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Second-degree atrioventricular heart block after doxapram administration
G S De Villiers1, A Walele, P L Van der Merwe
1Department of Pediatrics and Child Health, Faculty of Medicine, University Stellenbosch, Tygerberg Hospital, Cape Province, South Africa.
The Journal of Pediatrics
|July 22, 1998
Summary
Doxapram, a respiratory stimulant, can cause heart rhythm problems like atrioventricular block in premature infants. Stopping the drug resolved the issue, highlighting a potential cardiac side effect.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Pharmacology
Background:
- Idiopathic apnea of prematurity is a common concern in neonates.
- Doxapram hydrochloride is a widely used respiratory stimulant for premature infants.
- Reported side effects of doxapram are generally considered minimal.
Observation:
- Three cases of premature infants experiencing adverse cardiac events were observed.
- These events occurred during doxapram administration for apnea of prematurity.
- The observed cardiac abnormality was second-degree atrioventricular block.
Findings:
- Doxapram administration was associated with QT interval prolongation in all three cases.
- QT interval prolongation is a known risk factor for cardiac arrhythmias.
- The infants developed second-degree atrioventricular block, a serious heart rhythm disturbance.
Implications:
- Doxapram may pose a risk of cardiac arrhythmias, specifically atrioventricular block, due to QT prolongation.
- Continuous cardiac monitoring may be warranted during doxapram therapy in neonates.
- Discontinuation of doxapram led to the resolution of the atrioventricular block and normalization of heart rhythm.