Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/toxicity , Fetus/drug effects , Acute Kidney Injury/chemically induced , Acute Kidney Injury/embryology , Animals , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Female , Heart Arrest/chemically induced , Heart Arrest/embryology , Hemostasis/drug effects , Humans , Infant, Newborn , Obstetric Labor, Premature/drug therapy , Pregnancy , Prenatal Exposure Delayed Effects , Prostaglandins/biosynthesisABSTRACT
A 8 day-old full-term newborn showed severe cardiac disturbances after intravenous injection of erythromycin. The neonate, suspected of having Chlamydia pneumonitis because of tachypnea and rhinitis, had been given 5 injections of erythromycin without clinical effect. Pallor, vomiting and bradycardia developed a few minutes after the 6th injection, and ECG showed ventricular arrhythmia, prolonged QT interval and an atrioventricular block. The infant died in intensive care unit. This case and the analysis of other published cases of cardiac disturbances following the parenteral use of erythromycin, indicate the potential arrhythmogenic risk of this drug. It is suggested that newborns treated with erythromycin should be monitored by ECG.
Subject(s)
Erythromycin/adverse effects , Heart Arrest/chemically induced , Heart Rate/drug effects , Erythromycin/administration & dosage , Humans , Infant, Newborn , Injections, IntravenousABSTRACT
Thirteen newborn infants (five premature, eight full term) with severe seizures and not responding to phenobarbital and diazepam received a lidocaine (LD) infusion. The schedule was 4 mg/kg/h on the 1st day, 3 mg/kg/h on the 2nd day, 2 mg/kg/h on the 3rd day, and 1 mg/kg/h on the 4th day. The LD plasma levels were measured every 24 h just before decreasing the dose. The control of seizures was achieved in 11 of 13 patients, with plasma LD concentration ranging from 2.8 to 10.5 mg/L. The LD concentration was linearly correlated with the dose in each group. In the premature group, LD clearance was always smaller than in the full-term group. Although no side effects were observed on heart rate and blood pressure, it is suggested that the dose of LD be adjusted to maintain the LD concentrations between 3-6 mg/L.
Subject(s)
Infant, Newborn/blood , Lidocaine/therapeutic use , Seizures/drug therapy , Diazepam/blood , Humans , Infant, Premature/blood , Infusions, Intravenous , Lidocaine/administration & dosage , Lidocaine/blood , Lidocaine/pharmacokinetics , Seizures/metabolismSubject(s)
Angiotensin-Converting Enzyme Inhibitors/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Fetus/drug effects , Kidney/drug effects , Product Surveillance, Postmarketing , France , Humans , Infant, Newborn , Kidney Diseases/chemically induced , Kidney Diseases/epidemiology , Kidney Diseases/prevention & controlSubject(s)
Camphor/adverse effects , Adolescent , Camphor/poisoning , Camphor/therapeutic use , Child , Child, Preschool , Humans , Infant , RiskSubject(s)
Clonidine/adverse effects , Hallucinations/chemically induced , Adult , Aged , Female , Humans , MaleABSTRACT
Computed interpretation of electrocardiograms may be needed as French hospitals are divided into units in which physicians belonging to other specialities than cardiology may be in charge of internal medicine patients. We experimented two rival systems: SADE and CARDIONICS. Recordings were taken in the wards, on paper and magnetic tape. The computer, called by telephone, read the tape, interpreted the data, and printed conclusions and measurements. No useful information was provided in any of the 32 first patients studied (mean age: 71). The machine made our situation worse, as we were repeatedly prompted to call in a cardiologist without sufficient reason. A rejection reaction was observed. Telephone problems in French hospitals, losses of time, errors of manipulation, sometimes unintelligible language, and inappropriate material are discussed from the point of view of the internist. We did not consider the problems of cardiologists, screeners and archivists. In non-universitary hospitals, the needs may be greater, calling for improvements in software and hardware.