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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

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Toxic additives in medication for preterm infants.

A Whittaker¹, A E Currie, M A Turner

¹Department of Infection, Immunity & Inflammation, University of Leicester Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK. hp28@le.ac.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition

|January 23, 2009

Summary

Preterm infants frequently receive medications containing potentially toxic excipients like ethanol and propylene glycol. Infants with chronic lung disease (CLD) faced higher exposure levels, necessitating strategies to reduce this toxic load.

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Area of Science:

Neonatal pharmacology
Pediatric toxicology
Clinical pharmacy

Background:

Limited data exists on excipient exposure in preterm infants during clinical care.
Excipients are inactive ingredients in medications, but can have physiological effects.

Purpose of the Study:

To quantify excipient exposure in preterm infants at a single center.
To assess the impact of chronic lung disease (CLD) on excipient exposure.

Main Methods:

Retrospective analysis of drug charts for infants receiving oral liquid medications.
Study included infants born <30 weeks gestation or <1500g at birth.
Focused on infants managed at the Leicester Neonatal Service.

Main Results:

Infants were exposed to over 20 excipients, including potentially neurotoxic ethanol and propylene glycol.
Infants with CLD showed higher concentrations of these toxins.
High sorbitol exposure exceeded adult recommended guidelines in some cases.

Conclusions:

Preterm infants commonly encounter potentially toxic excipients in medications.
Higher exposure levels were observed in infants with CLD.
Urgent development of strategies to minimize excipient exposure in preterm infants is needed.