Update on medications used to treat gastrointestinal disease in children.
Progress in the pharmacotherapy of pediatric gastrointestinal diseases continued during 1998 despite ongoing obstacles encountered by clinicians and researchers. The major change involved warnings that cisapride, a widely used prokinetic agent, could cause potentially fatal arrythmias in susceptible people. The risk for children is unclear and a consensus of prescribing guidelines is needed. Excellent pediatric-oriented reviews have been published that summarize our knowledge of proton pump inhibitors, probiotics, 5-hydroxtryptamine-3 (5-HT3) antagonists, and the treatment of gastrointestinal infections and chronic abdominal pain. Triple medication therapy for the eradication of Helicobacter pylori is now the standard of care, but the optimal combination and duration of therapy needs to be determined. Also described are interesting developments requiring further confirmation: the treatments of infectious diarrhea with zinc; achalasia and Hirschsprung's disease with botulinum toxin; weight loss with megestrol acetate; and sialorrhea with glycopyrollate.
Evans
J S
JS
Division of Pediatric Gastroenterology and Nutrition, Nemours Children's Clinic, Jacksonville, Florida 32207, USA.
Huffman
S
S
D000900:Anti-Bacterial Agents; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002648:Child; D020117:Cisapride / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000188:drug therapy*; D006801:Humans; D008535:Megestrol / Q000627:therapeutic use; D009853:Omeprazole / Q000627:therapeutic use; D045167:Progesterone Congeners / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000929:Antidepressive Agents, Tricyclic; D004791:Enzyme Inhibitors; D045167:Progesterone Congeners; D008535:Megestrol; D009853:Omeprazole; D020117:Cisapride