与局部施用皮质类固醇相关的系统性不良事件
Femke De Vleeschhauwer1, Kristina Casteels1,2, Ilse Hoffman1,2
1Department of Pediatrics, University Hospitals Leuven, 3000 Leuven, Belgium.
Children (Basel, Switzerland)
|August 29, 2024
概括
局部用皮质类固醇虽然对儿科疾病有益,但可以在儿童中引起系统性不良事件. 医疗保健提供者应该意识到这些风险,并密切监测患者,即使是局部治疗.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 皮肤病学 皮肤病学
- 过敏和免疫学 过敏和免疫学
背景情况:
- 局部皮质类固醇广泛用于儿科疾病.
- 尽管其概括是安全的,但系统性不良事件是可能的.
- 局部使用的皮质类固醇可以导致意外的全身吸收.
研究的目的:
- 提高儿童对局部皮质类固醇潜在系统性不良事件的认识.
- 要突出与吸入,鼻入和其他局部皮质类固醇配方相关的风险.
- 强调儿童患者需要警监测的必要性.
主要方法:
- 四名儿科患者的病例系列经历了系统性不良事件.
- 关于局部皮质类固醇的全身影响的综合文献综述.
- 对有关小儿皮质类固醇使用的现有证据的分析.
主要成果:
- 在使用各种局部皮质类固醇形式的儿童中记录有系统性不良事件的病例.
- 文献审查证实了系统吸收和不良影响的可能性.
- 确定需要加强临床警.
结论:
- 系统性不良事件可能发生在小儿患者局部使用的皮质类固醇.
- 仔细监测和个性化治疗至关重要.
- 需要进一步的研究才能充分理解和减轻这些风险.
相关概念视频
Local Anesthetics: Adverse Effects
399
While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
399
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
228
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
228
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
98
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
98
Local Anesthetics: Pharmacokinetics
747
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
747
Adrenal Gland Disorders
1.4K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.4K
Drug Delivery: Miscellaneous Routes
329
Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection, and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
329


