Phenobarb. in neonates?

  1. My nephew was born prematurely and is currently in NICU. They started giving him phenobarb. last night. He has never had any seizure activity. When my sister asked the MD, she said it's for hepatic problems.
    Has anyone heard of this before? My drug books say this drug should not be given if there could be hepatic disorders.

    I'd appreciate any info.

    Thank you,
    Allison
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  2. 4 Comments

  3. by   prmenrs
    Phenobarb is sometimes used in neonates for a high DIRECT bilirubin. A high INDIRECT can be treated w/lights, but that is contraindicated for a high direct.

    It might be helpful to know why his direct is high.
  4. by   prmenrs
    P.S. try www.neofax.com it may be listed as a use on that site.
  5. by   Allison P
    Thank you for your response. He has a grade IV brain bleed. They think the bilirubin might be elevated due to the breakdown and reabsorption of the blood.

    Thanks,
    Allison
  6. by   kids
    Originally posted by Allison P
    Thank you for your response. He has a grade IV brain bleed. They think the bilirubin might be elevated due to the breakdown and reabsorption of the blood.

    Thanks,
    Allison
    The phenobarb is likely serving a dual purpose in his case then. With the bleed he is at risk to have seizures...which could extend the bleed.

    Keep in mind there is more than one kind of seizure and not all are as obvious as a Grand Mal. In my "past life" I did high tech peds home care, a fair portion of my caseload was micro preemies, a large share of them had grade III or IV bleeds and were on phenobarb for for seizure activity that only visually manifested as eye movements (interestingly usually left, up & out).
    As I recall most were able to be weaned off by age 2 (with no significant change in their EEGs)

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