Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units

Objective: this study had the objective to identify opioid-related Adverse Drug Events (ADE) with naloxone as a trigger and evaluate the patterns of naloxone administration in hospitalized children as well as verify the report of these ADE to the hospital’s pharmacovigilance department. Methods: a...

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Autores principales:	Haline Ogata, Fábio A. Motta, Marinei C. Ricier
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/1d3c8565380e4c6a967cf07ccc97e6fd
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spelling	oai:doaj.org-article:1d3c8565380e4c6a967cf07ccc97e6fd2021-11-28T02:45:53ZNaloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units10.30968/rbfhss.2019.102.04112179-59242316-7750https://doaj.org/article/1d3c8565380e4c6a967cf07ccc97e6fd2020-03-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/411https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objective: this study had the objective to identify opioid-related Adverse Drug Events (ADE) with naloxone as a trigger and evaluate the patterns of naloxone administration in hospitalized children as well as verify the report of these ADE to the hospital’s pharmacovigilance department. Methods: a retrospective review of electronic medical records was conducted with records of pediatric patients who received naloxone from January 1st, 2015 to June 30th, 2016. Descriptive statistics and analysis of Variance (ANOVA) followed by Tukey’s test were performed to analyze the results (P < 0.05 was considered statistically significant). The study was conducted in a tertiary children’s hospital in Paraná, Brazil. Results: we found 58 opioid-related ADE (3.2 events/month) and an underreporting rate of 93% at the hospital. All of the events occurred in Intensive Care Units (ICU) while most of the patients were female (51.7%) and infants (from 1 month old to 24 months old) (51.7%) inside the Cardiac ICU (63.8%). Fentanyl was the most prescribed opioid (66.2%); apnea (29.31%) and insaturation (20.69%) were the most reported symptoms during the ADE. All opioid-related ADEs caused temporary harm to the patients and required intervention. However, only 2.8% of the patients presented ADE by opioid intoxication. The opioid-related ADE were not influenced by opioid types, age groups or patients’ diseases. Conclusions: these findings showed a higher incidence of opioid-related ADE inside the Cardiac ICU among infants and a significant underreporting rate of these ADE to the pharmacovigilance department. Our study strengthens the importance of the human factor as a possible cause of ADE in pediatric patients, as well as the challenge to manage patient’s safety in pediatric institutions. Haline OgataFábio A. MottaMarinei C. RicierSociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 10, Iss 2 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Haline Ogata Fábio A. Motta Marinei C. Ricier Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
description	Objective: this study had the objective to identify opioid-related Adverse Drug Events (ADE) with naloxone as a trigger and evaluate the patterns of naloxone administration in hospitalized children as well as verify the report of these ADE to the hospital’s pharmacovigilance department. Methods: a retrospective review of electronic medical records was conducted with records of pediatric patients who received naloxone from January 1st, 2015 to June 30th, 2016. Descriptive statistics and analysis of Variance (ANOVA) followed by Tukey’s test were performed to analyze the results (P < 0.05 was considered statistically significant). The study was conducted in a tertiary children’s hospital in Paraná, Brazil. Results: we found 58 opioid-related ADE (3.2 events/month) and an underreporting rate of 93% at the hospital. All of the events occurred in Intensive Care Units (ICU) while most of the patients were female (51.7%) and infants (from 1 month old to 24 months old) (51.7%) inside the Cardiac ICU (63.8%). Fentanyl was the most prescribed opioid (66.2%); apnea (29.31%) and insaturation (20.69%) were the most reported symptoms during the ADE. All opioid-related ADEs caused temporary harm to the patients and required intervention. However, only 2.8% of the patients presented ADE by opioid intoxication. The opioid-related ADE were not influenced by opioid types, age groups or patients’ diseases. Conclusions: these findings showed a higher incidence of opioid-related ADE inside the Cardiac ICU among infants and a significant underreporting rate of these ADE to the pharmacovigilance department. Our study strengthens the importance of the human factor as a possible cause of ADE in pediatric patients, as well as the challenge to manage patient’s safety in pediatric institutions.
format	article
author	Haline Ogata Fábio A. Motta Marinei C. Ricier
author_facet	Haline Ogata Fábio A. Motta Marinei C. Ricier
author_sort	Haline Ogata
title	Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
title_short	Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
title_full	Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
title_fullStr	Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
title_full_unstemmed	Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
title_sort	naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/1d3c8565380e4c6a967cf07ccc97e6fd
work_keys_str_mv	AT halineogata naloxoneasatriggertoidentifyopioidrelatedadverseeventsinpediatricintensivecareunits AT fabioamotta naloxoneasatriggertoidentifyopioidrelatedadverseeventsinpediatricintensivecareunits AT marineicricier naloxoneasatriggertoidentifyopioidrelatedadverseeventsinpediatricintensivecareunits
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Naloxone as a trigger to identify opioid-related adverse events in pediatric intensive care units

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