By Edmund Hey
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Additional info for Neonatal Formulary: Drug Use in Pregnancy and the First Year of Life
This can be abbreviated to ml (but it should not be contracted to cc or cm3). Decimal places: Carelessness here is a major cause of potentially lethal overtreatment. Decimals should be avoided where possible and, where unavoidable, always prefaced by a zero. Write 500 mg not 0·5 g. If a decimal has to be used, write 0·5 ml not ·5 ml. Do not use a comma, use a stop (0·5 ml not 0,5 ml). Time: This is best written using the 24 hour clock when prescribing for patients in hospital. Route of administration: This must always be indicated.
Maternal treatment during lactation would only result in the baby receiving about 2% of the maternal dose on a weight-for-weight basis. Acetazolamide is a sulphonamide derivative, and complications such as agranulocytosis, thrombocytopenia, aplastic anaemia, skin toxicity and crystalluria with calculus formation have all been reported on occasion, as with many of the sulphonamide drugs. Post-haemorrhagic hydrocephalus Trials have shown that regular tapping, to remove CSF, has no measurable impact on long-term disability.
Using fluid from the main IV line to do this can also make the baby briefly and abruptly hyperglycaemic. 9 Beware giving a small newborn baby excess sodium unintentionally. The use of flush solutions of Hep-lok®, Hepsal® or 0·9% sodium chloride can expose a baby to an unintended excess of intravenous sodium. The steady infusion of 1 ml/hour of heparinised 0·9% sodium chloride (normal saline) to maintain catheter patency is sometimes enough to double a very small baby’s total daily sodium intake.
Neonatal Formulary: Drug Use in Pregnancy and the First Year of Life by Edmund Hey