Children phenobarbital

Carbamazepine serum levels are reduced to some extent by phenobarbital, and carbamazepine-10,11-epoxide levels are raised. In children, phenobarbital clearance is decreased by carbamazepine. 

A, adult AED, antiepileptic drug C, child Co, combination therapy M, monotherapy PB, phenobarbital VD, volume of distribution. 

It is not surprising that infant L. suffered diffuse encephalopathy (brain disorder), a cerebral infarction, and seizures during the neonatal period (Yager, 2002). Both asphyxia and hypoglycemia are injurious to the brain. The treatment for seizures consists of providing normal metabolic substrates (e.g., glucose) and appropriate anticonvulsant therapy (phenobarbital), as was done in the present case. The long-term treatment for the child s developmental disabilities is complex and involves the skills of many members of the health care team. 

Boreus lO. Plasma concentrations of phenobarbital in mother and child after combined prenatal and postnatal administration for prophylaxis of hyperbihmbinemia. J Pediatr 1978 93 695. 

Oil of sassafras has been reported to interfere with serum phenytoin concentration determination. A 4-mo-old boy was admitted to the hospital for failure to thrive and possible child abuse after an outpatient visit revealed that he was below the third percentile for height and weight, and had scattered bruises, including one above the left eye. The child s mother had a seizure disorder and was taking phenytoin and phenobarbital. It was suspected that she may have... 

A 3-year-old child taking both phenobarbital and phenytoin required quinidine 300 mg every 4 hours to achieve therapeutic serum quinidine levels, and had an estimated quinidine half-life of only 1.4 hours. Difficulty in achieving adequate serum quinidine levels was also reported in a woman taking phenytoin and primidone. Her quinidine half-life was... 

Another study eonfirmed that this interaction occurred in 20 neonates, but no statistically significant effect was found in 40 infants. Decreased chloramphenicol levels have been described in a single case report of a child who was also being treated with phenytoin and phenobarbital. The serum chloramphenicol levels were 35.1 micrograms/mL prior to the antiepileptics, 19.1 micrograms/mL after 2 days of phenytoin and 13.2 micrograms/mL a month after the addition of phenobarbital. For more information on the interaetion of ehloramphenieol with phenytoin see Phenytoin + Chloramphenieol , p.555. 

A child given a 6-week eourse of intravenous chloramphenicol 100 mg/kg daily in four divided doses had a reduction in chloramphenicol peak and trough serum levels of 46% and 74%, respectively, within 2 days of starting phenytoin 4 mg/kg daily. Levels were further reduced by 63% and 87%, respectively, by the addition of phenobarbital 4 mg/kg daily. Consider also Chloramphenieol + Phenobarbital , (p.300). In contrast, 6 children (aged 1 month to 12 years) developed raised, toxic chloramphenicol levels while reeeiving phenytoin. ... 

Wilson JT, Wilkinson GR. Chronic and severe phenobarbital intoxication in a child treated with primidone and diphenylhydantoin. J Pediatr (1973) 83, 484-9. 

A threefold increase in ciclosporin clearance was seen in another child with a kidney transplant while taking phenobarbital. Reductions in ciclosporin levels due to phenobarbital have been described in other patients. " ... 

The clearance of theophylline increased hy 337% over a 4-week period in a child treated with periodic doses of secobarbital and regular doses of phenobarbital."... 

Yazd 1 Kissling GE, Tran TH, Gottschalk K, Schuth CR Phenobarbital increases the theq>hylline requirement of premature infants being treated for apnea. AmJDis Child ( 9Z7) 141,97-9. 

Skin A child who was given sodium valproate for epilepsy developed a febrile rash 4 weeks after receiving phenobarbital as well [231" ]. Laboratory testing showed a leukocytosis with eosinophilia and raised C-reactive protein and liver enzymes. Anticonvulsant hypersensitivity syndrome due to phenobarbital was suspected and phenobarbital was withdrawn, with slow full recovery. 

Wakamoto H, Nakamura Y, Ebihara T, Tokuda K, Ohmori H. Reversible coma associated with prolonged high-dose phenobarbital therapy in bilateral Sturge-Weber syndrome. J Child Neurol 2009 24(12) 1547-51. 

Cerminara C, Bagnolo V, De Leonardis F, ConigKo A, Roberto D, Compagnone E, et al. Hepatocellular adenoma associated with long-term exposure to phenobarbital a paediatric case report. Childs Nerv Syst June 2012 28(6) 939 1. 

Oztekin O, Kalay S, Tezel G, Akcakus M, Oygur N. Can we safely administer the recommended dose of phenobarbital in very low birth weight infants Childs Nerv Syst August 2013 29(8) 1353-7. 

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