A Study of Plasma Diazepam Levels in Mother and Infant

Gamble, J. A. S.; Moore, J.; Lamki, H; Howard, P. J.

doi:10.1111/j.1471-0528.1977.tb12659.x

Cited by 26 publications

(3 citation statements)

References 11 publications

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“…One reason for the adverse effects observed in the neonates may be that, following maternal administration of D, the total concentrations of D and DD in the umbilical cord blood can exceed those in maternal blood (Idanpaan-Heikkila et al, 1971; Gamble et al, 1977;Kanto et al, 1973).…”

Section: Discussionmentioning

confidence: 99%

Decreased serum protein binding of diazepam and its major metabolite in the neonate during the first postnatal week relate to increased free fatty acid levels.

Nau¹,

Luck²,

Kuhnz³

1984

Brit J Clinical Pharma

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The protein binding of diazepam (D) and its major active metabolite N-desmethyl diazepam (DD) was investigated in vitro in the serum of 14 mothers at birth, 21 foetuses at birth, in 100 neonates between 1 and 11 days of age and in 16 control subjects. The free (unbound) fractions of D and DD in the foetus were similar to those in the controls, but lower than those in the mothers. During the first day of life the free fractions of D and DD doubled in the neonates and subsequently declined slowly to reach near control levels at 1 week of age.The sharp increase and slow decrease of the free fractions of D and DD during the first postnatal week was closely paralleled by sharply increasing and decreasing free fatty acid (FFA) concentrations. Bilirubin and albumin levels were of lower importance in regard to the protein binding of D and DD.These results indicate that the greatly increased FFA levels shortly after birth result in increased free fractions of D and DD. Because of the known immaturity of the neonatal hepatic elimination capacity, these elevated free fractions may result in elevated free concentrations of the two compounds, which may help to explain the adverse effects observed clinically in some D-exposed neonates.

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Section: Discussionmentioning

confidence: 99%

Decreased serum protein binding of diazepam and its major metabolite in the neonate during the first postnatal week relate to increased free fatty acid levels.

Nau¹,

Luck²,

Kuhnz³

1984

Brit J Clinical Pharma

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“…The drug may persist in the circulation of the neonate for up to 1 week (Gamble et al, 1977). In non-pregnant women, circulating diazepam is largely bound to albumin (Klotz et al, 1975;Kaplan, 1980) and is metabolised in the liver (Klotz et al, 1976).…”

Section: Introduction Methodsmentioning

confidence: 99%

“…Diazepam is one of the most commonly prescribed drugs in the management of pre-eclampsia and eclampsia: A number of studies have indicated that it can rapidly cross the placenta (Mandelli et al, 1975;Mirkin & Singh, 1976;Haram & Bakke, 1980) and reach steady-state concentrations in the foetus similar to (Cree et al, 1973) or higher (Gamble et al, 1977) than in the mother. The drug may persist in the circulation of the neonate for up to 1 week (Gamble et al, 1977).…”

Section: Introduction Methodsmentioning

confidence: 99%

Serum protein binding of diazepam in maternal and foetal serum during pregnancy.

Lee¹,

Ss²,

Richens³

et al. 1982

Brit J Clinical Pharma

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Cord blood diazepam: Clinical effects in neonates of eclamptic mothers

et al. 1993

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Diazepam used in the treatment of eclampsia crosses the placental barrier readily, and may cause various clinical effects in the neonates. Twenty-five (25) live born babies of eclamptic mothers receiving diazepam were studied and cord blood diazepam concentration was estimated. Effect of low dose of diazepam is minimal apart from lowering of rectal temperature and the effects lasted for a period of 12 hours. But high dose (> 30 mg) of diazepam and prolonged duration of diazepam therapy in mothers causes significant depression of the newborn and the effects lasted for a period of 36-48 hours. As the clinical condition of the newborn is not related to the diazepam concentration in cord blood, the cord blood estimation is not helpful in the assessment of clinical effects of the drug in newborn. The tissue storage of the drug in newborn appears to be responsible for the clinical effects.

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A Study of Plasma Diazepam Levels in Mother and Infant

Cited by 26 publications

References 11 publications

Decreased serum protein binding of diazepam and its major metabolite in the neonate during the first postnatal week relate to increased free fatty acid levels.

Decreased serum protein binding of diazepam and its major metabolite in the neonate during the first postnatal week relate to increased free fatty acid levels.

Serum protein binding of diazepam in maternal and foetal serum during pregnancy.

Cord blood diazepam: Clinical effects in neonates of eclamptic mothers

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