Adrian wrote:
>This list occasionally has pretensions to be academic, and it would be
>nice to see evidence of eg Phenergan being followed by SIDS with some
>pre-processing such as indicating whether the rate at which babies die
>of SIDS who have also had Phenergan was different from the rate at
>which they die of SIDS not having recently had Phenergan.
>
Following an initial report that 4 of 7 infants with sudden
infant death syndrome (SIDS) had been given trimeprazine
before death and that a series of severe apnoeic crises had
been observed in the twin of a SIDS victim given
promethazine, (1) the same workers studied 52 SIDS victims,
36 near-miss infants and 175 control subjects to investigate
the role of nasopharyngitis and phenothiazines in this
syndrome. (2) It was found that there was no difference in
the incidence of nasopharyngitis between the 3 groups, but
that the proportion of infants given phenothiazines was
higher in both the SIDS group (23%) and the near-miss group
(22%) than in the control group (2%). It was suggested that
the SIDS victims may represent infants with excessive
sensitivity to this group of drugs. In a subsequent study,
(3) they found that the incidence of central and obstructive
sleep apnoeas was increased in 4 healthy infants given
promethazine for 3 days, although the duration of the
attacks was unaltered and generally short, with a range of 3
to 10 seconds. A report on behalf of the Commission of the
European Communities, (4) stated that no link between sudden
deaths in infants and drug administration had been confirmed
by national drug monitoring centres. It was likely that the
risk of apnoea was associated with all sedative drugs,
especially in overdose. (4) Previously,
phenothiazine-induced hyperthermia had been proposed as a
contributory factor in SIDS. (5)
The current view is that phenothiazine antihistamines should
not be given to young children. Recommendations for the age
at which children can receive these drugs range from 1 to 2
years.
1. Kahn A, Blum D. Possible role of phenothiazines in sudden
infant death. Lancet 1979; ii: 364-5.
2. Kahn A, Blum D. Phenothiazines and sudden infant death
syndrome. Pediatrics 1982; 70: 75-8.
3. Kahn A, et al. Phenothiazine-induced sleep apneas in
normal infants. Pediatrics 1985; 75: 844-7.
4. Cockfield. Phenergan, Theralene, Algotropyl-drugs
responsible for the death of new-born babies. Off J EC 1986;
29: C130/25-6.
5. Stanton AN. Sudden infant death syndrome and
phenothiazines. Pediatrics 1983; 71: 986-7.
Better?
Regards
Jeff Green
Community Locum and Consultant Pharmacist
[log in to unmask]
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|