Related Experiment Video

Updated: Nov 2, 2025

MEDUSA for Identifying Death Regulatory Genes in Chemo-genetic Profiling Data
07:17

MEDUSA for Identifying Death Regulatory Genes in Chemo-genetic Profiling Data

Published on: February 7, 2025

700

Risks and mitigation strategies to prevent etoposide infusion-related reactions in children

Emma M Tillman1, Sarah L Suppes2, Nicholas Miles1

  • 1Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Pharmacotherapy
|June 15, 2021
PubMed

Insights

Etoposide infusion reactions in pediatric cancer patients are uncommon but can occur. Strategies like pre-treatment and extended infusions help manage these adverse drug reactions (ADRs).

Area of Science:

  • Pediatric Oncology
  • Clinical Pharmacology
  • Patient Safety

Background:

  • Etoposide is a critical antineoplastic agent for pediatric cancers.
  • Infusion-related reactions are a known complication of etoposide therapy.
  • Understanding the incidence and management of these reactions is crucial for patient care.

Purpose of the Study:

  • To compare etoposide infusion-related reactions over a decade at two pediatric hospitals.
  • To analyze the impact of interventions on reaction rates.
  • To evaluate the safety of rechallenging patients after adverse drug reactions (ADRs).

Main Methods:

  • Retrospective analysis of etoposide infusion-related reactions over 10 years.
  • Comparison of reaction rates between two freestanding pediatric hospitals.
  • Evaluation of outcomes for patients rechallenged after experiencing ADRs.

Main Results:

  • Overall infusion reaction rate was 1% across both institutions.
  • Specific rates at Children's Mercy Hospital increased post-2017 (4.8% in 2018, 3.4% in 2019, 7.9% in 2020) following in-line filter implementation.
  • 41% of 32 patients with reactions were rechallenged and tolerated future doses with modifications.

Conclusions:

  • Multicenter collaboration is vital for investigating adverse drug reactions (ADRs).
  • Variations in clinical practice can reveal important information about ADRs and risk factors.
  • Management strategies, including pre-treatment and extended infusions, enable safe rechallenge of patients.

Keywords:
childdrug hypersensitivitydrug-related side effects and adverse reactions

More Related Videos

In Vivo Immunogenicity Screening of Tumor-Derived Extracellular Vesicles by Flow Cytometry of Splenic T Cells08:02

In Vivo Immunogenicity Screening of Tumor-Derived Extracellular Vesicles by Flow Cytometry of Splenic T Cells

Published on: September 23, 2021

2.8K
Pancreatic Duct Infusion: An Effective and Selective Method of Drug and Viral Delivery06:03

Pancreatic Duct Infusion: An Effective and Selective Method of Drug and Viral Delivery

Published on: September 30, 2021

5.2K

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
55
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
65
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
48
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
69
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
49
Prevention of Further Absorption of Poison01:14

Prevention of Further Absorption of Poison

In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.0K