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The first reaction is a phosphotransferase step that involves an intramolecular attack between the hydroxyl group at the 2' position on the inositol ring and the adjacent phosphate group resulting in a cyclic IP 3 intermediate

16 Treatment should be initiated in the inpatient setting for infants younger than five weeks' corrected gestational age or in older infants with poor social support or cardiovascular or respiratory comorbidities

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[11] Your prescriber will individualize both the route (IV or IM) and the timetable based on your weight, kidney function, and overall clinical picture