Children adverse events

Centers for Disease Control and Prevention Gamma hydroxy butyrate use—New York and Texas, 1995-96. JAMA 277 1511, 1997 Centers for Disease Control and Prevention Adverse events associated with ingestion of gamma-butyrolactone—Minnesota, New Mexico, and Texas, 1998-1999. MMRW Morb Mortal Wkly Rep 48 137-140, 1999 Chatlos JC Recent trends and a developmental approach to substance abuse in adolescents. Child Adolesc Psychiatr Clin N Am 5 1-27, 1996... 

Once the child has been stabilized on a stimulant medication, the child should come in for regular medication management. This may be as frequent as once a month for children with adverse events or unstable symptoms, or once every other month for those who are stable. 

Although these agents are commonly used, they are associated with a wide range of side effects (Table 26.2). For this reason, it is essential for the prescribing clinician to be familiar with the adverse events that can occur in a child who is being treated with one of these drugs. 

Wilens, T., Biederman, J., Kwon, A., Chase R., Greenberg, L., Mick, E., et al. (2003). A systematic chart review of the nature of psychiatric adverse events in children and adolescents treated with selective serotonin reuptake inhibitors. Journal of Child and Adolescent Psychopharmacology, 13, 143-152. 

In 36 premature infants, delivered at 25-35 weeks and with birth weights of 750-2050 g, ciprofloxacin (13.8 mg/ kg/day in two or three divided doses for 3-20 days) had good efficacy in 66% of cases (62). Thrombocjdopenia (five cases), raised transaminases (three cases), hjrper-bilirubinemia (three cases), and raised creatinine concentration (two patients) were reported as adverse events one child developed femoral osteitis. 

In eight children with juvenile rheumatoid arthritis, who had failed to respond to disease-modifying anti-rheumatic drugs, high-dose etanercept was well tolerated (35). None withdrew because of etanercept-related adverse events. One child reported transient erythema at the injection site after the first injection. Three had mild transient upper respiratory tract infections. There were no laboratory abnormalities. 

The safety of gadobenate dimeglumine has been evaluated in 2367 adults aged 18-88 years and 173 children. The overall incidence of adverse events was 20%. Events related to the contrast agent were reported in 15 % of the adults. Most of the adverse events were mild and transient and resolved spontaneously. Headache, injection site reactions, nausea, taste disturbance, and vasodilatation were the most common, with frequencies of 1.0-2.6%. Serious adverse events potentially related to the contrast agent were reported in 0.2%. These events included laryngospasm, which developed 10 minutes after the contrast injection in a 51-year-old woman, severe vomiting in a 5-year-old child, and pulmonary edema in a 65-year-old patient. 

One 13-month-old boy died 8 days after immunization. Autopsy showed that the cause of death was aspiration of vomit. The most commonly reported neurological adverse events were febrile seizures. Epilepsy was diagnosed in three children sjmptoms manifested for the first time 1, 10, and 21 days after immunization. One child was later diagnosed as having severe Lennox-Gastaut syndrome medical records subsequent to the acute phase were not available for the other two. 

A follow-up study has been carried out in 105 children with collapse (a hypotonic-hyporesponsive episode or a shock-like syndrome) after their first immunization with DTwP -I- IPV vaccine (11). Information about subsequent immunizations, health, and development in 101 of the children was supplied by child health-care units. The parents of one child refused further immunization, 16 children completed their schedule with the combination diphtheria -I- tetanus -I- poliomyelitis vaccine (DT-IPV), and the other 84 children received further pertussis vaccine (DTP-IPV), totalling 236 doses 74 children received the complete series of three additional doses. None of the children had recurrent collapse, and other adverse events were only minor. About half were given paracetamol prophylactically for the first subsequent dose most of them did not take it for further doses. The authors suggested that it is unnecessary to withhold further doses of pertussis vaccine in a child with collapse after a previons dose. It has been suggested that the threat of natural pertussis in non-immunized children should be taken much more into account than the fear of developing a collapse reaction (12). In another study (13) in the USA, one of the 14 children not completely immunized becanse of a hypotonic-hyporesponsive episode after a previons dose later developed natural pertussis, which lasted for 3 months and was transmitted to both her parents. 

An effective carboplatin desensitization protocol has been reported in a child with hypersensitivity, allowing additional months of carboplatin treatment (248). After premedication with diphenhydramine, ranitidine, and methylprednisolone, eight dilutions of carboplatin (0.01-50.0 mg) were given intravenously at 15-minute intervals at a rate of 1 mg/minute. Subsequently, carboplatin 600 mg was given as a continuous infusion over 3 hours without adverse effects. Whether desensitization is generally suitable for overcoming allergic adverse events should be tested prospectively (249). 

The effects of tiagabine have been studied in a 4-month, single-blind study in 52 children over the age of 2 years with different syndromes of refractory epilepsy (5). Adverse events, mostly mild to moderate, were reported by 39% of the children during the single-blind placebo period and by 83% of the children during tiagabine treatment. The events predominantly affected the nervous system weakness (19%), nervousness (19%), dizziness (17%), and somnolence (17%) were the most common. One child had hallucinations that responded to dosage reduction. Only three children withdrew because of adverse events. 

No changes in hematological or biochemical parameters were observed in adults and children with atopic eczema orally administered 2 g (adult dose) or 1 g (child dose) of borage seed oil daily for 12 weeks. Adverse events in the... 

A child with Duchenne muscular dystrophy received a dose of sugammadex to reverse rocuronium-induced profound neuromuscular block [32" ]. There was fast and efficient recovery from profound neuromuscular block and no adverse events. 

A child received phenylephrine 2.5% in screening for ophthalmic pathology. Pallor developed in the area was the phenylephrine that had contact with the skin. There were no other adverse events and the pallor disappeared after 2 hours. 

Jerrell JM, Hwang TL, Livingston TS. Neurological adverse events associated with antipsychotic treatment in children and adolescents. J Child Neurol 2008 23 (12) 1392-9. 

Cortese S, Holtmann M, Banaschewski T, Buitelaar J, CoghiU D, Danckaerts M, et al. Practitioner review current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J Child Psychol Psychiatry and Allied DiscipHnes 2013 54(3) 227-A6. 

Jalali S, Balakrishnan D, Zeynalova Z, PadhiTR Rani PK. Serious adverse events and visual outcomes of rescue therapy using adjunct bevacizumab to laser and surgery for retinopathy of prematurity. The Indian twin cities retinopathy of prematurity screening database report number 5. Arch Dis Child Fetal Neonatal Ed 2013 98(4) F327-33. 

Thapar, A., Harold, G., and McGuffin, P. (1998). Life events and depressive symptoms in childhood—shared genes or shared adversity A research note. / Child Psychol Psychiatry 39 1153-1158. 

Clatk, D.B., Lesnick, L., and Hegedus, A.M. (1997) Ttaumas and other adverse life events in adolescents with alcohol abuse and dependence. J Am Acad Child Adolesc Psychiatry 36 1744—1751. 

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