I received a call from Owen's pediatrician this evening. His liver/kidney function numbers look okay, but his bilirubin levels are at around 7. Normal numbers are under 1.5. He definitely has Jaundice, now we just need to find the source. Dr Robin consulted Owen's Gi doc and they agreed that the next step needs to be an abdomen ultrasound.
Owen is scheduled for an ultrasound at Phoenix Children's tomorrow at 1:45. If they find a blockage of some sort, he will undergo surgery to remove it.
There will of course, be plenty of research on my end. I will be consulting Cardiology, both here and at Stanford. I don't take the idea of surgery lightly, but I know we need to resolve the issue quickly.
Owen is acting fine, no pain. He is tolerating his food more and more. I questioned if the issue was a rare complication of the Amoxicillan. He has never had antibiotics orally.. only the IV antibiotics after surgery/caths. I researched and confirmed that Augmentin can have side effects including jaundice, but he was on Amoxicillan. Hmmmm.
I'll will update when I know something tomorrow. Keep the little guy in your prayers!
Tuesday, October 25, 2011
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Amoxicillin/clarithromycin/lansoprazole may cause high levels of bilirubin in the blood.
This drug may also cause the following symptoms that are related to high levels of bilirubin in the blood:
Hepatic side effects have included moderate elevations of AST (SGOT) and/or ALT (SGPT) levels with the use of amoxicillin and lansoprazole. Cholestatic jaundice, hepatic cholestasis, and acute cytolytic hepatitis with the use of amoxicillin. Abnormal liver function tests, increased alkaline phosphatase, bilirubinemia have also been reported with the use of lansoprazole.
Amoxicillin/clarithromycin/lansoprazole is contraindicated for use in patients who are receiving drugs primarily metabolized in the liver by the CYP3A isoform. Concomitant administration with cisapride, pimozide, astemizole, terfenadine, ergotamine or dihydroergotamine is contraindicated. There have been postmarketing reports of drug interactions when clarithromycin and/or erythromycin are administered concomitantly with cisapride, pimozide, astemizole, or terfenadine resulting in cardiac arrhythmias (QT prolongation, ventricular tachycardia, ventricular fibrillation, and torsades de pointes). Fatalities have been reported.
Clarithromycin is primarily excreted via the liver and kidneys. In patients with hepatic impairment and normal renal function, clarithromycin may be administered without dosage adjustment. However, decreased dosage or prolonged dosing intervals may be appropriate in the presence of severe renal impairment with or without coexisting hepatic impairment.
Other side effects have included changes in laboratory parameters with the use of lansoprazole. These have included increased creatinine, increased alkaline phosphatase, increased globulins, increased/decreased/abnormal WBC, abnormal AG ratio, abnormal RBC, eosinophilia, hyperlipemia, increased/decreased electrolyte, increased/decreased cholesterol, increased glucocorticoids, increased LDH, increased/decreased/abnormal platelets, and increased gastrin levels. Urine abnormalities such as albuminuria, glycosuria, and hematuria were also reported.
Side Effects to Watch
Watch closely for the following side effects and notify your physician immediately should any of these develop:
Abnormal heart rate, fluttering in the chest, weakness, faintness, dizziness or loss of consciousness (signs of a serious condition called "torsade de pointe or QT prolongation" in which irregular heartbeats occur)
Abnormal bruising or signs of bleeding such as bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash (signs of problems with blood clot formation)
Lab and Diagnostic Tests
If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):
Blood tests to assess normal clotting - in people who develop signs of bleeding such as abnormal bruising or signs of bleeding including bleeding from the gums, nose, digestive tract, vagina (females), faintness, dizziness, loss of consciousness, or rash
EKG - if abnormal heartbeats (rapid slow or irregular) develop
tum version: 154.0 (Jun 16, 2010)
v
and p.s..... just wanted to share that with you.
I am saying Prayers it's nothing that involves surgery.
Praying for your Amazing Owen.
with Hope,
~ Chris A ~
Definitely praying for Owen! It's been so fun to see all of the Disney presents he has been getting, but jaundice, and especially the possibility of surgery, is no fun at all!
Fyi: Augmentin is made up of two drugs, one of which is amoxicillin. Hope Owen is looking and feeling better soon!
Saying prayers for all of you!
Prayers for Owen!
And all of you.
I bet Mickey prays, too.
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