Application and Safety of Digoxin in 323 Children

Chen Wenwen; Jiang Yongxian; Tao Wanjun; Li Li; Qin Min; Li Gen

doi:10.13407/j.cnki.jpp.1672.108X.2020.12.013

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Application and Safety of Digoxin in 323 Children

更新时间：2022-11-03

- Application and Safety of Digoxin in 323 Children
- Vol. 26, Issue 12, Pages: 43-46(2020)
- 作者机构：
  
  1. 电子科技大学医学院附属医院，成都市妇女儿童中心医院,四川,成都,610091
  2. 成都中医药大学药学院,四川,成都,611137
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672.108X.2020.12.013
  CLC：
- Published：2020，
  
  Published Online：10 December 2020，
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Chen Wenwen, Jiang Yongxian, Tao Wanjun, et al. Application and Safety of Digoxin in 323 Children. [J]. 26(12):43-46(2020)
DOI：

Chen Wenwen, Jiang Yongxian, Tao Wanjun, et al. Application and Safety of Digoxin in 323 Children. [J]. 26(12):43-46(2020) DOI： 10.13407/j.cnki.jpp.1672.108X.2020.12.013.

摘要

目的：探讨儿童地高辛用药情况及安全性，为临床合理用药提供参考。方法：回顾性调查我院2017年1月至2019年5月使用地高辛的347例患儿，对其年龄、性别、科室分布、用药剂型及维持剂量、原发疾病、联合用药情况等进行统计分析。结果：最终纳入323例患儿，其中年龄<2岁占91.33%，男性多于女性。主要科室为新生儿重症监护病房（NICU，30.03%）、小儿心脏内科病房（22.91%）、外科重症监护病房（SICU，20.43%）及儿科重症监护病房（PICU，19.50%）。口服溶液（65.63%）多于片剂（34.37%）。地高辛维持剂量低于推荐用药剂量下限共246例（76.16%），在说明书推荐范围内63例（19.50%），超过推荐用药上限14例（4.33%）。原发疾病情况符合说明书适应症，联合用药种类按使用频率依次为利尿剂、抗菌药物、血管紧张素转化酶抑制剂（ACEI）、β受体阻滞剂、钙通道阻滞药，包含6种使地高辛血药浓度增加的药物。323例患儿临床结局治愈率67.80%，死亡率1.24%，不同剂量组治愈率和病死率比较差异无统计学意义。地高辛片剂与口服溶液说明书患儿年龄分段情况和用药剂量不完全一致，维持剂量最大相差10倍，不利于临床使用的计算。不良反应发生率0.62%。结论：为保障儿童安全用药，建议开展地高辛已上市剂型儿童群体药动学研究，统一不同剂型说明书中儿童用法用量，促进临床合理用药。监测血清地高辛浓度，并由药师全面分析并跟踪用药情况，提供个体化用药指导。

Abstract

Objective: To investigate the application and safety of digoxin in children

so as to provide reference for rational application in clinic. Methods: Retrospective analysis was performed on 347 children with digoxin in our hospital from Jan. 2017 to May 2019. Age

gender

department distribution

dosage form and maintenance dose

primary diseases and drug combination were statistically analyzed. Results: Totally 323 children were enrolled

of which 91.33% were younger than 2 years old

and there were more males than females. The main departments were neonatal intensive care unit (NICU

30.03%)

pediatric cardiology unit (22.91%)

surgical intensive care unit (SICU

20.43%) and pediatric intensive care unit (PICU

19.50%). The proportion of cases taking oral solution (65.63%) was higher than that of tablets (34.37%). A total of 246 cases (76.16%) of digoxin maintenance dose was lower than the lower limit of recommended dosage

63 cases (19.50%) were within the recommended range of instructions

and 14 cases (4.33%) were above the upper limit of the recommended dosage. The primary diseases of these cases were in line with the instructions. According to the frequency of use

combination drug were respectively diuretics

antibiotics

angiotensin-converting enzyme inhibitors (ACEI)

β-receptor blockers and calcium channel blockers in order of frequency of use

including 6 types that could increase the blood concentration of digoxin. The clinical outcome of 323 children had a cure rate of 67.80% and a mortality rate of 1.24%

there was no statistically significant difference in the cure rate and mortality in different dose groups. Digoxin tablets were not completely consistent with the oral solution instructions in terms of age and dosage

and the maximum difference of maintenance dose was 10 times

which was not conducive to the calculation of clinical use. The incidence of adverse drug reactions was 0.62%. Conclusion: In order to ensure the safe application of drugs for children

it is suggested to carry out pharmacokinetic study on children with the marketed dosage form of digoxin

unify the usage and dosage of children in different dosage form instructions

and promote rational clinical application of drugs. The concentration of digoxin should be monitored

and the pharmacists should comprehensively analyze and track the application of digoxin and provide individualized medication guidance.

关键词

地高辛儿童安全性早产儿

Keywords

goxinchildrensafetypreterm neonates

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Related Author

Chen Wenwen

Jiang Yongxian

Tao Wanjun

Yang Jia

Li Gen

Ren Danyang

Yang Yanming

Tu Caixia

Related Institution

The Affiliated Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu Women’s and Children’s Central Hospital

Kunming Children’s Hospital / Children’s Hospital of Kunming Medical University, Kunming

Kunming MedicalUniversity, Kunming

Wuxi Children’s Hospital

Shanghai Children’s Hospital, Children’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai

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