枸橼酸咖啡因在早产儿和足月新生儿中的药动学及其在呼吸暂停治疗中的应用进展

卢金淼, 朱琳, 李静, 李智平

中国药学杂志 ›› 2017, Vol. 52 ›› Issue (21) : 1884-1888.

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中国药学杂志 ›› 2017, Vol. 52 ›› Issue (21) : 1884-1888. DOI: 10.11669/cpj.2017.21.003
综述

枸橼酸咖啡因在早产儿和足月新生儿中的药动学及其在呼吸暂停治疗中的应用进展

  • 卢金淼, 朱琳, 李静, 李智平
作者信息 +

Pharmacokinetics of Caffeine Citrate and the Progress of Its Application in the Treatment for Apnea of Prematurity

  • LU Jin-miao, ZHU Lin, LI Jing, LI Zhi-ping
Author information +
文章历史 +

摘要

早产儿和足月新生儿呼吸暂停是常见的早产新生儿严重疾病, 持续的呼吸暂停会对脑部及器官发育造成危害。甲基黄嘌呤类化合物, 如茶碱、咖啡因常用于治疗早产儿和足月新生儿呼吸暂停。其中, 咖啡因治疗安全范围更大, 给药1日1次, 更受临床关注。咖啡因的安全性、有效性和性价比最好, 可以减少最初2到7 d内的呼吸暂停发作次数以及间歇正压通气使用次数, 降低经气管插管和经鼻导管持续气道正压通气的依赖时间、降低持续供氧的时间、提高撤机成功率、降低支气管肺发育不良发生率、减少动脉导管未闭、减少激素应用、视网膜病有积极治疗作用等。另外, 咖啡因治疗可以减少正压通气时间, 从而降低了总治疗成本。我国使用枸橼酸咖啡因用于早产儿和足月新生儿呼吸暂停的治疗。为此, 笔者就咖啡因在早产儿和足月新生儿中的药动学及其在早产儿和足月新生儿呼吸暂停等相关疾病中的应用进展做一综述。

Abstract

Apnea in premature infants is a common preterm neonatal serious disease, persistent apnea will cause harm to brain and organ development. Methylxanthine compounds such as theophylline and caffeine are used to treat apnea in premature infants. Among them, the caffeine treatment of greater safety and ease of administration once a day, and more attention due to caffeine safe, effective, cost-effective the best, Aranda described it as "silver bullet in neonatal medicine". Caffeine reduced the number of apneic episodes during the first 2 to 7 d and the number of intermittent positive pressure ventilation use and showed a dependency on other beneficial effects such as can reduced time of tracheal intubation and nasal catheter continuous positive airway pressure, reduce the duration of continuous oxygen supply, improve the success rate of weaning, reduce the incidence of bronchopulmonary dysplasia, reduce patent ductus arteriosus, reduce the use of hormones, retinopathy of premature children have a positive therapeutic effect. Caffeine treatment reduces positive airway pressure, thereby reducing overall treatment costs. In 2013, China approved caffeine citrate for the treatment of apnea in premature infants. In this paper, the pharmacokinetics of caffeine in premature infants and its application in apnea and related diseases of premature infants were reviewed.

关键词

早产儿呼吸暂停 / 药动学 / 支气管肺发育不良 / 咖啡因 / 神经发育 / 代谢

Key words

apnea in premature infants / pharmacokinetics / bronchopulmonary dysplasia / caffeine / neurodevelopment / metabolism

引用本文

导出引用
卢金淼, 朱琳, 李静, 李智平. 枸橼酸咖啡因在早产儿和足月新生儿中的药动学及其在呼吸暂停治疗中的应用进展[J]. 中国药学杂志, 2017, 52(21): 1884-1888 https://doi.org/10.11669/cpj.2017.21.003
LU Jin-miao, ZHU Lin, LI Jing, LI Zhi-ping. Pharmacokinetics of Caffeine Citrate and the Progress of Its Application in the Treatment for Apnea of Prematurity[J]. Chinese Pharmaceutical Journal, 2017, 52(21): 1884-1888 https://doi.org/10.11669/cpj.2017.21.003
中图分类号: R969.3   

参考文献

[1] BAIRAM A, UPPARI N, MUBAYED S, et al. An Overview on the Respiratory Stimulant Effects of Caffeine and Progesterone on Response to Hypoxia and Apnea Frequency in Developing Rats[M]. Berlin:Springer International Publishing, 2015.
[2] REN D T, WANG Y, SHEN J, et al. Study on pharmacokinetics of theophylline in different groups of infants[J]. Chin Pharm J(中国药学杂志), 2000, 35(6):399-400.
[3] SKOUROLIAKOU M, BACOPOULOU F, MARKANTONIS S L. Caffeine versus theophylline for apnea of prematurity:a randomised controlled trial[J]. J Paediatr Child Health, 2009, 45(10):587-592.
[4] JACOB V A, WINIFRED G, HARDUR B, et al. Efficacy of caffeine in treatment of apnea in the low-birth-weight infant[J]. J Pediatr, 1977, 90(3):467-472.
[5] ARANDA J V, BEHARRY K, VALENCIA G B, et al. Caffeine impact on neonatal morbidities[J]. J Matern Fetal Neonatal Med, 2010, 23(Suppl 3):20-23.
[6] YUAN L, CHEN C. Clinical applications of caffeine in neonates[J]. World Clin Drugs(世界临床药物), 2009, 30(9):518-522.
[7] HENDERSON-SMART D J, DE PAOLI A G. Methylxanthine treatment for apnoea in preterm infants[J]. Cochrane Database of Systematic Reviews, 2010, 12(12):CD000140.
[8] BARBARA S, ROBIN S R, PETER D, et al. Caffeine therapy for apnea of prematurity[J]. New Engl J Med, 2006, 354(20):2112-2121.
[9] DUKHOVNY D, LORCH S A, SCHMIDT B, et al. Economic evaluation of caffeine for apnea of prematurity[J]. Pediatrics, 2011, 127(1):146-155.
[10] JACOB V, ARANDA, CLARENCE E C, et al. Pharmacokinetic profile of caffeine in the premature newborn infant with apnea[J]. J Pediatrics, 1979, 94(4):663-668.
[11] HOY S M, SCOTT L J. Indomethacin/prochlorperazine/caffeine:a review of its use in the acute treatment of migraine and in the treatment of episodic tension-type headache[J]. Cns Drugs, 2011, 25(4):343-358.
[12] AMATO M, ISENSCHMID M, HPPI P. Percutaneous caffeine application in the treatment of neonatal apnoea[J]. Eur J Pediatrics, 1991, 150(8):592-594.
[13] LEE T C, CHARLES B, STEER P, et al. Population pharmacokinetics of intravenous caffeine in neonates with apnea of prematurity[J]. Clin Pharmacol Therapeu, 1997, 61(6):628-640.
[14] CAROL K T. Pediatric & Neonatal Dosage Handbook with International Trade Names Index 2012-2013[J]. 2012.
[15] LELO A, MINERS J O, ROBSON R A, et al. Quantitative assessment of caffeine partial clearances in man[J]. Br J Clin Pharmacol, 1986, 22(2):183-186.
[16] BORY C, BALTASSAT P, PORTHAULT M, et al. Metabolism of theophylline to caffeine in premature newborn infants[J]. J Pediatrics, 1979, 94(6):988-993.
[17] PEARLMAN S A, DURAN C, WOOD M A, et al. Caffeine pharmacokinetics in preterm infants older than 2 weeks[J]. Develop Pharmacol Therapeu, 1989, 12(2):65.
[18] ALDRIDGE A B, ARANDA J V, NEIMS A H. Caffeine metabolism in the newborn[J]. Clin Pharmacol Therapeu, 1979, 25(4):447-453.
[19] VILHELMIINA P, JENNIFER B, ZHAI Q, et al. The effect of caffeine citrate on neural breathing pattern in preterm infants[J]. Early Human Develop, 2015, 91(10):565-568.
[20] JULIEN C A, VBAIRAM A J. Caffeine reduces apnea frequency and enhances ventilatory long-term facilitation in rat pups raised in chronic intermittent hypoxia[J]. Pediatric Res, 2010, 68(2):105.
[21] WEICHELT U, CAY R, SCHMITZ T, et al. Prevention of hyperoxia-mediated pulmonary inflammation in neonatal rats by caffeine[J]. Eur Respiratory J, 2013, 41(4):966-973.
[22] LI J, LI G, HU J L, et al. Chronic or high dose acute caffeine treatment protects mice against oleic acid-induced acute lung injury via an adenosine A2A receptor-independent mechanism[J]. Eur J Pharmacol, 2011, 654(3):295-303.
[23] SOLOVEYCHIK V, BINNUN A, IONCHEV A, et al. Acute hemodynamic effects of caffeine administration in premature infants[J]. J Perinatol, 2009, 29(3):205-208.
[24] LEE H S, KHOO Y M, CHIRINOBARCELO Y, et al. Caffeine in apnoeic Asian neonates:a sparse data analysis[J]. Br J Clin Pharmacol, 2002, 54(1):31-37.
[25] GIANLUCA L, LAURA F, RENTA P, et al. The real-world routine use of caffeine citrate in preterm infants:a european postauthorization safety study[J]. Neonatology, 2016, 109(3):221.
[26] ERGENEKON E, DALGINAZAN, AKSOY E, et al. Caffeine intoxication in a premature neonate[J]. Paediatric Anaesthesia, 2001, 11(6):737-739.
[27] WELSH C, PAN J, BELIK J. Caffeine impairs gastrointestinal function in newborn rats[J]. Pediatric Res, 2015, 78(1):24-28.
[28] SMITS P, LENDERS J W, THIEN T. Caffeine and theophylline attenuate adenosine-induced vasodilation in humans[J]. Clin Pharmacol Therapeu, 1990, 48(4):410-418.
[29] HIROSHI J, KAZUYOSHI K, HACHIRO U, et al. Pharmacological natures of caffeine-induced endothelium-dependent and-independent contraction in canine mesenteric artery[J]. Life Sci, 1995, 57(12):1155-1162.
[30] LAMPKIN S J, TURNER A M, LAKSHMINRUSIMHA S, et al. Association between caffeine citrate exposure and necrotizing enterocolitis in preterm infants[J]. Am J Health-System Pharmacy, 2013, 70(7):603-608.
[31] CURZIDASCALOVA L, AUJARD Y, GAULTIER C, et al. Sleep organization is unaffected by caffeine in premature infants[J]. J Pediatrics, 2002, 140(6):766-771.
[32] POBLOTZKI M V, E RIEGER-FACKELDEY, SCHULZE A. Effects of theophylline on the pattern of spontaneous breathing in preterm infants less than 1000 g of birth weight[J]. Early Human Development, 2003, 72(1):47-55.
[33] FREDHOLM B B. Adenosine, Adenosine Receptors and the Actions of Caffeine[J]. Pharmacol & Toxicol, 2010, 76(2):93-101.
[34] SCHMIDT B, ROBERTS R S, DAVIS P, et al. Long-term effects of caffeine therapy for apnea of prematurity[J]. New Engl J Med, 2007, 357(19):1893-1902.
[35] BARBARA S, PETER J A, LEX W D, et al. Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity[J]. JAMA, 2012, 307(3):275-282.
[36] STEER P A, HENDERSON-SMART D J. Caffeine Versus Theophylline for Apnea in Preterm Infants[M]. John Wiley & Sons, Ltd, 1998.
[37] BHATIA J. Current options in the management of apnea of prematurity[J]. Clin Pediatrics, 2000, 39(6):327-336.
[38] BHATTMEHTA V, JOHNSON C E, DONN S M, et al. Accuracy and reliability of dosing equations to individualize theophylline treatment of apnea of prematurity[J]. Pharmacother J Human Pharmacol Drug Ther, 2012, 15(2):246-250.
[39] MUNISHA B, SAM O. Management of apnoea and bradycardia in the newborn[J]. Paediatrics & Child Health, 2014, 24(1):17-22.
[40] STEER P, FLENADY V, SHEARMAN A, et al. High dose caffeine citrate for extubation of preterm infants:a randomised controlled trial[J]. Archives of Disease in Childhood Fetal & Neonatal Edition, 2004, 89(6):499-503.
[41] MOHAMMED S, NOUR I, SHABAAN A E, et al. High versus low-dose caffeine for apnea of prematurity:a randomized controlled trial[J]. Eur J Pediatr, 2015, 174(7):949-956.
[42] MCPHERSON C, NEIL J J, TJOENG T H, et al. A pilot randomized trial of high-dose caffeine therapy in preterm infants[J]. Pediatr Res, 2015, 78(2):198-204.
[43] PATEL R M, LEONG T, CARLTON D P, et al. Early caffeine therapy and clinical outcomes in extremely preterm infants[J]. J Perinatol, 2013, 33(2):134-140.
[44] DOBSON N R, PATEL R M, SMITH P B, et al. Trends in caffeine use and association between clinical outcomes and timing of therapy in very low birth weight infants[J]. J Pediatr, 2014, 164(5):992-998.
[45] DAVIS P G, SCHMIDT B, ROBERTS R S, et al. Caffeine for apnea of prematurity trial:benefits may vary in subgroups[J]. J Pediatr, 2010, 156(3):382-387.
[46] PICONE S, BEDETTA M, PAOLILLO P. Caffeine citrate: when and for how long. A literature review[J]. J Matern Fetal Neonatal Med, 2012, 25(Suppl 3):11-14.
[47] DOYLE J, DAVIDSON D, KATZ S, et al. Apnea of prematurity and caffeine pharmacokinetics:potential impact on hospital discharge[J]. J Perinatol Offi J California Perinatal Assoc, 2015, 36(2):141.
[48] NATARAJAN G, BOTICA M L, THOMAS R, et al. Therapeutic drug monitoring for caffeine in preterm neonates:an unnecessary exercise?[J]. Pediatrics, 2007, 119(5):936-940.
[49] SCHOEN K, YU T, STOCKMANN C, et al. Use of methylxanthine therapies for the treatment and prevention of apnea of prematurity[J]. Paediatric Drugs, 2014, 16(2):169-177.
[50] ARMANIAN A M, IRANPOUR R, FAGHIHIAN E, et al. Caffeine administration to prevent apnea in very premature infants[J]. Pediatr Neonatol, 2016, 57(5):408-412.
[51] BUCHER H U, DUC G. Does caffeine prevent hypoxaemic episodes in premature infants?[J]. Eur J Pediatr, 1988, 147(3):288-291.
[52] HENDERSON-SMART D J, DE PAOLI A G. Prophylactic methylxanthine for prevention of apnoea in preterm infants[J]. Cochrane Database of Systematic Reviews, 2010, 2(12):CD000432.

基金

国家自然科学基金资助项目(81370776);中国-世界卫生组织2016-2017双年度合作项目:儿童用药安全性和可及性相关因素对策研究资助项目(2016/647672-0)
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