ABSTRACT
The interest in the use of medicines in children has grown considerably over the last few years, with neonates being a unique group within this population. They have altered renal and hepatic function in comparison with adults and older children. They also have limited ability to absorb medicines enterally, particularly when they are sick. It is rarely appropriate to prescribe medicines to neonates purely as a proportion of the adult dose. Medicines tend not to be manufactured with the neonate in mind and are frequently supplied in a form that makes administration difficult, both in calculation and delivery of the dose. This creates problems for the staff on the neonatal unit in terms of the administration and economic use of drugs. Many medicines used in neonates are either not licensed, or used off-label, i.e. outside the terms of the marketing authorisation (previously known as the product licence). This may be a matter of great concern to staff working in a neonatal intensive care unit as information is often collected in infants after the drug has been used in adults. It is the responsibility of health professionals to ensure that toxicity of medicines is kept to a minimum but that children are not denied appropriate medicines (Choonara et al. 1996). In order for nurses to both safely administer drugs to neonates and monitor their effects, it is important that they have an understanding of the way that the body deals with drugs.
