Evaluation and comparison of efficacy and adverse drug reactions for single or two divided caffeine dosing and simulation of pharmacokinetic parameters to treat apnea of prematurity in preterm neonates

Apnea of prematurity is a common disease due to physiological immaturity in breathing control system of preterm infants.Treatment options are limited and include supportive therapy, continuous positive airway pressure (CPAP) and methylxanthines. Patients who not respond to these interventions require intubation and mechanical ventilation. Methylxanthines such as caffeine administered to stimulate breathing and reduce needing for mechanical ventilation in preterm infants. Different doses of this drug have been used in the preterm infants. However, more studies are needed to determine the optimal dose of caffeine in infants. The relation of caffeine pharmacodynamics and pharmacokinetics in neonates is not well known and a little data available about the correlation of pharmacokinetics and clinical effects. The aim of this study was evaluation the caffeine effects and determining the pharmacokinetics parameters in the apnea treatment in the premature infants. Neonates who diagnosed with apnea and gestational age of <37 weeks, was administered the loading dose of 20 milligrams per kilogram of caffeine intravenously. The maintenance dose of caffeine was infused to infants of group1 and group2 as 5 mg per kilogram once daily or 2.5 mg per kilogram twice daily respectively. The infant's plasma samples were used to measure plasma concentrations of caffeine. The rate of extubation and CPAP failure and length of stay in NICU were compared between two groups of patients.

Mazandaran University of Medical Sciences