Деякі препарати, що мають різну токсичність у дітей
Drug | Clinical Syndrome | Mechanism | Comments |
|---|---|---|---|
Anesthetics, topical (eg, benzocaine, mixture of lidocaine and prilocaine) | Cyanosis | Formation of methemoglobin (ferrous iron oxidized to ferric iron) | Incidence rare |
Ceftriaxone | Bilirubin displaced from albumin | Affects only neonates | |
Codeine* | Respiratory depression Death | Ultrarapid metabolization of codeine to morphine | Genetic variant Deaths have occurred after surgery and in a breastfed infant whose mother took codeine |
Diphenoxylate | Respiratory depression Death | CNS depression (in immature CNS) | Overdose syndrome, usually in children < 2 years |
Fluoroquinolones | Cartilage toxicity | Unknown | Suspected based on animal studies, but adverse effects in humans unproved—short-term use may be safe |
Lindane (topical) | Seizures CNS toxicity | Probably enhanced absorption in children | Should not be used in children < 50 kg (alternative should be used) |
Prochlorperazine | Altered CNS function Extrapyramidal effects Opisthotonus Bulging fontanelles | Actions via multiple CNS receptors | Febrile and dehydrated infants especially at risk |
Selective serotonin reuptake inhibitors | Suicidal ideation | Unknown | Increased incidence of suicidal ideation in children and adolescents |
Tetracycline | Discoloration and pitting of tooth enamel | Chelation with calcium in growing teeth | Not given to children < 8 years |
* See also the American Academy of Pediatrics' clinical report about codeine metabolism in children. | |||
CNS = central nervous system. | |||