Gray baby syndrome (also termed Gray or Grey syndrome) is a rare but serious side effect that occurs in newborn infants (especially premature babies) following the intravenous administration of the antimicrobial chloramphenicol. This condition is due to a lack of glucuronidation reactions occurring in the baby, thus leading to an accumulation of toxic chloramphenicol metabolites. The UDP-glucuronyl transferase enzyme system of infants, especially premature infants, is immature and incapable of metabolizing the excessive drug load. Insufficient renal excretion of the unconjugated drug. Toxic levels of chloramphenicol after 2–9 days result in: Vomiting Ashen gray color of the skin Limp body tone Hypotension (low blood pressure) Cyanosis blue discolouration of lips and skin. Hypothermia Cardiovascular collapse Treatment Chloramphenicol therapy is discontinued immediately; exchange transfusion may be required to remove the drug. Sometimes, phenobarbital (UGT induction) is used.
Posted on: Fri, 23 Jan 2015 23:07:17 +0000
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