Gray baby syndrome

Chlor am phe ni co 1 Gray baby syndrome, aplastic anemia... 

The answer is c. (Hardman, pp 1134-1135.) Hematologic toxicity is by far the most important adverse effect of chloramphenicol The toxicity consists of two types (1) bone marrow depression (common) and (2) aplastic anemia (rare) Chloramphenicol can produce a potentially fatal toxic reaction, the gray baby syndrome, caused by diminished ability of neonates to conjugate chloramphenicol with resultant high serum concentrations. Tetracyclines produce staining of the teeth and phototoxicity... 

The gray-baby syndrome occurs in babies which are still deficient in glucuronyl-transferase. The syndrome is characterized by distension of the abdomen, anorexia, progressive cyanosis, vasomotor collapse, hypothermia and shock. 

Chloramphenicol Prevents bacterial protein synthesis by binding to the 50S ribosomal subunit Bacteriostatic activity against susceptible bacteria Use is rare in the developed world because of serious toxicities Oral, IV hepatic clearance (half-life 2.5 h) dosage is 50-100 mg/kg/d in four divided doses Toxicity Dose-related anemia, idiosyncratic aplastic anemia, gray baby syndrome... 

Chloramphenicol Significant Concentrations too low to cause gray baby syndrome possibility of bone marrow suppression does exist recommend not taking... 

Gray baby syndrome Cyanosis of the newborn due to inadequate capacity for glucuronidation of chloramphenicol. 

Chloramphenicol is not adequately detoxified and excreted by the fetus or the premature infant. Administration of this antibiotic to the mother shortly before parturition may produce gray coloration of the infant s skin with associated muscle hypotonia and circulatory collapse, known as the gray baby syndrome (9). (This side effect is more noted in premature infants.)... 

By the mid-1960s the problem of administering inappropriate drug doses to pediatric patients had been clearly documented. In 1959 reports of the gray baby syndrome in neonates were published documenting the toxicity of chloramphenicol when adult doses were miniaturized to infants without consideration of maturation differences. The resulting deaths occurred because neonates have immature glucuronyl transferase activity necessary for the biotransformation of chloramphenicol and therefore accumulation occurred. When chloramphenicol... 

Dose-dependent bone marrow suppression is common aplastic anemia is rare (1 in 35,000). Gray baby syndrome in neonates (i glucuronysyl transferase) and optic neuritis in children. Inhibits metabolism of phenytoin, sulfonylureas, and warfarin. 

Newborn infants are deficient in glucuronyl transferase. Thus, when treating newborns, doses of chloramphenicol should not exceed 50 mg/kg per day. Large doses will precipitate gray baby syndrome, characterized by vomiting, hypothermia, gray skin tone, and shock. 

Neonates, especially if premature, may develop a serious illness termed gray baby syndrome if exposed to excessive doses of chloramphenicol. This syndrome usually begins several days after treatment is started. Within 24 hours, vomiting, refusal to suck, irregular and rapid respiration, abdominal distention, periods of cyanosis, and passage of loose, green stools occur. The children are severely ill by the end of the first day. Over the next 24 hours, they turn an ashen-gray color and become flaccid and hypothermic. A similar syndrome has occurred in adults who were... 

Gray baby syndrome in neonates (i glucuronosyl transferase)... 

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