cents who were par­tic­i­pants in the larger on­go­ing Na­tional Health and Nu­tri­tion Ex­am­i­na­tion Sur­vey (NHANES). For chil­dren un­der the age of 16, par­ents pro­vided in­for­ma­tion on med­i­ca­tion use. Those who were 16 or older an­swered for them­selves.

Over­all, 19.8 per cent of chil­dren and ado­les­cents had taken at least one pre­scrip­tion med­i­ca­tion in the pre­vi­ous 30 days, with 13.9 per cent us­ing med­i­ca­tions longterm and 7.1 per cent us­ing them for a short pe­riod of time.

Med­i­ca­tion use in­creased with age, from 14.7 per cent in chil­dren up to age 5 years to 22.8 per cent among ado­les­cents aged 13 to 19 years old. Short term use was most com­mon among the younger chil­dren, who were less likely to be tak­ing med­i­ca­tions long term.

The most com­mon med­i­ca­tions were res­pi­ra­tory agents, usu­ally for asthma, and psy­chother­a­peu­tic agents, in­clud­ing stim­u­lants and an­tide­pres­sants.

The vast ma­jor­ity of po­ten­tial drug-drug in­ter­ac­tions in­volved an­tide­pres­sants. The most com­mon po­ten­tial in­ter­ac­tion was QT pro­lon­ga­tion, an ab­nor­mal heart rhythm that can cause sud­den death in oth­er­wise healthy kids.

“QT could oc­cur within days,” Qato said. “It can last more than a month af­ter tak­ing the drug. So even though a child may have used the drug for a week or a few weeks, the ad­verse ef­fect can be a se­ri­ous one.” The study didn’t look at whether any of the chil­dren ac­tu­ally de­vel­oped any of the po­ten­tial side ef­fects from their med­i­ca­tions. It only looked at how many kids were at risk.

Still, the find­ings were a sur­prise to Dr Nathan Sam­ras, an as­sis­tant pro­fes­sor in the divi­sion of pae­di­atrics and in­ter­nal medicine at the Univer­sity of Cal­i­for­nia, Los An­ge­les. “It was eye open­ing,” said Sam­ras, who was un­af­fil­i­ated with the new study. “I was sur­prised by the preva­lence of pre­scrip­tions for all kids as well as the po­ten­tial for drug-drug in­ter­ac­tions.”

Sam­ras said he hopes the new re­search will prompt par­ents to re­port all med­i­ca­tions taken by their chil­dren - in­clud­ing those sold over-the-counter - to the chil­dren’s doc­tors.

While prais­ing the study for rais­ing aware­ness of pos­si­ble dan­ger­ous drug in­ter­ac­tions, Sam­ras said he hoped it would not lead to par­ents and physi­cians “over­re­act­ing.” “You don’t want peo­ple to be too scared to use med­i­ca­tions when they have more po­ten­tial ben­e­fits than risks,” he ex­plained. – Reuters

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