'Gray baby syndrome' is an adverse reaction to one of the following drugs?

Appeared in: MNS 2024

Explanation

Chloramphenicol is the antibiotic directly linked to Gray baby syndrome.
The syndrome occurs in neonates and premature infants because their livers are too immature to metabolize and excrete the drug effectively.
This immaturity involves a deficiency of the enzyme UDP-glucuronyl transferase, leading to toxic accumulation of chloramphenicol.
The accumulation causes a cascade of symptoms, including the characteristic ashen gray skin color, flaccidity, hypothermia, and potentially fatal cardiovascular collapse.

Option A: Vancomycin is not associated with Gray baby syndrome. Its classic adverse effect is 'Red man syndrome'.
Option B: Clonidine is an antihypertensive medication. Its side effects, such as sedation and dry mouth, are unrelated to Gray baby syndrome.
Option D: Quinine is an antimalarial drug. Its characteristic toxicity is 'Cinchonism', not Gray baby syndrome.

Clinical Relevance

Nursing practice connection: Knowing Pharmacology: Adverse Drug Reactions and Syndromes helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
This concept is critical for pediatric and neonatal nursing. Nurses must be aware that neonates have immature organ systems, which significantly alters drug metabolism and increases the risk of toxicity.
A key nursing responsibility is to question and verify drug dosages for neonatal patients, especially for drugs with known toxicities like chloramphenicol.
Monitoring is crucial. A nurse observing symptoms like poor feeding, vomiting, or a change in skin color in a neonate receiving chloramphenicol must immediately report it as a potential sign of Gray baby syndrome.

How to Approach the Question

This is a factual recall question from pharmacology.
First, identify the specific syndrome mentioned in the question stem: 'Gray baby syndrome'.
Next, access your knowledge base of specific, named adverse drug reactions that are classically linked to certain medications.
Evaluate each option by trying to match it with the syndrome. Think: 'What is the main adverse effect of Vancomycin? Clonidine? Chloramphenicol? Quinine?'
Recall that Chloramphenicol is the drug famously associated with Gray baby syndrome in infants.
Confirm your answer by ruling out the others: Vancomycin causes Red man syndrome, and Quinine causes Cinchonism. Clonidine's side effects do not fit.

Concept Tested & Keywords

QCTgluoFx_Hgne3Pwg2IEH

E6 Pharmacology Katzung 16e pp. 1274-1276, 1275-1277

E6 Pharmacology KD Tripathi Essentials 9e Part 3 p. 72-74

Practise the full MNS 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.