The use of propranolol in the treatment ofinfantile hemangioma
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616-006.311.03-085.22 (2)
Патология. Клиническая медицина (6963)
SM ISO690:2012
CIOBANU, Cristina, SOLONARI, Rodica, GURANDA, Diana, CIOBANU, Nicolae, AMBROS, Igor, CHIROȘCA, Dragoș. The use of propranolol in the treatment ofinfantile hemangioma. In: Direcții de reformare a sistemului farmaceutic din perspectiva cursului european al Republicii Moldova, Ed. Ediția a 2-a, 28 aprilie 2023, Chişinău. Comrat: Universitatea de Stat din Comrat, 2023, Ediția a 2-a, pp. 163-165. ISBN 978-5-88554-205-0.
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Direcții de reformare a sistemului farmaceutic din perspectiva cursului european al Republicii Moldova
Ediția a 2-a, 2023
Conferința "Direcții de reformare a sistemului farmaceutic din perspectiva cursului european al Republicii Moldova"
Ediția a 2-a, Chişinău, Moldova, 28 aprilie 2023

The use of propranolol in the treatment ofinfantile hemangioma

CZU: 616-006.311.03-085.22

Pag. 163-165

Ciobanu Cristina, Solonari Rodica, Guranda Diana, Ciobanu Nicolae, Ambros Igor, Chiroșca Dragoș
 
”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
 
Disponibil în IBN: 17 mai 2023


Rezumat

Introduction. Infantile hemangiomas (IH) are the most common benign vascular tumors of infancy, occurring in 1-4% of infants and visible from birth. The risk factors refer to: female sex, prematurity, low birth weight, multiple pregnancies, advanced maternal age and the "in vitro" fertilization procedure. IH most commonly affects the head and neck region. Morphologically, hemangiomas are classified into superficial, deep and mixed types. Superficial hemangiomas, when fully formed, are characterized by vascular plaques or red nodules. Deep hemangiomas appear as partially compressible, subcutaneous, bluish vascular swellings. Until now, the treatment of hemangiomas and vascular malformations represents a multilateral problem [1], which requires treatment correlated with the age of the child, the location and the stages of the evolution of IH. Aim of the study. Evaluation of the magistral pharmaceutical forms used in the treatment of hemangioma in children prescribed by pediatricians in the Republic of Moldova. Material and methods. For the realization of this study, national and international bibliographic sources related to the etiology and treatment of infantile hemangiomas with the evaluation of doctors' prescriptions during 2022 present in the Vasile Procopișin University Pharmaceutical Center (Vasile Procopișin UPhC) were used as materials. Results. Preponderantly, infantile hemangiomas do not require medical or surgical intervention. The American Pediatric Association has limited the treatment of IH to a few drugs, depending on clinical picture of the disease: glucocorticoids (topical, intralesional, and oral), interferon alfa, and rarely topical vincristine and imiquimod in the treatment of significant IH. From the literature, using the Medline, PubMed, Embase databases, it was identified that beta-blockers, especially propranolol, are currently the most commonly used worldwide for the treatment of IH in infants between 5 weeks and 6 months of age [2]. Beta-blockers induce involution of infantile hemangiomas and are currently considered first-line treatment for problematic infantile hemangiomas. Furthermore, the recommendations of the European Medicines Agency warn that the treatment of IH with beta-blockers needs the monitor of possible adverse effects such as: arterial hypotension, bradycardia, hypoglycemia, irritability, constipation, etc. In the Republic of Moldova, during 2022, pediatric doctors, the most frequently prescribed propranolol as solid pharmaceutical formulation – powder. The age of the patients according to the prescriptions was from 5 months to 1.2 years, the duration of treatment from 4 weeks to 6 months. Propranolol powders were prepared using lactose, starch and glucose as excipients. For infants in the first week of life, 0.5 mg/kg/day was indicated, with increases of 1 mg/kg/day at one month, and for children older than two months – 2 mg/kg/day, with progressive increases of dose. In the Vasile Procopișin UPhC at the request of doctors, ointments of 1% and 2% with propranolol, based on a hydrophobic excipient – vaseline, prepared by suspending the active principle, were formulated with a lower periodicity. Conclusions. Infantile hemangiomas are the most common infant tumor. While majority of IHs do not require therapy and regress spontaneously, approximately 10% of IHs develop complications such as obstruction, ulceration, or disfigurement. International pediatric associations and domestic pediatricians indicate and prescribe oral and external propranolol as the most effective drug in the treatment of this condition.

Cuvinte-cheie
infantile hemangioma, propranolol, drug compounding