Department of Pediatrics, University of Western Ontario, London, Ontario, Canada.
Physiology and Pharmacology, University of Western Ontario, London, Ontario, Canada.
Clin Pharmacol Ther. 2017 Jun;101(6):725-735. doi: 10.1002/cpt.677. Epub 2017 Apr 29.
Adverse drug reactions (ADRs) represent a major health problem worldwide, with high morbidity and mortality rates. ADRs are classified into Type A (augmented) and Type B (bizarre) ADRs, with the former group being more common and the latter less common but often severe and clinically more problematic due to their unpredictable nature and occurrence at any dose. Pediatric populations are especially vulnerable to ADRs due to the lack of data for this age group from the drug development process and because of the wide use of off-label and unlicensed use of drugs. Children are more prone to specific types of ADRs because of the level of maturity of body systems involved in absorption, metabolism, transportation, and elimination of drugs. This state-of-the-art review provides an overview of definitions, classifications, epidemiology, and pathophysiology of ADRs and discusses the available evidence for related risk factors and causes of ADRs in the pediatric population.
药物不良反应(ADR)是一个全球性的主要健康问题,具有较高的发病率和死亡率。ADR 分为 A 型(增强型)和 B 型(奇异型)ADR,前者更为常见,后者则不太常见,但由于其不可预测性和任何剂量下的发生,往往更为严重和临床上更具问题。儿科人群由于药物开发过程中缺乏针对该年龄组的数据,以及药物的超说明书和未授权使用广泛,因此特别容易受到 ADR 的影响。儿童由于参与药物吸收、代谢、运输和消除的身体系统的成熟度水平,更容易发生特定类型的 ADR。本综述概述了 ADR 的定义、分类、流行病学和病理生理学,并讨论了儿科人群中与 ADR 相关的风险因素和原因的现有证据。