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Colic medication and apparent life-threatening events
R A Hardoin1, J A Henslee, C P Christenson
1Southwest SIDS Research Institute, Lake Jackson, Texas 77566.
Insights
Colic medications containing Dramamine and Donnatal may cause cardiorespiratory instability and GER in infants. Further evaluation is needed to confirm if these common infant colic treatments contribute to apparent life-threatening events (ALTE).
Area of Science:
- Pediatric Medicine
- Neonatology
- Clinical Pharmacology
Background:
- Apparent life-threatening events (ALTE) in infants often lack clear etiology.
- Infants experiencing ALTE were previously treated for colic with a mixture of dimenhydrinate (Dramamine) and Donnatal.
Purpose of the Study:
- To investigate the potential link between colic medication and cardiorespiratory abnormalities and gastroesophageal reflux (GER) in infants presenting with ALTE.
Main Methods:
- Case series evaluation of eight infants with ALTE histories.
- Polygraphic evaluation conducted after withdrawal of dimenhydrinate/Donnatal colic medication.
- Assessment for cardiorespiratory abnormalities and significant gastroesophageal reflux (GER).
Main Results:
- All eight infants exhibited cardiorespiratory abnormalities upon polygraphic evaluation.
- Significant gastroesophageal reflux (GER) was documented in four of the eight infants.
- No underlying cause for ALTE was identified through comprehensive initial work-up.
Conclusions:
- The study suggests a potential contribution of dimenhydrinate/Donnatal colic medication to cardiorespiratory instability and GER in susceptible infants.
- Further research is warranted to confirm the role of this common colic treatment in infant ALTE.
Abstract:
Eight infants with histories of apnea and cyanosis were referred to the Southwest SIDS Research Institute for evaluation of apparent life threatening events (ALTE). All of the infants had been treated for colic with a 1:1 concentration of dimenhydrinate (Dramamine) and phenobarbital, hyoscyamine sulfate, atropine sulfate and scopolamine hydrobromide (Donnatal). The medication was pre-mixed by local pharmacists. A comprehensive work-up failed to reveal a cause for the ALTE in any infant. The Dramamine/Donnatal mixture was withdrawn and polygraphic evaluation was conducted. Cardiorespiratory abnormalities were identified in all eight infants and significant gastroesophageal reflux (GER) was documented in four. The possibility that colic medication contributes to cardiorespiratory instability and GER in vulnerable infants requires serious consideration and further evaluation.