caffeine citrate
Methylxanthine medication used to treat apnea of prematurity by stimulating the respiratory center and reducing episodes of breathing cessation in preterm infants.
Full Definition
Caffeine citrate is a central nervous system stimulant and the preferred methylxanthine for treating apnea of prematurity in infants born before 35 weeks gestation. It works by blocking adenosine receptors in the brainstem respiratory center, increasing respiratory drive and reducing both central and mixed apneic episodes. Caffeine has several advantages over theophylline, including a longer half-life allowing once-daily dosing, a wider therapeutic window with less toxicity, and fewer drug interactions. The typical loading dose is 20 mg/kg followed by maintenance dosing of 5-10 mg/kg daily. Beyond treating apnea, caffeine therapy has been associated with improved neurodevelopmental outcomes, reduced bronchopulmonary dysplasia, and earlier successful extubation in very low birth weight infants. Monitoring includes periodic assessment of heart rate, blood pressure, and growth parameters.
Usage
Usage note: Specify 'citrate' form to distinguish from other caffeine preparations; dosing is based on caffeine citrate, not caffeine base.
In Context
- "Caffeine citrate was initiated at 6 mg/kg daily to treat recurrent apneic episodes in the 32-week infant." — Medication order
- "The preterm infant showed marked reduction in apnea frequency after starting caffeine citrate therapy." — Progress note