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Adverse Drug Reactions in Children with Congenital Heart Disease: A Scoping Review
Esmaeel Toni1, Haleh Ayatollahi2, Reza Abbaszadeh3
1Medical Informatics, Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Insights
Adverse drug reactions (ADRs) in children with congenital heart disease (CHD) are common, affecting multiple systems. Cardiovascular disorders and clinical findings were most frequent, necessitating tailored treatments and further research for improved pediatric CHD management.
Area of Science:
- Pediatric Cardiology
- Pharmacovigilance
- Clinical Pharmacology
Background:
- Congenital heart disease (CHD) is a significant cause of mortality in children.
- Drug therapies for pediatric CHD often extrapolate from adult data, potentially leading to different adverse drug reactions (ADRs).
- Understanding pediatric-specific ADRs is crucial for safe and effective CHD management.
Purpose of the Study:
- To investigate and characterize the adverse drug reactions (ADRs) associated with medications used in children diagnosed with congenital heart disease (CHD).
Main Methods:
- A comprehensive scoping review was conducted in 2023.
- Searched multiple databases including PubMed, Web of Science, Scopus, Cochrane Library, Ovid, ProQuest, and Google Scholar.
- Included English-language studies reporting ADRs in pediatric CHD patients up to November 1, 2023, analyzed via content analysis.
Main Results:
- Eighty-seven articles were included, identifying symptoms/signs/clinical findings and cardiovascular disorders as the most frequent ADRs in pediatric CHD.
- Prostaglandin E1, amiodarone, prostaglandin E2, dexmedetomidine, and captopril were associated with the highest reported ADRs.
- ADRs spanned cardiovascular, respiratory, endocrine, metabolic, genitourinary, gastrointestinal, and musculoskeletal systems.
Conclusions:
- A broad spectrum of ADRs affects children with CHD, particularly with antiarrhythmics, diuretics, beta-blockers, anticoagulants, and vasodilators.
- Individualized treatment strategies are essential, especially for vulnerable pediatric populations.
- Further research into pharmacogenetics, optimal dosing, and alternative therapies is vital for enhancing patient outcomes in CHD.
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.
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