Safety of Benzodiazepines in Newborns

Ng, Eugene; Klinger, G; Shah, Vibhuti; Taddio, Anna

doi:10.1345/1542-6270(2002)036<1150:sobin>2.0.co;2

Cited by 11 publications

(17 citation statements)

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“…The possible adverse effects of unnecessary anticonvulsant treatment in critically ill neonates are important. Hypotension, hypoventilation resulting in the need for mechanical ventilation, and fatal cardiac arrhythmias have all been attributed to anticonvulsant treatment in the newborn period 10 11…”

Section: Discussionmentioning

confidence: 99%

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Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures

Murray

Boylan

Ali

et al. 2008

Archives of Disease in Childhood - Fetal and Neonatal Edition

391

288

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Section: Discussionmentioning

confidence: 99%

“…Because of the difficulty in deciding clinically whether a baby is seizing, clinical seizures may be overestimated, resulting in unnecessary treatment. Neonatal seizures may also be either underdiagnosed resulting in undertreatment, or incorrectly categorised resulting in potentially harmful treatment 10 11…”

mentioning

confidence: 99%

Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures

Murray

Boylan

Ali

et al. 2008

Archives of Disease in Childhood - Fetal and Neonatal Edition

391

288

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show abstract

“…Excessive calcium influx, which can occur following over-activation of the GABA A receptor during this time period, results in cell death (Orrenius et al, 2003;Paschen, 2003;Siesjo, 1994;Tymianski, 1996). Work in fetal primates (Khazipov et al, 2001), along with data in humans documenting that benzodiazepines (GABA A receptor agonists) can exacerbate seizures in premature and newborn human infants (Guerrini et al, 1998;Montenegro et al, 2001;Ng et al, 2002), has verified that the "excitatory" actions of developmental GABA A receptor activation are not relegated to non-human species. Given this information, an investigation of the anatomical and behavioral consequences of early anesthetic exposure is warranted.…”

mentioning

confidence: 99%

Response to neonatal anesthesia: Effect of sex on anatomical and behavioral outcome

2008

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Numerous studies have documented the consequences of exposure to anesthesia in models of term and post-term infants, evaluating the incidence of cell loss, physiological alterations and cognitive dysfunction. However, surprisingly few studies have investigated the effect of anesthetic exposure on outcomes in newborn rodents, the developmental equivalent of premature human infants. This is critical given that one out of every eight babies born in the United States is premature, with an increased prevalence of surgical procedures required in these individuals. Also, no studies have investigated if the genetic sex of the individual influences the response to neonatal anesthesia. Using the newborn rat as the developmental equivalent of the premature human, we documented the effect of a single bout of exposure to either the inhalant isoflurane or the injectable barbiturate phenobarbital on hippocampal anatomy, hippocampal dependent behavioral performance and normal developmental endpoints in male and female rats. While both forms of anesthesia led to significant decrements in cognitive abilities, along with a significant reduction in volume and neuron number in the hippocampus in adulthood, the decrements were significantly greater in males than in females. Interestingly, the deleterious effects of anesthesia were manifest on developmental measures including surface righting and forelimb grasp, but were not evident on basic physiological parameters including body weight or suckling. These findings point to the hazardous effects of exposure to anesthesia on the developing central nervous system and the particular sensitivity of males to deficits.

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“…As an example of an interactive drug class query, benzodiazepine utilization was examined across age strata. A χ 2 analysis was used to determine differences in the utilization of various benzodiazepines. As another function of this application, the most frequently performed procedures were also assessed.…”

Section: Methodsmentioning

confidence: 99%

“…Our approach was to create a utilization‐specific data mart by loading periodically spooled data files from our accounting database. The IT strategy was based on the desire to (1) leverage existing business processes and reporting tools to produce flat file data input, (2) produce a custom‐built reporting module that allows for quick enhancement/addition of new reports and creation of new database entries and views, (3) perform a variety of interactive analyses, and (4) lower the total cost of ownership without expensive software licensing. Herein, we describe our hospital drug utilization (HDU) system, showing the initial functionality via typical queries of interest using data from the 2001 calendar year.…”

Section: Recent Investigations Of Drug Utilization In Various Clinicamentioning

confidence: 99%

An Informatics Approach to Assess Pediatric Pharmacotherapy: Design and Implementation of a Hospital Drug Utilization System

Zuppa

Vijayakumar

Jayaraman

et al. 2007

The Journal of Clinical Pharma

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Drug utilization in the inpatient setting can provide a mechanism to assess drug prescribing trends, efficiency, and cost-effectiveness of hospital formularies and examine subpopulations for which prescribing habits may be different. Such data can be used to correlate trends with time-dependent or seasonal changes in clinical event rates or the introduction of new pharmaceuticals. It is now possible to provide a robust, dynamic analysis of drug utilization in a large pediatric inpatient setting through the creation of a Web-based hospital drug utilization system that retrieves source data from our accounting database. The production implementation provides a dynamic and historical account of drug utilization at the authors' institution. The existing application can easily be extended to accommodate a multi-institution environment. The creation of a national or even global drug utilization network would facilitate the examination of geographical and/or socioeconomic influences in drug utilization and prescribing practices in general.

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Safety of Benzodiazepines in Newborns

Cited by 11 publications

References 0 publications

Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures

Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures

Response to neonatal anesthesia: Effect of sex on anatomical and behavioral outcome

An Informatics Approach to Assess Pediatric Pharmacotherapy: Design and Implementation of a Hospital Drug Utilization System

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