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Related Experiment Videos

Iatrogenic hyperosmolality in a neonate. A case report

J H van der Westhuyzen, G M Berger, N Beyers

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |December 26, 1981
    PubMed
    Summary

    A newborn developed high serum osmolality from glycerol and alcohol in phenobarbitone elixir used for seizures. This highlights risks in medication ingredients and formulation changes.

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    Area of Science:

    • Neonatal Medicine
    • Clinical Toxicology
    • Pediatric Pharmacology

    Background:

    • Neonatal seizures require prompt and effective treatment.
    • Phenobarbitone elixir is a common anticonvulsant for infants.
    • Medication formulations can contain unexpected active or toxic components.

    Observation:

    • An infant presented with severe hyperosmolality of unknown etiology within the first week of life.
    • The infant's condition was linked to the administration of a local phenobarbitone elixir.
    • Investigations revealed elevated levels of glycerol and alcohol contributing to the osmolality.

    Findings:

    • Cryptic osmols, identified as glycerol and alcohol, were responsible for the infant's elevated serum osmolality.
    • These osmols originated from the excipients within the phenobarbitone elixir.
    • The specific formulation of the elixir contained potentially harmful inactive ingredients.

    Implications:

    • Clinicians must consider the osmolality contribution from all medication components, including excipients.
    • Modifications to established drug formulations require rigorous safety assessments.
    • This case underscores the importance of vigilant monitoring for adverse effects related to pharmaceutical ingredients in neonates.

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