Severe and prolonged sedation in five neonates due to persistence of active diazepam metabolites.

Abstract:

UNLABELLED:Five neonates who suffered from an unexpected long period of respiratory failure, muscular hypotonia, and drowsiness were observed in a retrospective study. Prior to this general depression, unusually high doses of diazepam were administered to all patients via intravenous bolus injection. Serum levels of diazepam and its active metabolites were substantially elevated in the course of the disease. The persistence of the very long-acting N-desmethyldiazepam with considerable extension in neonates and even more exaggerated in premature infants is emphasized due to the reduced capacity of the hepatic biotransformation system. CONCLUSION:The intravenous application of diazepam imposes a risk of marked and prolonged general depression in neonates. Pronounced adverse effects are to be expected for prematures even after a single diazepam intravenous bolus if the dosage is not appropriate. Diazepam should not be used for short sedation and is not the drug of choice for anticonvulsant therapy in neonates.

journal_name

Eur J Pediatr

authors

Peinemann F,Daldrup T

doi

10.1007/s004310100745

keywords:

subject

Has Abstract

pub_date

2001-06-01 00:00:00

pages

378-81

issue

6

eissn

0340-6199

issn

1432-1076

journal_volume

160

pub_type

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