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This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 27 No. 8, August 2006 Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Abbott, M. B. Articles by Wu, S. Search for Related Content PubMed PubMed Citation Articles by Abbott, M. B. Articles by Wu, S.

(Pediatrics in Review. 2006;27:283-288.)
© 2006 American Academy of Pediatrics

Medication Potpourri

Myles B. Abbott, MD^*
Robert H. Levin, PharmD
Susan Wu, MD

^* Clinical Professor of Pediatrics, University of California, San Francisco, Calif
Professor Emeritus of Clinical Pharmacy, University of California, San Francisco, Calif
Visiting Assistant Professor of Clinical Pediatrics, University of Southern California, Los Angeles, Calif

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Recognize which maternal exposures can result in early hemorrhagic disease of the newborn.
   
2. List which drugs may precipitate or exacerbate seizures.
   
3. Understand the action that should be taken when peak concentrations of gentamicin are adequate but trough concentrations are too high.
   
4. Know which commonly used pediatric drugs might produce sensorineural hearing loss.
   
5. Discuss the uses and abuses of anticholinergics in the treatment of gastrointestinal disease.
   
6. Know which drugs affect the elimination of other drugs.
   

	Introduction

 
Pediatricians and other child health-care practitioners need to understand the adverse effects of commonly prescribed drugs. It also is helpful to understand the mechanisms involved so untoward effects can be prevented. In using some drugs, it is especially important to understand their kinetics and elimination so they can be administered safely. This article addresses: 1) the adverse effects of certain drugs in three clinical areas (neonatal hemorrhage, seizures, and hearing); 2) the kinetics of gentamicin; 3) the potential abuses of anticholinergics; and 4) the mechanisms by which one drug affects the elimination of others. Health-care practitioners who have additional questions about these drugs should seek advice from clinical pharmacists.

	Early Hemorrhagic Disease of the Newborn Due to Maternal Drugs

 
Certain anticonvulsants, antibiotics, and anticoagulants taken during pregnancy increase the risk of bleeding in the newborn. These medications produce a vitamin K deficiency that can manifest in the neonate within three time periods: early (in the first 48 hours after birth), classic (2 days to 2 weeks after birth), and late (2 weeks to 3 months after birth). Typically, prenatal exposure to these medications causes early disease that presents with cephalohematoma, often accompanied by bleeding at unusual sites (eg, intracranial, pleural, peritoneal, or gastrointestinal). This bleeding can be life-threatening.

All neonates are born having little or no vitamin K reserve. Under normal conditions, vitamin K concentrations decrease initially . . . [Full Text of this Article]