中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
邻甲氧基苯乙酸酯 | 2-methoxyphenyl acetate | 613-70-7 | C9H10O3 | 166.177 |
5-氯-2-甲氧基-苯酚 | 5-chloro-2-methoxyphenol | 3743-23-5 | C7H7ClO2 | 158.584 |
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
1-乙酰氧基-4-氯-2-甲氧基苯 | 4-chloroguaiacol acetate | 85430-09-7 | C9H9ClO3 | 200.622 |
To investigate whether adverse effects in a premature neonate could be attributed to nefazodone exposure via breast milk.
The breast-fed white infant (female, 2.1 kg, 36 weeks corrected gestational age) of a 35-year-old woman (60 kg) taking nefazodone 300 mg/d was admitted to the hospital because she was drowsy, lethargic, unable to maintain normal body temperature, and was feeding poorly. A diagnosis of exposure to nefazodone via breast milk was considered only after other more likely diagnoses had been excluded. After breast feeding was discontinued, the infant's symptoms resolved slowly over a period of 72 hours. The maternal plasma and milk concentration—time profiles for nefazodone and its metabolites, triazoledione, HO-nefazodone, and m-chlorphenylpiperazine, were quantified by HPLC. The calculated infant dose for nefazodone and its active metabolites (as nefazodone equivalents) via the milk was only 0.45% of the weight-adjusted maternal nefazodone daily dose.
Our data suggest a putative association between maternal nefazodone ingestion and adverse effects in a premature breast-fed neonate. The measured amount of drug exposure would normally be considered safe in a full-term infant. However, there was a temporal relationship between resolution of adverse effects in the infant and cessation of breastfeeding.
This case highlights the importance of individualizing the risk—benefit analysis for exposure to antidepressants in breast milk, especially when dealing with premature neonates.
探讨早产儿是否由于通过母乳摄入nefazodone而产生不良反应。
一名35岁女性(60公斤)每日服用nefazodone 300毫克,其母乳喂养的白种女婴(体重2.1公斤,36周矫正孕龄)因昏昏欲睡、懒散、无法维持正常体温并且喂养困难而被送入医院。仅在排除了其他更可能的诊断后,才考虑通过母乳摄入nefazodone导致的症状。在停止母乳喂养后,婴儿的症状缓慢缓解,历时72小时。通过高效液相色谱法测定了母亲血浆和乳汁中nefazodone及其代谢物triazoledione、HO-nefazodone和m-chlorphenylpiperazine的浓度-时间曲线。根据体重调整的母亲nefazodone每日剂量计算,婴儿通过乳汁摄入的nefazodone及其活性代谢物(作为nefazodone当量)仅占母亲剂量的0.45%。
我们的数据表明,母亲服用nefazodone与早产婴儿母乳喂养后出现的不良反应可能存在关联。在足月婴儿中,测量到的药物暴露量通常被认为是安全的。然而,婴儿不良反应的缓解与母乳喂养的停止存在时间上的关系。
这个案例突出了在处理早产婴儿的抗抑郁药物母乳摄入风险-收益分析时个体化的重要性。