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О безопасности анальгетиков у детей

magazine-vrach-2012-08-008

О безопасности анальгетиков у детей

Проблемы безопасности ограничивают применение многих анальгетиков и нестероидных противовоспалительных средств в педиатрии. Начиная с 80-х годов прошлого века, после обнаружения причинно-следственной связи между приемом ацетилсалициловой кислоты и развитием синдромом Рейе самым применяемым антипиретиком в педиатрии стал парацетамол. Однако его применение ассоциируется со значительной заболеваемостью и смертностью, обусловленной прежде всего гепатотоксичностью при передозировке. Кроме того, результаты многочисленных фармакоэпидемиологических исследований позволяют предположить, что применение парацетамола ассоциируется с повышенным риском развития бронхиальной астмы у взрослых и детей, в том числе подвергшихся внутриутробному воздействию препарата. В этой связи все большее внимание в качестве альтернативы парацетамолу привлекает ибупрофен. В статье приводятся данные рандомизированных контролируемых и фармакоэпидемиологических исследований, подтверждающих безопасность и хорошую переносимость ибупрофена в педиатрии.
About the safety of analgesics in children
Safety problems limit the use of many analgesics and nonsteroidal anti-inflammatory drugs in pediatrics. Since the 1980s when a cause-and-effect relation was found between acetylsalicylic acid intake and Reye’s syndrome, paracetamol has become the most widely used antipyretic in pediatrics. However, its use is associated with significant morbidity and mortality primarily caused by hepatotoxicity in overdose. Moreover, the results of numerous pharmacoepidemiological studies may suggest that the use of paracetamol is associated with an increased risk of asthma in adults and children, including those exposed to intrauterine paracetamol. In this connection, ibuprofen as an alternative to paracetamol attracts increasingly more attention. The paper gives the data of randomized controlled and pharmacoepidemiological studies that confirm the safety and good tolerability of ibuprofen in pediatric care.

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