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Acetaminophen and Acetylsalicylic Acid Exposure in a Preterm Infant after Maternal Overdose

Leeann Pavlek1, Monica Kraft1, Caitlyn Simmons1

  • 1Department of Pediatrics, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio.

American Journal of Perinatology
|June 27, 2018
PubMed

Insights

This case study reports the successful management of a premature infant with high acetaminophen and aspirin levels due to maternal ingestion. N-acetylcysteine effectively treated acetaminophen toxicity in this neonate.

Area of Science:

  • Neonatal Medicine
  • Clinical Toxicology
  • Pharmacology

Background:

  • Maternal ingestion of medications during pregnancy can impact neonatal health.
  • Acetaminophen (Tylenol) and aspirin (acetylsalicylic acid) overdose can cause significant toxicity.
  • Premature infants may have altered drug metabolism and increased susceptibility to toxicity.

Observation:

  • A 26-week premature infant presented with supratherapeutic levels of acetaminophen and aspirin following maternal overdose.
  • The neonate exhibited coagulopathy, indicated by abnormal coagulation studies.
  • Despite clinical stability, toxic drug concentrations posed a risk.

Findings:

  • Treatment with N-acetylcysteine led to a marked decrease in acetaminophen levels.
  • Salicylate levels decreased spontaneously.
  • The neonate tolerated N-acetylcysteine without further toxic effects.

Implications:

  • This case highlights the successful use of N-acetylcysteine in managing acetaminophen toxicity in a preterm neonate.
  • It provides a reference for managing supratherapeutic acetaminophen and aspirin concentrations from maternal ingestion in premature infants.
  • Early intervention and consultation with specialists are crucial for optimal neonatal outcomes.

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