| Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry. | |
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MedLine Citation:
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PMID: 19898693 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Regulatory decisions and scientific statements regarding the management of attention-deficit hyperactivity disorder (ADHD) raise questions about the safety of medications and the appropriate pretreatment evaluation to determine suitability for treatment with medication. This is particularly true in the setting of known structural or functional heart disease. The present paper reviews the available data, including peer-reviewed literature, data from the United States Food and Drug Administration Web site on reported adverse reactions in children using stimulant medication, and Health Canada data on the same problem. A consensus-based guideline on appropriate assessment is provided, based on input from members of the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry, with specific expertise and knowledge in the areas of both ADHD and pediatric cardiology. The present statement advocates a thorough history and physical examination before starting stimulant medications, with an emphasis on the identification of risk factors for sudden death, but does not routinely recommend electrocardiographic screening or cardiac subspecialist consultation unless indicated by history or physical examination findings. A checklist for identifying children who are potentially at risk of sudden death (independent of ADHD or medications used to treat it) is provided. Although recommendations are based on the best evidence currently available, the committee further agrees that more research on this subject is necessary to optimize the approach to this common clinical scenario. |
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Authors:
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A E Warren; R M Hamilton; S A Bélanger; C Gray; R M Gow; S Sanatani; J-M Côté; J Lougheed; J LeBlanc; S Martin; B Miles; C Mitchell; D A Gorman; M Weiss; R Schachar |
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Publication Detail:
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Type: Journal Article; Practice Guideline; Review |
Journal Detail:
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Title: The Canadian journal of cardiology Volume: 25 ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-09 Completed Date: 2009-12-01 Revised Date: 2010-11-02 |
Medline Journal Info:
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Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada |
Other Details:
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Languages: eng Pagination: 625-30 Citation Subset: IM |
Affiliation:
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IWK Health Centre, Dalhousie University, Halifax, Nova Scotia. andrew.warren@iwk.iwk.nshealth.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Age Factors Attention Deficit Disorder with Hyperactivity / diagnosis, drug therapy* Canada Cardiovascular Diseases / diagnosis*, drug therapy, mortality Central Nervous System Stimulants / adverse effects, therapeutic use* Child Child, Preschool Death, Sudden, Cardiac / prevention & control* Dose-Response Relationship, Drug Drug Administration Schedule Electrocardiography Female Follow-Up Studies Humans Male Mass Screening Risk Assessment Sex Factors Sickness Impact Profile Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Central Nervous System Stimulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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