PROBLEMATIC POLYPHARMACY IN OUTPATIENT THERAPY OF CHILDREN: POTENTIAL RISKS OF DRUG INTERACTIONS

Abstract

Relevance. The development of medical and pharmaceutical technologies has allowed ensuring the quality of life of children even with severe chronic diseases, but often the treatment of such children is associated with polypharmacy. Objective is to assess the risks of drug interactions in children with polypharmacy. Materials and methods. The course of pharmacotherapy of 54 children with atopic diseases, diseases of the gastrointestinal tract, parasitic infestation, inflammatory diseases of the genital organs, etc. aged from birth to 17 years, who received simultaneously from 5 to 11 drugs (average 6.4 ± 1.5 drugs) Results. Problematic polypharmacy was founded in 31 children (75.0% of schoolchildren and 38.5% of preschool children) with polypharmacy. Among them, 22 patients (71.0%) had pharmacokinetic risks, and 17 children (54.8%) had pharmacodynamic interactions. Among the causes of pharmacokinetic interaction – the use of inhibitors (omeprazole, etc.) and inducers (phenobarbital, St. John's wort, etc.) metabolism, pharmacodynamic interaction – the simultaneous use of several glucocorticoids, drugs with similar organ toxicity, and more. Conclusions. Outpatient use of 5 or more drugs is combined in more than half of children at risk of their interaction, development of side effects or reduced effectiveness of treatment.