THERAPY IN CONGENITAL HYPERBILIRUBINEMIA: PHENOBARBITAL AND DIETHYLNICOTINAMIDE
| Autor: | William A. Newton, Inta J. Ertel |
|---|---|
| Rok vydání: | 1969 |
| Předmět: |
medicine.medical_specialty
Bilirubin business.industry Therapeutic effect medicine.disease Therapeutic trial Gastroenterology Serum bilirubin chemistry.chemical_compound chemistry Internal medicine Pediatrics Perinatology and Child Health medicine Older child Kernicterus Phenobarbital Congenital hyperbilirubinemia business medicine.drug |
| Zdroj: | Pediatrics. 44:43-48 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.44.1.43 |
| Popis: | Two different drugs, phenobarbital and diethylnicotinamide (Coramine), were compared for their efficacy in treating congenital hyperbilirubinemia. Phenobarbital is known to be effective in reducing bilirubin levels in children and adults. The therapeutic effect of oral diethylnicotinamide has not been evaluated; the drug has only been used intramuscularly in newborn twins. Two sisters, ages 4 and 10, with the clinical picture of the Crigler-Najjar syndrome were given therapeutic trials of phenobarbital and diethylnicotinamide. Both drugs lowered the serum bilirubin levels, but there were quantitative differences in their lowering effect. Phenobarbital (4 mg/kg/day, orally) caused a marked drop of the total bilirubin (from 23.6 to 4.8 mg/100 ml in the older child and from 11.6 to 2.4 mg/100 ml in the younger child), and both children became anicteric. Diethylnicotinamide (60 mg/kg/day, orally) was less effective in lowering their bilirubin. The lowest levels achieved in these two patients were 13.2 mg/100 ml and 8.8 mg/100 ml, respectively, and both remained jaundiced. There was also an enhanced lowering effect observed with a larger dose of phenobarbital (5 mg/kg/day) which was not observed when a larger dose of diethylnicotinamide (100 mg/kg/day) was administered. These studies suggest that phenobarbital is the agent of choice for therapy of congenital hyperbilirubinemia. The medical indications for therapy are the prevention of kernicterus and the psychological advantage of rendering these children anicteric. |
| Databáze: | OpenAIRE |
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