Pharmacotherapy for Seizures in Neonates with Hypoxic Ischemic Encephalopathy

Elissa G. Yozawitz, Arthur Stacey, Ronit M. Pressler

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Seizures are common in neonates with moderate and severe hypoxic ischemic encephalopathy (HIE) and are associated with worse outcomes, independent of HIE severity. In contrast to adults and older children, no new drugs have been licensed for treatment of neonatal seizures over the last 50 years, because of a lack of controlled clinical trials. Hence, many antiseizure medications licensed in older children and adults are used off-label for neonatal seizure, which is associated with potential risks of adverse effects during a period when the brain is particularly vulnerable. Phenobarbital is worldwide the first-line drug and is considered standard of care, although there is a limited evidence base for its efficacy. Second-line agents include phenytoin, benzodiazepines, levetiracetam, and lidocaine. These drugs are discussed in more detail along with two emerging drugs (bumetanide and topiramate). More safety, pharmacokinetic, and efficacy data are needed from well-designed clinical trials to develop safe and effective antiseizure regimes for the treatment of neonatal seizures in HIE.

Original languageEnglish (US)
Pages (from-to)1-15
Number of pages15
JournalPediatric Drugs
DOIs
StateAccepted/In press - Aug 2 2017

Fingerprint

Brain Hypoxia-Ischemia
Seizures
Newborn Infant
Drug Therapy
etiracetam
Pharmaceutical Preparations
Bumetanide
Controlled Clinical Trials
Phenytoin
Standard of Care
Phenobarbital
Lidocaine
Benzodiazepines
Pharmacokinetics
Clinical Trials
Safety
Brain
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

Cite this

Pharmacotherapy for Seizures in Neonates with Hypoxic Ischemic Encephalopathy. / Yozawitz, Elissa G.; Stacey, Arthur; Pressler, Ronit M.

In: Pediatric Drugs, 02.08.2017, p. 1-15.

Research output: Contribution to journalArticle

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