title: Nutritional support and cardioprotection with L-carnitine: prescription appropriateness and safety concerns in Mexican neonates.
abstract: Medication errors are probably more common in neonates than is generally appreciated. In Mexican pediatric hospitals, L-carnitine is mainly used for nutritional support and to treat cardiomyopathy secondary to neonatal asphyxia. Using a longitudinal-retrospective approach we assessed the appropriateness of all L-carnitine prescriptions written during a 12-month period at a NICU of a second-level hospital located in Toluca, Mexico. Reports of adverse reactions possibly related to L-carnitine therapy were collected and characterized. Overall, administration of L-carnitine was considered justified and appropriate only in 18% of patients. 60.7% of L-carnitine prescriptions were rated as inappropriate because the prescribed doses fell outside the recommendations. The overall rate of ADRs calculated from the patient population was 18.03%. All of them were of gastrointestinal type: abdominal cramps (8 cases, 61.54%) and vomiting (5 cases, 38.46%). Our results supported the establishment of an L-carnitine rational use policy at the NICU of the hospital under study.
authors.affiliation: Laboratorio de Toxicología, Departamento de Farmacia, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Tollocan esquina Paseo Colón. Col. Universidad. Toluca, Estado de México.
authors.forename: Leobardo Manuel
authors.initials: LM
authors.lastname: Gómez-Oliván
authors.forename: Analleli
authors.initials: A
authors.lastname: Valdés-Alanis
authors.forename: Lucila I
authors.initials: LI
authors.lastname: Castro-Pastrana
authors.forename: Marcela
authors.initials: M
authors.lastname: Galar-Martinez
authors.forename: Carolina Angélica
authors.initials: CA
authors.lastname: Romero-Castillo
mesh_terms: D002331:Carnitine / Q000009:adverse effects*; D004363:Drug Utilization; D006321:Heart / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008137:Longitudinal Studies; D008800:Mexico; D018529:Nutritional Support; D012189:Retrospective Studies
chemical_list: D002331:Carnitine