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Non-steroidal Anti-inflammatory Drugs in Newborns and Infants

Jacob V Aranda1, Fabrizio Salomone2, Gloria B Valencia1

  • 1State University of New York Downstate Medical Center, 450 Clarkson Avenue, Box 49, Brooklyn, NY 11203, USA.

Pediatric Clinics of North America
|November 28, 2017
PubMed

Insights

Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are crucial for neonatal care, treating pain, fever, and preventing serious conditions. Understanding their mechanism of blocking prostaglandin synthesis may lead to new targeted therapies for infant health.

Area of Science:

  • Neonatal pharmacology
  • Pediatric drug mechanisms
  • Molecular biology in infant health

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are widely used in neonates.
  • These medications serve critical roles including pain and fever management, patent ductus closure, and prevention of intraventricular hemorrhage and retinopathy of prematurity.
  • Their mechanism involves inhibiting cyclooxygenase (COX) enzymes and peroxidases, thereby blocking prostaglandin synthesis.

Purpose of the Study:

  • To explore the multifaceted roles of NSAIDs and acetaminophen in neonatal care.
  • To elucidate the molecular mechanisms underlying their therapeutic effects and potential morbidities.
  • To highlight the significance of prostaglandin synthesis inhibition in neonatal physiology and pathology.

Main Methods:

  • Review of existing literature on NSAID and acetaminophen use in neonates.
  • Analysis of the biochemical pathways involving cyclooxygenase (COX) enzymes and prostaglandin (PG) synthesis.
  • Examination of the effects of these drugs on cellular processes, including caspases and cell death.

Main Results:

  • NSAIDs and acetaminophen effectively manage pain and fever in newborns.
  • These drugs are instrumental in patent ductus arteriosus closure and preventing intraventricular hemorrhage.
  • Evidence suggests a potential role in preventing retinopathy of prematurity.
  • Inhibition of prostaglandin synthesis impacts various physiological processes.

Conclusions:

  • NSAIDs and acetaminophen are essential therapeutic agents in neonatal medicine.
  • Understanding the inhibition of prostaglandin synthesis is key to their efficacy.
  • Further research into these molecular pathways could enable the development of targeted drugs to reduce neonatal morbidities.

Keywords:
AcetaminophenCyclooxygenasesIbuprofenIndomethacinKetorolacNSAIDsNewbornsParacetamol

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