Hi, please read the following scenario:
In a newborn 60 hrs. old, (presenting in the ED) with elevated bilirubin levels. CSF was obtained via LP, with local anesthetic of 1% Lido. (TSB 19mg/dl). CSF specimen visualized as clear yellow in color, (comparable to urine). While freshly discharged and at home with family, (between 48 and 60 hrs of life), he became lethargic, extreme irritability, demonstrated continuous high pitched crying for hrs, mom was exclusively breast feeding. Baby lacked complete interest in feeding, and inconsolable. Therefore mom gave baby a safe dose of tylenol, that was prescribed for the baby the day before (while in the hospital) to help with pain post circumcision. Mom gave baby 2 doses of tylenol within a safe hour range. Mom noticed after administering the tylenol, his sx's became slightly less intensified. (Reason why she provided the 2nd dose to him). Eventually when the tylenol wore off, mom brought him to the ED, (12 hrs after discharge) Upon arrival she noticed, Baby's eyes rolling back in his head. Extremely hypotonic. My ? is, does tylenol compete with bilirubin, in regards to protein binding, and crossing the blood brain barrier (i.e yellow CSF.) Did the tylenol (in regards to protein binding) help decrease the amount of bili from entering the chil's CSF? If you could answer my question, i'd greatly appreciate it. I'm a pediatric emergency room RN.