Non-steroidal Anti-inflammatory Drugs in Newborns and Infants

Pediatr Clin North Am. 2017 Dec;64(6):1327-1340. doi: 10.1016/j.pcl.2017.08.009.

Abstract

Nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen are used in young infants and newborns for pain and fever control, patent ductus closure, prevention of intraventricular hemorrhage, and potentially for prevention of retinopathy of prematurity. These drugs inhibit cyclooxygenase 1 (COX-1), COX-2, and peroxidases, thus, blocking prostaglandin (PG) synthesis. PGs are eicosanoids that regulate several physiologic, pathologic, and cellular processes, including vasomotor tone, platelet aggregation, sensitization of neurons to pain, and many molecular events critical to physiologic homeostasis. NSAIDs inhibit caspases and cell death. Increasing knowledge of these molecular entities may allow targeted drug development to prevent or minimize neonatal morbidities.

Keywords: Acetaminophen; Cyclooxygenases; Ibuprofen; Indomethacin; Ketorolac; NSAIDs; Newborns; Paracetamol.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acetaminophen / therapeutic use*
  • Analgesics, Non-Narcotic / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Humans
  • Infant
  • Infant, Newborn
  • Prostaglandin-Endoperoxide Synthases / drug effects*

Substances

  • Analgesics, Non-Narcotic
  • Anti-Inflammatory Agents, Non-Steroidal
  • Acetaminophen
  • Prostaglandin-Endoperoxide Synthases