Awareness of Healthcare Professionals About Sorbitol-Related Diarrhea in Pediatrics

Abstract

Objective: We aimed to identify sorbitol content in liquid drugs and to spread awareness about sorbitol-related diarrhea to healthcare professionals. The aim of the study was to raise awareness of healthcare professionals about sorbitol-related side effects in certain situations, for example, when dealing with critically ill patients in intensive care units where drug administration and side effects are problematic, and to provide a reference list of sorbitol content in the most commonly used pediatric drugs to clinicians. Material and Methods:The study was prospective and cross-sectional, consists of two parts including drug information database review and a survey of healthcare professionals. The drug information database review was undertaken in 2015 and survey questionnaires were delivered to healthcare professionals at a University Hospital in 2016. All liquid pharmaceutical preparations marketed in Turkey by the year of 2015 were included. Volunteered and convenience sample of healthcare professionals (22 doctors and 24 nurses) were given the questionnaire and returned by 15 doctors and 20 nurses (response rate: 68% and 83%, respectively).Results: There were 13,852 pharmaceutical products containing sorbitol as an "additive substance"; of those, 1726 were liquid preparations. The results revealed that 60% of nurses were aware and cautious of the additive substances in the drug while administering doses; however, only 20% of doctors considered additive substances during prescribing in pediatrics. More than 60% of the participants were concerned that additive substances may cause gastrointestinal side effects.Conclusion: Clinicians should be aware of the risk of sorbitol-related diarrhea in patients, particularly those who are in intensive care units, have fever, infections, or other gastrointestinal diseases. Appropriate drug dosage forms or administration routes should be considered in vulnerable patients including pediatric and critically ill patients. Amaç: Bu çalışmanın amacı, sorbitol kaynaklı diyare hakkında sağlık çalışanlarının farkındalığını saptamaktır. Çalışmada temel hedef, ilaç uygulamaları ve yan etkiler açısından kritik durumdaki yoğun bakım hastalarında olduğu gibi, sorbitol kaynaklı diyare konusunda sağlık çalışanları arasında farkındalığı arttırmak, pediyatride en sık kullanılan ilaçların sorbitol içerikleri konusunda klinisyenlere rehber bir liste oluşturabilmektir.Gereç ve Yöntemler: Çalışma prospektif ve kesitsel bir çalışmadır; ilaç veri tabanı incelemesi ve sağlık çalışanlarına yönelik anket uygulanması olmak üzere iki kısımdan oluşmaktadır. İlaçlar hakkındaki veri tabanı incelemesi 2015 yılında yapılmış ve bir Üniversite Hastanesindeki sağlık çalışanlarına yönelik anket de 2016 yılında uygulanmıştır. Türkiye'de 2015 yılı itibari ile bulunan tüm sıvı farmasötik ürünler çalışmada değerlendirilmiştir. Gönüllü ve ankete katılımda uygun olan sağlık çalışanlarından oluşan bir örnekleme (22 doktor ve 24 hemşire) anketler dağıtılmış ve 15 doktor ve 20 hemşireden cevaplar alınmıştır (cevap or...

Effects of Drugs and Excipients on Hydration Status

“…However, nowadays, it is considered that they may influence absorption properties and drug bioavailability, depending on the dosage form [37]. In this sense, there are excipients that induce osmotic diarrhea, such as sorbitol [33,158,184,185], mannitol [33,158,186], xylitol [33,158], fructose [33,158], phosphates [34,158], polyethylene glycol [187], and magnesium salts [33,35,158] (Table 2).…”

Prevalence, Risk, and Challenges of Extemporaneous Preparation for Pediatric Patients in Developing Nations: A Review

“…Thus, it is important to consider the medication of pediatric and critical disease patients. According to the European excipient review, the daily admissible intake of sorbitol is limited to 5 mg/kg in children 0–2 years old and 140 mg/kg in those older than two years [ 50 ].…”