Hospital pediatrics. Drug-induced disease in children (lecture notes)

Free technical library

Lecture notes, cheat sheets
Free library / Directory / Lecture notes, cheat sheets

Hospital pediatrics. Drug-induced disease in children (lecture notes)

Lecture notes, cheat sheets

Directory / Lecture notes, cheat sheets

Comments on the article

Table of contents (expand)

LECTURE No. 14. Drug-induced disease in children

Complications are divided into:

1) medicinal, which are divided into true side effects of drugs;

2) toxic effects of drugs;

3) complications associated with the sudden withdrawal of the drug;

4) individual intolerance to the drug.

Side effect of drugs: an undesirable effect of a drug due to its structure and properties that it has on the body along with its main actions. The toxic effects of drugs can be caused by: overdose, rapid saturation of the body, rapid administration of average and even minimal doses, insufficient excretory function of the body, disruption of the processes of drug neutralization in the body (in case of primary liver failure).

Complications due to rapid withdrawal of medications: withdrawal syndrome, abstinence, exacerbation of the symptoms for which treatment was carried out. Individual drug intolerance is divided into unusual and perverse reactions. An unusual reaction of the body to normal doses of drugs that are harmless to most people. Individual intolerance is a disease of altered reactivity, a disease of the body. Individual intolerance includes idiosyncrasy and an allergic reaction. Idiosyncrasy is a genetically determined, peculiar reaction to a certain medicine when first taken. The cause of idiosyncrasy is an insufficient amount or low activity of enzymes (for example, a lack of the enzyme glucose phosphate DG in response to taking certain drugs quinidine, SA drugs, aspirin, pyrazalones, antibiotics leads to the development of hemolytic anemia).

Factors in the development of drug disease are as follows.

1. Uncontrolled use of medications by both doctors and patients themselves; the presence of an underlying disease changes the body’s reactivity, and altered reactivity manifests itself in unexpected effects when using medications.

2. Polypharmacy, creating conditions for polyvalent sensitization; Poor nutrition when using medications can alter the body's reactivity and drug tolerance.

3. Age-related decrease in the participation of enzyme systems in the breakdown and neutralization of certain substances (higher sensitivity of children to barbiturates and salicylates, in the elderly - to SG).

4. Genetic conditionality of a number of drug-induced lesions.

5. The degree and rate of sensitization of the body partly depends on the route of drug administration (local applications and inhalations lead to increased sensitivity of the body; with intravenous administration of drugs, sensitization of the body is less than with intramuscular and intravenous injections).

Allergic reactions are the most common cause of intolerance to certain medications.

Allergy is understood as an altered reactivity of the body to the action of a given substance due to the hereditary high sensitivity of the body.

Drug-induced illness is one of the most significant clinical forms of the body’s allergic reaction to medications.

Necessary steps for the development of drug allergies:

1) transformation of the drug into a form that is capable of interacting with proteins;

2) transformation of the drug into a form that can react with body proteins to form a complete antigen;

3) the body’s immune reaction to this formed complex, which has become foreign, in the form of the synthesis of antibodies through the formation of immunoglobulins.

Stages of allergic manifestations: preimmunological - this is the formation of complete (complete) allergens (antigens). Immunological, when an “antigen-antibody” reaction occurs in the tissues of shock organs. The antigen-antibody reaction is a specific reaction that is caused only by the introduction of a specific allergen.

Pathochemical reaction - as a result of the formation of the antigen-antibody complex, biologically active substances (histamine, heparin, serotonin, etc.) are released; the reaction is nonspecific. The pathophysiological reaction is manifested by the action of biologically active substances on various organs and tissues. Classification of allergic reactions.

1. An immediate type reaction is associated with the presence of circulating antibodies in the blood. This reaction occurs 30-60 minutes after administration of the drug and is then characterized by acute manifestations: local leukocytosis, eosinophilia in a blood test.

2. A delayed-type reaction is caused by the presence of antibodies in tissues and organs, is accompanied by local lymphocytosis, and occurs 1-2 days after taking the drug.

Classification of allergic reactions according to pathogenetic type.

1. True (allergic) reactions are divided into chimergic (B-dependent) and kythergic (T-dependent):

1) chimergic allergic reactions are caused by the reaction of an antigen with antibodies, the formation of which is associated with B lymphocytes;

2) kythergic allergic reactions with the combination of the allergen by sensitized lymphocytes.

2. False (pseudoallergic, non-immunological) reactions - do not have an immunological stage in their development.

Classification of medicinal disease.

1. Acute forms: anaphylactic shock, bronchial asthma, Quincke's edema, vasomotor rhinitis, acute hemolytic anemia.

2. Prolonged forms: serum sickness, Lyell's syndrome, drug-induced vasculitis, etc.

3. Mild (itching, Quincke's edema, urticaria), in which symptoms disappear 3 days after using antihistamines; moderate severity (urticaria, eczematous dermatitis, erythema multiforme, fever up to 39 °C, poly- or monoarthritis, toxic-allergic myocarditis). Symptoms disappear after 4-5 days, but require the administration of GC in average doses of 20-40 mg.

4. Severe form (anaphylactic shock, exfoliative dermatitis, Lyell's syndrome), damage to internal organs (myocarditis with rhythm disorders, nephrotic syndrome). All symptoms disappear after 7-10 days of combined administration of GCs, immunomodulators and antihistamines.

Diagnosis of a drug-induced disease: a carefully collected allergological anamnesis. It should be borne in mind that many patients do not take the drugs that they use daily (sedatives, laxatives, analgesics, eye drops, nasal drops) as medications.

The essence of elimination tests is the abolition of absolutely all medications.

Skin allergy tests (IV, scarification, application) give a sharply positive reaction with certain drug allergens.

Provocative tests (nasal, inhalation, conjunctival). Basophil test. The hemaglucination reaction involves agglutination of allergen-laden red blood cells by the patient's serum. RBTL (blast transformation reaction of lymphocytes) is used to diagnose a delayed type allergic reaction. The patient's lymphocytes are mixed with a possible allergen. After many days of incubation, the degree of transformation of lymphocytes is assessed by morphological criteria or by DNA or RNA synthesis using an isotopic label by Lyell et al.

Treatment of medicinal disease: bed rest; a non-irritating diet with sufficient fluid intake; stopping all medications; desensitizing therapy (calcium chloride, antihistamines, calcium, glucocorticoids); specific hyposensitization is ineffective; not performed for pancytopenia; symptomatic therapy.

Treatment of anaphylactic shock.

1. S / c to enter 0,5-1 ml of 0,1% solution of adrenaline.

2. Prevention of aspiration of vomit.

3. Inject 10,0 ml of a 10% solution of Ca chloride intravenously or 10,0 ml of a 10% solution of Ca gluconate intravenously.

4. IV stream, then drip 300-500 ml of 5% glucose solution or saline + 0,5-1 ml of 0,1% adrenaline solution or 1,0 ml of 1% mesatone solution with HA.

5. For bronchospasm - 10 ml of 2,4% aminophylline solution, novocaine blockade.

6. With laryngeal edema - tracheostomy, humidified oxygen

7. Antihistamines (suprastin 2% - 2,0, tave-gil 0,1% - 1,0, diphenhydramine 1% - 1,0).

8. Cardiac glycosides.

9. For anaphylactic shock of penicillin etiology - up to 1 million units of penicillinase, again after 6-8 hours.

10. Resuscitation (artificial ventilation, closed cardiac massage when respiratory and cardiac activity ceases).

Author: Pavlova N.V.

<< Back: Differential diagnosis of liver diseases in children. Clinic, diagnosis, treatment

>> Forward: Helminthiasis in children. Clinic, diagnosis, treatment, prevention (Ascariasis. Alveococcosis. Hookworm disease (hookworm and necatoriasis). Diphyllobothriasis. Opisthorchiasis. Teniosis. Trichocephalosis. Fascioliasis. Echinococcosis. Enterobiasis)

We recommend interesting articles Section Lecture notes, cheat sheets:

▪ Agricultural law. Crib

▪ The main dates and events of domestic and foreign history. Crib

▪ Age-related psychology. Crib

See other articles Section Lecture notes, cheat sheets.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

The existence of an entropy rule for quantum entanglement has been proven 09.05.2024

Quantum mechanics continues to amaze us with its mysterious phenomena and unexpected discoveries. Recently, Bartosz Regula from the RIKEN Center for Quantum Computing and Ludovico Lamy from the University of Amsterdam presented a new discovery that concerns quantum entanglement and its relation to entropy. Quantum entanglement plays an important role in modern quantum information science and technology. However, the complexity of its structure makes understanding and managing it challenging. Regulus and Lamy's discovery shows that quantum entanglement follows an entropy rule similar to that for classical systems. This discovery opens new perspectives in the field of quantum information science and technology, deepening our understanding of quantum entanglement and its connection to thermodynamics. The results of the study indicate the possibility of reversibility of entanglement transformations, which could greatly simplify their use in various quantum technologies. Opening a new rule ... >>

Mini air conditioner Sony Reon Pocket 5 09.05.2024

Summer is a time for relaxation and travel, but often the heat can turn this time into an unbearable torment. Meet a new product from Sony - the Reon Pocket 5 mini-air conditioner, which promises to make summer more comfortable for its users. Sony has introduced a unique device - the Reon Pocket 5 mini-conditioner, which provides body cooling on hot days. With it, users can enjoy coolness anytime, anywhere by simply wearing it around their neck. This mini air conditioner is equipped with automatic adjustment of operating modes, as well as temperature and humidity sensors. Thanks to innovative technologies, Reon Pocket 5 adjusts its operation depending on the user's activity and environmental conditions. Users can easily adjust the temperature using a dedicated mobile app connected via Bluetooth. Additionally, specially designed T-shirts and shorts are available for convenience, to which a mini air conditioner can be attached. The device can oh ... >>

Energy from space for Starship 08.05.2024

Producing solar energy in space is becoming more feasible with the advent of new technologies and the development of space programs. The head of the startup Virtus Solis shared his vision of using SpaceX's Starship to create orbital power plants capable of powering the Earth. Startup Virtus Solis has unveiled an ambitious project to create orbital power plants using SpaceX's Starship. This idea could significantly change the field of solar energy production, making it more accessible and cheaper. The core of the startup's plan is to reduce the cost of launching satellites into space using Starship. This technological breakthrough is expected to make solar energy production in space more competitive with traditional energy sources. Virtual Solis plans to build large photovoltaic panels in orbit, using Starship to deliver the necessary equipment. However, one of the key challenges ... >>

Random news from the Archive

The most dangerous countries 06.12.2011

Scientists at the United Nations University in Bonn (Germany), summing up the results of natural disasters from 1970 to 2010, deduced for each of the 173 countries covered by statistics, a disaster risk index.

This took into account not only the likelihood of, for example, an earthquake, drought, typhoon or tsunami, but also how strong the infrastructure is, whether the available means of protection are reliable and how quickly the state can cope with a disaster and its consequences. The higher the index, the more dangerous life.

The most dangerous for living were the small island states of the Pacific Ocean - Vanuatu (risk index 32) and Tonga (29,08). The safest are Qatar (risk index 0,02) and Malta (0,72). Life in Russia is slightly more dangerous than in Belgium (3,56 versus 3,51) or Ukraine (3,02), but safer than in the US (3,72) or England (3,61).

Other interesting news:

▪ The Pentagon's Logic Weapon

▪ Old Quadruped

▪ Photons instead of electrons for revolutionary processors

▪ The material is 10 times stronger than steel

▪ SSD 7,68 TB from Kingston Technology

News feed of science and technology, new electronics

Interesting materials of the Free Technical Library:

▪ section of the site Firmware. Article selection

▪ article Roerich Nicholas Konstantinovich. Famous aphorisms

▪ article What is the Red Planet? Detailed answer

▪ article Tuberous sour. Legends, cultivation, methods of application

▪ article Polyethylene insulation. Encyclopedia of radio electronics and electrical engineering

▪ article Albanian proverbs and sayings. Large selection

Leave your comment on this article:

All languages of this page

Home page | Library | Articles | Website map | Site Reviews