APNOEA OF PREMATURITY. STUDY OF THE ACTION OF METHYLXANTHINES IN THE TREATMENT AND PREVENTION OF APNOEA CRISES IN PREMATURE PATIENTS
ADELA-VALERIA NEAMȚU 1, MIRELA-ANIȘOARA SIMINEL 2, LUMINIȚA-CRISTINA CHIUTU 2, COSTEL-VALENTIN MANDA 3, CĂTĂLINA COTEANU 4, LILIANA STANCA 2 , OLIVIA GAROFIȚA MATEESCU 2, SIMONA-DANIELA NEAMȚU 3*, DANIELA MARIA CALUCICĂ 3, MONICA DENISA ELENA POPESCU 3, OCTAVIAN CROITORU 3
1 PhD Student, Doctoral School, University of Medicine and Pharmacy of Craiova, Petru Rareș Street, 200638, Romania
2 Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Petru Rareș Street, 200638, Romania
3 Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Petru Rareș Street, 200638, Romania
4 "Filantropia" Clinic Laboratory Municipal Hospital, 1 Filantropiei Street, 200143 Craiova, Romania
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Serum methylxanthine concentrations in premature infants show marked variability due to immature hepatic metabolism and drug interactions. This study aimed to evaluate newborns diagnosed with apnoea of prematurity through a comprehensive clinicobiological analysis and to highlight the role of therapeutic drug monitoring (TDM) in preventing complications related to overaccumulation and in optimising administration strategies. A prospective observational study was conducted on 331 premature neonates divided into a study group and a control group. In the study group, 75 infants were treated with caffeine citrate and 6 with theophylline ethylenediamine. Hydroelectrolytic and metabolic imbalances occurred in infants treated with caffeine citrate. Strong correlations were observed between electrolyte imbalances and convulsions (r = -0.44), respiratory complications (r = 0.48) and hyperglycaemia with oedema (r = -0.57). High serum caffeine citrate exposure (80 µg/mL) was associated with a significantly increased risk of respiratory complications, ecchymoses and oedema. Adjustment of therapeutic doses, guided by serial monitoring of serum caffeine citrate titres, may improve clinical outcomes in critical cases, reduce adverse drug effects, and support safer, individualised therapeutic management of apnoea of prematurity.
