NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

For what reason should Ceftriaxone not be used in neonates (0-28 days)?

1. It causes hypertension

2. No renal dose adjustment is needed

3. It's not effective in neonates

4. None of the above

The correct answer is: No renal dose adjustment is needed

Ceftriaxone should not be used in neonates (0-28 days) because of its potential to displace bilirubin from albumin binding sites, leading to an increased risk of kernicterus (bilirubin encephalopathy). This displacement of bilirubin can cause severe neurological damage in neonates. Therefore, it is crucial to avoid using ceftriaxone in this population to prevent this serious adverse effect. Option A is incorrect because ceftriaxone does not cause hypertension as a reason for avoiding its use in neonates. Option C is also incorrect as ceftriaxone is effective in treating various infections in the appropriate patient population, but its use in neonates is contraindicated due to the risk of kernicterus. Option D is incorrect as the correct reason for not using ceftriaxone in neonates is the need to avoid displacing bilirubin and causing kernicterus, rather than the reasons listed in options A and C.