Severe hypertension in a very-low-birth-weight infant caused by caffeine combined with cimetidine or erythromycin
10.3760/cma.j.issn.1008-5734.2018.03.016
- VernacularTitle:咖啡因联用西咪替丁或红霉素致极低出生体重儿严重高血压
- Author:
Xintian SHEN
1
;
Ping ZHOU
;
Xiaoqin LIANG
;
Yu CHEN
;
Ming ZHONG
;
Xiaomei FAN
;
Huijuan GUO
Author Information
1. 518103,暨南大学附属深圳宝安妇幼保健院药剂科
- Publication Type:Journal Article
- Keywords:
Infant,premature,diseases;
Caffeine;
Erythromycin;
Cimetidine;
Hypertension
- From:
Adverse Drug Reactions Journal
2018;20(3):232-234
- CountryChina
- Language:Chinese
-
Abstract:
A male preterm infant,who was born at 28 weeks+2 of gestational age and diagnosed as preterm hyaline membrane disease (PHMD)2 hours after birth,was given nasal continuous positive airway pressure (nCAPA)therapy,intratracheal instillation of poractant alfa injection,intravenous infusion of ceftazidime and penicillin for infection,and caffeine for stimulating respiration. On day 4 of treatment,the infant′s heart rate reached 160-170 beats/min. It was suspected that caffeine induced tachycardia,and the heart rate restored when caffeine was withdrawn. On day 16,the infant′s condition was improved significantly,nCAPA was changed to noninvasive positive pressure ventilation and caffeine was given again to stimulate respiration. On day 24,cimetidine was given due to bile reflux. On day 28,intravenous infusion of erythromycin was given because of positive Ureaplasma urealyticum DNA in sputum. On day 29,cimetidine was stopped. Since day 25 after treatment,the systolic pressure was higher than 83 mmHg for 9 continuous days and elevated to 106/75 mmHg on day 34. The severe hypertension was considered to be caused by caffeine. When caffeine was stopped,the blood pressure returned to normal. On day 46,the infant′s symptoms were improved significantly,high flow oxygen was given,erythromycin was stopped,and caffeine was added for the third time. Hypertension did not recur. The relationship between the hypertension and drugs was evaluated by Karch-Lasagna method,indicating that the hypertension was probably related to combined use of caffeine and cimetidine or erythromycin.
