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Administrering av koffeincitrat till för tidigt födda barn med apné
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences, Division of Pharmacokinetics and Drug Therapy.
2018 (Swedish)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Administration of caffeine citrate to newborns with apnea

Background: For over 40 years, caffeine has been the best medicine in the treatment of neonatal apnea. It is a nonspecific inhibitor of adenosine receptors of subtype A1- and A2Aaa. The commercial product is an orphan drug named Peyona, which is usually administrated intravenously through intermittent infusion. This is both time consuming and expensive, which leads us to the conclusion to study the ability of administrating it as an intravenous injection.

Objective: To investigate the possibilities to administrate caffeine citrate as an injection instead of an intermittent infusion in newborns with apnea.

Materials and Methods: Non-clinical measurements of the concentration and amount of caffeine that reaches the patient (dose: 15 mg caffeine citrate) after intermittent infusion of 15 minutes were performed by using UV-vis Druglog apparatus for two types of infusion systems; A+C (lowest dead space) and A+B+C (highest dead space). In addition, a survey and unstructured interviews touching upon the administration of caffeine citrate were conducted as well as a simplified cost-value evaluation.

Results: The amount of caffeine citrate detected after 15 minutes was 14.3 mg (95%CI 14.0 – 14.6) respectively 10.2 mg (95%CI 8.9 – 11.4) for system A+C and A+B+C. The majority of the nurses (n=15) of the total n=18 claimed to administrate Peyona according to existing guidelines from the Swedish national formulary for pediatric drugs, known as ePed. The annual cost-savings for Peyona 20 mg/mL would be 180,000 SEK if Peyona is given as an intravenous injection at the Astrid Lindgren Childen’s Hospital.

Conclusion: The full dose of caffeine citrate given did not reach the patient after 15 minutes of infusion as expected. An amount of caffeine citrate always came out with the flush samples given for system A+C and A+B+C. Therefore, new guidelines for Peyona 20 mg/mL is now available on ePed to administrate Peyona as an intravenous injection followed by a slowly given flush over ten minutes. 

Place, publisher, year, edition, pages
2018. , p. 47
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-360507OAI: oai:DiVA.org:uu-360507DiVA, id: diva2:1248092
Subject / course
Pharmacotherapy
Educational program
Master of Science Programme in Pharmacy
Supervisors
Examiners
Available from: 2018-10-02 Created: 2018-09-13 Last updated: 2018-10-02Bibliographically approved

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CiteExportLink to record
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