Карпова Е.П., Воробьева М.П., Тулупов Д.А. Возможности применения деконгестантов у детей. Педиатрия (Прил. к журн. Consilium Medicum). 2018; 1: 43–45. DOI: 10.26442/2413-8460_2018.1.43-45
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Karpova E.P., Vorobyeva M.P., Tulupov D.A. Possibilities of using decongestants in children. Pediatrics (Suppl. Consilium Medicum). 2018; 1: 43–45. DOI: 10.26442/2413-8460_2018.1.43-45
Возможности применения деконгестантов у детей
Карпова Е.П., Воробьева М.П., Тулупов Д.А. Возможности применения деконгестантов у детей. Педиатрия (Прил. к журн. Consilium Medicum). 2018; 1: 43–45. DOI: 10.26442/2413-8460_2018.1.43-45
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Karpova E.P., Vorobyeva M.P., Tulupov D.A. Possibilities of using decongestants in children. Pediatrics (Suppl. Consilium Medicum). 2018; 1: 43–45. DOI: 10.26442/2413-8460_2018.1.43-45
Назальные деконгестанты являются одними из самых часто назначаемых групп препаратов для купирования симптома назальной обструкции при воспалительной патологии верхних дыхательных путей у детей. В результате бесконтрольного применения назальные деконгестанты могут оказывать токсическое действие на организм ребенка. Цель исследования – оценить роль назальных деконгестантов в структуре детской токсикологической патологии многопрофильного стационара.
Материалы и методы. Проведен ретроспективный анализ данных медицинских карт пациентов токсикологического отделения и годовых отчетов ГБУЗ «ДГКБ №13 им. Н.Ф.Филатова» Департамента здравоохранения г. Москвы с отравлением назальными деконгестантами с 2015 по 2017 г. Полученные данные сравнили с данными за 2011–2012 гг. Результаты. Отравление назальными деконгестантами остается самой частой причиной госпитализации детей в токсикологическое отделение (91–20%). Наиболее часто отравления отмечаются в группе детей от 1 до 3 лет. Наибольший риск развития серьезных нежелательных явлений отмечается у препаратов на основе нафазолина, что составляет, по нашим последним данным, 71,7–77,4% от всех отравлений назальными сосудосуживающими препаратами. Выводы. Необходим строгий контроль за применением назальных сосудосуживающих препаратов в педиатрической практике при полном отказе от средств на основе нафазолина.
Nasal decongestants are one of the most frequently prescribed groups of drugs for relieving the symptom of nasal obstruction in the inflammatory pathology of the upper respiratory tract in children. As a result of uncontrolled use, nasal decongestants can have a toxic effect on the baby's body.
The purpose of the study was to evaluate the role of nasal decongestants in the structure of the children's toxicological pathology of a multidisciplinary hospital. Materials and methods. A retrospective analysis of the data of the medical records of the patients of the toxicological department and the annual reports of the Filatov State Children's Clinical Hospital No. 13 of the Moscow City Health Department with poisoning by nasal decongestants from 2015 to 2017. The obtained data were compared with data for 2011–2012. Results. Poisoning by nasal decongestants remains the most common cause of hospitalization of children in the toxicological department (91–20%). The most frequent poisoning is observed in the group of children from 1 to 3 years. The greatest risk of developing serious adverse events is noted in drugs based on nafazoline, which, according to our latest data, is 71.7–77.4% of all nasal vasoconstrictor poisoning. Conclusions. Strict control over the use of nasal vasoconstrictive drugs in pediatric practice is required with complete abandonment of funds on the basis of naphazoline.
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5. Musshoffa F, Madeaa B, Woelfleb J, Vlanicb D. Xylometazoline poisoning: A 40-fold nasal overdose caused by a compounding error in 3 children. Forensic Sci Int 2014; 238 (5): e3-e5. https://doi.org/10.1016/j.forsciint.2014.02.011
6. Eccles R, Martensson K, Chen SC. Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin 2010; 26 (4): 889–99. https://doi.org/10.1185/03007991003648015
7. Campos R, Santervas FY, Jordana VE, Cubells LC. Intoxicación accidental por descongestionante tópico nasal Accidental intoxication due to a topical nasal decongestant. An Pediatr (Barc) 2006; 64 (1): 107–8. https://doi.org/10.1016/S1695-4033(06)70023-6
8. Заплатников А.Л. Топические деконгестанты в педиатрической практике: безопасность и клиническая эффективность. Педиатрия им. Г.Н.Сперанского. 2006; 6: 69–75. / Zaplatnikov A.L. Topical decongestants in pediatric practice. Pediatriya im. G.N.Speranskogo. 2006; 6: 69–75 [in Russian]
9. Карпова Е.П., Тулупов Д.А. О безопасности применения назальных сосудосуживающих препаратов в педиатрической практике. Рос. ринология. 2014; 1: 12–4. / Karpova E.P., Tulupov D.A. O bezopasnosti primeneniia nazal'nykh sosudosuzhivaiushchikh preparatov v pediatricheskoi praktike. Ros. rinologiia. 2014; 1: 12–4. [in Russian]
10. Hofmann T, Koidl B, Wolf G et al. Influence of preservatives and topical steroids on ciliary beat frequency in vitro. Arch Otolaryngol Head Neck Surg 2004; 130 (4): 440–5. https://doi.org/10.1001/archotol.130.4.440
11. Васина Л.А. Влияние местных деконгестантов, содержащих раствор ксилометазолина, на цилиарную активность реснитчатых клеток. Рос. ринология. 2008; 3: 14–7. / Vasina L.A. Effect of topical decongestants containing a solution of xylometazoline on the ciliary activity of ciliated cells. Ros. rinologiya. 2008; 3: 14–17. [in Russian]
12. Hofmann T, Koidl B, Wolf G. In vitro studies of the effect of vasoconstrictor nose drops on ciliary epithelium of human nasal mucosa. Laryngorhinootologie 1995; 74 (9): 564–7.
13. Boek WM, Graamans K, Natzijl H et al. Nasal mucociliary transport: new evidence for key role of ciliary beat frequency. Laryngoscope 2002; 112 (3): 570–3. https://doi.org/10.1097/00005537-200203000-00029
14. Lockey RF. Rhinitis medicamentosa and the stuffy nose. J Allergy Clin Imm 2006; 118 (5): 1017–8. ISSN: 00916749. PubMed: 17088123. https://doi.org/10.1016/j.jaci.2006.06.018
15. Doshi J. Rhinitis medicamentosa: what an otolaryngologist needs to know. Eur Arch Otorhinolaryngol 2009; 266 (5): 623–5. https://doi.org/10.1007/s00405-008-0896-1
16. Graf P. Rhinitis medicamentosa: A review of causes and treatment. Treatments Resp Med 2005; 4 (1): 21–9. ISSN: 11763450. PubMed: 15725047. https://doi.org/10.2165/00151829-200504010-00003
17. Лопатин А.С. Сосудосуживающие препараты: механизм действия, клиническое применение и побочные эффекты. Рос. ринология. 2007; 1: 43–9. / Lopatin A.S. Vasoconstrictor drugs: mechanism of action, clinical application and side effects. Ros. rinologiya. 2007; 1: 43–9. [in Russian]
18. Wenzel S, Laux G, Sagowski C et al. Naphazoline intoxication: Course and therapy. Laryngo Rhino Otologie 2003; 82 (2): 105–8. ISSN: 09358943. PubMed: 12624838. https://doi.org/10.1055/s-2003-37723
19. Vernacchio L, Kelly JP, Kaufman DW, Mitchell AA. Cough and Cold Medication Use by US Children, 1999–2006: Results From the Slone Survey. Pediatrics 2008; 122 (2): e323–e329. https://doi.org/10.1542/peds.2008-0284
20. Fukushima H, Norimoto K, Seki T et al. Acute pulmonary edema associated with naphazoline ingestion. Clin Toxicology 2008; 46 (3): 254–6. ISSN: 15563650. PubMed: 17852165. https://doi.org/1080/15563650701438441
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1. Åkerlund A, Millqvist E, Öberg D. Prevalence of upper and lower airway symptoms: The Skövde population-based study. Acta Oto-Laryngologica 2006; 126 (5): 483–8. ISSN: 00016489. PubMed: 16698697 https://doi.org/10.1080/00016480500416835
2. Bousquet J, Duchateau J, Pignat JC, Fayol C. Improvement of quality of life by treatment with cetirizine in patients with perennial allergic rhinitis as determined by a French version of the SF-36 questionnaire. J Allergy Clin Immunol 1996; 98 (2): 309–16. ISSN: 00916749. PubMed: 8757208 https://doi.org/10.1016/S0091-6749(96)70155-0
3. Ryazantsev S.V., Karneeva O.V., Garashenko T.I. i dr. Acute sinusitis. Clinical recommendations. М., 2016. http://www.nmaoru.org/files/KR313%20Ostryj%20sinusit.pdf [in Russian]
4. Karneeva O.V., Polyakov D.P., Gurov A.V. i dr. Acute otitis media. Clinical recommendations. M., 2016. http://www.nmaoru.org/files/KR314%20Ostryj%20srednij%20otit.pdf [in Russian]
5. Musshoffa F, Madeaa B, Woelfleb J, Vlanicb D. Xylometazoline poisoning: A 40-fold nasal overdose caused by a compounding error in 3 children. Forensic Sci Int 2014; 238 (5): e3-e5. https://doi.org/10.1016/j.forsciint.2014.02.011
6. Eccles R, Martensson K, Chen SC. Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin 2010; 26 (4): 889–99. https://doi.org/10.1185/03007991003648015
7. Campos R, Santervas FY, Jordana VE, Cubells LC. Intoxicación accidental por descongestionante tópico nasal Accidental intoxication due to a topical nasal decongestant. An Pediatr (Barc) 2006; 64 (1): 107–8. https://doi.org/10.1016/S1695-4033(06)70023-6
8. Zaplatnikov A.L. Topical decongestants in pediatric practice. Pediatriya im. G.N.Speranskogo. 2006; 6: 69–75 [in Russian]
9. Karpova E.P., Tulupov D.A. O bezopasnosti primeneniia nazal'nykh sosudosuzhivaiushchikh preparatov v pediatricheskoi praktike. Ros. rinologiia. 2014; 1: 12–4. [in Russian]
10. Hofmann T, Koidl B, Wolf G et al. Influence of preservatives and topical steroids on ciliary beat frequency in vitro. Arch Otolaryngol Head Neck Surg 2004; 130 (4): 440–5. https://doi.org/10.1001/archotol.130.4.440
11. Vasina L.A. Effect of topical decongestants containing a solution of xylometazoline on the ciliary activity of ciliated cells. Ros. rinologiya. 2008; 3: 14–17. [in Russian]
12. Hofmann T, Koidl B, Wolf G. In vitro studies of the effect of vasoconstrictor nose drops on ciliary epithelium of human nasal mucosa. Laryngorhinootologie 1995; 74 (9): 564–7.
13. Boek WM, Graamans K, Natzijl H et al. Nasal mucociliary transport: new evidence for key role of ciliary beat frequency. Laryngoscope 2002; 112 (3): 570–3. https://doi.org/10.1097/00005537-200203000-00029
14. Lockey RF. Rhinitis medicamentosa and the stuffy nose. J Allergy Clin Imm 2006; 118 (5): 1017–8. ISSN: 00916749. PubMed: 17088123. https://doi.org/10.1016/j.jaci.2006.06.018
15. Doshi J. Rhinitis medicamentosa: what an otolaryngologist needs to know. Eur Arch Otorhinolaryngol 2009; 266 (5): 623–5. https://doi.org/10.1007/s00405-008-0896-1
16. Graf P. Rhinitis medicamentosa: A review of causes and treatment. Treatments Resp Med 2005; 4 (1): 21–9. ISSN: 11763450. PubMed: 15725047. https://doi.org/10.2165/00151829-200504010-00003
17. Lopatin A.S. Vasoconstrictor drugs: mechanism of action, clinical application and side effects. Ros. rinologiya. 2007; 1: 43–9. [in Russian]
18. Wenzel S, Laux G, Sagowski C et al. Naphazoline intoxication: Course and therapy. Laryngo Rhino Otologie 2003; 82 (2): 105–8. ISSN: 09358943. PubMed: 12624838. https://doi.org/10.1055/s-2003-37723
19. Vernacchio L, Kelly JP, Kaufman DW, Mitchell AA. Cough and Cold Medication Use by US Children, 1999–2006: Results From the Slone Survey. Pediatrics 2008; 122 (2): e323–e329. https://doi.org/10.1542/peds.2008-0284
20. Fukushima H, Norimoto K, Seki T et al. Acute pulmonary edema associated with naphazoline ingestion. Clin Toxicology 2008; 46 (3): 254–6. ISSN: 15563650. PubMed: 17852165. https://doi.org/1080/15563650701438441
Авторы
Е.П.Карпова, М.П.Воробьева, Д.А.Тулупов*
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
*tulupov-rmapo@yandex.ru
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E.P.Karpova, M.P.Vorobyeva, D.A.Tulupov*
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaya, d. 2/1
*tulupov-rmapo@yandex.ru