2014
DOI: 10.5935/medicalexpress.2014.05.06
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Abstract: BACKGROUND: Apnea of prematurity consists in 15 to 20 sec. of breathing cessation and is the most important disorder in the control of breathing in preterm infants. It is treated with caffeine citrate. OBJECTIVES: The objectives of this article are to review: (1) the mechanisms of action, (2) the effects, (3) the metabolism, (4) the pharmacokinetics, and (5) the adverse effects of caffeine citrate in preterms. METHODS: The bibliographic search was performed using PubMed and EMBASE databases as search engines a… Show more

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Cited by 9 publications
(9 citation statements)
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“…The present review endeavored to summarize the state of the art concerning this facet of neonatology. Stimulation of the central nervous system has been the focus of other recent reviews 36,37.…”
Section: Discussionmentioning
confidence: 99%
“…The present review endeavored to summarize the state of the art concerning this facet of neonatology. Stimulation of the central nervous system has been the focus of other recent reviews 36,37.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, physiological variables related to renal function would influence caffeine clearance in newborns. Several other factors including genetic variation in hepatic metabolic enzymes and caffeine receptors may also contribute to the variability in pharmacodynamic responses [15][16][17] . This study included neonates with normal AST, ALT, BUN, and creatinine levels, and excluded newborns with kidney or liver disease.…”
Section: Resultsmentioning
confidence: 99%
“…Caffeine metabolism occurs in the liver, mainly by CYP1A2, with a subsequent N-demethylation at positions 1, 3 and 7 and hydroxylation at position 8. In preterm neonates, ∼86% of caffeine citrate is excreted unchanged in the urine [97], as the processes of caffeine metabolism maturates progressively through time (N7-demethylation at the post-natal age of ∼4 months [98], acetylation by N-acetyltransferase (NAT2) completely developed by 1 year of postnatal age [99] and 8-hydroxylation activity starting as early as 1 month of age [100]). Thus, the maturity of the hepatic enzymes, dependent mainly by the postnatal age regardless of birthweight and gestational age, affects the plasma half-life of the drug [98,101].…”
Section: Caffeine Pharmacokineticsmentioning
confidence: 99%
“…Elimination of caffeine occurs mainly by renal excretion in the first weeks of life, which is slower in premature and term neonates compared with older children and adults, because of immaturity of renal functions [96]. Clearance of caffeine in neonates is influenced by gestational age, postconceptional age, parenteral nutrition and comorbidities [96,99,100,103,104], with values ranging from 0.08 to 0.13 mL•kg −1 •min −1 compared to that of adults and older children of 1.5 and 4.4 mL•kg −1 •min −1 , respectively [100,105].…”
Section: Caffeine Pharmacokineticsmentioning
confidence: 99%