- General Drug Summary
- Description
- A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory gamma-aminobutyric acid subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [PubChem]
- Also Known As
- Fenobarbital; Phenobarbitol; Phenobarbitone; Phenobarbituric Acid; Phenylethylbarbiturate; Phenylethylbarbituric Acid; Phenylethylmalonylurea
- Categories
- Excitatory Amino Aci
- Structure
- Summary In Neonatal Jaundice
-
2 record(s) for Phenobarbital Chemoprevention in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 2196130
- Phenobarbital
- Chemoprevention
- NA
- Summary
- Be treated with high risk of severe Neonatal jaundice, or scarcity of resources for the management of Neonatal jaundice with phototherapy and exchange transfusion.
- Pharmacologic approaches to the prevention and treatment of neonatal hyperbilirubinemia. Clinics in perinatology, 1990 Jun [Go to PubMed]
- Bcause of the high frequency, serious sequelae, and complex and costly management, neonatal jaundice is a good candidate for preventive treatment. In this respect the clinical problem of neonatal jaundice has many similarities with the problem of hemorrhagic disease of the newborn. Both conditions are transient peculiarities of newborn metabolism. Most neonates exhibit the biochemical abnormality, but a small minority is placed in jeopardy of life or suffers serious sequelae. In both conditions a loose relationship exists between the degree of biochemical abnormality and the clinical manifestations that are poorly predicted by monitoring the abnormalities. The administration of vitamin K at birth corrected the biochemical abnormalities and eliminated clinical hemorrhagic disease. The simplicity, efficacy, and safety of vitamin K prevention of hemorrhagic disease of the newborn is the prototype in the search for the solution to the problem of neonatal jaundice. For most neonates, antenatal phenobarbital comes lose to this prototype in terms of efficacy and simplicity. The combination of antenatal and postnatal therapy seems suitable for use in preterm labor in combination with tocolysis. This recommendation is conditional on the demonstration of safety by long-term follow-up. The competitive inhibition of HO by synthetic metalloporphyrins offers an even simpler solution, but the level of efficacy achieved with the doses and compounds used so far are not comparable with that of phenobarbital. For the time being, phenobarbital is recommended for population groups with high risk of severe neonatal jaundice, or scarcity of resources for the management of neonatal jaundice with phototherapy and exchange transfusion.
- 6821654
- Phenobarbital
- Chemoprevention
- Clinical Trial
- Summary
- Prophylactic treatment with phenobarbital deal with G6PD deficiet Mediterranean males.
- Neonatal hyperbilirubinaemia in heterozygous glucose-6-phosphate dehydrogenase deficient females. British journal of haematology, 1983 Feb [Go to PubMed]
- Glucose-6-phosphate dehydrogenase (G6PD, D-glucose 6-phosphate: NADP oxidoreductase, E.C. 1.1.1.49) activity and the percentage of G6PD deficient erythrocytes was determined in 50 girls heterozygous for G6PD deficiency, 25 of whom had had hyperbilirubinaemia at birth and 25 who had normal bilirubin levels. The enzymatic activity was 2.32 +/- 0.87 I.U./g Hb in the first group and 3.31 +/- 0.92 I.U./g Hb in the second group. The percentage of G6PD deficient erythrocytes was 54.1 +/- 15.3 and 65.3 +/- 14.0, respectively. The level of enzymatic activity exceeded 4 I.U./g Hb and the percentage of G6PD deficient cells fell below 40% in only one of the subjects who had developed hyperbilirubinaemia. Levels of enzymatic activity below 4 I.U./g Hb, or percentages of G6PD deficient erythrocytes higher than 40% can therefore be considered to be associated with a high risk of developing neonatal hyperbilirubinaemia. In our opinion, these babies should receive prophylactic treatment with phenobarbital, as do G6PD deficiet Mediterranean males.
-
25 record(s) for Phenobarbital Effective in Inducing Remission in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 1250562
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Phenobarbital prophylaxis was found to be a safe, effective, and economic method of preventing hyperbilirubinemia in the newborn.
- Routine phenobarbital for prevention of neonatal hyperbilirubinemia. Obstetrics and gynecology, 1976 Mar [Go to PubMed]
- In a parallel study conducted over a 1-year period, involivng 460 private prenatal patients, the effect of routine prenatal phenobarbital for the prevention of neonatal jaundice was evaluated. The incidence of significant jaundice (bilirubin levels greater than or equal to 10 mg/100 ml) occurred in 4.1% of the 221 test patients compared to 16.3% of the 239 control patients. No significant complications resulted from the drug therapy, and the newborn infants demonstrated no adverse effects attributable to the phenobarbital. Mothers who were given prophylactic phenobarbital took their infants home earlier, less often brought infants back to the hospital for photo-therapy, and spent fewer dollars for their total medical care than their control conterparts. Routine phenobarbital prophylaxis was found to be a safe, effective, and economic method of preventing hyperbilirubinemia in the newborn.
- 7280702
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Phenobarbital is highly recommended used in the evaluation of Neonatal jaundice.
- Effect of phenobarbital on 99mTc-IDA scintigraphy in the evaluation of neonatal jaundice. Seminars in nuclear medicine, 1981 Jul [Go to PubMed]
- Hepatobiliary scintigraphy with 99mTc-IDA derivatives was used to evaluate 40 neonates with mixed jaundice. Fourteen patients proved to have biliary atresia. The remaining 26 patients had intrahepatic cholestasis with patent extrahepatic ducts. Sixteen of the 40 patients underwent examinations without phenobarbital stimulation. Sixteen patients had two examinations, one before and one after 3-7 days of phenobarbital therapy. The remaining 8 patients had their initial examinations after phenobarbital therapy. The results of this study show that administration of phenobarbital in a dose of 5 mg/kg/day for at least 5 days prior to the examination enhances and accelerates biliary excretion of IDA compounds and thereby significantly increases the accuracy of 99mTc-IDA scintigraphy in differentiating extrahepatic biliary atresia from neonatal hepatitis. Its routine use in the evaluation of neonatal jaundice is therefore highly recommended.
- 9853069
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Difficult to use and inefficient medicine treated to Neonatal jaundice .
- [Pharmacologic treatment of neonatal jaundice. A new approach]. Archives de pédiatrie : organe officiel de la Soc, 1998 Nov [Go to PubMed]
- Pharmacological treatment of neonatal jaundice is again topical. At the beginning of the eighties, clofibrate was added to phenobarbital which was difficult to use and inefficient. Clofibrate is a better enhancer of glucuronosyl transferase induction than phenobarbital and causes 100% increase of hepatic bilirubin clearance within 6 hours. In the treatment of early jaundice in full term neonate, it significantly reduces bilirubinemia in 16 hours, and decreases the intensity and duration of jaundice and also phototherapy requirement. At the end of the eighties, new molecules inhibiting hepatic production of heme to bilirubin, like metalloporphyrins, were introduced. These molecules block the transformation of heme to biliverdin and bilirubin. Among them, the Sn-mesoporphyrin seems to have the best efficacy when used prophylactically in premature infants between 30 and 36 weeks of gestational age, and also curatively in full-term neonates, with minimal side effects. However the product is not yet manufactured nd can not be used in pediatrics practice. Therefore clofibrate represents the only pharmacological treatment of neonatal jaundice actually available.
- 2198547
- Phenobarbital
- Effective in Inducing Remission
- Review
- Summary
- Has a role in stimulating liver conjugating enzymes.
- [Treatment of neonatal hyperbilirubinemia]. La Pediatria medica e chirurgica : Medical and sur, [Go to PubMed]
- Hyperbilirubinemia remains one of the most common and more important pathological conditions in the newborn. The possibility that low levels of serum bilirubin could be responsible for bilirubin encephalopathy in the small premature infant is of great concern for the neonatologist. In fact, premature newborns, as recognized more than 70 years ago by Y1ppo, are prone to develop hyperbilirubinemia. The so-called physiologic of developmental hyperbilirubinemia could be harmful for the small preterm infant, who is at risk of developing bilirubin encephalopathy in the presence of low plasma bilirubin concentrations. Current methodologies for suppressing severe neonatal jaundice include: 1) Attempts to stimulate liver conjugating enzymes by drugs, such as phenobarbital. 2) Attempts to degrade bilirubin"
in viv"
by phototherapy. 3) Exchange transfusion. It is too soon to consider Sn-protoporphyrin as a drug for the prevention and treatment of neonatal hyperbilirubinemia. However, if it can be shown that the use of tin-protoporphyrin can serve as a safe and less costly alternate treatment, a considerable improvement in the management of neonatal jaundice will be achieved.
- 8623049
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Phenobarbital premedication (5 mg/kg per day for a minimum of 5 days in divided doses) is used in infants who are being examined for Neonatal jaundice to increase the accuracy of 99mTc-IDA scintigraphy in differentiating extrahepatic biliary atresia from neonatal hepatitis.
- Hepatobiliary scintigraphy in children. Seminars in nuclear medicine, 1996 Jan [Go to PubMed]
- Hepatobiliary scintigraphy using iminodiacetic (IDA) radiopharmaceuticals provides clinically useful information on the function of the biliary tract in a variety of pathological processes in children, including neonatal jaundice, gallbladder dysfunction, trauma, and liver transplantation. Phenobarbital premedication (5 mg/kg per day for a minimum of 5 days in divided doses) is used in infants who are being examined for neonatal jaundice to increase the accuracy of 99mTc-IDA scintigraphy in differentiating extrahepatic biliary atresia from neonatal hepatitis. Biliary atresia can be ruled out in an infant if a patent biliary tree is shown with passage of activity into the bowel. If no radiopharmaceutical is noted in the bowel on imaging up to 24 hours, distinction between severe hepatocellular disease and biliary atresia cannot be made. The literature reports 91% accuracy, 97% sensitivity, and 82% specificity for hepatobiliary imaging in the diagnosis of biliary atresia. The impairment of both intrahepatic an extrahepatic biliary drainage is an important cause of liver disease in cystic fibrosis. Hepatobiliary scintigraphy in cystic fibrosis has shown characteristic patterns of dilatation of mainly the left hepatic duct, narrowing of the distal common bile duct, gallbladder dysfunction, and delayed bowel transit. Cholecystitis in children may be acalculous. Sensitivity and specificity for the scintigraphic diagnosis of acute acalculous cholecystitis is reported to range from 68% to 93% and 38% to 93%, respectively. Cholescintigraphy in a suspected bile leak provides information generally not available with other techniques, except for direct cholangiography. If the amount of intraperitoneal accumulation of the tracer is greater than that entering the gastrointestinal tract, surgery is usually indicated. Hepatobiliary imaging in children who have undergone liver transplantation will assess graft vascularity, parenchymal function, biliary drainage, presence of a leak, and obstruction.
- 1247472
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- As preventive of Neonatal hyperbilirubinemia, phenobarbital is efficient at doses as low as 1 mg/kg/day.
- [Effect of minimal doses of phenobarbital on bilirubinemia in the newborn infant]. Boletín médico del Hospital Infantil de México, [Go to PubMed]
- To evaluate the effect of lower than usual doses of phenobarbital on prevention of hyperbilirubinemia in the neonate, a study was carried out in neonates with subnormal weight and of similar characteristics regarding gestational age, intrauterine growth, absence of pathology, type and amount of milk formula ingested and values for indirect serum bilirubin previous to the initiation of the administration of phenobarbital on their second day of life; they were separate at random into three groups according to the dose of phenobarbital given (1 mg, 3 mg and 5 mg per kilo and per day, respectively) and were numerically distributed in similar manner. In all groups, serum indirect bilirubin rate was confirmed to be practically the same; the differences did not show statistical significance from the 2nd to the 6th day of life, when the study was done. As preventive of neonatal hyperbilirubinemia, the drug is efficient at doses as low as 1 mg/kg/day. It is believed that similar responses with different low doses of henobarbital is due to the fact that the drug enzymatic induction phenomenon is brought forward, even at minimal doses, such as has been demonstrated through experiences in animals where the effect is produced even with doses of micrograms per kilogram of weight.
- 22689841
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Used to treat with Neonatal jaundice .
- Intractable neonatal jaundice due to hereditary spherocytosis and Gilbert's syndrome. BMJ case reports, 2011 [Go to PubMed]
- In this article the authors present a case of pathological neonatal jaundice resistant to phototherapy in a baby with a family history of Gilbert's syndrome and hereditary spherocytosis. Her presentation was ultimately explained with a diagnosis of both conditions, and required treatment with phenobarbitone. The authors discuss the mechanism by which Gilbert's syndrome results in hyperbilirubinaemia and its similarities with Crigler-Najjar syndrome. The presentation of hereditary spherocystosis in the neonatal period is also explored, as is the mechanism of exaggerated hyperbilirubinaemia when the two conditions co-exist.
- 6674910
- Phenobarbital
- Effective in Inducing Remission
- Review
- Summary
- Have a role to normal G-6-PD patients,but failed to effected in G-6-PD-deficient neonates.
- Effect of phenobarbital treatment on erythrocyte glucose-6-phosphate dehydrogenase in human newborns. Pediatric pharmacology (New York, N.Y.), 1983 [Go to PubMed]
- The effect of phenobarbital (PB) treatment on erythrocyte glucose-6-phosphate dehydrogenase (G-6-PD) levels was studied in normal and G-6-PD-deficient human newborns. An increase of erythrocyte G-6-PD levels was observed in normal G-6-PD patients, while increase in the enzymatic activity was not observed in G-6-PD-deficient neonates.
- 10460084
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Used for the treatment of long-standing jaundice,and phenobarbital intoxication can be well solved by exchange transfusion in newborn.
- Exchange transfusion treatment in a newborn with phenobarbital intoxication. Pediatric emergency care, 1999 Aug [Go to PubMed]
- A comatose, 14-day-old boy was referred to our emergency department (ED) after an overdose of phenobarbital, which was used for the treatment of long-standing jaundice. Plasma phenobarbital concentration was 112.4 microg/ml before treatment. One hour after giving albium transfusion, an exchange transfusion, which took about 45 minutes, was performed. Volume of exchange was 400 ml (volume of exchange (ml) = 2 x 85 ml/kg). After the exchange transfusion, the phenobarbital concentration decreased to 50.84 microg/ml. At clinical and laboratory follow-up, the patient recovered fully. This case suggests that exchange transfusion is an effective and successful treatment for phenobarbital intoxication in newborn.
- 7720308
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Not be needed when Tc-99m mebrofenin scintigraphy assessmenting of infantile jaundice.
- Utility of Tc-99m mebrofenin scintigraphy in the assessment of infantile jaundice. Clinical nuclear medicine, 1995 Feb [Go to PubMed]
- Technetium-99m mebrofenin hepatobillary excretory patterns were assessed in 36 infants with hyperbilirubinemia. Phenobarbital was administered to 22 patients before imaging. Final diagnoses included: intrahepatic cholestasis (14 patients), neonatal hepatitis (nine patients), biliary atresia (eight patients), alpha-1-antitrypsin deficiency (two patients), Alagille's syndrome (two patients), and cystic fibrosis (one patient). No patient with biliary atresia showed bowel activity by 24 hours. Of the 28 infants without biliary atresia, 23 (82%) had bowel activity visualized by 6-8 hours and 26 (90%) had bowel activity by 24 hours. Two had no bowel activity at 24 hours: one had cystic fibrosis and one had neonatal hepatitis. Of the 26 patients with bowel visualization, the time to visualize bowel did not differ between patient groups with and without phenobarbital induction. All of the patients with hepatitis, including those with marked dysfunction, showed good hepatic uptake. Mebrofenin scintigraphy is an imporant imaging technique in the diagnostic evaluation of infants with hyperbilrubinemia. In addition to biliary atresia, intrahepatic cholestasis due to cystic fibrosis and severe neonatal hepatitis may also cause bowel nonvisualization up to 24 hours. The results of this study suggest phenobarbital induction may not be needed when Tc-99m mebrofenin scintigraphy is used for the assessment of infantile jaundice.
- 2516635
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Used for biliary atresia.
- [Hepatobiliary scintigraphy in the study of neonatal hepatic cholestasis]. La Radiologia medica, 1989 Dec [Go to PubMed]
- Severe neonatal cholestasis is a clinical problem requiring a differential diagnosis of intra- (hepatitis) and extrahepatic (biliary atresia) causes, prognosis and therapy being different in the two cases. Eighteen patients of pediatric age underwent US and hepatobiliary scintigraphy. US findings were aspecific in both hepatitis and biliary atresia. In the 11 patients with hepatitis, hepatobiliary scintigraphy after phenobarbital revealed labeled bile in the bowel. Only in 1 patient with cytomegalovirus hepatitis was a scintigraphic pattern similar to that of biliary atresia. On the contrary, no intestinal radioactivity within 24 hours was seen in 6 patients with biliary atresia. A portoenterostomy (Kasai's operation) was performed on 4/6 cases with biliary atresia. These patients were followed with hepatobiliary scintigraphy in order to evaluate anastomotic functionality. In a case of biliary cirrhosis secondary to occlusion, orthotopic liver transplantation was performed whose success was scintigraphicallymonitored. Our results point to hepatobiliary scintigraphy after phenobarbital as the best noninvasive procedure for both diagnosis and postoperative follow-up of biliary atresia. Labeled bile excretion within 24 hours was rarely found in both atresia and neonatal hepatitis.
- 4004495
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- After intra-muscular injection of Phenobarbital,we can see the rapid increasing in plasma concentration.
- [Pharmacokinetics of injectable phenobarbital in the premature infant. Study of a new lyophilized form]. Archives françaises de pédiatrie, 1985 Apr [Go to PubMed]
- A lyophilized preparation of phenobarbital was studied in newborns without cerebral palsy. Plasma levels were determined using gas chromatograph fitted with thermo ionic probe after either an intra-muscular (IM) injection in premature infants or an intravenous (IV) injection over single dose of phenobarbital 10 mg/kg within 6 hours after birth. Five term babies were included in the study as controls and received an IM injection. The results showed rapid increase in plasma concentration after IM injection in 10 of 13 subjects with a peak concentration reached 60 minutes after injection. The mean ratio (maximal concentration/dose) was 1.25 and 1.10 for term infants and preterm infants respectively. In all cases, the drug was well tolerated. In 15 preterm infants (n: 7 IM and n: 8 IV) the plasma concentrations were followed over a period of 15 days. The disappearance curve was biphasic; it varied the first 7 days, then remained constant for the following week (apparent half life 106 hours).
- 702253
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Reduce serum bilirubin concentration in the newborn infant.
- Plasma concentrations of phenobarbital in mother and child after combined prenatal and postnatal administration for prophylaxis of hyperbilirubinemia. The Journal of pediatrics, 1978 Oct [Go to PubMed]
- Phenobarbital is known to reduce serum bilirubin concentration in the newborn infant, but optimal dosage is unknown. Ten pregnant women and their infants were given a standard regimen including prenatal maternal administration and postnatal administration to the infant during the first week of life. The plasma levels of phenobarbital in the infants were found to increase during the period of administration, and to remain high for many days beyond the period of hyperbilirubinemia. Optimal dose schedules for phenobarbital should be based both upon pharmacologic effects (including those other than bilirubin disposition) and upon the pharmacokinetic profile of the drug in the newborn infant.
- 15716985
- Phenobarbital
- Effective in Inducing Remission
- Randomized Controlled Trial
- Summary
- Prophylactic oral phenobarbital does not decrease the need for phototherapy or exchange transfusions in G6PD-deficient neonates.
- A randomized, triple-blind, placebo-controlled trial of prophylactic oral phenobarbital to reduce the need for phototherapy in G6PD-deficient neonates. Journal of perinatology : official journal of the , 2005 May [Go to PubMed]
- Decreased conjugation is probably more important than hemolysis for causing jaundice in G6PD-deficient neonates. The role of enzyme inducers, like phenobarbital, in G6PD deficiency is unclear. This randomized controlled trial was performed to evaluate Phenobarbital's role in reducing the need for phototherapy among G6PD-deficient neonates.
This stratified, randomized, triple-blinded, placebo-controlled trial was conducted in a level III NICU. Consecutive babies with gestation >/=34 weeks and birth weight >/=1800 g were screened from cord blood. G6PD-deficient neonates, who were otherwise healthy, were enrolled. Rh isoimmunization, maternal Phenobarbital use and lack of parental consent were exclusion criteria. Subjects were randomly allocated to receive 5 mg/kg day of oral phenobarbital/ placebo for first 3 days. They were monitored daily for total serum bilirubin (TSB) until declining TSB was documented twice. The primary outcome was requirement for phototherapy and secondary outcomes were duration of phototherapy, need for exchange transfusion, peak TSB and adverse effects. Sample size of 56 could detect a decline in phototherapy requirement from 40 to 5% with 80% power and 5% error.
Of 2370 babies screened, 63 were G6PD-deficient. Of them, 56 eligible babies were allocated to phenobarbital (n=27)or placebo (n=29). The mean age of administration of the first dose was 18.55+/-7.3 h. In total, 44% in phenobarbital group and 41% in placebo group required phototherapy (p=1.0). There was no significant difference in exchange transfusion rates (18.5 vs 10%, p=0.46). No baby had adverse reactions.
Prophylactic oral phenobarbital does not decrease the need for phototherapy or exchange transfusions in G6PD-deficient neonates.
- 17537
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Sixty-seven babies were utilized to (a) document the serum bilirubin lowering effect and safety of a phenobarbitone .Results indicate a significantly lower serum bilirubin level in the treated group of babies.
- Hepatic enzymes, their induction and usefulness in predicting maximal serum bilirubin levels in premature newborn infants. European journal of pediatrics, 1977 Jun 1 [Go to PubMed]
- Sixty-seven babies were utilized to (a) document the serum bilirubin lowering effect and safety of a phenobarbitone and nikethamide combination in neonatal hyperbilirubinaemia of non-hemolytic origin; (b) determine whether birthweight and/or SGOT, SGPT or SGGT activity on day one of life correlated with the maximum serum bilirubin level achieved; and (c) investigate the pattern of hepatic enzyme levels in serum under normal conditions anf following drug induction. Results indicate a significantly lower serum bilirubin level in the treated group of babies. Birthweight and day one SGGT levels, and SGGT/birthweight ratio correlated well with the maximum serum bilirubin reached, the latter ratio being particularly useful in predicting the degree of hyperbilirubinaemia.
- 7422399
- Phenobarbital
- Effective in Inducing Remission
- Randomized Controlled Trial
- Summary
- Prenatal phenobarbital is a practical, effective, and safe method for decreasing the incidence of Neonatal hyperbilirubine.
- Effectiveness and safety of prenatal phenobarbital for the prevention of neonatal jaundice. Pediatric research, 1980 Aug [Go to PubMed]
- The effect of 100 mg of phenobarbital (PB) at bedtime for the last few wk of pregnancy on the incidence and severity of neonatal hyperbilirubinemia was studied. No effect was observed in the newborns of mothers who took less than ten tablets. In the 1310 newborns of adequately treated mothers (PB greater than or equal to 1.0 g), the incidence of marked jaundice (bilirubin > 16.0 mg/dl) and the need to perform an exchange transfusion were reduced by a factor of six in relation to the incidence in 1553 control infants. A randomly selected group of 415 children (182 control, 233 PB) were reexamined at 61 to 82 months of age. There was no difference in the overall morbidity and mortality between the control and treatment group. A detailed neurologic assessment failed to reveal any differences between the two groups. In the VisuoMotor Integration test, the PB group scored significantly better than the control group. In the Draw-A-Woman and the Verbal Intelligence Test, the difference was in the same direction but was not statistically significant. The degree of jaundice was not found to significantly influence the performance in the neurological examination and the intelligence tests. Sensorineural hearing defect was significantly more common in the children with moderate or marked jaundice (bilirubin > 12 mg/dl) than in those with lesser degrees of jaundice. Prenatal PB is a practical, effective, and safe method for decreasing the incidence of neonatal hyperbilirubinemia.
- 8033008
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Administration of phenobarbital for 5 days before serial US examination is very useful in the diagnosis of neonatal hepatitis when differentiation between neonatal hepatitis and biliary atresia is impossible.
- Effect of phenobarbital on serial ultrasonic examination in the evaluation of neonatal jaundice. Clinical imaging, [Go to PubMed]
- The diagnosis of some cases of neonatal jaundice is complicated because of inability to identify the gallbladder, which makes it very difficult to differentiate biliary atresia from neonatal hepatitis even by serial ultrasonic (US) examination. Serial (US) examination after the administration of phenobarbital as a cholagogue at a dosage of 5 mg/kg/day for 5 days was performed to evaluate nine patients with neonatal jaundice. In five of the nine patients, the gallbladder was identified by a change in size following oral feeding. These patients were diagnosed as having neonatal hepatitis. The gallbladders of the other four patients were not identified before, during, or after feeding. They were diagnosed as having biliary atresia and the diagnoses were confirmed by surgery. Administration of phenobarbital for 5 days before serial US examination is very useful in the diagnosis of neonatal hepatitis when differentiation between neonatal hepatitis and biliary atresia is impossible because of inability to identifythe gallbladder by US alone.
- 12644704
- Phenobarbital
- Effective in Inducing Remission
- Review
- Summary
- Decrease the Elevated bilirubin levels.
- Induction of bilirubin clearance by the constitutive androstane receptor (CAR). Proceedings of the National Academy of Sciences of, 2003 Apr 1 [Go to PubMed]
- Bilirubin clearance is one of the numerous important functions of the liver. Defects in this process result in jaundice, which is particularly common in neonates. Elevated bilirubin levels can be decreased by treatment with phenobarbital. Because the nuclear hormone receptor constitutive androstane receptor (CAR) mediates hepatic effects of this xenobiotic inducer, we hypothesized that CAR could be a regulator of bilirubin clearance. Activation of the nuclear hormone receptor CAR increases hepatic expression of each of five components of the bilirubin-clearance pathway. This induction is absent in homozygous CAR null mice but is observed in mice expressing human CAR instead of mouse CAR. Pretreatment with xenobiotic inducers markedly increases the rate of clearance of an exogenous bilirubin load in wild-type but not CAR knockout animals. Bilirubin itself can also activate CAR, and mice lacking CAR are defective in clearing chronically elevated bilirubin levels. Unexpectedly, CAR expression is very low in livrs of neonatal mice and humans. We conclude that CAR directs a protective response to elevated bilirubin levels and suggest that a functional deficit of CAR activity may contribute to neonatal jaundice.
- 19925451
- Phenobarbital
- Effective in Inducing Remission
- Review
- Summary
- Used to treat cholestatic liver diseases.
- Xenobiotic-sensing nuclear receptors CAR and PXR as drug targets in cholestatic liver disease. Current drug targets, 2009 Nov [Go to PubMed]
- Cholestasis results in the intrahepatic retention of cytotoxic bile acid and it can thus lead to liver injury and/or liver fibrosis. Cholestatic liver damage is counteracted by a variety of intrinsic hepatoprotective mechanisms including a complex network of drug metabolizing enzymes and transporters. During the last decade, much progress has been made in dissecting the mechanisms which regulate the hepatic xeno- and endobiotic metabolism by nuclear receptors. The xenobiotic receptors CAR and PXR are two important members of the NR1I nuclear receptor family. They function as sensors of toxic byproducts derived from the endogenous metabolism and of exogenous chemicals, in order to enhance their elimination. Ligands for both receptors, including phenobarbital, have already been used to treat cholestatic liver diseases before the mechanisms of these receptors were revealed. Furthermore, Yin Zhi Huang, a traditional Chinese herbal medicine, which has been used to prevent and treat neonatal jaundice, was identifid to be a CAR ligand which also accelerates bilirubin clearance. Therefore, CAR and PXR have a protective effect on cholestasis by activating both detoxification enzymes and transporters. As a result, novel compounds targeting CAR and PXR with specific effects and fewer side effects will therefore be useful for the treatment of cholestatic liver diseases. This article will review the current knowledge on xenobiotic-sensing nuclear receptors CAR and PXR, while also discussing their potential role in the treatment of cholestatic liver diseases.
- 6787555
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Used to treat biliary atresia.
- Hepatobiliary scintigraphy with 99mTc-PIPIDA in the evaluation of neonatal jaundice. Pediatrics, 1981 Jan [Go to PubMed]
- Hepatobiliary scintigraphy with technetium 99m-labeled p-isopropylacetanilido iminodiacetic acid (99mTc-PIPIDA) was used to evaluate 22 neonates with mixed jaundice. Ten patients were proved to have biliary atresia; ten others were diagnosed as having neonatal hepatitis. In the remaining two, jaundice was secondary to prolonged hyperalimentation. Initial studies in all ten patients with biliary atresia showed no evidence of excretion of the tracer into the intestinal tract. Following three to seven days of oral administration of phenobarbital, repeat studies were performed in six of the ten patients. None showed evidence of excretion. Initial studies of the 12 patients with intrahepatic cholestasis showed definite excretion in five, questionable evidence of excretion in two, and no demonstrable excretion in five. Studies after phenobarbital therapy in five of the seven patients with questionable or no excretion on the initial studies showed definite excretion in four. Only in one patient who had poor hepaticextraction did the phenobarbital therapy not change the scintigraphic pattern. The authors conclude that hepatobiliary scintigraphy with 99mTc-PIPIDA after three to seven days of phenobarbital therapy is a highly accurate test for differentiating biliary atresia from other causes of neonatal jaundice.
- 12208095
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- pharmacological interventions to prevent hyperbilirubinaemia are utilized and the mainstay of treatment remains phototherapy. Previously studied pharmacological agents such as D-penicillamine, phenobarbital and clofibrate may yet prove useful.
- Pharmacological interventions for the treatment of neonatal jaundice. Seminars in neonatology : SN, 2002 Apr [Go to PubMed]
- In the neonate, hyperbilirubinaemia is usually due to a combination of an increased bilirubin load and decreased bilirubin elimination. Despite an understanding of the enzymatic pathways leading to bilirubin production and elimination, very few pharmacological interventions to prevent hyperbilirubinaemia are utilized and the mainstay of treatment remains phototherapy. Previously studied pharmacological agents such as D-penicillamine, phenobarbital and clofibrate may yet prove useful. Recent clinical trials using metalloporphyrins to inhibit heme catabolism and bilirubin production provides a novel pharmacological intervention for the treatment of neonatal jaundice. The safety and efficacy of these therapies will need to be confirmed prior to widespread use.
- 372140
- Phenobarbital
- Effective in Inducing Remission
- Practice Guideline
- Summary
- The prevention of Neonatal hyperbilirubinemia by phenobarbital is widely used in many countries.
- Phenobarbital in prophylaxis of neonatal jaundice. A control trial of two regimens. Helvetica paediatrica acta, 1977 Sep [Go to PubMed]
- The prevention of neonatal hyperbilirubinemia by phenobarbital is widely used in many countries. However, dose and period of administration vary according to authors, as the dose-effect relation is not known and since little research in pharmacokinetics of phenobarbital has been done so far. In the present study we compared the effect on serum bilirubin of a single injection of 10 mg/kg body weight and of a prolonged administration of 10 mg/kg/day during 3 days in premature and full-term newborn infants. The single injection had the same effect as the prolonged administration, provided it was given within 12 h after birth.
- 16247547
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Phenobarbital is effective in treating to Hyperbilirubinemia when used with intensive phototherapy.
- [Persistent neonatal hyperbilirubinemia resulting from Gilbert's syndrome in association with RhD hemolytic disease]. Jornal de pediatria, [Go to PubMed]
- To report on an infrequent association of pathologies causing considerable increase in bilirubin production and a significant decrease in its excretion.
The third pregnancy of an RhD negative woman. Her first child was normal and delivered to term and did not receive Rhogam. The second pregnancy was problematic due to Rh isoimmunization. She delivered a child to term, who required three exchange transfusions, but died on the 8th day of life. The third child was delivered at term, ORh positive, direct Coombs positive and had stump bilirubin of 6.5 mg/dl and hematocrit at 44%. Five hours after birth the child was jaundiced. Phenobarbital and intensive phototherapy were introduced. Hyperbilirubinemia was soon controlled, but relapsed whenever phototherapy was discontinued. On the 10th day of life the child received a transfusion for significant anemia. As jaundice persisted to the 13th day, associated Gilbert syndrome was considered and DNA sequence analysis was requested. The test demonstrated a mutant homozygote genotype UDPT1A1[TA]7TAA. Phototherapy remained necessary until the 17th day of life and she was discharged from hospital the following day, after biirubinemia had been controlled. She returned for follow-up and exhibited normal growth and neurological development.
This case demonstrates the significance of increased bilirubin production/decreased bilirubin excretion causing intense hyperbilirubinemias and, in the absence of vigorous treatment, kernicterus. The effectiveness of intense phototherapy has also been demonstrated, reducing the risks of more aggressive treatments such as exchange transfusion. It also provides evidence of the importance of bilirubinemia follow-up until complete resolution.
- 875318
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- Used to treat biliary atresia.
- [Indocyanine green kinetics in newborns with non-hemolytic hyperbilirubinemia (author's transl)]. Klinische Wochenschrift, 1977 May 1 [Go to PubMed]
- The kinetic parameters of indocyanine green elimination from blood were determined after an intravenous load of the dye in a dosage of 2-4 mg per kg body weight in 22 newborns with a non-hemolytic hyperbilirubinemia. Since the uptake of indocyanine green by liver is selectively carried out and the dye is not further metabolised, these kinetic parameters serve as measures for the performance of hepatocellular elimination. 11 of these newborns were treated 5 days previously with 7.5 mg phenobarbital per kg body weight. Compared to the untreated group, the serum bilirubin concentration significantly decreased after treatment with phenobarbital and the parameters of elimination of the dye from blood changed as described by saturation-kinetics. The maximal elimination-rate Vmax and the Michaelis-Menten-constant Km were significantly higher in newborns treated with phenobarbital (71.1 muMol/l-min and 356.4 muMol/l) than in the untreated ones (23.4 muMol/l-min and 100.0 mutmol/l). Kinetic data of indocyanine green limination gathered in newborns treated with and without phenobarbital support the hypothesis that cytoplasmatic proteins oliver should facilitate the uptake of organic anions inclusively bilirubin into the liver cell. A defiency of such transport proteins may be one of the causes of non-hemolytic hyperbilirubinemia in newborns.
- 1134846
- Phenobarbital
- Effective in Inducing Remission
- Clinical Trial
- Summary
- The effect of intramuscularly treated phenobarbital to decrease the serum bilirubin is more pronounced to the orally treated.
- Glucaric acid excretion as index of hepatic glucuronidation in neonates after phenobarbital treatment. Pediatric research, 1975 May [Go to PubMed]
- The urinary excretion of glucaric and glucuronic acid was investigated in neonates receiving phenobarbital intramuscularly or orally. Whereas there was no significant difference from the control-subjects in glucuronic acid elimination, the increase in glucaric acid excretion was significantly higher in the intramuscularly treated neonates. Infants with orally administered phenobarbital showed only insignificantly greater glucaric acid elimination. The decrease of serum bilirubin levels was more pronounced in the intramuscularly treated than in the orally treated group. The determination of glucaric acid may be an important reflection of hepatic microsomal induction of the enzymes of the glucuronic acid pathway.
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1 record(s) for Phenobarbital Effective in Basic Research in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 7828452
- Phenobarbital
- Effective in Basic Research
- In Vitro Study
- Summary
- Increase cytochrome P-450 levels and bilirubin glucuronyl transferase activity,and is the most effective inducer of glutathione-S-transferase (GSHT) activity in treating with Neonatal jaundice.
- Induction of hepatic bilirubin and drug metabolizing enzymes by individual herbs present in the traditional Chinese medicine, yin zhi huang. Developmental pharmacology and therapeutics, 1993 [Go to PubMed]
- Yin Zhi Huang (YZH) is a decoction of four plants which is widely used in Asia to treat neonatal jaundice. This study compares the ability of phenobarbital and the individual herbs comprising YZH, Artemisia, Gardenia, Rheum, and Scutellaria baicalensis, to induce hepatic drug and bilirubin metabolizing enzymes in rats. Herbal decoctions (30 ml/kg/day) or phenobarbital (60 mg/kg/day) were administered for 5 days. Only phenobarbital increased cytochrome P-450 levels whereas Gardenia slightly decreased levels. Artemisia, Rheum and phenobarbital increased bilirubin glucuronyl transferase activity. Glucuronidation of alpha-naphthol was increased by Gardenia and phenobarbital, whereas Artemisia and Rheum were ineffective inducers. Phenobarbital was the most effective inducer of glutathione-S-transferase (GSHT) activity. Phenobarbital and Gardenia both induced delta 5-3-ketosteroid isomerase activity, a marker for the Ya subunit of GSHT responsible for intracellular bilirubin transport in liver. The selective pattens of enzyme induction suggest potential value for using specific plant decoctions to modify drug and bilirubin metabolic pathways.
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4 record(s) for Phenobarbital NA in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 3505611
- Phenobarbital
- NA
- Clinical Trial
- Summary
- Show no any clinically important effects on the course of jaundice .
- The course of hyperbilirubinemia in the very low birth weight infant treated with phenobarbital. Journal of perinatology : official journal of the , 1987 [Go to PubMed]
- We examined the effect of early phenobarbital therapy on the course of jaundice in 57 infants with birth weight below 1,500 g. The study group of 28 infants was treated with a phenobarbital loading dose of 20 mg/kg at 4.2 (3.6) [mean (SD)] hours of age, followed by a maintenance dose of 5 mg/kg/day for one week; 29 infants served as controls. Seventeen study and 19 control infants suffered from periventricular-intraventricular hemorrhage (IVH). The two groups had comparable risk factors that can potentially affect the course of hyperbilirubinemia. Peak serum bilirubin concentration was 7.9 (1.8) mg/dl in the treated group and 8.6 (2.2) mg/dl in the control group. Three infants in the treated group and seven infants in the control group had peak serum bilirubin concentration above 10 mg/dl. These differences in the peak serum bilirubin concentration or in the number of infants with peak serum bilirubin concentrations above 10 mg/dl are not statistically significant. However, treated infants achieved peak seru bilirubin concentration earlier (mean age 90 hours as compared to 138 hours in control infants), and required phototherapy for a shorter duration of time (5.5 days in the treated group as compared to 7.5 days in the control group). While these differences in the two groups with regard to age of peak serum bilirubin concentration and duration of phototherapy are statistically significant, they do not seem to be clinically important. Thus, in our group of very low birth infants phenobarbital failed to show any clinically important effects on the course of jaundice when used in conjunction with phototherapy.
- 402463
- Phenobarbital
- NA
- Clinical Trial
- Summary
- Administration of phenobarbital failed to alter Phase II hyperbilirubinemia and did not enhance either maxima hepatic uptake or excretion of bilirubin.
- Development of bilirubin transport and metabolism in the newborn rhesus monkey. The Journal of pediatrics, 1977 Apr [Go to PubMed]
- Hepatic transport and metabolism of bilirubin have been examined in term, premature, and postmature newborn Macaca mulatta (rhesus) monkeys with and without prior phenobarbital treatment of pregnant mother and neonate. In untreated neonates a biphasic pattern of physiologic unconjugated hyperbilirubinemia has been observed. Phase I was characterized by a rapid increase in serum bilirubin concentration to 4.5 mg/dl by 19 hours and an equally rapid decline to 1.0 mg/dl by 48 hours of age. Phase II was characterized by a stable elevation at 1.0 mg/dl (four times greater than in the adult) from 48 to 96 hourse of age, followed by a decline to normal adult concentrations thereafter. An identical pattern was observed in 29 normal, term human neonates, but the duration of each phase was approximately three times as long as that in the monkey. Phase I hyperbilirubinemia appears to result from a sixfold increase in bilirubin load presented to the liver in the neonatal period, combined with marked deficieny in hepaticbilirubin conjugation, the rate-limiting step during Phase I. Hepatic uptake of bilirubin is not rate limiting during Phase I but may contribute to Phase II hyperbilirubinemia. An increased bilirubin load persists throughout the first 19 days of life in the monkey. Phase I physiologic jaundice in the monkey neonate was completely eliminated by prenatal maternal and neonatal administration of phenobarbital. A threefold enhancement of hepatic conjugation of bilirubin (glucuronyl transferase activity) during Phase I entirely accounted for the prevention of hyperbilirubinemia. The bilirubin load was unaffected by administration of phenobarbital. Whereas in control neonates the bilirubin load slightly exceeded hepatic bilirubin conjugating capacity and resulted in retention of bilirubin, in phenobarbital-treated neonates, hepatic conjugating capacity slightly exceeded that required for the bilirubin load. Administration of phenobarbital failed to alter Phase II hyperbilirubinemia and did not enhance either maxima hepatic uptake or excretion of bilirubin. Hepatic glucuronly transferase activity was increased threefold during Phase II and during the remainder of the neonatal period. Premature birth retarded maturation of hepatic glucuronyl transferase activity. In one phenobarbital-treated premature monkey neonate, there was no apparent response to treatment. Accelerated maturation of bilirubin uptake, conjugation, and excretion of bilirubin was observed in one postmature monkey neonate.
- 17443599
- Phenobarbital
- NA
- Randomized Controlled Trial
- Summary
- In this randomised controlled trials,antenatal phenobarbital did not met the use for reducing Neonatal jaundice in red cell isoimmunized pregnant women.
- Antenatal phenobarbital for reducing neonatal jaundice after red cell isoimmunization. The Cochrane database of systematic reviews, 2007 [Go to PubMed]
- Neonates from isoimmunized pregnancies have increased morbidity from neonatal jaundice. The increased bilirubin from haemolysis often needs phototherapy, exchange transfusion or both after birth. Various trials in pregnant women who were not isoimmunized but had other risk factors for neonatal jaundice have shown a reduction in need for phototherapy and exchange transfusion by the use of antenatal phenobarbital. A recent retrospective case-controlled study showed reduction in the need for exchange transfusion for the neonates from isoimmunized pregnancies.
To assess the effects of antenatal phenobarbital in red cell isoimmunized pregnancies in reducing the incidence of phototherapy and exchange transfusion for the neonate.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2006).
Randomised and quasi-randomised controlled trials of pregnant women established to have red cell isoimmunization in the current pregnancy during their antenatal testing and given phenobarbital alone or in combination with other drugs before birth.
All three review authors independently assessed study eligibility and quality.
No trials met the inclusion criteria for this review.
The use of antenatal phenobarbital to reduce neonatal jaundice in red cell isoimmunized pregnant women has not been evaluated in randomised controlled trials.
- 9035206
- Phenobarbital
- NA
- Clinical Trial
- Summary
- Tc-99m disofenin CS after premedication with phenobarbital and cholestyramine is a convenient and reliable method of differentiating BA from neonatal hepatitis, with a diagnostic accuracy superior to that of US. However, US is the initial imaging procedure of choice in patients presenting with jaundice to rule out anatomic anomalies such as CC.
- Comparison technetium of Tc-99m disofenin cholescintigraphy with ultrasonography in the differentiation of biliary atresia from other forms of neonatal jaundice. Pediatric surgery international, 1997 [Go to PubMed]
- Technetium Tc-99m disofenin cholescintigraphy (CS) and ultrasonography (US) are two major clinical methods used in differentiating biliary atresia (BA) from neonatal jaundice. To compare the diagnostic utility of these two modalities, 66 patients with neonatal cholestasis (15 BA, 3 choledochal cyst (CC), 32 neonatal hepatitis, 13 prolonged jaundice, 2 total parenteral nutrition, and 1 sepsis) underwent Tc-99m disofenin CS and US. The diagnostic sensitivity, specificity, and accuracy of CS in differentiating BA from other forms of neonatal jaundice was 100%, 87.5%, and 90.5%, respectively, and for US 86.7%, 77.1%, and 79.4%, respectively. Tc-99m disofenin CS after premedication with phenobarbital and cholestyramine is a convenient and reliable method of differentiating BA from neonatal hepatitis, with a diagnostic accuracy superior to that of US. However, US is the initial imaging procedure of choice in patients presenting with jaundice to rule out anatomic anomalies such as CC.
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3 record(s) for Phenobarbital Adverse Event in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 15771689
- Phenobarbital
- Adverse Event
- Clinical Trial
- Summary
- G mutation of phenobarbital response enhancer module is not associated with the Neonatal hyperbilirubinemia in Japanes.
- G mutation of phenobarbital response enhancer module is not associated with the neonatal hyperbilirubinemia in Japanese. Pediatrics international : official journal of the, 2005 Apr [Go to PubMed]
- Neonatal hyperbilirubinemia is frequent and severe in Japanese newborns. Previously, it has been reported that half of the Japanese neonates with severe hyperbilirubinemia carried the 211G > A (p.G71R) mutation of the bilirubin uridine diphosphate-glucuronosyltransferase (UGT1A1) gene causing Gilbert syndrome. Recently, it was reported that the -3263T > G mutation in the phenobarbital response enhancer module in UGT1A1 was associated with the majority of cases of Gilbert syndrome. The gene frequency of the -3263T > G mutation was determined and the relation with neonatal hyperbilirubinemia in Japanese was studied.
UGT1A1 in 119 neonates born at Yamagata University Hospital, Yamagata, Japan, and 26 subjects who had undergone phototherapy due to severe hyperbilirubinemia at four other hospitals were studied. The gene frequency of -3263T > G mutation in Japanese, Korean, Chinese and German healthy adult controls was also determined. Hyperbilirubinemia was assessed with a Jaundice Meter and UGT1A1 was analyzed by sequence determination or restriction enzyme method.
The gene frequency of the -3263T > G mutation was 0.26 in Japanese subjects and was similar to the prevalence in Korean, Chinese and German populations. However, there was no significant increase in the gene frequency of the mutation in the neonates who required phototherapy for hyperbilirubinemia compared to that in the neonates without severe hyperbilirubinemia. In addition, neonates with or without the mutation did not show a significant change in the level of bilirubin and the mutation also did not show a synergic effect with the 211G > A mutation on the level of bilirubin.
The -3263T > G mutation is not likely to be associated with the neonatal hyperbilirubinemia in Japanese.
- 7811186
- Phenobarbital
- Adverse Event
- Review
- Summary
- Act as a sedative-hypnotic,and may leads to neonatal jaundice, necrotising enterocolitis, clinical sepsis and congenital syphilis.
- Neonatal narcotic withdrawal in Hong Kong Chinese. Asia-Oceania journal of obstetrics and gynaecology, 1994 Sep [Go to PubMed]
- A retrospective case controlled study was carried out to study the neonatal characteristics, outcome and narcotic withdrawal syndrome in 51 neonates exposed to narcotic antenatally. The birth weight, head circumference and body length were significantly smaller in the study group while the incidence of prematurity (41%) and small-for-gestational age babies was increased (27.5%). Narcotic withdrawal occurred in 83% of narcotic exposed neonates. About half of them had onset of withdrawal symptoms within the first 24 hours. All of these newborns were treated by either phenobarbitone (45%), chlorpromazine (9.5%) or both (40.5%). The average duration of treatment was 15.7 days. There was one neonatal death due to in utero withdrawal and hypoxia, and another post-neonatal death due to sudden infant death. Neonatal jaundice, necrotising enterocolitis, clinical sepsis and congenital syphilis were more common in the drug-addicted group.
- 1781340
- Phenobarbital
- Adverse Event
- Cohort Report
- Summary
- A unique cohort of adolescents who were exposed to phenobarbital in utero, long-term effects are evident in the human.
- Critical periods of neuroendocrine development: effects of prenatal xenobiotics. Advances in experimental medicine and biology, 1991 [Go to PubMed]
- Phenobarbital, when administered prenatally in a small dose to animals, produced profound, and permanent effects on reproductive function in the offspring. Preliminary analysis of a unique cohort of adolescents who were exposed to phenobarbital in utero, suggests that long-term effects are also evident in the human. The precise nature of these effects is currently being determined and will be reported separately. These effects may be qualitatively and quantitatively different from effects seen in animals because of species difference in the timing or neuroendocrine differentiation. Of greater importance, however, is the fact that biologic and pharmacologic effects can be seen in the human following exposure to xenobiotics perinatally. Implications for other pharmacologic agents await further investigation. The rat model appears to have validity for extrapolation to man.
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1 record(s) for Phenobarbital Not Effective to Patients in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 909669
- Phenobarbital
- Not Effective to Patients
- Clinical Trial
- Summary
- Female newborns responded much better (3:1) to prophylaxis.
- Phenobarbital prophylaxis of neonatal hyperbilirubinemia. Evaluation of a nightly dose. Obstetrics and gynecology, 1977 Nov [Go to PubMed]
- In an attempt to improve the success of a previous study of the prevention of neonatal hyperbilirubinemia employing phenobarbital in a single 30-mg nightly dose from 32 weeks' gestation until delivery, 246 patients were tested against 270 control subjects. A 39% reduction in significant hyperbilirubinemia was realized but this fell far short of previous findings with a larger dose. Premature infants received no apparent protection against jaundice. Mature infants had no severe jaundice (more than 16 mg/100 ml) and the resolution of hyperbilirubinemia was more rapid. No apparent difference in drowsiness or daytime sedation from previous experience was found. Female newborns responded much better (3:1) to prophylaxis. These disappointing results favor a return to the 1-g daily divided dose.
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1 record(s) for Phenobarbital Effective in Complication in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 6607624
- Phenobarbital
- Effective in Complication
- Clinical Trial
- Summary
- Sedative-hypnotic effect.
- An imaging approach to persistent neonatal jaundice. AJR. American journal of roentgenology, 1984 Mar [Go to PubMed]
- Fifteen patients with persistent neonatal jaundice were evaluated by sonography and radionuclide scintigraphy. The sonographic features of both neonatal hepatitis and biliary atresia are nonspecific. Hepatobiliary scintigraphy after phenobarbital pretreatment in patients with neonatal hepatitis demonstrates normal hepatic extraction and delayed tracer excretion into the gastrointestinal tract. If there is neonatal hepatitis with severe hepatocellular damage, the hepatic extraction of tracer activity is decreased and excretion may be delayed or absent. Patients under 3 months of age with biliary atresia have normal hepatic extraction of tracer with no excretion into the gastrointestinal tract. Sonography in patients with a choledochal cyst shows a cystic mass in the porta hepatis with associated bile-duct dilatation. Hepatobiliary scintigraphy confirms that the choledochal cyst communicates with the biliary system. Initial sonography demonstrates hepatobiliary anatomy; subsequent phenobarbital-enhanced radionclide scintigraphy determines hepatobiliary function. An expedient diagnostic approach is recommended for the evaluation of persistent neonatal jaundice.
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1 record(s) for Phenobarbital Effective in Maintaining Remission in Neonatal Jaundice.
- PMID
- Drug Name
- Efficacy
- Evidence
- 17220819
- Phenobarbital
- Effective in Maintaining Remission
- Clinical Trial
- Summary
- Act as sedative-hypnotic effects in the treatment to the infants with direct hyperbilirubinemia and jaundice.
- Hepatobiliary scintigraphy and gamma-GT levels in the differential diagnosis of extrahepatic biliary atresia. The quarterly journal of nuclear medicine and mole, 2007 Mar [Go to PubMed]
- The aim of this paper is to identify extrahepatic biliary atresia (EHBA) as the cause of cholestasis in neonates with prolonged jaundice and thus accelerate the decision for surgical intervention, which is critical for prognosis.
We retrospectively studied 21 infants (13 girls, 8 boys) aged 2-16 weeks who have undergone( 99m)Tc-mebrofenin iminodiacetate ((99m)Tc-BrIDA) scintigraphy. They were referred because of direct hyperbilirubinemia and jaundice persisting beyond the 2nd postnatal week. They had received phenobarbitone premedication prior to scintigraphy. Dynamic images for 30 min and then static images (if required) at 1, 2 and 24 h postinjection were acquired. Images were evaluated visually and semiquantitatively, by calculating the liver-to-heart (L/H) ratio. Age, L/H ratios, and serum gamma glutamyl transpeptidase (gamma-GT) levels were compared (Mann-Whitney U test) between infants with EHBA (Group A) and infants without (Group B). The L/H ratios were correlated with age in each group and with gamma-GT in the entire population.
A total of 7/21 infants were classified in Group A and 14/21 in Group B. The L/H ratios were significantly lower in Group A. The correlation between L/H ratio and age was negative in EHBA and positive in non-atretic infants. The gamma-GT levels were inversely correlated with the L/H ratios in the entire population, being significantly higher in Group A.
In long-standing neonatal direct hyperbilirubinemia, (99m)Tc-BrIDA scintigraphy and the L/H ratio index seem to give useful information in the differential diagnosis of EHBA, especially when associated with markedly elevated serum gamma-GT levels.