Which of the following drug may cause Gray Baby syndrome

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Chloramphenicol is the antibiotic responsible for causing Gray Baby syndrome.
This severe adverse reaction occurs specifically in neonates and premature infants because their livers are too immature to metabolize the drug effectively.
The deficiency of the glucuronyl transferase enzyme leads to toxic accumulation of chloramphenicol.
This toxicity manifests as an ashen-gray skin color, abdominal distension, vomiting, hypotension, and can lead to cardiovascular collapse and death.

Option B: Penicillin's most significant adverse effect is hypersensitivity, not Gray Baby syndrome.
Option C: Doxycycline, a tetracycline, is known for causing permanent tooth discoloration and affecting bone growth in children.
Option D: Kanamycin is an aminoglycoside antibiotic whose major toxicities are damage to the ears (ototoxicity) and kidneys (nephrotoxicity).

Clinical Relevance

Nursing practice connection: Knowing Adverse Drug Reactions in Neonates helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A fundamental nursing responsibility is understanding drug contraindications for specific patient populations, such as neonates, to prevent severe or fatal adverse events like Gray Baby syndrome.
Nurses act as a crucial safety check in medication administration. They must be empowered to question a prescription for chloramphenicol in a newborn, escalating concerns to the prescriber and pharmacist.
What if? If chloramphenicol were prescribed for an adult with normal liver function, the risk of Gray Baby syndrome would be virtually zero. The primary nursing concern would shift to monitoring for its other major side effect: bone marrow suppression, by checking routine blood counts.

How to Approach the Question

This is a factual recall question that tests your knowledge of specific, high-yield adverse drug reactions.
First, identify the key clinical term in the question stem: 'Gray Baby syndrome'.
Access your memory of pharmacology. This unique and severe syndrome is classically associated with one specific antibiotic.
Evaluate the options provided. Chloramphenicol is the drug directly linked to Gray Baby syndrome.
To confirm, mentally review the hallmark toxicities of the other options: Penicillin (allergy), Doxycycline (teeth/bone issues), and Kanamycin (ear/kidney toxicity). This process of elimination confirms Chloramphenicol is the correct answer.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 3 pp. 72-74, 71-73

E6 Pharmacology Nurses Shanbhag 3e p. 305-307

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