Abstract | BACKGROUND: Diphemanil can be useful in some neonates presenting with bradycardia due to vagal hyperreflectivity. Paradoxically, this drug may induce atrio-ventricular ( AV) block in premature babies. CASE REPORTS: Case no 1. A premature neonate suffering from acute respiratory distress from birth required respiratory support, antibiotics and caffeine. Despite this treatment, he underwent many episodes of apnea, and bradycardia that appeared on day 4 and did not respond to IV doxapram (1 mg/kg/h). He was given diphemanil on day 9 (10 mg/kg/d) and permanent bradycardia with complete AV block and a normal QT interval appeared 2 days later. Cessation of diphemanil and administration of IV isoprenaline led to a normal sinusal rhythm, but there were bladder, intestinal and ocular signs of atropinic intoxication. A complete definitive recovery occurred 5 days after cessation of diphemanil. Case no 2. A premature neonate developed episodes of apnea 2 days after birth. These episodes persisted and were complicated by bradycardia on day 4 despite administration of caffeine. Vagal stimulation on day 7 was positive and the infant was then given diphemanil (10 mg/kg/d). Permanent bradycardia occurred 2 days later, with partial AV block and a normal QT interval. The child recovered a normal sinusal rhythm 2 days after cessation of diphemanil. CONCLUSIONS:
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Authors | S Bennasr, C Baumann, I Casadevall, Y Bompard, E Jacqz-Aigrain |
Journal | Archives francaises de pediatrie
(Arch Fr Pediatr)
Vol. 50
Issue 5
Pg. 413-5
(May 1993)
ISSN: 0003-9764 [Print] France |
Vernacular Title | Bloc auriculo-ventriculaire compliquant l'utilisation du diphémanil (Prantal) chez deux nouveau-nés prématurés. |
PMID | 8239894
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Bronchodilator Agents
- Parasympatholytics
- Piperidines
- diphemanil methylsulfate
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Topics |
- Bradycardia
(drug therapy, etiology)
- Bronchodilator Agents
(adverse effects, therapeutic use)
- Drug Administration Schedule
- Heart Block
(chemically induced)
- Humans
- Infant, Newborn
- Infant, Premature
- Male
- Parasympatholytics
(administration & dosage, adverse effects, therapeutic use)
- Piperidines
(adverse effects)
- Respiratory Distress Syndrome, Newborn
(complications, therapy)
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