Analiza ambulantnega in bolnišničnega zdravljenja z antagonisti adrenergičnih receptorjev beta na Pediatrični kliniki UKC Ljubljana v letih 2022 in 2023

Škvarč, Tina (author), Kerec Kos, Mojca (mentor), Laptoš, Tomislav (comentor)

V Sloveniji sta za uporabo v pediatrični populaciji registrirani samo dve zdravilni učinkovini iz skupine antagonistov adrenergičnih receptorjev beta, in sicer metoprolol za arterijsko hipertenzijo in propranolol za aritmijo in hemangiom. Uporaba metoprolola in propranolola za druge indikacije ali uporaba ostalih zdravilnih učinkovin iz te skupine je v pediatrični populaciji nenamenska. Namen naloge je retrospektivna analiza ambulantnega in bolnišničnega zdravljenja z antagonisti adrenergičnih receptorjev beta na Pediatrični kliniki UKC Ljubljana v letih 2022 in 2023. Analizirali smo vrsto, odmerek in morebitno titracijo učinkovine, indikacijo, farmacevtsko obliko, vrsto uporabljenega zdravila (industrijsko proizvedeno ali magistralno) in (ne)namensko uporabo. V letih 2022 in 2023 se je z omenjenimi zdravili zdravilo 205 bolnikov. Največ jih je prejemalo bisoprolol (36,9 %) ali propranolol (37,3 %). Sledila sta jima metoprolol in nadolol s skoraj 10 % deležem vsak. Največkrat so zdravniki predpisovali peroralne farmacevtske oblike. Večina bolnikov je uporabljala zdravilo v obliki peroralne suspenzije (49 %) ali tablete (34 %). Skoraj dve tretjini bolnikov (61,3 %) je prejemalo zdravila, ki so bila izdelana v Galenskem laboratoriju Lekarne UKC Ljubljana. Najmlajši bolniki so imeli predpisane večinoma magistralne pripravke, starejši pa zdravila industrijske izdelave. Največ bolnikov se je zdravilo zaradi prirojenih malformacij obtočil (17,6 %) ali tahikardije (17,1 %). Nadolol je zdravilo izbora za bolnike s podaljšanim QT intervalom in drugih motenj srčnega ritma, propranolol pa za bolnike s Fallotovo tetralogijo, hemangiomom ali portalno hipertenzijo. Odmerki so v skladu z literaturnimi podatki. Z izjemo novorojenčkov je v vseh starostnih skupinah najpogostejše redno zdravljenje. Najvišji delež redne terapije smo imeli pri zdravljenju z nadololom (90 %), najnižjega pa s propranololom (58 %). Večina antagonistov adrenergičnih receptorjev beta se uporablja nenamensko (80,58 %). Analiza zdravljenja bolnikov nudi celovit vpogled v obravnavo teh bolnikov in s tem osnovo za potencialno optimizacijo zdravljenja v prihodnje.

• Language: Slovenian
• Keywords: pediatrija, antagonisti adrenergičnih receptorjev beta, farmacevtske oblike, trajanje zdravljenja, nenamenska uporaba
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2024
• PID: 20.500.12556/RUL-164884
• Publication date in RUL: 15.11.2024

Secondary language

• Language: English
• Title: Analysis of ambulatory and hospital treatment of patients with beta blocking agents at the Division of Paediatrics of the University Medical Centre Ljubljana in years 2022 and 2023

Abstract

In Slovenia only two medications from the beta-blocking agents group are registered for use in the pediatric population: metoprolol for arterial hypertension and propranolol for arrhythmia and hemangiomas. The use of metoprolol and propranolol for other indications, or the use of other medications from this group in the pediatric population, is off-label. This retrospective research aimed to analyze ambulatory and hospital treatment with beta-blocking agents at the Division of Paediatrics at the University Medical Centre Ljubljana during the years 2022 and 2023. We analyzed the type, dosage and possible titration of medication, indication, dosage form, type of medication used (industrially manufactured or magistral medicinal product), and possible off-label use. Between 2022 and 2023, 205 patients received beta-blocking agents. The majority received bisoprolol (36,9 %) or propranolol (37,3 %), followed by metoprolol and nadolol, each with almost 10 % share. Physicians most frequently prescribed oral pharmaceutical forms. Most patients used the medication in the form of an oral suspension (49 %) or tablets (34 %). Nearly two-thirds of the patients (61,3 %) were given medications produced in the galenic laboratory of University Medical Centre Ljubljana. The youngest patients were mostly prescribed magistral medicinal products, while older patients were given industrially manufactured medicines. The majority of patients were treated for congenital malformations of the circulatory system (17,6 %) and tachycardia (17,1 %). Nadolol was the medication of choice for patients with long QT syndrome and other hearty rhythm malfunctions, while propranolol was used for patients with Fallot's tetralogy, hemangiomas, and portal hypertension. The dosages are consistent with literature guidelines. Except for newborns, continuous treatment was the most common approach across all age groups. The highest percentage of continuous treatment was observed with nadolol (90 %) and the lowest with propranolol (58 %). Most beta-blocking agents were used off-label (80,58 %). This analysis of patient treatment provides a comprehensive overview and serves as a basis for the potential optimization of future treatments.

• Keywords: paediatrics, beta-blocking agents, dosage forms, duration of treatment, off-label use