Bilirubin toxicity

Using this approach, the incidence of acute bilirubin toxicity has markedly decreased, and the occurrence of kernicterus is now extremely rare. 

Shapiro SM Bilirubin toxicity in the developing nervous system. Ped Neurol 29 410-421,2003-... 

Twenty percent of all human newborns accumulate enough bilirubin to stain their skin, resulting in jaundice. Bilirubin binds to cellular and mitochondrial membranes, causing cell death in a variety of tissues clinically, bilirubin toxicity may lead to mental retardation, cerebral palsy, deafness, seizures, or death. 

This chapter examines various aspects of bilirubin encephalopathy including bilirubin metabolism, bilirubin toxicity, in-vivo studies and studies in Gunn rats, human studies, and treatment modalities. 

An in vitro study. Photodermatol. Photoimmunol. Photomed. 17 (6) 272-277 Santella, R.M., Rosenkranz, H.S., and Speck, W.T. (1978). Intracellular deoxyribonucleic acid — modifying activity of intermittent phototherapy, J. Pediatr. 93 106-109 Schenker, S., McCandless, D.W., and ZoUman, P. (1966). Studies of cellular toxicity of unconjugated bilirubin in kemicteric brain. J. Clin. Invest. 45 1213-1220 Schenker, S., Hoyumpa, A.M., and McCandless, D.W. (1986). Bilirubin toxicity to the brain (ker-nicterus) and other tissues. In Bile Pigments and Jaundice. Ed., by Ostrow, J.D., Marcel Dekkker, NY... 

Rifabutin Adults0 5 mg/kg (300 mg) Children Appropriate dosing unknown Hematologic toxicity, uveitis, gastrointestinal symptoms, polyarthralgias, hepatotoxicity, pseudojaundice (skin discoloration with normal bilirubin), rash, flulike syndrome, orange discoloration of bodily fluids (sputum, urine, sweat, tears) Drug interactions are less problematic than rifampin... 

Doxorubicin—monitor cumulative dose for cardiac toxicity (not to exceed 550 mg/M2 or 450 mg/M2 with prior chest radiotherapy) vesicant—avoid extravasation use 50% for bilirubin 1.5-3.0 use 25% for bilirubin > 3.0... 

---