ALTERATIONS IN THE ELECTRORETINOGRAM OF NEWBORN PIGLETS BY PROPIONIC ACID-DERIVATIVE NONSTEROIDAL ANTIINFLAMMATORY DRUGS BUT NOT BY INDOMETHACIN AND DICLOFENAC

Different nonsteroidal antiinflammatory drugs (NSAID), especially ibup rofen, are being considered as an alternative to indomethacin for use in the newborn and as antipyretics for infants. However, some of these NSAID have been shown to cause visual complications. We therefore stu died the effects of different NSAID indomethacin 19.6 mu mol/kg (7 mg/ kg), diclofenac 15.7 mu mol/kg (5 mg/kg), ibuprofen 48 and 194 mu mol/ kg (10 and 40 mg/kg), naproxen 79 mu mol/kg (20 mg/kg), and flurbiprof en 41 mu mol/kg (10 mg/kg) on photopic and scotopic electroretinograms (ERG) and retinal prostaglandin E(2), prostaglandin F-2 alpha, and 6- keto-prostaglandin F-1 alpha levels in piglets 1-5 d old. All NSAID de creased retinal prostaglandin levels, but their effects on the ERG wer e not identical. Indomethacin and diclofenac did not alter the ERG. In contrast, the propionic acid derivatives ibuprofen (the two doses use d), naproxen, and flurbiprofen affected the amplitude as well as the i mplicit time of the ERG under photopic and scotopic conditions. These changes are suggestive of generalized alterations in the function of r ods and cones. Prior inhibition of prostaglandin synthesis by indometh acin did not modify the effects of ibuprofen on the ERG. These finding s thus show a dissociation between the effects of NSAID on the ERG and prostaglandin synthesis. Because ERG changes are associated with visu al alterations, these effects of propionic acid derivatives should be taken into account before considering their use in infants.