The role of nonsteroidal anti-inflammatory drugs in pediatric patients

Like in the adult population, nonsteroidal anti-inflammatory drugs (NSAIDS) are commonly used agents for their anti-inflammatory, anti-pyretic and analgesic effects in pediatrics. They are also used for some distinct indications in pediatrics such as Kawasaki disease, patent ductus arteriosus (PDA)...

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Bibliographic Details
Published in:Pharmacological research 2012, Vol.65 (1), p.5-8
Main Authors: Dills, Robin, Anderson, Leigh A., Pierce, Catherine A.
Format: Article
Language:English
Subjects:
Age Factors
Analgesics
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Anti-pyretics
Antiinflammatory
Antipyretics - administration & dosage
Antipyretics - adverse effects
Antipyretics - therapeutic use
Child
Child, Preschool
Drug Administration Routes
Fever - drug therapy
Humans
Infant
Nonsteroidal anti-inflammatory drugs
Pain - drug therapy
Pediatrics
Risk Assessment
Risk Factors
Treatment Outcome
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Summary:Like in the adult population, nonsteroidal anti-inflammatory drugs (NSAIDS) are commonly used agents for their anti-inflammatory, anti-pyretic and analgesic effects in pediatrics. They are also used for some distinct indications in pediatrics such as Kawasaki disease, patent ductus arteriosus (PDA) closure, and Juvenile Idiopathic Arthritis (JIA). The primary mechanism thought to cause their therapeutic effects is the inhibition of prostaglandin synthesis. NSAIDs inhibit cyclooxygenase (COX) which is an enzyme that is necessary for the formation of prostaglandins. Unfortunately, this same mechanism, the inhibition of prostaglandins, is thought to be the most likely cause of gastrointestinal (GI) mucosal damage, because prostaglandins through multiple mechanisms assist in the preparation and maintenance of the protective barrier of the mucosal lining of the stomach. Similarly, prostaglandins in the kidney promote intrarenal plasma flow and electrolyte balance. The efficacy and safety of NSAIDs must be considered in prescribing these agents. The real conundrum of these therapies is determining the role of newer agents such as intravenous ibuprofen compared to existing alternatives. Available data for intravenous ibuprofen in adults is promising, but further studies are needed in pediatric patients to determine efficacy, place in therapy, and safety.
ISSN:1043-6618
1096-1186
DOI:10.1016/j.phrs.2011.08.010