Pharmacological interventions for the treatment of neonatal jaundice.
In the neonate, hyperbilirubinaemia is usually due to a combination of an increased bilirubin load and decreased bilirubin elimination. Despite an understanding of the enzymatic pathways leading to bilirubin production and elimination, very few pharmacological interventions to prevent hyperbilirubinaemia are utilized and the mainstay of treatment remains phototherapy. Previously studied pharmacological agents such as D-penicillamine, phenobarbital and clofibrate may yet prove useful. Recent clinical trials using metalloporphyrins to inhibit heme catabolism and bilirubin production provides a novel pharmacological intervention for the treatment of neonatal jaundice. The safety and efficacy of these therapies will need to be confirmed prior to widespread use.
Department of Neonatal and Developmental Medicine, Stanford University, 750 Welch Road, Suite315, Palo Alto, CA 94304, USA. dennery@stanford.edu
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Dennery
D000362:Agar / Q000494:pharmacology / Q000627:therapeutic use; D001663:Bilirubin / Q000378:metabolism; D002606:Charcoal / Q000494:pharmacology / Q000627:therapeutic use; D002994:Clofibrate / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D004365:Drugs, Chinese Herbal / Q000494:pharmacology / Q000627:therapeutic use; D006418:Heme / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000188:drug therapy* / Q000378:metabolism; D008102:Liver Circulation / Q000187:drug effects; D008665:Metalloporphyrins / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D010088:Oxidoreductases / Q000037:antagonists & inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D044925:Oxidoreductases Acting on CH-CH Group Donors; D010396:Penicillamine / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D010634:Phenobarbital / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D004365:Drugs, Chinese Herbal; D008665:Metalloporphyrins; D002606:Charcoal; D006418:Heme; D000362:Agar; D010088:Oxidoreductases; D044925:Oxidoreductases Acting on CH-CH Group Donors; C019789:biliverdin reductase; C042401:bilirubin oxidase; D010396:Penicillamine; D002994:Clofibrate; D001663:Bilirubin; D010634:Phenobarbital