Adverse effects in a newborn infant breast-fed by a mother treated with doxepin
Adverse effects in a newborn infant breast-fed by a mother treated with doxepin
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DOI：
10.1345/aph.18210
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发表时间：
1999-06-01
影响因子：
2.9
通讯作者：
von Brenndorff, AI
中科院分区：
文献类型：
--
作者：
Frey, OR;Scheidt, P;von Brenndorff, AI
目的：报告不良反应，在新生儿的母亲在怀孕期间，而母乳喂养多虑平治疗。病例摘要：9天大的白色男孩被录取，因为不良吸吮和吞咽，肌肉张力减退和呕吐。他昏昏欲睡，体重减轻了150 g。入院时，他由母亲哺乳，母亲正在接受多塞平35 mg/d治疗。采用高效液相色谱法和荧光偏振免疫分析法对血浆和乳汁样品进行分析。通过母乳喂养摄入的多塞平和N-去甲基多塞平（DDP）的量约为10-20 μ g/kg/d（即，仅为母亲体重调整剂量的2.5%）。在婴儿血浆中可检测到少量多塞平（类似于10 μ g/L）; DDP低于10 μ g/L的检测下限。所有的不良反应消退后48小时内母乳stopping.DISCUSSION：尽管小剂量的多塞平及其活性代谢物摄入母乳喂养的婴儿，有积累和由此产生的不良反应的风险。在新生儿中，代谢活性大大降低，并可能进一步降低hyperglucinemia.CONCLUSIONS：现有数据表明，多虑平治疗的妇女应该非常谨慎地母乳喂养婴儿，如果在所有，虽然需要更大的数据库来证实这一点。
OBJECTIVE: To report adverse effects in a newborn infant whose mother had been treated with doxepin during pregnancy and while breast-feeding.CASE SUMMARY: The nine-day-old white boy was admitted because of poor sucking and swallowing, with muscle hypotonia and vomiting. He was drowsy and had lost 150 g. At the time of admission, he was breast-fed by his mother who was being treated with doxepin 35 mg/d. Samples of plasma and breast milk were taken and analyzed by HPLC and fluorescence polarization immunoassay. The amount of doxepin and N-desmethyldoxepin (DDP) ingested via breast-feeding was approximately 10-20 mu g/kg/d (i.e., only 2.5% of the weight-adjusted dose of the mother). Doxepin was detectable in small amounts in the infant's plasma (similar to 10 mu g/L); DDP was below the lower limit of detection of 10 mu g/L. All adverse effects subsided within 48 hours after breast-feeding was stopped.DISCUSSION: Despite the small doses of doxepin and its active metabolite ingested by breast-fed babies, there is a risk of accumulation and resultant adverse effects. In newborns, the metabolic activity is considerably decreased and may be further reduced by hyperbilirubinemia.CONCLUSIONS: Available data suggest that women treated with doxepin should breast-feed their infants with great caution, if at all, although much larger databases are needed to confirm this.