Neonatal Drugs Section Fifth Edition2012 PDF

Neonatologis ts
Pock et Dr ug Re ference
Fifth edition
2012
For suggestions and inquries

maged.zakaria@yahoo.com
New in this edition

Revised drug dosage: reflecting recent changes in Neofax
2011, British National Formulary for Children 2011-2012
and Manual of Neonatal Care 2012.
Addition of New drugs: EMLA cream, Famotidine,
Hyalase, Lanzor, Noradrenaline and Vfend.
Neonatologists Pocket Drug Reference
Acetylcistein
Acetylcysteine 200 mg effervescent sachets
Dose: 200 - 400 mg PO up to 3 times daily if n ecessary.
BNFC2011-12
/ ... ) / (
Solution concentration 50 mg/mL .
USES
Meconium ileus.
Mucolytic; lowers mucous viscosity and facilit ates its remov al by
the mucocili ary action.
It improv es th e phagocytic cap acity of alv eolar mac rophages.
ADVERSE EFFECTS / PRECAUTIONS

Hypersensitivi ty-like react ions including rash es and an aphylaxis .
Mild increase in INR and P T.
Avoid with peptic u lceration.
TREATMENT OF ACETAMINOPHEN TOXICITY

N-acetylcysteine (use conce ntration of 40 mg/mL)
LD: 150 mg/kg in D 5W IVI ov er 60 minut es.
MD: 50 mg/kg IVI over 4h then 100 mg/kg over 16h until clinical
and biochemic al markers of hepatic injury i mprov e (e.g. INR
normaliz es).
In acetaminophen poisoning, givin g acetylcysteine by mouth
[unlicensed route] is an alt ernative if intravenous access is not
BNFC2011-12
possible.
Acyclovir (Zovirax)
250 mg / 5 mL Vial or 200 mg / 5 mL Susp.
Dose: 20 mg/kg/8h IVI over 1h, for 14 days (in localized HSV infect ions) or
Neofax2011
21 days (in disseminat ed or CNS infect ions ).
In Chicke npox and Herpes Zoster Infection: 10-20 mg/kg/8h IVI over 1h for
B NFC2011 -12
at least 7 days.
In Prophylaxis of Chickenpox After Delivery: 10 mg/kg/8h IVI over 1h;
BN FC2011 -12
continued until serological tests confirm absence of virus.
Prolong dosing interval to Q12h in PT <34 wk PMA, in RF or LCF.
/ ... ) + ( ) / (
Infusion sol ution concentration 5 mg/ mL.
Maximum Infusion solution concentration 7 mg/mL.
Dilution should be used within 24h. Dont refrigerate.
Compatible with D5 W and NS.
Neofax2011
For Chronic Suppression: 75 mg/kg/dose Q12h PO.
/ ... ) / (
Store oral suspension at room temperature.
REN AL IMP AIRMENT
BNFC2011-12
2
Cr Cl 25-50 mL/ min/1.73 m IV dose Q12 h.

Cr Cl 10-25 mL/ min/1.73 m2 IV dose Q24 h.
2
Cr Cl 10-25 mL/ min/1.73 m For HZV PO Q8h.
Cr Cl < 10 mL/min/1.73 m2 For HZV or HSV PO Q12h.
USES
Neonatal HSV, VZV infections with CNS and pulmonary involvement.
MONITOR
Periodic CBC.
S erum concent r at ion 2h after dose is ~ 2 g/mL.
Renal and hepatic function.
IV site for phlebitis use more diluted infusion.
ADVERSE EFFECTS / PREC AU TION S
Neutropenia (20%) dose or use Neupogen if ANC remains < 500/mm3 .

Phlebitis at IV site (due to alkaline pH of 10).
Transient renal dysfunction and crystalluria slow infusion rate, good
hydration.
USE IN PR EGAN ANCY

Not known to be harmfulmanufacturers advise use only when potential
benefit outweighs risk.
Addamel N
Trace Elements
Contents Per mL
-
Chromic Cl 5.33 mcg

Copper Cl 0.34 mg
Xylitol 300 mg
FeCl3 0.54 mg
K iodide 16.6 mcg
Manganese Cl 99 mcg
Na fluoride 0.21 mg
- Na molybdate 4.85 mcg

- Na selenite 10.5 mcg
- ZnCl2 1.36 mg
Adenocor
Adenosine 3 mg / mL vial
Starting Dose: 50 g/kg rapid IV push (1-2 sec)
Increase dose in 50 g/kg increments Q2min until return of sinus rhythm.
Neofax201 1
Usual maximum dose: 250 g/kg.
150 g/kg; repeat injection Q1-2min increasing dose by 50100 g/kg until
BNFC201 1-12
tachycardia terminated or max. single dose of 300 g/kg given.
... ) . + ) ( / (
) (
Solution concentration 300 g/mL.
The injection should be administered by rapid IV injection into a central or
large peripheral vein. Flush IV with saline immediately.
Dont refrigerate; crystallization will occur.
Compatible with: D5 W and NS
USES
Acute treatment of sust ained paroxy smal S V T (adenosine sinus node

automaticity and AV node conduction with no negative inotropic effects; can
be used safely with impaired cardiac function or postoperative arrhythmias ).

F lushing, dy spnea and irritabilit y (frequent but resolve within 1 min).
Tr ansient (duration < 1 min) arrhy t hmias may occur between termination of
SVT and onset of normal sinus rhythm (discontinue if asystole or severe
bradycardia occur).
Hy pot ension (discontinue if severe).
A pnea (in preterms).
Recur rence in 30% of treated patients.
Aminophylline/Theophylline and caffeine adenosine s effect by
competitive antagonism.
nd
rd
Contraindications 2 or 3 degree AV block (unless pace maker fitted); long
QT syndrome; severe hypotension; decompensated HF; asthma.
In SVT, adenosine is given by rapid IV. IV amiodarone, flecainide or a betablocker can be tried. The use of d. c. shock and vagal stimulation also have a
role in the treatment of SVT. Atenolol, sotalol and flecainide are used for the
prophylaxis of paroxysmal SVT.
USE IN PR EGAN ANCY

Large doses may produce fetal toxi city; manufa cturer advises use only if
essential.
Adrenaline 1 mg / mL
Severe brad ycardia, hypo tension: 0.1 - 0.3 mL /kg of 1:10,000

concentration ( equal to 0.01-0.03 mg/kg), IV push or IC.
Given v ia ETT in high doses up 0.05-0.1 mg/kg, followed
Neofax2011
immediat ely b y 1 mL NS.
/ ) + ( ) / (
) (
/ ) / (
) ( .
IVI: Start 0 .1 g/kg/min , max. of 1 g/kg/min.
Neofax2011
Adjust to desired response.
/ / . ) + ( ) / (
/ /
Infusion solution concentration 20 g/mL.
Incomp atible w ith NaHCO3 . Prot ect from light .
Compatible with dobutamin e, dop amin e, L asix , f entanyl ,

heparin , mid azolam and KCl.
Maximu m infusion concentration 60 g/mL.
Aerosol Therapy: 0.05-0.15 mL of 1:1000 concentrat ion dilut ed
Gome lla2009
with NS to 3 mL, Qh, maxi mum 4 doses.
+ ) / ( -
a 1:100 (1%) solution contains 10 mg in 1 ml
a 1:1000 (1) solution contains 1 mg in 1 ml
a 1:10,000 solution contains 0.1 mg in 1 ml
USES
Acute card iov as cular coll aps e; wh en adequ at e ventil ation and
chest compression have f ail ed to increase the HR > 60 bpm.
Short-term use for s ys t emic h yp otens ion .
In older inf ants, may b e used SC to relief of b ronch os pas m .
Adrenaline 1 mg / mL
MONITOR
Heart rat e, blood pressure and IV sit e for signs of infilt ration .

If possible correc t acidosis before administration of epin ephrin e
to enhanc e the effec tiv eness of the dru g.
Hypokalemia and s erum l actate.
Hypergl ycemia.
Cardiac arrhythmi as (premature v entricul ar compl ex es and V T).
Renal vascular ischemi a ( add low dose of dopamine with IVI).
Bolus Sev ere hypertension with intracranial h emo rrhage .
Myocardi al oxygen requirement.
IV infiltration caus es tissue ischemia and necros is.
Amikin
Amikacin 500 mg / 2 mL
Ne ofax2011
Dose: as tabl e IVI ov er 30 min.

... ) . + ) ( / (
... /
/ ... ) / (
Infusion solution concentration 5 mg/mL.
Also available in 100 mg p er 2 mL vi als
IM injection is associated with vari abl e absorption especi ally in
the v ery small inf ants.
Compatible with : D 5W, D 10W, D 20W and NS.
PMA (wk)
Postnatal (d)
29 *
Dose (mg/kg)
0-7
18 (3.6 mL)
8-28
15 (3 mL)
29
15
30-34
0-7
18
8
15
35
All
15
* or significant asphyxia, PDA or ttt with indomethacin.
Interval (h)
48
36
24
36
24
24
USES
G-ve Bacill i - resistant to oth er aminoglycosides - usually
combined with a -l actam antibiotic (in sep arate infusion).
ADVERSE EFFECTS
Patients with i mpai red ren al function, dehydration and those who
receiv e high dosage or p rolonged therapy are at risk of toxicit y.
Transi ent and rev ersible ren al tubular dysfunction urinary
loss of Na, Ca, and Mg.
Vestibular and auditory ototoxici ty (irrev ersibl e).
Neuro muscular blockade wh en used with p ancuronium and in
patients with hyp ermagn esemia.
DC or adjust dose when theres an evidenc e of oto- or
nephrotoxicity.
Amikin
Amikacin 500 mg / 2 mL
PRECAUTIONS
The use of other oto- and neph rotoxic drugs (lasix / v ancomycin)
may thes e side effects.
SERUM LEVEL
Measure wh en treating for > 48h.
Obtain peak conc entrat ion 30 minutes aft er end of infusion or 1
hour after IM injection and trough l ev el just prio r to th e next
dose, ref rigerate blood sampl e soon.
Peak: 20-30 g/mL
Trough : 2-5 g/mL
INTERACTIONS WITH
Analgesics: pl asma conc entration of amikac in and gent amicin
possibly by indometacin.
Antib acterials: risk of nephrotoxic ity and ototoxicity wh en gi ven
with t eicoplanin or vancomycin; possible risk of n ephrotoxicity
when giv en wi th cephalosporins.
Ampho tericin : risk of n ephrotoxicit y.
Digoxin : gentamicin possibly pl asma conc entration of digoxin.
Loop Diuretics: risk of otoxicity.
Amiodarone
Cordarone 150 mg / 3 mL amp.
LD: 5 mg/kg IVI ov er 30-60 min, preferabl y in a c entral v ein.

MD: 7-15 g/kg/min (10-20 mg/kg/d ay). B egin at 7 g/kg/min
and titrate b y monitoring effects.
Consider switching to o ral therapy w ithin 24 -48h.
Ne ofax2011
PO: 5-10 mg/kg Q12h.
... ) / (

Infusion So lution concentration should be < 2 mg/mL (unless
using a cent ral l ine).
Dose: 5 mg/kg over at least 3 min (for VF or pulseless ventricul ar
BNFC2011-12
tachycardi a refrac tory to d efibrill ation)
Compatible with D 5W, NS at concentrations of 1-6 mg/mL,
heparin and NaHCO3 .
Protect from light.
Avoid benzyl alcohol containin g injections in neon ates.
PO: initially 5-10 mg/kg Q12h for 7-10 days, then reduced to MD
BNFC2011-12
of 510 mg/kg Q24h.
/ . . ) + ) ( (
USES
Class III antiarrhythmic used for life-threat ening or drug-resistant
refrac tory SVT, VT and postoperativ e junctional ectopic
tachycardi a (JET).

Short term to xicity:
1. Bradycardia and hypotension (possibly associated with rapi d
rat es of infusion).
2. AV block (unl ess pacemaker fitt ed).
3. Polymorphic v entricul ar t achycardi a.
4. Irrit ation to p eripheral vessels (concent rations > 2 mg/mL) .
5. May ex ac erbat e an excit ing arrhyth mia.
Amiodarone

Long term toxic ity:
1. Hyperthyroidis m (due to inhibi tion of T4 and T3).
2. Hypothyroidism (due to high concentrations of inorgani c
iodine).
Amiodarone contains iodine and can cause both hypothyroidism or
hyperthyroidism can. Laboratory tests (T3 , T4 and TSH) should be
performed before treatment and every 6 months.
The thyrotoxicosis may be very refractory, and amiodarone should
usually be withdrawn at least temporarily to help achieve control;
treatment with carbimazole may be required.
Hypothyroidism can be treated with replacement therapy without
BNFC201 1-12
withdrawing amiodarone if it is essential.
3. Hepatitis and cholestat ic jaundic e (rare) .
4. Photosensitivity (10%), n ausea and vo mitin g (10%), optic
neuritis (4-9%) and pulmonary fibrosis (4-9%) have b een
report ed with prolonged oral use in adults.
MONITOR
HR and blood pressure.
ECG monitor and resuscitation facilities must be avail able durin g
IVI.
Liver-function and thyroid-function t ests required before
treatment and th en every 6 months.
+
Measure seru m K concentration b efore t reatment.
Pulmonary function t ests and CXR required before treatment.
Acute porphyria.
Amiodarone
INTERACTIONS WITH
Amio da ron e h as a lo ng h alf-life ; th er e is a pot en tia l f or dru g
in ter action s to occur for s everal w eeks (o r ev en mon th s ) afte r
tre atm ent with it h as b e en s top ped.
Anti- arrh yth mics: myoc ardial depression.
Antib acterials (p arenteral erythromycin , co-trimoxazole): risk
of ventricul ar arrhyth mias - avoid concomit ant use.
Antico agulants : amiod arone inhibits metabolism of coumarins
and phenindione ( antico agulan t eff ect).
Antiepileptics: amiod arone inhibits met abolism of ph enyto in (
plasma conc entrat ion).
Beta-blockers : risk of bradyc ardi a, AV block and myoc ardi al
depression; risk of ventricul ar arrh ythmi as when amiodaron e
given with sot alol - avoid concomitan t use.
Cardiac Glycosides: amiodarone plas ma conc entration of
d igo xin (h
halv e do s e of digox in).
Diuretics: c ardi ac toxicity wi th amiodaron e if hypokal emi a
occurs.
Grapefruit Juice: pl asma conc entration of amiodaron e is .
Human Albumin 20%

Dose
1 gm (5 mL)/kg/dose IVI o ver 2 hour.
Indications
As a volume expand er (1:3 D 5W)

For hypoalbuminemia (1:1 D 5W)
Use vial w ithin 4h of openin g.
Indication
IV Dosage
Hypovolemia
0.5 g/kg/dose
Hypoalbuminemia
0.5-1 g/kg/dose
Administration
Infuse 5% albumin over >60 min,
may be infused more rapidly (1020 min) in hypovolemic shock,
repeat as needed
Infuse 5% albumin over >2h,
repeat q1-2d.
Dilutions may be made with NS
or D5 W in cases of Na restriction
MNC2012
USES
Sev ere hypoalbu minemia associat ed with lo w plasma volu me and
gen eral ized edema where s alt and water.
Adjunct in treatment of hyp erbili rubinemia b y exch ange
transfusion.
Parac entesis of large volume ascit es associated with port al
hypert ension.
CONTRAINDICATIONS
Cardiac f ailure.
Sev ere an emi a.

Hypersensitivi ty react ions (anaphylaxis and urtic ari a) .
Nausea and vomi ting.
Fev er, tachyc ardia and chills.
Atropine 1 mg / mL
IV (over 1 min) or IM: 0.01-0.03 mg/kg/dose Q10-15min to
achiev e d esired effect with a maxi mum tot al dose of 0.04 m g/kg.
ET: 0.01-0.03 mg/kg/dose immediat ely follo wed by 1 mL N S.
PO: begin wi th 0.02 mg/kg/dose Q4-6h, may gradually to 0.09
Ne ofax2011
mg/kg/dose.
... ... ) . + ) ( / (
Infusion solution concentration 0.05 mg/mL
Compatible with D 5 W and NS.
Give IV dosage form PO .
USES
Rev ersal of sev ere sinus bradycardi a, particularly when
parasymp ath etic influenc es on heart (di goxin, b eta-blockers,
hyperact ive carotid sinus reflex) p redominat e.
Th e muscarinic effects of n eostigmine wh en rev ersing
neuromuscular b lockad e.
Duration of action is 6 hours.
MONITOR
Heart rat e.

Cardiac arrhythmi as particul arly during th e first 2 minutes
following IV use.
Fev er, especi ally in brain-d amaged infants.
Abdominal dist ension with d ecreas ed bowel activity.
Esophageal reflux ( esophageal sphincter ton e).
Mydriasis and cyclopl egi a.
Atrovent
Ipratropium Bromide 250-500 g / 2 mL
Dose: 75-175 g via jet nebulizer Q6-8h
Dose: 25 g/kg/dose via nebulizer Q8h
Neofax2011
Gomella2009
- / ) + . ( ) / (
- / ) + . ( ) / (
USES
Anti-cholinergic bronchodilator for pri mary treatment of COPD and
adjunctiv e treat ment of acut e bronchospasm (peak effect within 1 2h, duration of eff ect 4-6h).
Not useful for bronchiolitis.
Bronchodilator effect may be potentiated when given

with -2 agonist i.e. albuterol. Both drugs are
compatible when admixed if given within 1 h.
ADVERSE EFFECTS
Temporary blurrin g of vision.
Precipitation of narrow- angl e glaucoma or eye p ain (if solution
comes into direct contac t wi th the ey es).
Augmentin
Amoxycillin/Clavulanic acid 600 mg / 60 mL
BNFC2011-12
IV Dose: 30 mg/kg Q12h.

Amo xycillin Dose for Listerial Meningitis:
Neonate < 7 days: 50 mg/kg Q12h; dose may be doubled in
meningitis.
Neonate 728 days: 50 mg/kg Q8h; dose may be doubled in
BNFC2011 -12
meningitis.
... / ... ) / (
Infusion solution concentration 10 mg/mL .
BNFC2011-12
PO Dose: 0.25 mL/kg of the 156 mg/ 5 mL susp. Q8h.
/ ... ) / (
/ ) / .(
USES
Infections due to beta-lactamase-producing strains (where amoxicillin
alone not appropriate) including respiratory-tract infections, bone and
joint infections, genito-urinary and abdominal infections, cellulitis,
animal bites.

Diarrhea, vomiting
Hypersensitivity reactions, jaundice, fever.
Pseudomembranous colitis
HEPATIC IMPAIRMENT
Monitor hepatic function
Cholestatic jaundice may occur either during or shortly after the use of
co-amoxiclav, usually self limiting. The duration of therapy should not
usually exceed 14 days.
RENAL IMPAIRMENT )IV ROUTE(
Cr Cl 10-30 mL/ min/1.73m2 use normal initial IV dose then half dose Q12h
Cr Cl <10 mL/min/1.73 m2 use normal initial IV dose then half dose Q24h
RENAL IMPAIRMENT )PO ROUTE(
GFR 10-30 mL/ min/1.73m2 use normal dose Q12h

2
GFR<10 mL/min/1.7 3m use half nor mal dose Q12h
Azactam
Aztreonam 1 g / 50 mL
Ne ofax2011
Dose: 30 mg/kg/dose IVI ov er 5-10 min or IM.
/ . . ) / (

Compatible with D 5 W, D 10W and NS.
PMA
(weeks)
29
30-36
37-44
45
Postnatal
(days)
0-28
>28
0-14
>14
0-7
>7
All
Interval
(hours)
12
8
12
8
12
8
6
USES
Bactericidal against aerobic G-v e organisms (e.g. E. coli , H.
influenza, Pseudomonas, and Serratia). Usuall y used with
ampicill in (empiric al) or amino glycosides (syn ergistic against
Pseudomonas and Ent erob acteriac eae).
MONITOR
Seru m glucose 1h after administration .
Periodic CBC, AST, AL T.

Provide adequ ate amounts of glucose to avoid hypogl ycemia;
contains 780 mg L-arginine / g (23.4 mg/kg/dose).
Eosinophilia.
Seru m AL T, AST.
Phlebitis at th e injection sit e.
RENAL IMPAIRMENT
Cr Cl 10-30 mL/min /1.73m use normal initial dose th en

dose
2
Cr Cl <10 mL /min /1.73m use normal initial dose th en dose
Bebe-vit Drops
Vitamin
Per 1 mL
1.500 IU
400 IU
5 mg
40 mg
Thiamine (B 1)
0.5 mg
Ri bofla vin (B 2)
Ni cotinamide (B 3)
0.6 mg
8 mg
Pyri doxine(B 6)
0.6 mg
Sodium Bicarbonate 8.4 %

1 mEq NaHCO3 / mL (2 mOsmol / mL)
Usual dose: 1 -2 mEq/kg IVI over at least 30 min.
Dose (in mEq) based on Base Deficit = 0.3 X Base deficit (mEq/L) X weight
Neofax2011
(kg). Give dose then assess need for remainder.
Dose (in mEq) based on HCO3 level = 0.5 X [24 - serum HCO3 - (mEq/L) X
weight (kg)]. Give dose then assess need.
Dose in RTA: 2-3 mEq/kg/day in divided doses for type I and IV. Proximal
MNC20 12
RTA (type II) requires larger doses, as high as 10 mEq/kg/day.
Can be administrated also by IVI or PO.
... + ... ) .(
Maximum Concentration 0.5 mEq/mL.
Recommended Concentration 0.25 mEq/mL.
Na Content is 1 mEq/mL.
Also available as Sodium Bicarbonate 5 % (0.6 mEq/mL).
Compatible with D5 W, D10 W, NS, furosemide, heparin, insulin and KCl.
Incompatible with dobutamine, dopamine, epinep hrine, MgSO4 , midazolam
and norepinephrine.
USES
To correct normal anion gap met abolic acidosis caused by renal or GI losses.
NaHCO3 is n ot a reco mmended therapy in NRP. Administration during
prolonged resuscitation remains controversial use only after adequate
ventilation is established and there is no response to other therapies:
- Pulmonary vascular resistance.
- Improves myocardial function.
- Response of myocardium to sympathomimetics.
MONITOR
ABG.
Serum calcium, sodium and potassium.
ADVERSE EFFECTS
IVH (with rapid infusion).
PCO2 pH (i f given during inadequate ventilation).
Local tissue necrosis.
Hypocalcemia.
Hypernatremia and hypokalemia.
Brufen
Ibuprofen 100 mg / 5 mL Syrup
First dose 10 mg/kg
Second and third doses 5 mg/kg.
Administer at 24 h int erv als.
Course may be rep eat ed after 48 hours if necessary .
Ne ofax2011
BNFC2011-12
/ ... ) / (
USES
Closure of PDA.
Not indicated for IVH prophyl axis.
MONITOR
Urine output.
Assess for ductal closure.
Signs of bleeding.
ADVERSE EFFECTS
Less severe d ecrease in UOP than indo meth acin.
Inhibit plat el et aggregation.
Contraind icated in pret erms with inf ection, activ e bl eedin g,
thrombocytopeni a or coagul ation def ects, NEC, signific ant renal
dysfunction and CHD with duct-depend ent systemic blood flo w.
INTERACTIONS WITH
Antifun gals: plas ma conc entrat ion is by voricon azole.
INTERACTIONS WITH
Caffeinospire
Caffeine Citrate 20 mg / mL
LD: 20-25 mg/kg IV ov er 30 min or P O.
MD: 5-10 mg/kg/dose Q24h IV slowl y or PO .
May consider an addi tional LD and high er MD if able to moni tor
Ne ofax2011
serum concent rations.
/ . . )/ (
/ . . )/ (
Compatible with D5 W and D50 W.
USES
Neonatal Apnea, including post-extub ation and post anesth esia
(antagoniz es adenosine Respiratory cent er output,
chemorecepto r sensitivity to CO 2, smooth muscle relaxation and
COP).
st
The rate of BPD fro m 47% to 36% if started du ring the 1 10
days of life in inf ants with B W of 500-1250 g. Also, improv es the
rat e of surviv al without n eurodevelop ment al disabi lity at 18-21
months correct ed age.
MONITOR
Therapeutic serum trough le vel on D5 of therapy 5-25 g/mL.
Monitor HR; withhold dose if > 180 bpm.
Agit ation.
ADVERSE EFFECTS
Restlessness.
Vomiting.
Functional cardiac symp toms.
May be associated with NEC (not prov ed).
Calcium Chloride 10%

Acute ttt of sympto matic hypoc alcemia: 0.35-0.7 mL /kg/dose IV.
Dilute, th en infuse ov er 10-30 min whi le monitorin g for
bradycardi a. Stop if HR < 100 bpm.
Mainten ance ttt: 0.75-3 mL/kg/d ay IVI for 3-5 days.
In exchan ge transfusion: 0.33 mL/100 mL blood exch anged, IVI
Ne ofax2011
over 10-30 min.
/ ... + ...
Each 100 mg = 1 mL = 27 mg ele mental Ca
Dont give intra- arterially.
Compatible with D 5W , D 10W, N S, amikacin, amiod arone,
dobutamine, dopamine, epinephrin e, hydrocortisone, mi lrinone,
morphine and prostaglandin E1.
Incomp atible w ith amphotericin B, N aHCO3 and Mg sal ts.
USES
Treat ment and prevent ion of hypocalc emi a (ionized calcium < 4
Ne ofax2011
mg/dL and total calciu m < 8 mg/dL).
MONITOR
Seru m Ca l ev el ; measure ionized c alcium di rect ly.
Check IV site for extrav asation
Correct Mg if pres ent.
Bradycardia (IV).
GI tolerance (PO).
ADVERSE EFFECTS
More likely than c alcium gluconat e to caus e metabol ic acidosis.
Bradycardia or cardi ac standstill with rapid infusion.
Cutaneous necrosis or calcium d eposition occurs with
extravasat ion.
Bolus infusion by UAC is associated with int estinal bleeding and
lower-ext remity t issue necrosis.
Infusion by UVC may result in hep atic necrosis if it is lodged in a
branch of the port al v ein.
Calcium Gluconate 10%

Acute ttt of sympto matic hypocalcemia: 1-2 mL/kg/dose IV.
Dilute, th en infuse ov er 10-30 min whi le monitorin g for
bradycardi a. Stop if HR < 100 bpm.
Mainten ance ttt: 2-8 mL/kg/day IVI for 3-5 days.
In exch ange transfusion : 1 mL/100 mL blood exchan ged IVI over
Ne ofax2011
10 min.
/ ... + ...
Each 100 mg = 1 mL = 9.3 mg elemental C a

Dont give intra- arterially.
Administration by continuous infusion is more efficacious than
intermitt ent bolus dosing due to l ess ren al calc ium loss.
Compatible with D 5W , D 10W, N S, amikacin, amiod arone,
dobutamine, dopamine, hep arin, epineph rine, hydrocortisone,
milrinon e, mo rphine and prostagl andin E1.
Incomp atible w ith amphotericin B, N aHCO3 and Mg sal ts.
USES
Treat ment and prevent ion of hypocalc emi a (ionized calcium < 4
Ne ofax2011
mg/dL and total calciu m < 8 mg/dL)
MONITOR
Seru m ionized C a level .
Correct hypo magnesemia if pres ent.
Check IV site for extrav asation.
Bradycardia (IV).
GI tolerance (PO).
Earl y hypocalcemia is common in asphyxiat ed infants, PT and
IDM. It may occur also with alkalosis or followin g exch ange
transfusion.
Signs of hyp ocalce mia include muscle t witching, jitt eriness,
gen eral ized seizures, Q Tc abov e 0.4 sec .
Capoten
Captopril 25 mg tab.
Initial Dose: 0.01 - 0.05 mg/kg/dose PO Q8-12h. Adjust dose and

Neofax201 1
interval based on response. Administer 1 h before feeding.
Initial Dose:
PT infants: 0.01 - 0.05 mg/kg/dose PO Q8-12h.
FT infants : 0.05 - 0.1 mg/kg/dose PO Q8-24h.
MNC2012
Max. recommended dose: 0.5 mg/kg/dose PO q6-24h.
... ) . / (

/
Solution concentration 1 mg/mL.
Onset of action is 15 min after a dose, with peak effects seen in 30-90
minutes. Duration of action is usually 2-6 hours, but may be
significantly longer (>24 hours).
USES
Moderate to severe hypertension.
Afterload reduction in patients with CHF.
MONITOR
Blood pressure, particularly after the first dose.
Renal function and serum K +.

Hypotension, rash, fever.
Eosinophilia, neutropenia.
GI disturbances.
Jaundice or elevated liver enzymes is a reason for immediate drug
MNC2012
withdrawal.
Cerebral blood flow (seizures, apnea, and lethargy).
Renal blood flow (oliguria).
K + (if receiving K-sparing diuretics or K supplements).
Contraindicated in patients with bilateral renovascular disease or with
unilateral renal artery stenosis in a solitary kidney.
Capoten
Captopril 25 mg tab.
INTERACTIONS WITH
General Anesthetics: hypotensive effect.

NSAIDs: risk of renal impairment, antagonize hypotensive effect.
Antacids: absorption of ACE inhibitors possibly .
Heparins: risk of hyperkalemia.
Beta-blockers: hypotensive effect.
Calcium-channel Blockers: hypotensive effect.
Digoxin: captopril possibly plasma concentration of digoxin.
Corticosteroids: hypotensive effect of ACE-i is antagonized.
Diazoxide: hypotensive effect.
Diuretics: hypotensive effect; K + with K +-paring diuretics and
aldosterone antagonists (monitor K + concentration).
Potassium Salts: risk of severe hyperkalemia.
Prostaglandins: hypotensive effect.
Ceclor
Cefaclor susp. 125 mg / 5 mL
For child ren 1 m - 12 y: 20 mg/kg/d ay in 3 div ided doses, doubl ed
BNFC2011-12
for severe inf ection (usual max. 1 g dai ly).

. / ... ) / (
USES
Acute Otitis M edia Infect ion, H. Influenzae Pn eumoni a, Lo wer
Respiratory Infect ions, Pharyngi tis, Pneumoni a, Skin Infect ion,
Strept . Pneu monia, Tonsillitis, UR T Inf ection, U TI Infections.
RENAL IMPAIRMENT
BNFC2011-2012
No dosage adjustment required .
ADVERSE EFFECTS
Most Frequent:
Seru m Sickn ess, Vulvov agin al Candidi asis .
Less Frequent:
Abdominal Pain wi th Cramps, Diarrhea, Nausea, Oral Candidi asis,
Vomiting.
Rare:
Allergic Reactions, Anaphyl axis, Angio ed ema, Drug Fev er,
Eryth ema,
Erythema
Multiforme,
Hemol ytic
Anemia,
Hypoprothrombinemia, Pruri tus of Skin, Pseudo membranous
Enterocol itis, R enal Diseas e, Seizure Disord er, Skin Rash, Stevens Johnson Syndrome.
Cefazolin
Cefazolin 1 g / 10 mL
Dose: 25 mg/kg/dose IV slow push or IM.
Neofax201 1
/ ... ) + ( )/ (
/ ... ) / (
Brands inc lude Totacef and Zinol 500 mg and 1 g vials.
PMA
Weeks
Postnatal
days
Interval
hours
0-28
>28
0-14
>14
0-7
>7
All
12
8
12
8
12
8
6
29
30-36
37-44
45
USES
st
Its a bact ericid al 1 generation ceph alosporin, mainly G +ve with

poor CNS pen etration.
Peri-operativ e inf ection prophyl axis .
UTI and soft tissue infections caus ed by e.g. penic illin r esistant
Staph. aureus, Kl ebsiella and Proteus.
ADVERSE EFFECTS (RARE)

Phlebitis
Eosinophilia
Cefdin
Cefdinir 125 mg / 5 mL susp.
Dose: 14 mg/kg/day PO.
Once-daily dosing is as effective as twice daily dosing.
/ ... ) / (
USES
rd
A 3 gen erat ion cephalosporin that is activ e against G-ve

organisms includin g H. influenza, Enterobact eriac eae, Citrob acter
sp., E. col i, Kl ebsiell a and Prot eus.
Active against G+ve organisms such as Staph. aureus, St aph.
epidermidis, strept. pn eumoni a and Strept. pyogen es.

Diarrhea, loos e stools
Nausea, vomit ing, abdomin al pain
Abnormal liv er t ests.
Allergic reactions.
Storage
Keep suspension in th e frid ge for up to 10 days after
reconstitution.
Cetal
Acetaminophen 250 mg / 5 mL syrup
Oral Dose: LD 20-25 mg/kg MD 12-15 mg/kg/dos e.
Rectal Dose: LD 30 mg/kg MD 12-18 mg/kg/dose.
IV Dose: 7.5 mg/kg Q4-6h; max. 30 mg/kg/day .
Gestationa l Age
Interval
FT
PT 32 wk PMA
PT < 32 wk PMA
Q6h
Q8h
Q12h
Ne ofax2011
Ne ofax2011
BNFC2010-11
... / ... ) / (
... / ... ) / (
... / ... ) (
... ) / (
Use Perfalgan either undiluted or dilute to a concentration of 1
mg/mL in D5 W or NS; use within 1h of dilution.
Brands include: Paracetamol 120 mg / 5 mL
Rectal suppositories associated with erratic release.
USES
Fever reduction.
Mild to moderate pain.
MONITOR
Signs of pain, Temperature.
Liver function.
ADVERSE EFFECTS
Liver toxicity (if prolonged administration > 48h or excessive dosing)
Rash, fever.
Thrombocytopenia, leucopenia and neutropenia
Routine prophylactic use of acetaminophen at the time of vaccination is not
recommen ded because of a potentional reduction in antibody response.
TREATMENT OF TOX ICITY

N-acetylcysteine (use conc. of 40 mg/mL)
LD: 150 mg/kg in D5 W IVI over 60 minutes.
MD: 50 mg/kg IVI over 4h then 100 mg/kg over 16h until clinical and
biochemical markers of hepatic injury improve (e.g. INR normalizes).
Chloral Hydrate 500 mg / 5 mL

Dose: 25-50 mg/kg/dose PO or PR.
Onset within 10-15 min.
MNC2012
) ( ...
The preparation is light sensitive.
USES
Sedative-Hypnotic for short term use only.
No analgesic properties.
MONITOR
Level of sedation.

Oral preparation should be diluted or administrated after
a feeding to reduce gastric irritation.
Paradoxical excitation in infants with pain.
Allergic manifestations.
Acute overdose: CNS, respiratory and myocardial
depression, cardiac arrhythmias, ileus and bladder atony.
Indirect hyperbilirubinemia.
Contraindicated with significant hepatic or renal disease.
Ciprofloxacin
Rancif 200 mg / 100 mL
Dose: 6-10 mg/kg/dose Q 12h IVI ov er 60 min for complicat ed UTI
BNFC2011-12
or severe respiratory and GI t racts infec tions.

Dose for Pseudomonal lower respiratory-tract infection in cystic
BNFC2011-12
fibrosis in inf ants > 1 mo : 10 mg/kg IV Q8h.
/ ... ) / (
USES
Mainly G-ve; salmon ell a, shigella, c ampylob acter, neisseria and
pseudomonas.
Moderat e activity against G+ve; Strept. pn eumoniae (not used for
pneumococcal pn eumoni a) and Ent ercoccus faecalis.
Chlamydi a and some mycobact eri a.
Most anaerobes are not susceptibl e.
Avoid use with MRSA (resistant).
MONITOR
Liver function

Nausea, vomit ing, and diarrhea
Skin rash, o r abnormal liv er function.
Quinolones caus e arthropath y in the wei ght-bearing joints of
immature ani mals and are th erefo re gen erally not reco mmended
in children and growin g adol escents. Howev er, the signific ance of
this effect in humans is uncertain and in some specific
circumstances short t erm use of a quinolon e in children is justifi ed.
BNFC2011-12
RENAL IMPAIRMENT
Cr Cl <20 mL /min /1.73m use half normal dose
Claforan
Cefotaxime 500 mg / 5 mL
Neofax2011
Dose: 50 mg/kg/dose IVI ov er 30 min , or IM.
Dose may b e doubled in sev ere infect ion and meningi tis .
Disseminated Gonococcal Infectio ns: 25 mg/kg/dos e IVI over 30
min, or IM Q12h for 7 days, with a duration of 10 -14 days if
Ne ofax2011
meningitis is document ed.
... / . . ) / (
Infusion solution concentration 100 mg/ml.

... / . . ) / (
PMA (wks)
29
30-36
37-44
45
Postnatal (D)
0-28
>28
0-14
>14
0-7
>7
All
Interval (h)
12
8
12
8
12
8
6
USES
Neonat al menin gitis and sepsis by G-ve organisms (e.g. E. coli, H.
influenza and Kl ebsiell a).
Disseminat ed gonococcal inf ections.
MONITOR
Periodic CBC.
RENAL IMPAIRMENT
2
Cr Cl <5 mL/min/1.73m use usual initial IV dos e then h alf dose

Rash, Phlebitis and Diarrh ea
Leucopenia, granulocytop enia, and eosinophilia.
Clexane
Enoxaparin sodium (LMWH) 100 mg / mL
Initial Treatment of Thrombosis:
Neofax2011
FT inf ants 1.7 mg/kg/dose Q12h SC.

PT inf ants 2 mg/kg/dose Q12h SC.
Infants > 3 mo of age 1 mg/kg/dose Q12h SC .
Adjust dose to maintain anti-factor Xa level between 0.5-1 units/mL.
Low Risk Prophylaxis:
Neofax2011
Dose 0.75 mg/kg/dose Q12h SC .

Infants > 3 mo of age 0.5 mg/kg/dose Q12h SC.
Adjust dose to maintain an ti-fac tor X a level 0 .1-0.4 units/mL .
/ ... ) / (
Compatible with N S and st eril e wat er.
USES
Anticoagul ation.
MONITOR
Anti-factor Xa 4h after a dose. Aft er at tainin g target l ev el, dose
adjustment is needed 1-2 times/month.
Signs of bleeding and thrombosis.
ADVERSE EFFECTS
Bleeding (even in therapeut ic ran ge) 4 %.
Hematoma at administration sit e.
Compart ment syndro me.
IC and GI h emorrhage.
Colimex
Colistin Sulphate 50.000 unit / mL
Dose: 0.75 mL/kg/dose PO Q8h.
/ ... ) / (
USES
Not used for GI infections by oral route but used for gut
sterilizat ion.
Cymevene
Ganciclovir 500 mg / 10 mL
Dose: 6 mg/kg/dose Q12h IVI ov er 1h for a mini mum of 6 weeks.
Chronic oral suppression: 30-40 mg/kg/dose Q8h PO
/ ... ) + ( ) / (

Infusion solution concentration 10 mg/ml .
USES
Prev ention of progressiv e hearing loss and lessening of
developmen tal del ays in babies with symptomatic congeni tal CMV
infection involvin g the CNS.
MONITOR
st
CBC ev ery 2-3 days durin g 1 3 weeks, th en weekly if stable.
ADVERSE EFFECTS
Significant neutrop enia in majo rity of p atients. R educe the dos e by
3
half if < 500 cel ls/mm . Stop if not resolved .
Anemia and thrombocytop enia.
Dalacin-C
Clindamycin 600 mg / 4 mL
Dose: 5-7.5 mg/kg/dose IVI ov er 30 minut es, or P O.
Neofax2011
) . + . ( ) / ( -
/
Infusion solution concentration 5 mg / mL.
PMA
weeks
29
30-36
37-44
45
Postnatal
days
0-28
>28
0-14
>14
0-7
>7
All
Interval
hours
12
8
12
8
12
8
6
USES
Bacteriostatic fo r bact eremia, pulmonary and d eep tissue
infections by anerobic bact eri a and some G+ve cocci .
Should NOT b e used in ttt of meningitis (poor CSF pen etration).
MONITOR
Liver function, G I status.
Therapeut ic serum level ran ges from 2-10 g/mL .
HEPATIC IMPAIREMENT
Increase dosing int erv al.
ADVERSE EFFECTS
Pseudomembranous colitis (Bloody diarrh ea, abdominal p ain, and
fever) discontinue, bo wel rest, TPN and consider oral
metronid azole.
Decadron 8 mg/2 mL amp.

Orazone 0.5 mg /5 mL syrup
Dexamethasone
Ne ofax2011
DART (Dexamethasone: A R ando mized Trial) P rotocol

0.075 mg/kg/dose
Q12h
for 3 days
0.05 mg/kg/dos e
Q12h
for 3 days
0.025 mg/kg/dose
Q12h
for 2 days
0.01 mg/kg/dos e
Q12h
for 2 days
Given IV slow push or PO Tot al of 10 days.
Extub ation/ airway edema: 0.25-0.5 mg/kg onc e. May repeat
MNC2012
Q8h for a total of 4 doses starting 4h b efore extub ation.
/ ... ) + ( ) / (
/ ... ) / .(
Phenadone Syrup contains 0.5 mg Dex amethasone and 2 mg
Chlorpheniramin e maleat e per 5 mL
Courses For Severe BPD
MNC2008
Begin tre atment after D7 but before D14 of life.

Short Course
D1
0.1 mg/kg Q12h
D2
0.075 mg/kg Q12h
D3
0.05 mg/kg Q12h
May repeat weekl y if nec essary
Long Course
D1
0.1 mg/kg Q12h
D2
0.1 mg/kg Q12h
If no response aft er 48-72h, Stop.
If respond, Continue
D3
0.075 mg/kg Q12h
D4
0.075 mg/kg Q12h
D5
0.05 mg/kg Q12h
D6
0.05 mg/kg Q12h
D7
0.05 mg/kg Q12h
D8
Off
D9
0.05 mg/kg Q12h
D10
End

Dexamethasone
USES
Anti-inflammato ry us ed to f acilit at e extubation and improv e lung
function in infants at high er risk for developin g CLD.
1. Treat only those at high risk.
2. Use lower doses.
3. Begin t re atm en t afte r D 7 b ut bef ore D 1 4 of life.
4. Dont giv e wi th indomethacin.
ADVERSE EFFECTS
Risk of CP. No in risk of ROP.

GI perforat ion and hemorrh age occur more in patients treat ed
beginning in D1 and in those treat ed concurrently with
indomethac in.
Hypergl ycemia and gl ycosuria. DKA?
+
Hypert ension, Na and wat er ret ention.
Cardiac effects on D14 of therapy include LV wall thickn ess
with outflow t ract obstruction, transient i mpairment of LV filling
and ST s egment d epression.
Hypokalemia, hypocalc emia, Hypertrigl yceridemia.
Risk of sepsis.
Renal ston es (in patients rec eivin g Lasix ).

Osteopeni a and inhibit ion of gro wth
Adren al insuffieci ency due to pituitary suppression.
MONITOR
Blood pressure and hyperglyc emi a durin g acut e illn ess.
Lipid profile (hyp erlipid emi a).
Guaiac gastric aspirat e.
Echo cardio g raph y if t re ating lon g er th an 7 d ays .

Dexamethasone
INTERACTIONS
ACE Inhibitors: corticosteroids antagoniz e hypot ensive effect .
Analgesics: risk of GI bleeding and ulceration wh en giv en with
NSAIDs.
Antib acterials: metabolis m is possibly inhibited by erythromyc in.
Antiepileptics: met abolism is by phenytoin ( effec t)
Risk of hypokal emi a when giv en with amphotericin - avoid
concomitant use unless cort icosteroids n eed ed to cont rol
react ions.
Barbiturates: met abolism is by b arbiturat es ( eff ect).
Beta-blockers : corticosteroids antagonise hypot ensiv e eff ect.
Calciu m Salts : corticosteroids absorption.
Cardiac Glycosides: risk of hypokal emi a.
Diazoxide: corticostero ids antagonise hypot ensive effect .
Diuretics: cort icosteroids ant agoniz e eff ect; risk of hypokal emi a
when giv en with ac et azolamid e, loop diuretics or thiazides and
rel ated diu retics.
Sodium Benzoate: corticosteroids possibly effects.
Theophylline: risk of hypokal emia.
Vaccines: high doses imp air immune response to vaccines; avoid
concomitant use with l ive vaccin es.
Hydralazine: corticosteroids antagonize its hypot ensive effec t.
Diamox or Cidamex
Acetazolamide 250 mg tab.
Diuretic: 5 mg/kg/dose Q24h IV or P O.
Anticon vulsant: 4-16 mg/kg/day PO divid ed ev ery 6-8h (not to
exceed 30 mg/kg/d ay or 1 g/day).
To alkalin ize urine: 5 mg/kg/dose PO 2-3 times ov er 24h.
To CSF production: 5 mg/kg/dose IV or PO Q6h increased by 25
mg/kg/day to a maxi mum of 100 mg/kg/day. L asix may be used
in combination.
/ . . ) / (
USES
Mild diuretic .
Anticonvulsant in ref ractory n eonat al seizures (ret ards abnormal
discharge f rom CNS n eurons).
Decrease CSF production in PHH.
Renal tubul ar acidosis.
MONITOR
Seru m el ectro lyt es (contraindicat ed in K and Na ) .

Plasma pH and Chlo ride.

GI irrit ation.
Anorexi a.
Transi ent hypokalemia .
Hyperchloremic metabolic acidosis.
Growth retardation.
Bone marro w suppression, thro mbocytopen ia, hemolytic anemia,
pancytopeni a and l eucopeni a.
Drowsiness, paresthesi as.
Diflucan
Fluconazole 2 mg / mL IV or 5 mg / mL PO
LD 12-25 mg/kg MD 6-12 mg/kg/dose

Neofax201 1
IVI over 30 min or PO
Invasive Candidiasis
Consider higher doses for treating severe infections.

) ...+ ...( ) / (
2 mg/mL

/ ) ... + ...(
Compatible with D 5W and D 10 W.
Prophylactic in VLBW
3-6 mg/kg/dose twice weekly.
infants at high risk for
Neofax201 1
IVI over 30 min or PO
invasive fungal disease
) ...+ ...( )/ (
2 mg/mL

LD 6 mg/kg on D 1
Neofax201 1
MD 3 mg/kg/dose/24h PO
... ... ) / (
Thrush
5 mg/mL
GA (wk)
29
30 and older
/
Postnatal (d)
0-14
>14
0-7
>7
Interval (h)
48
24
48
24
USES
Systemic infect ions, meningi tis and s ev ere superfici al mycoses
caused by Candida species.
MONITOR
Renal function.
AST, ALT and direct bilirubin especi ally in patients on the h igher
doses.
Periodic CBC for eosinophilia.
Diflucan
Fluconazole 2 mg / mL IV or 5 mg / mL PO
Rev ersible AST, ALT (in 12 %).

Interf ere with metabolism of barbi turat es and phenytoin ,
aminophyllin e, c affein e, th eophyllin e and midazol am.
Adjust dosage for imp aired renal function.
RENAL IMPAIRMENT
Use ext end ed dosing int erv als wh en s erum c reatinin e > 1.3
mg/dL .
2
Cr Cl < 50 mL/min/1.73m usual initial dose then halv e
subsequent doses.
INTERACTIONS WITH
Analgesics: fluconazole possibly plasma concentrat ion of

fentanyl.
Antib acterials: met abolism of fluconazole acc elerat ed by
rifampicin ( plasma concentration).
Antiepileptics: fluconazol e pl asma conc entration of phenytoin
(consider dose of phenyto in).
Antifun gals: tri azoles possibly antagonise effects of
amphotericin.
Anxio lytics and Hypno tics: fluconazol e pl asma concentration of
midazolam (risk of prolonged s edation).
Cisapride:
precipit ates
life-threatenin g
arrhythmias
(contraindicat ed).
Theophylline: pl asma concentration of theophylline.
Digibind
Digoxin immune Fab (38 mg per vial)
Dose (number of vials) =
Each vial contains 38 mg and will bind 0.5 mg di goxin.
Once ad ministered, d igoxin serum concent rations c an no longer
be det ermined accuratel y.
USES
Life threat ening di goxin toxicit y.
ADMINISTRATION
The cont ents in each vial to be us ed should be dissolved with 4
mL of St eril e W at er for Injection, by gentle mixin g, to giv e a cl ear,
colorless, approx imatel y isosmotic solution with a prot ein
concentration of 9.5 mg/mL.
Reconstituted product should be used promptly.
If it is not used immedi ately, it may be stored under refrigeration
at 2-8C for up to 4 hours.
Digibind is ad ministered by IVI over 30 minut es.
If cardi ac arrest is i mmin ent, i t can b e giv en as a bolus injectio n.
STORAGE
Refrigerat e at 2 to 8C.
Unreconstituted vials c an b e stored at up to 30C for a tot al of 30
days.
Dobutamine
Dobuject 250 mg / 5 mL
Dose: 2-25 g/kg/min IVI.
Begin lo w and titrate by monito ring effect .
Volume of drug needed per day =
Dobuject) or =
Neofax2011
(if using
(if using Dobutrex) is add ed
to 24 mL D 5W, D 10W, N S or LR, giv en as IVI at a rat e of 1 mL/h .
+ ... ) / (
/
Brands inc lude: Dobutrex 250mg/20mL.
10 g/kg/min dose is equal to 0.29 mL/kg/24h of Dobuject 250 mg / 5 mL
10 g/kg/min dose is equal to 1.15 mL/kg/24h of Dobutrex 250 mg / 20 mL
Incomp atible w ith NaHCO3 and Lasix .

Compatible with Alp rostadil, dop amin e, epin ephrine, f entanyl ,
heparin , insulin, MgSO4, midazolam, KCl , D 5W, D 10W , LR and N S.
USES
Hypoperfusion and hypotension, especi ally if relat ed to
myocardi al dysfunction.
Onset of action is 1-2 min after IV I with peak effect in 10 min .
serum half-life is sev eral minut es.
MONITOR
Heart rat e and Blood pressure.
IV sites for extravas ation.

Hypotension if patient is hypovol emic. Volume load ing is
recommend ed before starting th erapy.
Tachyc ardia at hi gh dosage.
Arrhyth mias, hyp ert ension and cutan eous vasodil atation .
Increases myoc ardial oxygen consumption.
Tissue ischemia occurs with infiltration.
Contraind icated in idiopathic h ypertrophic subaortic st enosis.
Dopamine
Intropin 200 mg / 5 mL
Dose: 2-20 g/kg/min IVI.
Begin low and titrate by monitoring effect.
Volume of d rug needed per d ay =
Neofax2011
then add ed to
24 mL D 5W and giv en as IVI at a rat e of 1 mL /h.
+ ... ) / (
/
5 g/kg/min is equal to 0.18 mL/kg/24h of Intropin 200 mg/5 mL
Incomp atible w ith NaHCO3 , Insulin and L asix .

Compatible with Dobutamine, epin ephrine, fent anyl, h eparin ,
MgSO4, midazol am, KCl , PGE1 , D 5W, D 10W , LR and N S.
Diluted solutions are stable for 24h. Admixtures exhibitin g a
color chan ge should not be used.
USES
Hypotension.
MONITOR
Heart rat e
Blood pressure
Urine output and periph eral perfusion.
IV sites for bl anching and infiltration.

Tachyc ardia and arrhythmias.
May increase pulmonary artery pressure.
Rev ersible suppression of prolactin and th yrotropin sec ret ion.
Tissue sloughing may occur with IV infil trat ion.
Use higher doses wi th caution in p atients with PPHN.
Contraind icated in Pheochro mocytoma, t achyarrythmias
hypovolemi a. Us e with caution in pulmonary hypert ension.
or
Dormicum or Midathetic
Midazolam 15 mg / 3 mL
1
Neofax2011
SED ATIVE DOSE:

IV (or IM) : 0.05-0.15 mg/kg ov er at l east 5 minutes, repeat as
required, usuall y Q2-4h.
IVI: 0.01-0.06 mg/kg/h ( aft er sev eral days of therapy due to
tolerance or clearance).
Intranas al: 0.2-0.3 mg/kg/dose using in ject able form.
Sublingu al: 0.2 mg/kg/dose using inject able form mixed with a
small amount of flavo red syrup .
ANTICON VULSAN T DOSE:
LD: 0.15 mg/kg IV over at least 5 min, follo wed by
Mainten ance IVI: 0.06-0.4 mg/kg/h (1-7 g/kg/min).
Ne ofax2011
( ) / (
- / ... )
Incomp atible w ith Albu min, L asix and NaHCO 3.

Compatible with D 5W, NS, steri le wat er for injection, dopamine,
dobutamine, epinephrin e, fent anyl, hep arin, insulin, mi lrinone,
morphine and KCl.
USES
Sedat ive, hypnotic (duration of action is 2-6h, and quite variabl e,
up to 22h, in premature bab ies and those with imp aired hep atic
function).
Anesthesi a induction.
Treat ment of refractory s eizures.
Dormicum or Midathetic
Midazolam 15 mg / 3 mL
MONITOR
Respiratory status and Blood pressure .
Hepatic function.
Signs of withdrawal after prolonged th erapy .
ADVERSE EFFECTS
Respiratory depression and respiratory arrest especially wh en
used for sedation in non-crit ical c are settin gs.
Sev ere hypot ension and seizures with bolus infusion.
Burning sensation with n asal ad ministration.
Seizure-like myoclonus (8% of P T inf ants recei ving continuous
infusion).
Edemex
Bumetanide 0.5 mg / 2 mL
Neofax2011
Dose: 0.005-0.1 mg /kg/dose IV slo w push, IM , or PO .

st
Given Q24h in th e 1 2 months of life then Q12h afterwards.
Infants with lun g diseas e and normal kidneys should be started

on a low dos e. Inf ants with CHF or RF will n eed a hi gher dose.
/ ... ) / . )
Compatible with D 5 W, NS, lasix , mil rinone and morphin e.

Incomp atibe with dobutamin e and midazol am .
USES
Potent loop diuretic used in R F, CHF or significant ed ema that is
refrac tory to L asix .
MONITOR
Seru m el ectro lyt es and UOP.
+
Seru m K level (esp. if rec eiving digoxin concurrently) .
Weigh t changes.
ADVERSE EFFECTS
Wat er and el ectrolyt es imbal ances; hyponat remia, hypokal emi a
and hypochloremic al kalosis.
Potentiall y ototoxic (l ess than Lasix).
May displac e bilirubin fro m albumin binding sites when giv en in
high doses or for prolonged periods.
Eltroxen
Levothyroxine T4 50 g tab.
Initial Oral Dose: 10-14 g/kg/dose PO Q24h (37.5-50
g/ dose for an average term infant). Dosage is adjusted
in 12.5 g increments.
Initial IV Dose: 5-8 g/kg/dose Q24h.
Neofax2011
. . ) (

Use immediately.
USES
Hypothyroidism
MONITOR
After 2 weeks of treatment Serum T4 level should be in th e high
normal range (10-16 g/dL) and should b e maintained in this range
for the first year of l ife. T3 l ev el should be normal (70-220 ng/dL)
and TSH should hav e d eclined f rom initial v alu e.
After 12 weeks of treatment Seru m T SH should be in the normal
range (< 15 mU /L).
Measure T4 and TSH at 2 weeks of age, then ev ery 1-2 months or 2
weeks aft er any chan ge in dosage.
Signs of hypo thyro idism: l ethargy, poor f eedin g, prolon ged
neonatal jaundic e, constipation, int ermitt ent cyanosis.
Signs of thyro toxicosis: hyp eractivit y, alt ered sleep patt ern,
tachycardi a, t achypnea, f ev er, exophthalmos and go iter.
Growth, d ev elopment and bon e-age advanc ement.
ADVERSE EFFECTS
Prolonged o vertreat ment can p roduce p remature craniosynostosis
and acceleration of bone age.
EMLA cream
Lidocaine 2.5% and Prilocaine 2.5%
Apply 1-2 gm to distal half of penis then wrap with the occlusive
dressing. Allo w dressing to remain intact for 60 -90 min, remove
and clean treat ed area compl etely prior to circumcision to avoid
Ne ofax2011
systemic absorption .
USES
Topical analgesia for ci rcumcision (appli ed 60-90 min before th e
procedure) .
Not effectiv e for h eel lancin g.
MONITOR
Blood meth emo globin conent ration.
ADVERSE EFFECTS
Blanching and redn ess resolv e without treat ment .
Methemoglobin emi a ( with applic ation of > 3 gm)
Contraind icated
with
congenital
or
idiop athic
meth emo globinemia,
with
oth er
drugs
c ausing
meth emo globinemia: sulfonamid es, acet aminoph en, nitrat es,
nitroglyc erin, n itroprusside, ph enobarbit al and phenytoin .
Epanutin or Ipanten
Phenytoin
Neofax201 1
LD: 15-20 mg/kg IVI over at least 30 min.
MD: 4-8 mg/kg Q24h IV slow push or PO.
Up to: 8 mg/kg/dose Q8-12h after 1 week of age.
Flush IV with saline before and after administration.
Avoid use in central lines; may precipitate. Not to be given IM.
... ) . + ( ) / (
/ ...
/ ... ) / (
Maximum rate of infusion 0.5 mg/kg/min
Infusion solution concentration 5 mg / mL
Incompatible with D 5W, D 10 W.
USES
Anticonvulsant for seizures refractory to phenobarbital.
HEPATIC IMP AIRM EN T
Reduce dose.
MONITOR
Bradycardia, arrhythmias and hypotension during infusion.
IV site for extravasation.
Serum therapeutic level is 6-15 g/mL in the 1 st weeks, then 10-20
g/mL due to change in protein binding. Obtain initial trough level
after 48h of IV LD.
Bilirubin displaces phenytoin from protein-binding sites, resulting in
increased free drug.
ADVERSE EFFECTS
Extravasation inflammation and necrosis.
Hypersensitivity reactions.
High serum concentration is associated with seizures.
With long term therapy: Arrhythmias, hypotension, gingivitis,
nystagmus, rickets, hyperglycemia, and hypoinsulinemia.
Epoetin alpha
Eprex 2000 iu / 0.5 mL
Dose: 200-400 iu/kg/dose, 3-5 times per week for 2-6
weeks. Total dose per week is 600-1400 iu/kg.
Short course: 300 iu/kg/dose daily for 10 days.
Administer SC or IVI (over 4h or continuously in TPN).
Supplemental iron, adequate proteins and Vit-E should
be initiated concurrently.
... ) . / (
For IVI: Dilut e in 2 mL of solutions containing at least 0.05%

protein and infuse over 4 hours. St able for 24h.
USE
Stimul ate erythropoi esis and the need for PRBCs transfusion in
high risk preterms (the most likel y to benefit are ELBW < 800 gm
with phl ebotomy losses > 30 ml /kg).
MONITOR
Weekly CBC to check for neutrop enia and RBC response.

Neutropeni a (rare, resolves with discontinuation of th e dru g).
STORAGE
Store b et ween 2-8 c.

Dont shake or f reeze.
Undiluted epo etin is stabl e pl astic syringes for 2 weeks.
Erythromycin
Erythrocin 200 mg / 5 mL
In Chlamydia trachomatis Conjunctivitis and Pneu monitis: 12.5
mg/kg/dose PO Q6h for 14 days.
For other infections and pro phyl axis : 10 mg/kg/dose P O Q6h.
In treatment and proph ylaxis of Pertussis: 12.5 mg/kg/dose P O
Q6h for 14 days (Azithromycin is th e drug of choic e in n eonat es).
Ne ofax2011
Dose for feeding intolerance due to dysmotility: 10 mg/kg/dose

PO Q6h for 2 days followed by 4 mg/kg/dose PO Q6h for 5 days.
Neofax2011
/ . . ) / (
For proph ylaxis of op hthalmia neon atoru m: ribbon of 0.5 %
Neofax2011
ointment instil led in each conjunctival sac.
USES
Infections by Chlamydi a, Mycopl asma, and Ureapl asma.
Treat ment and prophylax is for Bordet ell a p ertussis .
Substitute for p enicillin in all ergic intol eranc e.
Prokinetic agent (motilin-rec eptor agonist) in f eedin g intol eranc e.
MONITOR
Diarrhea and abdomin al discomfort.
CBC for eosinophilia.

Loose stools.
Intrah epatic chol estasis.
x10 risk of h ypert rophic pyloric stenosis in n eonat es under 2 wks
of age.
Plasma cl earance of midazol am (Dormicu m) by 50%
Serum conc entration of digoxin, midazola m, th eophyllin e and
carbamazepin e.
Famotidine
Antodine 20 mg / 2 mL amp.
Ne ofax2011
IV, slow push: 0.25-0.5 mg/kg/dose Q24h.

Continuous IVI of the daily dose in adult provid es better gastric
suppression than intermitt ent dosing.
PO: 0.5-1 mg/kg/dose Q24h.
Ne ofax2011
/ ... ) + ( ) / (
Infusion Solu tion Conentration 1 mg / mL.
Compatible with D 5W, D 10W , NS, calciu m gluconate, dobutamine,
dopamine, epin ephrine, hepain , insulin, MgSO 4, mid azolam,
morphine, KCl and N aHCO 3.
/ ... ) / (
Solution Conentration 2 mg / mL.
USES
Prev ention and t reatment of stress ulcers and G I hemorrh age
aggrev at ed by gastric ac id secretion.
MONITOR
Gastric pH (> 4)
ADVERSE EFFECTS
Increased risk of l at e-onset bact eri al and fungal s epsis.
Routine gastric ac id suppression in neonat es should be avoided .
In adu lts (<5%): h ead ache, dizziness, constipation and di arrh ea.
Fentanyl
Fentanyl-Janssen 50 g / mL
Sedation and Analgesia: 0.5-4 g/kg/dose IV slow push,
repeat as required, usually Q2-4h.
Infusion rate: 1-5 g/kg/h (quickly develop tolerance).
Neofax2011
Anesthesia: 5-50 g/kg/dose.
/ ... ) + ) (/ (

Infusion solution concentration 2 g / mL .

For a dose of 2 g/kg, give 1 mL/ kg
Stabl e for 24h refri gerat ed after d ilution.
Protect from light.
USES
Analgesia, sedat ion.
Anesthesi a.
MONITOR
Respiratory and c ardiov ascular status.
Abdominal dist ension, loss of bowel sounds .
Muscle rigidi ty.

Respiratory dep ression with an esthetic dose ( > 5 g/kg).
Chest wal l rigidit y (in 4% of neonat es who rec eiv ed 2.2-6.5
g/kg/dos e) with laryngospasm, rev ersibl e with naloxone .

Urinary ret ention with continuous infusion.
Tolerance to an algesic doses with prolonged use.
Withdrawal symptoms after IVI for 5 days or lon ger.
Flagyl
Metronidazole 500 mg / 100 mL Vial
LD: 15 mg/kg P O or IVI over 1h
MD: 7.5 mg/kg/dos e PO or IVI ov er 1h
Neofax2011
+ ... ( / (
... / + ...
... / ... ) / (
Na content is 14 mEq per 100 mL.
Infusion solution concentration 5 mg/ml.
PMA (wk)
29
30-36
37-44
45
Postnatal (d)
0-28
>28
0-14
>14
0-7
>7
All
Interval (h)
48
24
24
12
24
12
8
HEPATIC IMPAIRMENT
Reduce tot al d aily dose to one thi rd and give onc e daily
Use with c aution in h epatic enceph alopathy
USES
Meningitis, v entriculit is and endocarditis caused by Bactero ides
fragilis and other anaerob es resistan t to penici llin.
Serious intra-abdominal inf ections and C. difficil e coli tis.
Trichomonas v agin alis infec tions.

Carcinogenic?!!
Seizures, sensory polyn europathy (in adults rec eivin g high doses
over a prolonged period).
Brownish discoloration of urin e.
Fludrocortisone
Astonin-H or Cortilon 0.1 mg tab.
Dose: initially 0.05 mg PO once daily, adjusted according
to response; usual range 0.050.2 mg/day; higher doses
BNFC2011-12
may be required.
... ) . ( -
/
USES
Mineralocorticoid
insufficiency.
replacement
in
MONITOR
Blood pressure
Serum electrolytes; Na +, K+ and Ca ++.
Body weight

Hypertension
Na + and water retention
K+ and Ca ++ loss
adrenocortical
Folic Acid
Folicap 500 g cap.
Dose: 15 g/kg/dose or up to maximum 50 g/day PO,
Neofax2011
deep IM, IV or SC.
/ ) / (
Prevention of megaloblastic anemia
associated with
pyri me tha mine and s ulf adiaz ine treatment of congenital
toxoplas mosis:
Neonate: 5 mg 3 times a week (increased up to 20 mg 3 times a
week if n eutrop enic).
BNFC2010-11
Child 1 month-1 year: 10 mg 3 times a week.
USES
Megaloblastic and macrocytic an emia as a result of folate
deficiency .
MONITOR
Hematocrit
Hemoglobin
Reticulocyt e

May mask hematolo gical def ects of Vit B 12 deficiency, but it will
not prevent th e progression of irreversible neu rologic
abnormalities.
GI upset
Slight flushing
May dec rease ph enytoin seru m concent ration .
Contraind icated in pernicious, apl astic and normocytic an emia
Fortum
Ceftazidime 1 g / 40 mL
Neofax2011
Dose: 30 mg/kg/dose IVI over 30 min, or IM .

PMA (wks)
Postnatal (days)
0-28
>28
0-14
>14
0-7
>7
All
29
30-36
37-44
45
Interval (hrs)
12
8
12
8
12
8
8
MNC2012
Another Dose Regimen

Age
Weight
Dosage (IV/ IM)
All neonates
Postnatal age 7d
Postnatal age 7d
Postnatal age > 7d
50 mg/kg/dose Q12h
50 mg/kg/dose Q12h
50 mg/kg/dose Q8h
50 mg/kg/dose Q8h
< 1,200 g
1,200-2,000 g
> 2,000 g
> 1,200 g
... / ... ) / (
Infusion solution concentration 25 mg/ml .
... / ... ) / (
Also available as 250 mg and 1 g vials
USES
Neonatal meningitis and sepsis by G-ve organisms (e.g. E. coli, H. influenza,
Neisseria, Klebsiella, and Proteus species), esp. Pseudomonas aeruginosa.
Synergistic with aminoglycosides.
ADVERSE EFFECTS (UNCOMM ON)

Rash, Eosinophilia
Diarrhea, Hepatic ALT, AST.
False positive direct Coombs test.
Fungizone
Amphotericin-B 50 mg / 10 mL
Ne ofax 2011
Dose: 1-1.5 mg/kg IVI ov er 2-6h Q24h

Gome lla 2 009
Dose:
- Initial dose: 0.25-0.5 mg/kg IVI ov er 4-6h.
- MD: 0.5-1 mg/kg IVI over 2-6h Q24-48h for 2-6 wks or longer.
... ) . + ) ( / (
/ ...
Infusion solution concentration 0.1 mg/mL.
Compatible with D 5 W, D 10W, D 15W and D 20W .
Dont mix with NS.
Protect from light.
Stab le for 24h at roo m temperature or 7 days in refrigerator.
USES
Systemic fungal infections.
Sev ere superfici al mycoses.

+
Hypokalemia (K < 3 mmol /L) and t ransient in serum creatinin e

in ~16% of treated p atients.
RBF and GFR by 20-60%.
+
K and Mg loss due to tubular injury, reabsorption of Na and
renal tubular acidosis. N a in take > 4 mEq/kg/day may prevent o r
nephrotoxicity.
Concurrent use with oth er n ephrotoxic drugs may lead to
additiv e nephrotoxic ity.
Anemia, thrombocytop enia.
Consider analgesia befo re infusion.
Fev er, chi lls, nausea or vomitin g.
Cardiac arrest has occurred in patients who rec eiv ed 10 times th e
recommend ed dose.
Fungizone
Amphotericin-B 50 mg / 10 mL
MONITOR
CBC, el ectrolyt es, UOP, BUN and serum creatinine at l eas t e ver y
o ther d a y.
IV sites for i rrit ation (phlebit is).
RENAL IMPAIRMENT
If creatinine increases > 0.4 mg/dL from b aseline durin g
Neofax 2011
therapy, hold dose for 2-5 days.
Altern ate-day dosing is recommend ed ov er decreasin g d aily
Ne ofax 2011
dose in patients experi encing ren al toxici ty.
Discontinue if BUN > 40 mg/dL, s erum creatinin e is > 3 mg/dL, or
liver function tests are abnormal.
INTERACTIONS WITH
Antib acterials: risk of nephrotox icity when giv en with

aminogl ycosides; possible risk of n ephrotoxicity when
amphotericin gi ven with vancomyc in.
Cardiac Glycosides: hypokal emia caused by amphotericin
cardiac toxic ity with cardiac glycosides.
Corticosteroids: risk of hypokal emi a when amphotericin given
with corticost eroids - avoid concomit ant use unl ess needed to
control reactions.
Diuretics: risk of hypokalemi a when giv en with loop diuretics or
thiazides.
Garamycin
Gentamicin 40 mg / 4 mL
Ne ofax2011
Dose: as chart IVI ov er 30 minutes.
... ) + ( ( / )
/
Compatible with D 5 W, D 10W and NS
IM injection is associat ed with v ari able absorption, especi ally in
the v ery small inf ant.
PMA (wks)
Postnatal (d)
Dose (mg/kg)
0-7
5
29 *
8-28
4
29
4
0-7
4.5
30-34
8
4
35
All
4
Interval (h)
48
36
24
36
24
24
USES
Aerobic G-ve Bacilli (e.g. Ps eudomonas, Kl ebsiell a, E. coli).
Usually used in combin ation with a -lact am antibiotic.
ADVERSE EFFECTS
Transi ent and rev ersibl e ren al tubular dysfunction ( urinary loss
of Na, Ca, and Mg) .
Vestibular and auditory ototoxici ty.
Increased n euromuscular blockade wh en us ed with p ancuronium
and in patients wi th hypermagnes emi a.
The use of gentamicin ointment for n ewborn ocular p rophylaxis
has been associated with p eriocul ar ulc erativ e dermatitis.
SERUM LEVEL
Obtain peak concentration 30 minutes after end of infusion and
trou gh level just prior to the next dose, refrigerate blood sample soon
Peak: 5-12 g/mL
Trough: 0.5-1 g/mL
Gastrazole Omeprazole 20 mg cap.

Losec Omeprazole 40 mg vial
Neofax2011
Dose: 0.5 - 1.5 mg/kg/dose PO Q24h.
/ ... ) . / (


. . ) + ( ) / (
/
BNFC2011-12
Dilute with D5W or NS.
USES
Short-term (< 8 weeks) treatment of documented reflux
esophagitis or duodenal ulcer refractory to conventional
therapy.
Onse t of ac ti on within 1h with duration of ac ti on of 72h.
MONITOR
Symptomatic improvement within 3 days.
Intra-esophageal pH monitor to assess efficacy (pH > 4.0).
ALT, AST if duration of therapy > 8 wks.
ADVERSE EFFECTS
Hypergastrinemia.
Mild ALT, AST elevation.
Geveskon
Na Alginate / Na Bicarbonate
Dose: 1-2 mL after feeding PO Q 8h.
/ -
Each 5 mL contains 5 g sodium algin ate + 2.5 gm N aHCO 3
USES
NaHCO3 may, by acting as an antacid, control some of the symptoms
of gastro-oesophageal reflux.
Alginate reacts with gastric acid to form a viscous gel or raft that
then floats to the top of the stomach, acting as a mechanical barrier to
oesophageal reflux.

Metabolic alkalosis
Hypernatremia
Gaviscon Infant Sachets

Powder for oral suspension
Each dose of Gaviscon i nfant Sachets contains 225 mg of sodium alginate
and 87.5 mg magnesium alginate.
Prepare immediately before use as directed below:
For breast-fed infants:
< 4.5 kg, one dose and 2 doses if > 4.5 kg
Add 5 mL of cooled boiled water to the powder in a glass. Mix to a
smoothpaste and add another 10 mL water and mix.
Give after each feed using a spoon or feeding bottle.
For bottle-fed infants:
< 4.5 kg, one dose to be mixed into not less than 115 mL of each feed in
thebottle and shaken well.
> 4.5 kg, 2 doses to be mized into not less than 225 mL of ea ch fee d in
thebottle and shaken well.
Young chil dren:
2 doses, prepared as breast-fed infsnts. To be taken after each meal.
Glucagon
Glucagon 1 mg vial
Dose: 0.2 mg/kg/dose IV push, IM or SC.
Maximum dose: 1 mg.
IVI: begin with 0.01-0.02 mg/kg/h. Rise in bloog glucose
Neofax2011
should occur within 1h of starting infusion.
) (
USES
Hypoglycemia:
- Refractory to IV dextrose infusions
- When dextrose infusion is unavailable
- Documented glucagon deficiency.
Glucagon stimulates gluconeogenesis, inhibits small-bowel
motility and gastric acid secretion. In high doses, it has a
cardiac inotropic effect.
MONITOR
Blood glucose concentration; rise in blood glucose will last
~2h.
Rebound hypoglycemia
ADVERSE EFFECTS
Nausea and vomiting.
Tachycardia.
Ileus.
Hyponatremia.
Thrombocytopenia.
Heparin 5000 i.u. / mL

To maintain patency of peripheral and central vascular
Neofax2011
catheters: 0.5-1 units/mL of fluids to be infused.
Heparin loc k for central lines: 1-2 mL of 10 units/mL solution Q4MNC2012
6h and as needed.
Treatment of Thro mbosis: 75 units/kg bolus over 10 minutes,
followed by 28 units/kg/h IVI
- Measure aP TT 4 h aft er initiat ing th erap y
- Adjust dose to achiev e aPTT of 60 -85 seconds (corresponds to
an anti-facto r Xa l ev el of 0.35-0.7).
Ne ofax2011
- Limit treatment to 10-14 days.
) + ( ) / (
USES
To maint ain pat ency of peripheral and c entral v ascular cath et ers
(continuous infusions rather th an int ermi ttent flushes).
Treat ment of thro mbosis.
MONITOR
Platel et count ev ery 2-3 days.
aPTT (achieve aPTT of 60-85 seconds).
Signs of bleeding and thrombosis.

Heparin-induced thrombocytop enia (HIT) 1%.
Osteoporosis (with long-t erm use)
Fatal hemorrhage wi th incorrect concentration used .
Contraind icated in infants with evid ence of int racranial or G I
3
bleedin g or thro mbocytopeni a (<50.000/mm ).
Hepatitis B Immune Globulin

Hepabig 200 iu / mL Vial
Dose: 0.5 mL giv en in th e ant erol at eral thigh IM.
Ne ofax2011
Dont ad minister IV.

FT and PT with HBsAg +ve mother
FT and PT 2 kg with unknown
status of mothers HBsAg
PT < 2 kg with unknown status of
mothers HBsAg
Given within 12h of birth.

Given as soon as it is determined
that the mother is HBsAg +ve, within
7 days of birth.
Given within 12h of birth.
Uses
Passive immuniz ation of newborns whos e mothers have activ e
hepatitis B infection at the time of delivery, or who are HBsAg
+v e.
Infants born to moth ers who are HBeAg +v e have th e high est risk.
PRECAUTION FOR HBIG
When given at the same time as th e first dose of H epB v accine

Use a sep arate syringe and a different sit e.
Draw b ack on the plunger of th e syringe before inject ion to b e
certain the n eedle is not in a blood v essel.

Local pain and tend ern ess.
Systemic reactions if gi ven IV.
Use univers al prec autions wi th neonat es born to HBsAg +v e
mothers until they h av e been bathed c arefull y.
Hepatitis B Recombinant Vaccine

Euvax B
Dose: 0.5 mL giv en in th e ant erol at eral thigh IM.
Ne ofax2011
Store refrigerated at 2 C to 8 C .
Dont freeze-destroys potency.
st
Matern al HBs Ag +ve
Matern al HBs Ag
unknown
Matern al HBs Ag -ve
Give 1 dose before 12h of birth

(regardl ess of birth weight).
If < 2 kg, giv e 3 additional doses
beginning at 1-2 months of age.
st
Give 1 dose before 12h of birth
(regardl ess of birth weight).
If < 2 k g, give HBIG within 12h of age.
If 2 kg, give HBIG within 7 days of birth
if mother tests HBsAg +v e.
st
Give 1 dose shortly aft er birth, b efore
hospital discharge.
st
If < 2 kg and m ed ica lly s tabl e, giv e 1
dose at 30d of chronologic age or at time
of hospital discharge if before 30d of
chronologic age.
USES
Immunoprophyl axis against h epatitis B .
Safe for us e in infants born to HIV-positive mothers, although it
may b e l ess effective.
USES
Immunoprophyl axis against h epatitis B .

Soren ess at injection site.
Fev er > 37.7 C (in 1-6%).
Hyaluronidase
Hyalase 1500 iu amp.
Inject 1 mL (150 units) as 5 separate 0.2 mL SC injections around the
periphery of the extravasation site.
Use 25- or 26- gauge needle and change after each injection. Neofax2011
. ) / (
Solution Concentration 150 units / mL
Compatible with D 5W, D 10 W and NS.
USES
Prev ention of tissue inju ry caus e by IV extravasat ion of drugs
with hyperosmolarity or extreme pH (e.g. aminophylline,
amphotericin B, calciu m, ox acillin, ph enytoin , KCl, rifampicin ,
NaHCO3, v ancomycin, TPN and concentrated IV solutions).
Not indicated for treatment of extravas ations of vasoconstrictive
agents (e.g. dopamine, ep inephrin e and norepin ephrine) .

Not recommended for IV use.
Hydralazine
Slowapresoline 50 mg tab
Apresoline 20 mg vial
IV: begin with 0.1 - 0.5 mg/kg/dose Q6-8h. Increase gradually as
required to a maximum of 2 mg/kg/dose Q6h.
PO: 0.25-1 mg/kg/dose Q6-8h, or approximately twice the required IV
Neofax2011
dose. Administer with food to enhance absorption.
- / . . ) / (
Compatible with N S
To prepare an oral suspension, crush a 50 mg tablet in 4 mL of 5%
mannitol then add 46 mL of sterile water to make a final concentration
Neofax2011
of 1 mg/mL. Stable for 7 days refrigerated.
.. ) + + (
- /
NOTE: use with -Blockers the anti-hypertensive effect and the
magnitude of the reflex tachycardia. This is expected to reduce
hydralazine requirements to < 0.15 mg/kg/dose.
USES
Mild to moderat e hyp ert ension.
Afterlo ad reduction in pat ients with CHF.
MONITOR
Heart rat e and Blood pressure.
Guaiac stools.
Periodic CBC for lon g term use.

Diarrhea, emesis.
Temporary agranulocytosis.
Tachyc ardia, postural hypotension, headache, nausea, and a
lupus-like syndrome (10-20% of adults).
GI irrit ation, bleeding, drug fev er, rash, conjunctivit is, and bon e
marro w suppression (in adults, unco mmon).
Hydrochlorothiazide
Hydretic 12.5 mg tab
PO: 1-2 mg/kg/dose Q12h.
Admi nister with food (improves absorption).
Neofax2011
/ . . ) / . (
Solution concentration 2.5 mg/mL.
Effects increased when used in combination with furosemide or
spironolactone.
USES
Mild to moderat e edema.
Mild to moderat e hyp ert ension.
May imp rove pul monary function in patients with BPD.
Hydrochlorothiazide ren al excretion of calcium, inhibits
pancreatic rel ease of insulin and displac es bilirubin from albumin .
MONITOR
Seru m el ectro lyt es, calciu m, phosphorus and glucose.
Urine output and blood pressure.
Onset of action is within 1 hour.

Hypokalemia and oth er elect rolyt es abnormalities.
Hypergl ycemia.
Hyperuric emi a.
Contraind icated in patients with signific ant imp airment of ren al
or hepatic function.
Hydroferrin or Ferose
Iron Polymaltose Complex
For growing PT infants: 2 mg/kg/day (max. 15 mg/day),
begin after 2 weeks of age.
< 1.000 kg birth weight: 4 mg/kg/day.
If receiving erythropoietin: 6 mg/kg/day.
In 1 or 2 doses, diluted in formula.
/ . . ) / (
/ . . ) / (
Each Hydroferrin drop contains 1.67 mg elemental iron.
USES
Iron supplementation for prevention and treatment of
anemia.
MONITOR
Hemoglobin and reticulocyte counts during therapy
Observe stools.
Check for constipation.

In growing PT infants, iron supplementation should not be
started until adequate vitamin E is supplied in diet:
otherwise iron may hemolysis.
Nausea, constipation, black stools, erosion of gastric
mucosa.
Lethargy.
Hypotension.
Intravenous Immune Globulin

GAMMARAAS 5% (Human)
Usual Dose: 500-750 mg/kg/dos e (over 2-6h).
Ne ofax2011
In Neonatal Alloimmune Thro mbocytopenia: 400 mg 1 g/kg

Most studies have used a singl e dose, although addit ional doses
have b een giv en at 24h interv al.
0.01 0.02 mL /kg/min ov er 30 minutes th en th e
Regimen
rest of the amount o ver 1 h.
st
Rate/h in 1 30 min = 0.02 X Wt (kg) X 60
/ ... ) / ( ...
/ ...
Available as 1g in 20 mL 2.5 g in 50 mL 5 g in 100 mL
Compatible with D 5 W and D 15W .
USES
Adjuvant t reatment of fulmin ant neonatal s epsis, hemol ytic
jaundice, neonatal alloi mmun e thrombocytop enia.
Total IgG titers in treated , septic neonat es remain el evated for
~10 days.
MONITOR
HR and BP.
IV sites for phl ebitis.

Hypoglycemia ( rare).
Transi ent tachyc ardia and hypotension, resolv ed aft er stopping
the infusion.
The risk of NEC may be increased in term and lat e pret erm
infants treated for isoimmun e h emolyt ic jaundic e.
Associated with ren al dysfunction, ARF and osmotic nephrosis;
use minimu m concent ration with minimu m rate of infusion in
patients predisposed to AR F.
Indomethacin
Liometacen 50 mg vial
Closure of PDA: as tabl e IVI ov er at l east 30 minutes. Usual ly 3

doses per course, maximu m 2 courses.
Give at 12-24h intervals with clos e monitor to UOP, if anuria or
severe oli guri a, d elay subsequent dose.
Longer treatment cou rses may be used: 0.2 mg/kg/24h for a
Ne ofax2011
total of 5-7 days.
Prevention of IVH: 0.1 mg/kg Q24h, 3 doses start at 6-12h of age.
Neofax2011
- / ... ) / (

Stab le for 12d when stored at room temperature or refrigerat ed.
Compatible with steril e wat er, D 2.5W, D 5W, NS, Lasix, insulin, KCl
and NaHCO3.
Incomp atible w ith D 7.5W, D 10W , calcium gluconat e, dobut amin e
and dopamin e.
Age at 1 st dose
< 48 h
2 7 d
>7 d
1 st
0.2 mg/kg
0.2
0.2
2 nd
0.1
0.2
0.25
3 rd
0.1
0.2
0.25
USES
Closure of PDA.
Prev ention of IVH.
MONITOR
Urine output, s erum el ectrolytes, c reatinin e and BUN .
Blood glucose.
Assess murmur and pulse pressure.
GI bleeding (gu aiacin g stools and gastric aspirat e).
Platel et count or p rolonged bleeding fro m puncture sites.
Indomethacin
Liometacen 50 mg vial
ADVERSE EFFECTS
If oliguri a occurs, observe for hyponatremia and hypokalemia and
consider prolonging the dosing in terval of r en ally excr eted d ru gs .
Consider withholdin g feedings.
Hypoglycemia ( avoid ed by GIR by 2 mg/kg/min).
Contraind icated in active bl eedin g, significant thro mbocytopeni a
or coagulation def ects, NEC and significantly imp aired ren al
function.
Avoid rapid infusion (< 5 min).
GI perforation if used concurrently with st eroids.
INTERACTIONS WITH
ACE Inhib itors: risk of renal impai rment, also hypot ensive eff ect
antagoniz ed.
Antib acterials: indomet acin possibly plasma concentration of
amikacin and gen tamicin in n eonat es; possible risk of
convulsions when giv en with quinolones .
Antiepileptics: NSAIDs possibly eff ects of phenytoin.
Beta-blockers and C alciu m-channel Bloc kers: NSAIDs antagoniz e
hypotensive effect .
Cardiac Glycosides: NSAIDs possibly plasma conc entrat ion,
possible exac erbation of heart failure and of renal function.
Corticosteroids: risk of GI bleeding and ulc erat ion.
Diazoxide: NSAIDs antagoniz e hypot ensive effect .
Diuretics: risk of n ephrotoxicity of NSAIDs by diu ret ics, also
antagonism of diuretic eff ect; indometac in ant agoniz es eff ects of
+
diuretics; risk of hyperkal emia when giv en with K -sparin g
diuretics and aldosteron e ant agonists.
Pentoxifylline: possible risk of bl eedin g.
NSAIDs ant agonize h ypotensiv e eff ect of hyd ralazine.
Inderal or Mayestrotense
Propranolol 1 mg / mL
Hypertension and Tach yarrhythmias :
Starting IV Dose: 0.01 mg/kg Q6h over 10 min. Increase as needed to max.
0.15 mg/kg/dose Q6h.
Starting Oral Dose: 0.25 mg/kg/dose Q6h. Increase as needed to max. 3.5
Neofax2011
mg/kg/dose Q6h.
Infantile Hemangio mas :

MD: 2-3 mg/kg/day PO in 3 divided doses.
Some recommends: starting dose of 0.3-1 mg/kg/day to assess tolerability
and then increasing to 2 mg/kg/day incrementally over several days.
Tapering periods have ranged from 2 weeks to 1 month.
Neofax2011
/ ... ) + ( ) / (
IV solution concentration 0.1 mg/ mL.
Compatible with D5 W and NS.
/ ... ) / (
USE
Tachyarrhythmias and hypertension.
SVT especially if associated with Wolff-Parkinson-White syndrome.
Palliation of TOF and HOCM.
Adjuvant treatment of neonatal thyrotoxicosis.
Infantile hemangiomas.
MONITOR
Continuous ECG monitor.
Vital signs and systemic blood pressure.
Blood glucose during initiation of treatment and after dosage changes.
Assess for increased airway resistance.
ADVERSE EFFECTS / PR ECAU TIONS

Hypotension, bradycardia, bronchospasm and hypoglycemia.
For infants receiving propranolol, regular, frequent food intake (Q3 -4h) is an
important consideration with regards to risk for hypoglycemia.
Contraindicated i n patients with cardiogenic shock, sinus bradycardia
greater than 1st degree block, reactive airway disease or diminished
myocardial contractility.
A withdrawal syndrome (nervousness, tachycardia, sweating, hypertension)
with sudden cessation of the drug.
Inderal or Mayestrotense
Propranolol 1 mg / mL
INTER ACTION S
Cardiac Glycoside s: risk of AV block and bradycardia.
Hypotensive effect of beta-blockers antagonized by corticosteroids.
Diazoxide: enhances hypotensive effect.
Diuretics: enhances hypotensive effect.
Thyroid Hormones: metabolism of propranolol is accelerated.
Hydralazine: enhances hypotensive effe ct.
Human Insulin, Short-acting

Actrapid 100 Units / mL
Continuous IVI: 0.01-0.1 unit/kg/h.

Intermittent SC dose: 0.1-0.2 unit/kg Q6-12h.
Ne ofax2011
For hyperkalemia: initial IVI dextrose (0.5 g /kg/h) and regular

insulin (0.1-0.2 u/kg/h). D extrose and insulin dosages are
adjusted b ased on s erum glucose and pot assium conc entrat ion .
Ne ofax2011
For hyperkalemia: begin wi th a bo lus of insulin (0.05 u/kg) with 2

mL/kg of D 10W followed by IVI of D 10W at 2-4 mL/kg/h and
regul ar insulin (0.1 u/mL) at 1 mL /kg/h. Th e t wo solutions may b e
prepared individual ly to allo w adjustments in infusion rate in
MNC2012
response to hyp er- or hypoglycemia.
To absorption of insulin to IV solution bag or tubing, flush the
line with solution, wai t 20-30 min then flush the line again with
solution prior to initiation. Th e actual amount of insulin bein g
administrated could be less than the apparent amount . So,
adjustment of the insulin rat e should be based on the eff ect and
Gome lla2009 and Ne ofax2011
not solely on th e apparent insulin dose.
) + ( ) (
/ ...
Infusion solution concentration 0.1 u/mL.
Maximu m solution concentration 1 u/mL.
Compatible with D 5W , D 10W, NS, dobutamin e, h eparin ,
midazolam, milrinon e, KCl and NaHCO 3.
Incomp atible w ith dopamine.
... ) + ( ) (
...
SC solution concentration 0.5 - 1 u/mL DW or NS.
Neofax2011
Human Insulin, Short-acting

Actrapid 100 Units / mL
USES
Hyperglyce mic inf ants with persistent glucose into lerance :
- Glucose > 250 mg/dL despit e GIR by 2 mg/kg/min Q4-6h.
- Prolonged restriction of IV glucos e wi th required calories.
Routine use in VLBW to pro mote gro wth in n o t warrant ed.
Adjuvant th erapy for hyp erkal emi a.
MONITOR
Blood glucose concentration Q15-30 minutes after startin g
infusion and after ch anges in infusion rat e.

Hypoglycemia.
Insulin resistanc e.
Euglyc emic hyp erinsulinemi a due to exogenous
administration may caus e metabol ic acidosis.
Glucose level gradually to avoid rapid fluid shifts.
insulin
Kayexalate
Sodium Polystyrene Sulfonate
DOSE: 1 g/kg/dose PO Q6h via NGT or PR Q2-6h

For PO use: Dilute in 3-4 mL fluid per g of resin; 10%
sorbitol, water, or syrup may be used as diluent.
For PR use: Dilute in water or 25% sorbitol at a
concentration of 0.3-0.5 g/mL; retain enema for at least
30-60 min or several hours if possible
The Na+ content is ~100 mg/g (4.1 mEq/g) of the drug
Also available as Sorbisterit (calcium polystyrene sulfonate)
USES
Treatment of hyperkalemia
ADVERSE EFFECTS
Hypokalemia
Sodium retension
Hypocalcemia and hypomagnesemia
Fecal impaction
Klacid
Clarithromycin 250 mg / 5 mL
BNFC2011-12
Dose: 7.5 mg/kg/dose PO Q12h.
/ ... ) / (
USES
Clarithromycin acts like erythromycin and has a similar
spectrum of antibacterial activity i.e. mainly against G+ve
organisms, although it is usefully more active aga inst
Haemophilus influenzae.
Its used for respiratory tract infections including atypical
pneumonias and soft tissue infections.
ADVERSE EFFECTS
Macrolides are enzyme inhibitors and interfere with the
metabolic inactivation of some drugs, e.g. theophylline,
increasing their effects.
Konakion
Vitamin K1 10 mg / ml
Prophylaxis at birth: 0.5 - 1 mg IM (0.05-0.1 mL).
PT < 32 wk (> 1 kg) : 0.5 mg IM (0.05 mL).
PT < 32 wk (< 1 kg) : 0.3 mg IM (0.03 mL).
Severe hemorrh agic disease: 1-10 mg IV slow push.
Ne ofax2011
) / (
) + ( ) / (
IV infusion rate should not exceed 1 mg/min .
Protect from light.
USES
Prophylaxis and th erap y of he morrha gic d is e as e of n ewb orn .
H ypo pro th rombine mia ; s econdary to facto rs limiting absorption
or synthesis of vitamin K 1.
In fan ts r eceiv ing TP N an d infants r ec eivin g antibio t ics f or > 2
we eks should b e giv en at l east 0.5 mg of vit amin K 1 (IM or IV)
weekl y to prev ent vit amin K d epletion.
MONITOR
PT (wh en treat ing clottin g abnormali ties) aft er 2 -4 h.
ADVERSE EFFECTS
Pain and swellin g at IM site.
Efficacy is d ecreased in liv er disease.
Ineffective
in
heredit ary
hypoprothro mbinemia
or
MNC2012
hypoprothrombinemia caused by s ev ere liv er disease.
Vitamin K 1 may requi re 3h or more to stop activ e bl eeding so FFP
(10 mL/kg) may b e nec essary wh en bleeding is sev ere.
The dru g has no antagonistic effects against heparin.
L-Carnitine
(300 mg / ml Oral Liquid) or (1 g / 5 ml IV)
IV (included in TPN):
Starting dose of 10 mg/kg/day
PO: 25 mg/kg/dose Q6h.
Primary deficiency and organic acidemias:
Gomella2009
BNFC2011-12
PO: 50 mg/kg Q12h, higher doses up to 200 mg/kg daily

occasionally required.
IVI: initially 100 mg/kg over 30 minutes followed by a
continuous infusion of 4 mg/kg/h.
Slow IV injection over 23 minutes: 100 mg/kg/daily in
24 divided doses
USES
L-Carnitine is used in the management of a range of rare
genetic conditions associated with carnitine deficiency.
It is essential for the entry of long-chain fatty acids into
the mitochondria, where they are oxidized.
ADVERSE EFFECTS
Nausea, vomiting, abdominal pain and diarrhea.
Fishy body odour
Side-effects may be dose-related - monitor tolerance
during first week and after any dose increase.
Lanoxin
Digoxin 500 g / 2 mL
LD Digitalization : G en eral ly used only when treatin g

arrhyth mias and acute CHF. Give o ver 24h as 3 divided doses IV
slow push over 5-10 min.
Oral Doses: should be 25% greater than IV doses.
Ne ofax2011
Dont administ er IM
( .... ... ) + ( ) / (
/)
Infusion solution concentration 0.05 mg/mL .
/ ... ) / (
Total Load ing Dose
Mainten ance Doses
PMA
wks
IV
g/kg
PO
g/kg
PMA
wks
IV
g/kg
PO
g/kg
Interval
hours
29
30-36
37-48
49
15
20
30
40
20
25
40
50
29
30-36
37-48
49
4
5
4
5
5
6
5
6
24
24
12
12
Divide into 3 doses over 24h
Titrate based on clinical response
USES
Heart f ailure caus ed by dimin ished myoc ardi al contrac tility.
SVT, atrial flutt er and AF.
MONITOR
HR, Rhythm and Periodic ECG (to assess desired effects and signs
of toxicity).
+
+
Seru m K , Ca, Mg ( esp. with diuretics or amphot ericin B) ; K ,
Ca, M g predispose to toxicity.
Renal function.
Ther ap eut ic s eru m le vel (1-2 ng/mL).
Be aware of d rug int erac tions.
Lanoxin
Digoxin 500 g / 2 mL

Toxic Cardiac Effects:
- PR interval prolongation.
- Sinus bradycardia or SA block.
- Atrial or nodal ectopic beats.
- Ventricular arrhythmias.
Non Toxic Cardiac Effects:
- QTc interval shortening.
- ST segment sagging.
- T-wave amplitude dampening
- HR slowing.
Feeding intolerance, vomiting and diarrhea.
Lethargy.
INTERACTIONS
ACE Inhibitors: pl asma concentration possibly by c aptopril.

Analgesics: pl asma conc entration possibly by NSAIDs, also
possible exac erbation of heart failu re and reduction of ren al
function.
Antib acterials: plasma conc entrat ion possibly by gentamicin
and tri methopri m; plasma concent ration possibly by rif ampicin ;
plasma conc entrat ion by macrolid es ( risk of toxici ty).
Antiepileptics: pl asma conc entration possibly by pheny toin.
Ampho tericin : cardiac tox icity if hypokal emi a occurs.
Corticosteroids: risk of hypokal emi a.
Diuretics: cardi ac toxicit y if hypokal emi a occurs with
acet azolamid e, loop diuretics o r thi azides and relat ed d iuret ics;
plasma conc entrat ion by spironolacton e.
Lanzor
Lanzoprazole 15 and 30 mg cap.
Dose: 0.73 - 1.66 mg/kg/dose PO Q24h.
Neofax2011
/ . . ) / (
The contents of a capsule can be mixed in 40 mL of apple
juice and administrated by NG tube. Do not use other
liquids. The NG tube should be flushed with additional
Neofax2011
apple juice after administration.
USES
Reflux esophagitis.
Onse t of ac ti on within 1h with duration of ac ti on of 72h.
MONITOR
Symptomatic improvement within 3 days.
Intra-esophageal pH monitor to assess efficacy (pH > 4.0).
ALT, AST if duration of therapy > 8 wks.
ADVERSE EFFECTS
Hypergastrinemia.
Mild ALT, AST elevation.
Lasix
Furosemide 40 mg / 4 mL
Initial dose: 1 mg/kg IV slow push, IM or PO.
Maximum of 2 mg /kg/dose IV or 6 mg/kg/dose PO.
Initial intervals: PT Q24h FT Q12h FT > 1m Q6-8h
Consider alternate-day therapy for long term use.
Neofax201 1
/ ... ) / (
/ ... ) / (
Compatible with NS and sterile water for injection.
Acidic solutions (pH < 5.5) as D 5 W, D 10W cause Lasix to degrade when
they are mixed for several hours.
Brands include: Salurin 5 mg / 5 mL Syrup (not available in Egypt)
The injectable solution may also be used for oral administration.
Neofax201 1
Controlled IVI is recommended for high-dose parenteral therapy.

Compatible with NS, D5 W, D10 W, and sterile water for injection.
USES
Diuretic that may also improve pulmonary function.
HEPATIC IMPAIRMENT
K + may precipitate coma (K + sparing diuretics prevent this).
RENAL IMPAIRMENT
May need high doses.
Deafness and tinnitus may follow rapid IV injection.
MONITOR
Urine output and weight changes.
Serum and urine electrolytes and renal function periodically.
Serum K + at initiation, in patients receiving other diuretics or digoxin
concurrently.
Consider renal US for PT infants as furesmide may precipitate
nephrocalcinosis/nephrolithiasis.
Lasix
Furosemide 40 mg / 4 mL
ADVERSE EFFECTS
Water and electrolyte imbalances especially Na+, K + and

hypochloremic alkalosis.
Risk for K+ is increased with brisk diuresis, inadequate oral intake,
presence of cirrhosis, concomitant therapy with corticosteroids, ACTH,
or prolonged use of laxatives.
May lead to increased hyponatremia and a significant rise in serum
creatinine in patients receiving indomethacin for PDA closure.
Hypercalciuria, renal calculi and development of bone
demineralization (long term use).
Ototoxic (tinnitus and reversible or irreversible hearing impairment);
especially with rapid injection, severe renal impairment, higher than
recommended doses, hypoproteinemia, or concomitant therapy with
aminoglycosides or other ototoxic drugs.
Cholestatic jaundice and Cholelithiasis (in PT infants receiving longterm TPN and lasix).
Hypotension, fatigue, nausea and muscle cramps.
Contraindicated in patients with anuria.
Lipovens
Fat Emulsion 20%
Starting Dose: 0.5 g/kg/day IVI
Increased By: 0.5 g/kg/day
Maximum 3 g/kg/day
Infusion rate: should not > 0.15 g/kg/h
24h infusion time is preferred.
Neofax2011
)TPN ( ... ) / ( ) (
USES
Parent eral nutrition source of calori es 2 kcal/mL and essential
fatty acids.
MONITOR
Seru m tri glyc erid es (< 200 mg/dL)
Liver function t est
Platel et count, G lucose, Bil irubin, Albumin
ADVERSE EFFECTS
Hypertri glyc erid emi a and hyp erglyc emi a.
Extravasat ion may cause tissue inflammation and n ecrosis.
Use minimum dose in s ev ere hyperbi lirubin emi a, sepsis or severe
pulmonary dysfunction.
Destabilization of lipid emulsions (flocculat ion and s eparation)
may occur wh en th ey are co-infused with D ex/AA solutions
containg c alcium and high concentration of h eparin (> 1 u/mL).
This may be d ecreased b y:
- Minimizing th e contact time.
- Using low ( 1 u/mL) conc entrations of heparin.
- Adding a multivi tamin preparation to th e Dex /AA solution.
Neofax2011
Magnesium Sulphate
MgSO4 10%
Resuscitation (Pulseless Torsade s):
25-50 mg/kg IV/intraosseous rapid infusion (over several minutes).
Hypomagnesemia:
25-50 mg/kg IVI over 30-60 min; repeat dose as necessary. For
hypomagnesemia/torsades with pulses, an infusion time of 10 -20 min is
recommen ded.
Neofax2011
Daily Maintenance Requirements (TPN): 0.25-0.5 mEq/kg/24h IVI.
In PPHN:
BNFC2011-12
LD: 200 mg = 2 mL = 1.6 mEq/kg IVI over 20-30 min

MD: 20-75 mg= 0.2-0. 75 mL = 0.16 -0.6 mE q/kg/h IVI to maintain plas ma-Mg
concentration between 8.5-13.4 mg/dL (3.5-5.5 mmol/L), given for up to 5 days.
... + ...
/ ...
1 mL MgSO4 10 % = 100 mg Mg = 0.8 mEq Mg
Compatibility with D5 W, NS, LR, dobutamine, heparin sodium, insulin, milrinone,
morphine and KCl.
Incompatible with calcium chloride and NaHCO3
USE
Torsades de pointes (polymorphi c ventricular tachycardia associated with long
QT interval).
Hypomagnesemia
PPHN ?!
MONITOR
Monitor serum magnesium, calcium, and phosphate levels.
Renal function (periodically).
Infuse IV magnesium sulfate over several hours.

Hypotension and bradycardia (with rapid infusion).
Flushing
Depression of reflexes
Depressed cardiac function, CNS and respiratory depression.
Contraindicated in heart block, myocardial damage or renal failure.
Signs of hypomagnesemia include tetany, cardiac arrhythmia, decreased bone
stability, apathy and increased susceptibility to epileptic seizures.
Maxical-D
Calcium Carbonate 150 mg / 5 mL
Dose: 20-80 mg elemental Ca/kg/day PO in divided doses.
Neofax2011
/ . . ) / (
Each 5 mL contains: 150 mg elemental calcium, 173.25 mg
magnesium and 100 IU Vit D 3.
Each 2.5 mg Ca Carbonate contains: 1 mg elemental Ca.
Each 5 ml of Hi-Cal contains: 1.2 gm calcium glubionate
equivalent to 87 mg elemental calcium.
USE
Non-acute hypocalcemia in babies able to tolerate oral
medications (absorption in small intestine).
MONITOR
Periodic serum Ca ++ level.

Assess GI tolerance.
Assess serum phosphorous and vitamin D levels when
indicated.

Gastric irritation and diarrhea (hypertonic).
Use with caution in infants who are at risk for NEC.
Interferes with absorption of levothyroxine.
Maxipime
Cefepime 1 g Vials
Neofax201 1
Dose: as table, IVI over 30 minutes, or IM.
/ ) / (
Infusion solution concentration 40 mg/mL (max. 160).
Compatible with D5W, D10W, D5 LR and NS.
. / ) / (
IM solution concentration 250 mg/mL.
Stable for 24h at room temperature and 7 days
refrigerated.
DOSE
FT, PT 28 days
FT, PT > 28 days
Meningitis and severe infections with
pseudomonas or enterobacter
Neofax201 1
30 mg/kg Q12h
50 mg/kg Q12h
50 mg/kg Q12h
USES
G-ve organisms (e.g. E.coli, H.influenza, Enterobacter,
Klebsiella, Morganella, Neisseria, Serratia and Proteus
species), esp. Pseudomonas aeruginosa that is resistant to
3 rd generation cephalosporins.
G+ve organisms (e.g. Strep pneumonia, Strep pyogenes,
Strep agalactiae and Staph aureus).
ADVERSE EFFECTS (UNCOMMON)

Rash, Eosinophilia
Diarrhea, Hepatic ALT, AST.
Meronem
Meropenem 500 mg / 100 mL
Dose In Sepsis: 20 mg/kg/dos e IVI ov er 30 min
PT < 32 wks GA,
PT < 32 wks GA,
PT 32 wks GA,
PT 32 wks GA,
14 days PNA
> 14 days PNA
7 days PNA
> 7 days PNA
Q12h
Q8h
Q12h
Q8h
Dose in Meningitis and Pseudomonas Infection , all ages: 40

mg/kg/dose IVI over 30 min Q8h
/ ... ( / )
Longer infusion times (up to 4h) may be associat ed with
improv ed therap eutic effic acy.
USES
Pneumococcal meningitis and other G-ve organisms resistant to
other an tibiotics, especially ext ended spect rum lact amase
producing Klebsiella pn eumoni ae.
MONITOR
Periodic CBC for eosinophilia, thrombocytosis.
Assess IV sites for signs of inflammation.
AST, AL T.
RENAL IMPAIRMENT
Cr Cl 26-50 mL/min /1.73m us e normal dose Q12h

2
Cr Cl 10-25 mL/min /1.73m us e half normal dose Q12h
2
Cr Cl < 10 mL /min/1.73m use h alf normal dose Q24h

Diarrhea (4%), nausea and vo miting (1%).
Rash (2%).
Inflammation at injection sit e.
Risk of pseudomembranous colitis and fungal infections
Minophylline
Aminophylline 250 mg / 10 mL
Neofax2011
LD: 8 mg/kg IVI over 30 min or PO.
MD (8-12h Later): 1.5-3 mg/kg/dose PO or IV slow push Q8-12h.
... ) + ( ) / (
/ ...
Infusion sol ution concentration 5 mg/ mL
... ) . + ) ( / (
/ ...
Infusion sol ution concentration 5 mg/mL
Compatible with D5 W, D10 W and NS.
/ ... ) / (
If changing from IV aminophylline to PO theophylline, no adjustment.
USES
Neonatal Apnea, including post-extubation and post-anesthesia and
prostaglandin E 1 -induced.
Bronchodilator, may improve respiratory function.
MONITOR
Heart rate (w
w it hhold next dose if > 180 bpm).
Periodic blood glucose.
Agitation.
Feeding intolerance.
Therapeutic level in apnea of premat urit y 7-12 g/mL and in
br onchos pasm 10-20 g/mL.
ADVERSE EFFECTS
GI irritation.
Hyperglycemia.
CNS irritability and sleeplessness.
Renal calcifications when used with Lasix and/or dexamethasone.
TOX ICITY
Signs: sinus tachycardia, failure to gain weight, vomiting, jitteriness,
hyperreflexia and seizures.
Treatment: activated charcoal 1 g/kg by gavage tube Q2-4h. Avoid
sorbitol-containing preparations; may cause osmotic diarrhea.
Milrinone
Primacor 1 mg / mL
LD: 75 g/kg IVI over 60 min, immediately followed by
Neofax2011
MD: 0.5-0.75 g/kg/min.

Adjust infusion rate based upon hemodynami c and clinical response.
Premature infants < 30 weeks GA:
LD: 135 g/kg IVI for 3h, immediately followed by
MD: 0.2 g/kg/min
Neofax2011
/ ... ) + ( ) / (
/ / . .
/ ... ) + ( ) / (
/ / .
Maximum concentration for infusion 200 g/mL.
Compatible with dopamine, dobutamine, epinep hrine, fentanyl, heparin,
insulin, calcium chloride, calcium gluconate, KCl, NaHCO3 , D5 W, NS and LR.
Incompatible with Lasix .
USE
Short term (<72h) treatment of acute low cardiac output after cardiac
surgery or due to septic shock.
- Improves myocardial contractility without oxygen requirements
(unlike catecholamines)
- Enhancing myocardial diastolic relaxation
- Vascular resistance
MONITOR
Continuous monitoring of BP, HR and rhythm.
Cardiac output.
Fluid and electrolyte changes and renal function.
Platelet count.

Assure adequate vascular volume before therapy.
BP will fall 5-9% after LD but will gradually to baseline by 24h.
HR by 5-10% (common).
Thrombocytopenia.
Arrhythmia (occasionally).
Morphine Sulphate (10 mg /mL)

Dose: 0.05-0.2mg/kg/dose IV over at l east 5 minutes, IM or SC repeat
Neofax2011
as required, usually Q4h.
IVI: LD 100-150 g/kg over 1h followed by 10-20 g/kg/h.
Opioid dependence: begin at most recent IV morphine dose
equivalent. Taper to 10-20% per day as tolerated. PO dose is ~ 3-5
Neofax2011
times IV dose.
Initial treatment of neonatal narcotic abstinence: 0.03-0.1
mg/kg/dose PO Q3-4h. Wean dose by 10-20% every 2-3 day based on
abstinence scoring (the Finnegan score should be <9). Use the 0.4
Neofax2011
mg/mL oral morphine solution.
/ ... ). + .( ) / (
Infusion solution concentration 0.5 mg / mL.
/ ... ) / .(
A 0.4 mg/mL oral morphine solution may be made by adding 0.4 mL of
concentrated injectable solution to 9.6 mL of NS. Stable for 7 days
Neofax2011
refrigerated and protected from light.
For continuous infusions of morphine containing heparin: use only
NS; maximum mo rph ine concentration 5 mg/mL.
USES
Analgesia, sedation.
Treatment of opioid withdrawal and abstinence
MONITOR
Respiratory and cardiovascular status.
Abdominal distension, loss of bowel sounds
Consider urine retention if UOP is decreased
ADVERSE EFFECTS
Naloxone should be readily available to reverse adverse effects
Respiratory depression ( responsiveness of the RC to CO 2 tension)
Hypotension and bradycardia
Transient hypertonia
Ileus and delayed gastric emptying
Urine retention
Tolerance wean slowly
Motinorm
Domperidone 5 mg / 5 mL
Dose: 0.1-0.3 mg/kg/dose Q4-6h PO 15 min before feeds
BNFC2011-12
/ ... ) / (
USES
Management of severe gastro-esophageal reflux.
Mucosolvan
Solution for oral or inhalation use
Ambroxol hydrochloride 15 mg / 2 mL
Dose: 1.2-1.6 mg/kg/d ay (4-5 drops/kg/day) P O or inh alation .
/ ... ) / (
/ + ... ) / (
1 mL = 25 drops
USES
Mucokinetic and secretolytic.
Mycostatin
Nystatin 100.000 U / mL
PO: 1 mL (PT) to 2 mL (FT) divided and applied with swab
to each side of mouth Q6h. Continue for 3 days after
symptoms have subsided.
Topical: Apply Q6h. Continue for 3 days after symptoms
have subsided.
Prophylaxis: 1 mL PO or via oro/nasogastric tube 3 times
Neofax2011
per day.
/ - ) / (
/ ) / (
USES
Mucocutaneous candida.
Prophylaxis against invasive fungal infections in high risk
VLBW infants.
MONITOR
Response to drug.

Skin rash caused by vehicle in cream/ointment.
Narcan
Naloxone 0.4 mg / mL
Dose: 0.1 mg/kg IV push or IM, if adequate perfusion.
Neofax2011
... ) / . (
) (
Doses needed to reverse narcotic induced depression
may be as low as 0.01 mg/kg.
Tracheal administration is not recommended.
Store at room temperature and protect from light.
USES
Narcotic antagonist (onset within minutes after IV dose
and within 1h, if given IM).
Adjuvant therapy for customary resuscitation efforts for
narcotic-induced respiratory (CNS) depression.
MONITOR
Respiratory effort
Neurologic status
ADVERSE EFFECTS
No short-term toxicity reported.
Nebcin
Tobramycin 80 mg / 2 mL
Neofax2011
Dose: as table. IVI over 30 min.
... ) + ( ) / (
... /

. ) (

. ) (
Tobrin or Tobrex 0.3% Ophthalmic use: instill 1-2 drops i nto each eye
Q4h or more often if severe infe ction, or apply a small amount of ointment
into each eye 2-3 times/day or for severe infections Q3-4h.
PMA (wks)
Postnatal (d)
Dose (mg/kg)
0-7
5
29 *
8-28
4
29
4
0-7
4.5
30-34
8
4
35
All
4
Interval (h)
48
36
24
36
24
24
USES
Aerobic G-ve Bacilli (e.g. Pseu domonas, Klebsiella, E.coli). Usually combined
with a -lactam antibiotic (in separate infusion).
THER AP EUTIC SERUM C ONCEN TR ATIO NS

Peak: 5-12 g/mL
Trough: 0.5-1 g/ mL
ADVERSE EFFECTS
Transient and reversible renal tubular dysfunction ( urinary loss of Na, Ca,
and Mg).
Vestibular and auditory ototoxicity (irreversible).
Increased neuromuscular blockade when used with pancuronium and in
patients with hypermagnesemia.
Neomaint Solution
Contents per 1000 mL
Glucose
NaCl
KCl
120 gm/L
1.7535 gm/L
0.7445 gm/L
K
Na
Cl
Osmolarity
10 mEq/L
30 mEq/L
40 mEq/L
746.7 mOsm/L
Neupogen (Filgrastim 300 g/mL)

Granulocyte Colony-Stimulating Factor (G-CSF)
Dose: 10 g/kg/dose SC once a day
BNFC2011-12
/ . . ) / (

... ) / (
/
For subcutaneous or IVI, dilut e with Glucose 5 % to a concentration
of not <15 g/mL; to di lute to a conc entrat ion of 2 15 g/mL, add
albumin to produce a final albumin solution of 2 mg/mL; not
BNFC2011-12
compatibl e with NaCl solutions.
Brands inc lude Geneleukim
USES
Filgrastim has been used to treat sepsis -induced neutrop enia in
pret erm neon ates. There is no clear evid ence that G-CSF imp roves
survival or long-term outco mes.
Monitor
CBC and Neut rophil Count.
9
Discontinue if WBCs count exc eeds 50 X 10 /L.
ADVERSE EFFECTS (UNCOMMON)

Fev er
Vomiting
BNFC2010-11
Noradrenaline
Levophrine 4 mg / 4 mL amp.
Dose: 0.05-0.1 g/kg/min , titrate to desired effect ; max . dose 1 -2
MNC2012
g/kg/min.
Dose: 0.02-0.1 g/kg/min IVI adjusted according to response; max . 1
BNFC2011-12
g/kg/min.
) + ( ) / (
/ ...
Infusion Solu tion Concentration 0 .1 mg/mL

Dilute in D 5W (dilution in N S is not reco mmended). Infuse throu gh
MNC 2012
CVC.
Incomp atible w ith bicarbonat e or alkal ine solutions.
1 mg of noradrenalin e acid tartrat e is equival ent to 500 micrograms
of the base. Dose expressed as the b ase.
USES
Treat ment of shock that p ersists after adequ ate fluid vo lume
MNC2012
replac ement ; sev ere hypot ension; card iogenic shock.
Acute hypot ension (septic shock) or shock secondary to excessiv e
vasodilation.
Monitor
HR, UOP and peripheral p erfusion.
Blood pressure.
ADVERSE EFFECTS/PRECAUTIONS
Blood/volume depl etion should be corrected , if possible, before
norepinephrine th erapy.
Extravasat ion may cause s ev ere tissue nec rosis.
Hypert ension.
Bradycardia and arrhythmi as.
Peripheral isch emi a
Contraiond icated with p eripheral o r mesent eric vascular thrombosis
MNC2012
(ischemia may be increased and th e area of infarct ex tend ed).
NuTriVene-D Cap.
Daily Supplement
Dose: as tabl e. Divid e dosage and administ er P O 2-3 times p er d ay.
Weight
< 20 lbs
21 40 lbs
41 60 lbs
61 80 lbs
> 80 lbs
Dose
< 9 kg
10 18 kg
19 27 kg
28 36 kg
> 37 kg
2 Cap.
4 Cap.
6 Cap.
9 Cap.
12 Cap.
USES
Trisomy 21.
INGREDIENTS (Per 12 Cap.)

Total fat
Vit. A (Palmitate)
Vit. E (Succinate)
Folic acid
Niacinamide
Vit. B1
Vit. B2 (Riboflavin)
Vit. C (Na Ascorbate)
Chromium (Cl)
Mg (Oxide)
Molybdenum
Selenium
Acetyl-L -Carnitine
L-Citrulline
L-Histidine
L-Methionine
L-Proline
L-Tryp tophan
Betaine
Blue berry Powder
Coenzyme
Lutein
Meso. Insositol
Papain
Tau rine
<1 g
5000 iu
400 iu
400 g
125 mg
45 mg
45 mg
1000 mg
75 g
150 mg
75 g
90 g
45 mg
70 mg
25 mg
150 mg
100 mg
50 mg
500 g
150 mg
30 mg
6 mg
75 mg
5 mg
200 mg
Vit. A (Mixed Carotinoids)

Vit. D3 (Cholecalciferol)
Biotin
Folinic acid (Folinate)
Pantothenic acid
Vit. B12 (Cyanocobalamin)
Vit. B6 (Pyridoxine)
Calcium (Citrate)
Iodine (K Iodide)
Mn (Gluconate)
K (KCl)
Zinc
Choline Bitartrate
L-Glutathione (reduced)
Alpha-Keto glutaric acid
L-ornithine
L-Serine
L-Tyrosine
Bioflavonoids
Bromelain
Curcumin
Lycopene
Paba
R-Lipoic acid
3000 iu
300 iu
200 g
400 g
45 mg
90 g
35 mg
100 mg
7 g
1.5 mg
15 mg
30 mg
800 mg
150 mg
500 mg
100 mg
150 mg
100 mg
150 mg
5 mg
150 mg
6 mg
75 mg
25 mg
NuTriVene-D Cap.
Daily Enzyme Formula
Dose: as table. Administer PO 3 times per day.
Weight
Infants to 15 lbs
15 25 lbs
25 35 lbs
35 50 lbs
50 70 lbs
70 100 lbs
> 100 lbs
Dose
<6.8 kg
6.8 11.3 kg
11.3 15.9 kg
15.9 22.7 kg
22.7 31.3 kg
31.3 45.3 kg
> 45.3 kg
USES
Trisomy 21.
INGREDIENTS (Per 1 Cap.)

Lipase
Lactase
Cellulose
Alpha-Amylas e
25 mg
1 mg
1 mg
25 mg
Cap.
Cap.
Cap.
Cap.
Cap.
1 Cap.
1 1 Cap.
Orelox
Cefpodoxime 40 mg / 5 mL susp.
Dose in infants 15 d - 6m: 4 mg/kg/dose PO Q12h.
BNFC2011-12
/ ... ) / (
USES
Upper respiratory tract infect ions (but in pharyngi tis and
tonsillitis reserved for infect ions which are recurrent , chronic, or
resistant to oth er antibact eri als).
Lower respiratory tract inf ections (including bronchitis and
pneumonia).
Skin and soft tissue inf ections.
Uncomplicat ed urinary tract infec tions.
RENAL IMPAIRMENT
GFR 10-40 mL/min/1.73m dos e interval to Q24h.

2
GFR <10 mL /min /1.73m dose int erv al to Q48h.
ADVERSE EFFECTS
Most Frequent:
Seru m Sickn ess, Vulvov agin al Candidi asis.
Less Frequent:
Abdominal Pain wi th Cramps, Diarrhea, Nausea, Oral Candidi asis,
Vomiting.
Rare:
Allergic Reactions, Anaphyl axis, Angio ed ema, Drug Fev er,
Eryth ema,
Erythema
Multiforme,
Hemol ytic
Anemia,
Hypoprothrombinemia, Pruri tus of Skin, Pseudo membranous
Enterocol itis, R enal Diseas e, Seizure Disord er, Skin Rash, Stevens Johnson Syndrome.
Storage
Keep suspension in th e frid ge for up to 10 days after
reconstitution.
Pediamaint Solution
Contents per 1000 mL
Glucose
NaCl
KCl
Ca Gluconate
100 gm/L
2.164 gm/L
1.49 gm/L
4 gm/L
K
Na
20 mEq/L
37 mEq/L
Penicillin G Sodium
Benzylpenicillin 1,000,000 units Vial
Meningitis: 75,000 to 100,000 units/kg/dose IVI over 30 min or IM
Bacteremia: 25,000 to 50,000 units/kg/dose IVI over 15 min or IM
Neofax2011
GBS infections: 200,000 units/kg/day for bacteremia and 500,000

units/kg/day for meningitis, in divided doses at more frequent intervals.
Congenital Syphilis: 50,000 units/kg/dose IVI over 15 min Q12h for 1 st 7
days of life then Q8h thereafter, irrespective of GA. Treat for 10 days.
... ) . + ) ( / (
/
Na content is 2 mEq per 1 million units (600 mg).
Infusion solution concentration 50,000 units/mL.
PMA (wk)
29
30-36
37-44
45
Postnatal (d)
Interval (h)
0-28
>28
0-14
>14
0-7
>7
All
12
8
12
8
12
8
6
USES
Congenital $, gonococci, streptococci (non enterococcal).
MONITOR
Serum Na+ and K + when using high doses with RF.
Observe IV site for signs of extravasation.
ADVERSE EFFECTS
Cardiac arrest (with high doses infused rapidly).
BM depression, granulocytopenia.
Hepatitis.
Hypersensititvity has not been seen in neonates.
Phentolamine
Rogitine 10 mg / 1 mL
1-5 mL of a 0.5 mg/mL solution is injected SC into affected area
(depending on the size of the infiltrate).
. . ) + ) ( / (
Solution concentration 1 mg / mL.
Dont exceed 0.1 mg/kg o r 2.5 mg total .
Brands inc lude Rogitamin e
USES
Alpha-blocker agent us ed for prevent ion of dermal n ecrosis and
sloughing caused by extravasation of vasoconstrictiv e agents e.g.
dopamine.
MONITOR
Assess affected area for revers al fo ischemia.
Blood pressure.

Hypotension (if very large dose is used).
Consider using top ical 2% nitroglycerin oint ment if affect ed
extremit y is significant ly swoll en.
Polyvit Drops
Vitamin
Per 1 mL (20 drops)
A
D
E
C
Thiamine (B 1)
Ri bofla vin (B 2)
Ni cotinamide (B 3)
Pyri doxine (B 6)
10.000 IU
2.000 IU (100/drop)
2 mg
25 mg
25 mg
1 mg
20 mg
3 mg
/ ...
Polyvital Drops
Vitamin
Per 1 mL
A
D3
E
C
Thiamine (B 1)
Ri bofla vin (B 2)
Ni cotinamide (B 3)
Pyri doxine (B 6)
5000 iu
300 iu
2.5 mg
60 mg
1.5 mg
1.7 mg
19 mg
2.2 mg
Medical Management of Persistent Cholestasis

Clinical Impairment
Management
Malabsorption of dietary longchain triglycerides
Replace with dietary formula or

supplements containing medium-chain
triglycerides
Fat-Soluble Vitamin Malabsorption:

Vitamin A deficiency
(night blindness, thick skin)
Vitamin E deficiency
(neuromuscular degeneration)
Vitamin D deficiency
(metabolic bone disease )
Vitamin K deficiency
(hypoprothrombine mia)
Micronutrient deficiency
Deficiency of water-soluble
vitamins
10,00015,000 IU/day as Aquasol A

Replace with 50400 IU/day as oral tocopherol or TPGS
5,0008,000 IU/day of Vit-D2 or 35
g/kg/day of 25-hydroxycholecalci ferol
2.55.0 mg every other day as watersoluble derivative of menadione
Calcium, phos phate, or zinc
supplementation
Twice the RDA
Retention of Biliary Constituents such as Cholesterol:

Itch or Xanthomas
Choleretic bile acids and

ursodeoxycholicacid, 1520 mg/kg/day
Progressive Liver Disease; Portal Hypertension:

Variceal bleeding, Ascites and
hypersplenism
Interim management (control bleeding;

salt restriction; spironolactone)
End-Stage Liver Disease:

Liver failure
Transplantation
TPGS, D-tocopherol polyethylene glycol 1000 succinate, RDA, recommended
daily allowance
Potassium Chloride (KCl 15%)

Initial o ral replacement therapy: 0.5-1 mEq/kg/day di vided and
administrated with f eedin gs.
Acute treatment of sympto matic hypo kalemia: b egin with 0.5-1
Neofax2011
mEq /kg IV ov er 1 hour th en reassess.
) TPN ( . . ) (
The inject abl e form may b e gi ven in divid ed doses PO and dilut ed
Gome lla2009
in the infant s formula.
Maximu m Peripheral IV solution concentration 40 mEq/L .
Maximu m Central IV solution concentration 80 mEq/L .
Potassium M 165 mg / 5 mL
/ ... ) / (
Each 5 mL cont ains about 2.2 mEq K+
+
1 mEq K = 74.6 mg KCl (0 .5 mL KCl 15%)
MONITOR
+
Seru m K and renal function.

Continuous ECG monitor (if IVI) .
Check IV site for extrav asation and assess GI toleranc e.

Arrhyth mias (peaked T- waves, wid ened QRS, flatt en ed P wav es,
bradycardi a, h eart block and cardi ac arrest).
Thrombophl ebitis and pain at sit e of infusion.
GI irri tation (diarrh ea, vo miting, and bl eedin g) divid e dose and
administer with feeding.
+
Use with caution (if at all) in patients rec eiving K -sparin g
diuretics e.g. spironolacton e.
+
Effects of K include neuromuscul ar weakn ess, paralysis, il eus,

urine ret ention, ECG ch an ges ( ST d epression, low volt age T-wave,
appearanc e of U wav e) and di git alis toxicity.
Prostigmine
Neostigmine 12.5 mg / 5 mL
Myasthenia gravis: 0.1 mg IM. Given 30 min before
feeding. 1 mg PO (Given 2h before feeding). Dose may be
increased.
Reversal of neuromuscular blockade: 0.04-0.08 mg/kg IV.
Neofax2011
In addition to atropine 0.02 mg/kg.
... ) + ( ) / .(

Infusion solution concentration 0.5 mg/mL (1:2000).
USES
Neonat al transient or p ersist ent (congenit al) myasth enia grav is
Rev ersing effects of neuro muscular blocking drugs.
Monitor
Respiratory and C ardiov ascular status.
ADVERSE EFFECTS
Contraind icated with urinary or int estinal obstruction, bradycardia
or hypotension.
Use cautiously in patients with bronchospasm or arrythemi a.
Muscle weakn ess, tremors
Bradycardia, hypotension
Respiratory dep ression, bronchospasm
Diarrhea and exc essive sal ivation .
Prostin-VR
Prostaglandin E2 500 g / mL
Initial Dose: 0.05-0.1 g/kg/min IVI.

Titrate to response - oxygenation v ersus adverse effects
MD: as lo w as 0.01 g/kg/min IVI.
Neofax2011
May be giv en vi a UAC position ed near ductus arteriosus.
Initial Dose: 0.05 g/kg/min.
MD: 0.01-0.4 g/kg/min.
Higher doses are not likely to produc e addition al ben efits and
MNC2012
have a high er incid ence of side effects.
+ ... ) / (
/ ...
Volume of drug needed per day =
is added to 24
mL D 5W or NS and gi ven as IVI at a rat e of 1 mL /h.

Minimu m Infusion solution concentration 10 g/mL.
Maximu m Infusion solu tion concentration 20 g/mL.
Must be refrigerat ed. Prep are fresh infusion solutions ev ery 24h.
Compatible with dopamin e, dobutamin e, epin ephrin e, L asix ,

heparin , mid azolam , fent anyl and KCl.
USES
Promote dilat ation of ductus art eriosus in inf ants wi th CHD
depend ent on ductal shunting for ox ygenation /perfusion.
Maximum effect s een within 30 min in c yanotic lesions, may t ake
several hours in acyanotic l esions.
Monitor
Respiratory and C ardiov ascular status.
Improv ement in oxygen ation.
Ensure r eli able IV access.
Temperature.
Infusion site for ext rav asation and tissue nec rosis.
Prostin-VR
Prostaglandin E2 500 g / mL
ADVERSE EFFECTS
Be prepared to intubate / resuscitate .
Extravasat ion may cause tissue sloughing and necrosis.
Common (6-15%):
- Ap nea (consider t reatment with aminophylline) , seen most
often in n eonat es < 2kg at birth and usual ly appears during th e
st
MNC2012
1 h of drug infusion.
- Hypotension, cutan eous flushing and bradyc ardi a.
- Fev er and leu kocytosis.
- Hypokalemia wi th long t erm therapy ( > 20 days), especi all y
with doses > 0.05 g/kg/min .
- Gastric outlet obstruction and reversible cortical proliferatio n
of long bones aft er prolonged ttt (> 120h).
Uncommon (1-5%):
- Seizures.
- Hypoventil ation.
- Tachyc ardia.
- Cardiac arrest.
- Edema.
- Sepsis, diarrhea and DIC .
Rare ( <1%):
- Urticari a and bronchospasm.
- Hemorrh age.
- Hypoglycemia and hypocalc emia.
Musculoskeletal ch anges:
- Widen ed fontanels
- Pretibi al and soft tissue swel ling of the extremities may occu r
after 9 d ays of therapy.
- Cortical hyperostosis and periostitis may occur with long t erm
use (> 3 months).
- These chan ges resolve ov er weeks aft er discontinuation of
therap y.
Protam
Protamine Sulfate 10 mg / mL
Dose according to time since last heparin dose given:
<30 min: 1 mg / 100 units of heparin given.
30-60 min: 0.5-0.75 mg / 100 units of heparin given
60-120 min: 0.375-0.5 mg / 100 units of heparin given
>120 min: 0.25-0.375 mg / 100 units of heparin given
Maximum dose: 50 mg
IV Infusion rate should not exceed 5 mg/min.
Compatible with D5W and NS.
Neofax2011
USES
He parin a nta gonis t (combines ionically with heparin to
form a stable complex devoid of anticoagulant activity).
MONITOR
Vital signs
Clotting functions
Blood pressure (continuously).
Bleeding

Excessive doses can cause serious bleeding problems
(protamine is an anticoagulant when given alone).
Hypotension, bradycardia, dyspnea, and transitory
flushing (in adults).
Pulmicort Respules
Budesonide 0.5 mg / mL
BPD with assisted ventilation by aerosol inhalation:
BNFC2011-12
0.4 mg twice daily.
BPD with spontaneous respiration by inhalation of
BNFC2011-12
nebulizer suspension: 0.5 mg twice daily.
/ + ... )/ (
USES
May prevent or treat ventilator-induced chronic lung
disease.
Postnatal steroid treatment should only be considered in
babies who are ill and ventilator dependent more than a
week after birth.
Rifampicin
Rifocin 250 mg / 3 mL or Rimactane 2%
Ne ofax2011
Dose: 5-10 mg/kg/dose IVI ov er 30 min Q12h

/ ... ) + () / (

Dont ad minister IM or SC.
Compatible with D 5 W and NS .
Dose: 10-20 mg/kg/dose PO Q24h.
May ad minister wi th feedings.
Ne ofax2011
/ . . ) / (
Prophylaxis for high risk contacts
of invasive N. meningitidis
5 mg/kg/dose PO Q12 for 2d
Prophylaxis for high risk contacts

of invasive H. influenza type b
10 mg/kg/dose PO Q 24 for 4d
/ . . ) / (
/ . . ) / (
USES
Used in combination with v ancomycin or aminoglycosid es for ttt of
persistent staphylococcal inf ection.
Prophylaxis against N. men ingitidis and H. influenza e t ype b.
MONITOR
AST, AL T and bili rubin.
CBC for thrombocytop enia.
IV sites for phl ebitis.

Orange/red discoloration of body secretions.
Extravasat ion may cause local i rrit ation and infl ammation .
Potent CP450 enzyme inducer; Eff ect of aminophyllin e,
fluconazole, midazolam, morphine, phenobarbital, phen ytoin,
propranolol and zidovudin e.
HEPATIC IMPAIRMENT
Avoid use or dont exc eed 8 mg/kg dail y
Ringers Lactate
Lactated Ringers is a solution that is isotonic with
blood and intended for IV administration.
Contents:
Na
K
Ca
Bicarbonate (as lactate)
Cl
Osmolarity
130 mEq/L
4 mEq/L
2.7 mEq/L
28 mEq/L
108.7 mEq/L
273mOsm/L
Rocephin
Ceftriaxone 0.5 - 1 g Vials
In Sepsis: 50 mg/kg Q24h IVI over 30 min, or IM.
In Meningitis: 100 mg/kg LD then 80 mg/kg Q24h.
Neofax2011
In Disseminated gonococcal infection: 25-5 0 mg/kg Q24h IVI over 30 min,

or IM in a single daily dose for 7 days with a duration of 10 -14 days i f
meninigitis is documented.
Gonococcal Infection, Prophylaxis: 25-50 mg/kg (maxi mum 125 mg) IVI or
IM single dose.
In Uncomplicate d Gonococcal Ophthalmia: 25-5 0 mg/kg (maximum 125
Neofax2011
mg) IVI or IM single dose.
. / ... ) / (
Infusion sol ution concentration 100 mg/ mL.
Compatible with D5 W, D10 W and NS.
. / ... ) / (
IM solution concentration 250 mg/mL.
Max. IM solution concentration 350 mg/mL.
Brands Include Ce fotrix (250, 500, 1000 mg vials)
MNC2012
USES
Neonatal sepsis and meningitis by G-ve organisms (e.g. E. coli, Pseudomonas,
Klebsiella, H. influenza).
Gonococcal infections.
MONITOR
CBC.
Serum electrolytes, BUN and creatinine.
AST, ALT and bilirubin.
Consider abdominal US.

Not recommended for use with hyperbilirubinemia; it displaces bilirubin from
albumin binding sites.
Concurrent use of Ca-Contai ning solutions or products is contraindicated
within 48h of the last administration of ceftriaxone.
Eosinophilia, thrombocytosis and leuckopenia.
Rash, Bleeding time.
Diarrhea, transient GB precipitations ( colicky abdominal pain, nausea and
vomiting), AST, ALT.
BUN and serum creatinine.
Sandostatin
Octreotide 0.1 mg / mL amp.
For hyperinsuline mic hypo glycemia : Initially 1 g/kg/dose Q6h
SC or IV. Tit rat e upward to desired effect . Initial response should
occur within 8h; t achyphyl axis may occur within several d ays.
Ne ofax2011
Maximu m dose: 10 g/kg/dose Q6h.
For chylothorax : Init iall y 1 g/kg/h IVI. Tit rat e up ward as
necessary based on reduction in chyle production; dosage
increas es of 1 g/kg/h Q24h hav e been used.
Neofax2011
Maximu m dose: 10 g/kg/h.
/ ... ) / . (
For SC injection, use undilut ed drug.
For IVI, dilut e to 10-25 g/mL .
Ne ofax2011
USES
Refracto ry hyp erinsulinemic hypogl ycemia.
Adjunctive treatment of congenital and
chylothorax.
post-operativ e
MONITOR
Blood glucose.
Signs and sympto ms of NEC.

Vomiting, diarrhea, abdomin al distension and st eato rrhea.
Pulmonary hyp ert ension (in PT with CLD).
Hypergl ycemia in patients treat ed for chylothorax.
NEC has been report ed in t erm neonates.
Salbutamol Albuterol
Ventolin Farcolin 5 mg / mL
Salamol 5 mg / 2.5 mL
Dose: 0.1-0.5 mg (0.02-0.1 mL)/kg/dose Q2-6h via nebulizer .
PO: 0.1-0.3 mg/kg/dose Q6-8h.
Ne ofax2011
For Hyperkale mia: 0.4 mg (0.08 mL) /kg/dose Q2h via nebulizer.
. / ) + ... ( ) / (
A 0.1 mg/mL dilution for inhal ation c an be made b y addin g 0.5
mL of Salbu ta mol (5mg/mL) to 24.5 mL of NS. Label for
Modif ied fr om Neofax2011
inhalation only. St abl e for 7 days refri gerat ed.
. - / ... ) / (
Well absorb ed after PO. On s et of action is 30 min; d uratio n of
actio n is 4-8h. Tol eranc e may d ev elop.
USES
Bronchodilator.
Hyperkalemia.
MONITOR
Degree of bronchospasm.
Continuous ECG monitor. Stop if HR > 180 bpm.
+
Seru m K .
ADVERSE EFFECTS
Tachyc ardia, arrhythmi a.
Tremor.
+
Hypokalemia (driv es K intrac ellul arly).
Irrit able b ehavior.
Simethicone 2%
Activated Dimethicone drops or emulsion
Dose: 21 mg with or aft er each feed (max. 6 doses in 24h); may
be add ed to bottl e feed
- /
Dentinox Colic Drops

Simeticone
Dose: 2.5 mL with or after each feed (max. 6 doses in 24 hours);
may b e add ed to bottl e f eed.
USES
Colic or wind pain
Solu-Cortef vial
Hydrocortisone-Roussel tab
Hydrocortisone
Physiologic replacement: 7 -9 mg/m2 /day IV or PO in 2-3 doses
Chorioamnionitis -exposed E LBW i nfants to decrease risk of CLD : 0.5
Neofax201 1
mg/kg/dose IV Q12h for 12 days, then 0.25 mg/kg Q12h for 3 days.
2
CAH: 3-5 mg/m PO Q8h, adjusted according to response.

Acute adrenocortical insufficiency (Addisonian crisis): initially 10 mg as a
slow IV injection then 100 mg/m2 /day IVI or IV in divided doses Q68 h;
adjusted according to response; when stable reduce over 45 days to PO
maintenance dose.
Adrenal hypoplasia, Addisons disease, chronic maintenance or
replacement therapy: 810 mg/ m2 /day PO in 3 divided doses; higher doses
BNFC2011-12
may be needed.
Hypotension resistant to inotropic treatment and volume replacement:
initially 2.5 mg/kg IV repeated if necessary after 4h, then 2.5 mg/kg Q6h for
48h or until BP recovers, then dose reduced gradually over at least 48h.
BNFC2011-12
Hypoglycemia: 5 mg/kg/day IV in two divided doses if remains hypoglycemic

despite GIR of 12-15 mg/kg/min. The dose can then be rapidly tapered over
the course of a few days. Before administration, measure glucose, i nsulin
and cortisol levels at a time when the serum sugar is low <40 mg/dL. MNC20 12
BPD: a suggested regimen is a starting dose of 5 mg/kg/day for 3 days
tapered over 7-10 days. If no response is seen by 2-3 days, treatment is
MNC20 12
stopped.
MNC20 12
Vasopressor-resi stant Hypotension :
Day 1 initial dose
Day 2 follow in 12 h with
1 mg/kg/dose IV Q8h X 3 doses

0.5 mg/kg/dose IV Q12h X 2 doses
0.25 mg/kg/dose IV Q12h X 2 doses
0.125 mg/kg/dose IV X 1 dose
If BP i mproves and other vasopress ors have been weaned off, treatment
may stop after 24 hours.
Solu-Cortef vi al
Hydrocortisone-Roussel tab
Hydrocortisone
/ ... ) / (
Solution Co mp atibi lity D 5W, D 10W and NS.
... ) / (
..
2
Ne ofax2011
BSA ( m ) = (0.05 X Kg) + 0.05

Brands include S igm acortin 500 mg and or Fl eb oco rtid 100 mg
vials
USES
Co rtis ol def ici ency.
P res s or-res is tant hyp ot en s ion (hypotensiv e babi es who are cortisol
deficient ( < 15 g/dL) are most likely to respond, BP will within
st
2h of 1 dose).
Adjunctive therapy for p ers is ten t h ypo glyc emi a
Impro v e s urviv al and CLD in ELBW in fants expos ed to
ch orioamnion itis .
MONITOR
Blood pressure and Blood glucose during acut e il lness.
ADVERSE EFFECTS
Hypergl ycemia.
Hypert ension, salt and water retent ion.
Risk of GI perforation when used with indomethacin .
Risk of disseminated C andida inf ections.
Earl y, low dose hydrocortison e treatment was not associated with
increas ed CP. Treat ed infants had indicato rs of improved
Ne ofax2011
developmen tal outco me.
Soluvit N
Water-Soluble Vitamins
Contents Per Vial Thiamine nitrate 3.1 mg, Sodium riboflavine phosphate 4.9
mg (corresponding to Vitamin B2 3.6 mg), Nicotinamide 40 mg, Pyridoxine
hydrochloride 4.9 mg (corresponding to Vitamin B6 4.0 mg), P antothenic acid
15.0 mg, Sodium ascorbate 113 mg (corresponding to Vitamin C 100 mg)
Biotin 60 microgram, Folic acid 400 micrograms, Cyanocobalamin 5.0
microgram, Glycine 300 mg, Edetate sodium 500 micrograms, (with
preservative, 500 micrograms methyl hydroxybenzoate).
Sominaletta
Phenobarbital
LD: 20 mg/kg IV slo wly ov er 10-15 min, with refractory seizures

add 5 mg/kg dos es, up to a to tal of 40 mg/kg.
MD: 3-4 mg/kg/d ay (12-24 aft er LD) IV, IM, P O or PR. Giv en dail y
Neofax2011
(Q12h probably unnecessary).
Neonatal Abstinence Syndro me
LD: 16 mg/kg P O on D 1.
MD: 1-4 mg/kg/dose PO Q12h
Based on abstinenc e scoring, weanin g can b e ach eiv ed by
Neofax2011
decreasing dose 20% ev ery other day .
) + ( ) / (
...

/ ... ) / (
USES
Anticonvulsant.
May improve outcome in severely asphyxiated infants, used prior to
Neofax2011
onset of seizures (40 mg/kg IVI over 1h)
Neonatal abstinence syndrome in nonopiate- or polydrug-exposed
infants.
May enhance bile excretion in patients with cholestasis before 99 TcIDA scanning.
MONITOR
Therapeutic level 15-40 g/mL.
Sedation occurs at serum concentration of 40 g/mL and respiratory
depression at concentrations > 60 g/mL.
Altered (usually) serum concentrations if used with phenytoin or
valproate.
In neonatal abstinence syndrome, serum concentrations of 20-30
g/mL are associated with adequate symptom control.
Sominaletta
Phenobarbital
RENAL IMPAIRMENT
Use with caution.
HEPATIC IMPAIRMENT
May precipitate coma.
Avoid in severe impairment.
Because of a prolonged serum half-life, which may be increased by
hepatic and renal dysfunction, serum levels need to be monitored and
MNC20 12
maintenance dosing adjusted accordingly.
ADVERSE EFFECTS
Sedation at serum level > 40 g/mL.
Res p iratory depress ion at serum level > 60 g/mL.
Irritating to veins.
INTERACTIONS
Analgesics: possibly CNS effects of opioid analgesics.

Antibacterials: metabolism of chloramphenicol, doxycycline and
metronidazole ( plasma concentration); phenobarbital possibly
plasma concentration of rifampicin.
Plasma concentration of phenobarbital often by phenytoin, plasma
concentration of phenytoin often but may be .
Possibly plasma concentration of propranolol.
Cardiac Glycosides: metabolism of digitoxin ( effect).
Corticosteroids: metabolism of corticosteroids ( effect).
Diuretics: risk of osteomalacia when phenobarbital given with
carbonic anhydrase inhibitor.
Theophylline: metabolism of theophylline ( effect).
Thyroid Hormones: metabolism of thyroid hormones (may
requirements for thyroid hormones in hypothyroidism).
Vitamins: barbiturates possibly requirements for vitamin D.
Spironolactone
Aldactone 25 mg tab.
Dose: 1 - 3 mg/kg Q24h PO.
Neofax2011
/ ... ) / (
.
USES
In combination with other diuretics in treatment of CHF and BPD
(situations of aldosteron e secretion).
Ascites and edema.
Reduction of hypokal emia induc ed by diuretics or amphot ericin.
Addition of spirono lactone to thiazide diu retic therapy in BPD
Ne ofax2011
may yield little, if an y, additional benefit.
May require several days of therapy before effect is seen .
MONITOR
+
Seru m K in long t erm th erapy (discontinue if ).

+
Measuring u rinary K is a useful indicator of effectiven ess.
RENAL IMPAIRMENT
Use with c aution.
+
Monitor K concentration; hi gh risk of hyp erkalemia in RF
Avoid if rapidly d eteriorat ing or s evere ren al i mpairment.
ADVERSE EFFECTS
Hyperkalemia, hyponat remia.
False positiv e ELISA screening for congen i tal ad r en al hyp erp l as ia.
Rash.
Vomiting, diarrhea.
Dose-dependent androgenic effect in f emal es.
Gynecomastia in mal es.
A tumori gen in chronic ani mal toxicity studi es.
Use with c aution in patients with i mpaired r enal function.
Sulperazon
Cefoperazone / Sulbactam 1.5 g / 25 mL
Dose: 30 - 40 mg/kg/dose IV Q12h
*Could be giv en Q8h aft er 1 week of age
/ ... ) / .(
Cefobid
Cefoperazone 1 g/10 mL
Dose: 25 - 50 mg/kg/dose IM Q12h
/ ... ) / (
MONITOR
Renal function (if used with aminoglycosides).
CBC.
Liver enzymes.
ADVERSE EFFECTS
Hypersensitivity, skin reactions, fever and a change in
Coombs test.
Reversible neutropenia, decreased hemoglobin or
hematocrit, transient eosinophilia.
Diarrhea or loose stools.
Pseudomembranous colitis.
Transient elevations of BUN and serum creatinine.
Survanta
Beractant, Intratracheal Suspension 4-8 mL vials
DOSE: 4 mL/kg/dose, int ratracheally , divid ed into 4 aliquots,

given as soon as possible after birth , preferably wi thin 8 hours of
birth; may be rep eat ed within 48h at intervals of at least 6h for
up to 4 doses.
Each mL of Survanta contains 25 mg of phospholipids.
It is an off-whit e to li ght bro wn liquid supplied in singl e-use gl ass
vials cont aining 4 mL (100 mg phospholipids) or 8 mL (200 mg
phospholipids).
USES
Prophylaxis (< 29wk gestation).
Rescue treatment of mod erate to s ev ere RDS.
Respiratory failu re in mature infants due to MAS, pneu monia
and PPHN.
MONITOR
ETT pat ency and position
O2 saturation , ECG and blood pressure.
Impai red gas exchange caus ed by blockage of the airway.
Frequ ent assessment of oxygenat ion / v entil ation.

Dosing should be slowed or halted if :
- Infant beco mes dusky or agit at ed.
- HR slows.
- O2 saturation f alls > 15%
- Surfactant b acked up in the ETT.
Pulmonary h emorrhage (2-4%), mostly th e small est infants with
untreat ed PDA.
Survanta
How To Use Survanta

Swirl the vial gently (DO NOT SHAKE) to redisperse settling.
Warm the vial by standing at room temperature for at least 20 minutes or
warm in the hand for at least 8 minutes. Artificial warming methods
shouldnt be used. I f a prevention dose is to be given, preparation of
Survanta should begin before the infant's birth.
Unopened vials of Survanta that have been warmed to room temperature
may be returned to the refrigerator within 24h of warming, and stored for
future use. Survanta should not be removed from the refrigerator for > 24
h. Survanta should not be warmed and returned to the refrigerator > once.
Used vials with residual drug should be discarded.
Survanta is administered intratracheally by instillation through a 5-F endhole catheter. The length of the catheter should be shortened so that the
tip of the catheter protrudes just beyond the end of the ET above the
infant's carina. Survanta should not be instilled into a mainstem bronchus.
The catheter can be inserted into the infant's by briefly disconnecting the ET
from the ventilator. After administration of each quarter -dose, the catheter
is removed and the infant is ventilated for at least 30 seconds until stable.
To ensure homogenous distribution of Survanta throughout the lungs,
each dose is divided into four quarter-doses. Each quarter-dose is
administered with the infant in a different position. The recommended
positions are:
Head and body inclined 5-10 down, head turned to the right.
Head and body inclined 5-10 down, head turned to the left.
Head and body inclined 5-10 up, head turned to the right.
Head and body inclined 5-10 up, head turned to the left.
Survanta
Survanta Dosing Chart

WEIGHT
(gm)
TO TAL DO SE
(mL)
WEIGHT
(gm)
TO TAL DO SE
(mL)
600- 650
2.6
1301- 1350
5.4
651- 700
2.8
1351- 1400
5.6
701- 750
3.0
1401- 1450
5.8
751- 800
3.2
1451- 1500
6.0
801- 850
3.4
1501- 1550
6.2
851- 900
3.6
1551- 1600
6.4
901- 950
3.8
1601- 1650
6.6
951- 1000
4.0
1651- 1700
6.8
1001- 1050
4.2
1701- 1750
7.0
1051- 1100
4.4
1751- 1800
7.2
1101- 1150
4.6
1801- 1850
7.4
1151- 1200
4.8
1851- 1900
7.6
1201- 1250
5.0
1901- 1950
7.8
1251- 1300
5.2
1951- 2000
8.0
Sutrim (Co-trimoxazole)
Trimethoprim+Sulfamethoxazole 40+200 mg / 5 mL
Dose in infants > 6 wks of age: 24 mg/kg/12h PO .
BNFC2011-12
/ ... ) / (
USES
Cholera.
Prev ention and treatment of Pneu mocystis carinii infection.
Uncomplicat ed mal aria and meningi tis because of good tissue and
CSF pen etration.
Respiratory and urin ary tract infections
Sev ere systemic infec tion, possible comb ined i mmun e defici ency ,
or overt HIV, to reduce th e risk of b acterial infection.
AVOID IN BABIES WITH

Sev ere liv er dis ease.
Serious unconjugated jaundice.
Acute porphyria.

Co-trimoxazol e increases th e plas ma h alf life of phenytoin.
Risk of hemolytic an emi a in bab ies with G6PD defici ency
RENAL IMPAIRMENT
GFR 1530 mL/min/1.73m Use h alf normal dose.

2
If GFR < 15 mL/min/1 .73m or if plasma level of sulfamethoxazol e
cant be monitored Avoid.
Targocid
Teicoplanin 200 mg / 5 mLNS
Dose: 16 mg/kg LD IV followed by 8 mg/kg IV or IM once Q24h.
Neofax2011
Treat prov en sept icemia for at l east 7 days.
... ) / (
/
USES
Teicoplanin is active against many G+ve anerobes and is particularly
potent against Clostridium species. It is also active against most
Listeria, enterococci and staphylococci (including MRSA) although it
may work more as a bacteriostatic drug than as a bactericidal drug.
Vancomycin resistant organisms are sometimes sensitive to
teicoplanin.
Rifampicin may be synergistic in the management of staph. infection.
USES
Teicoplanin is active against many G+ve anerobes and is particularly
potent against Clostridium species. It is also active against most
Listeria, enterococci and staphylococci (including MRSA) although it
may work more as a bacteriostatic drug than as a bactericidal drug.
MONITOR
CBC
ALT, AST
Renal and auditory function on prolonged administration during renal
impairment or if other nephrotoxic or neurotoxic drugs given.
RENAL IMPAIRMENT
Reduce dose on day 4:
Use half normal dose if estimated GFR is 40-60 mL/min/1.73m2
Use normal dose if estimated GFR is < 40 mL/min/1.73m2
ADVERSE EFFECTS
Leucopenia and thrombocytopenia.
Disturbances of liver function.
Tazocin
Piperacillin + Tazobactam 4.5 g / 90 mL
Ne ofax2011
Dose: 50-100 mg/kg/dose IVI ov er 30 min
BNFC2011-12
Na content is 11.16 mEq / 4.5 g vial

Piperacillin : Tazobac tam = 8:1.
Dose is calculat ed as for pip eracillin compon ent.
/ ... ) / .(
PMA (wk)
29
30-36
37-44
45
Postnatal (d)
0-28
>28
0-14
>14
0-7
>7
All
Interval (h)
12
8
12
8
12
8
8
USES
Non-CNS infections, c aused by susceptible -lactamas e
producing bact eria (e.g. E. col i, Enterobact er, Kl ebsiel la, H.
influenzae, Proteus mirabilis, Pseudomonas spp., and St aph.
aureus. Also eff ectiv e against group B Streptococcus.
MONITOR
Observ e IV sit e for signs of extravasat ion.
ADVERSE EFFECTS
Eosinophilia
Hyperbilirubin emia
AST, AL T, BUN and seru m creat inine.
Tienam
Imipenem / Cilastatin 500 mg / 100 mL
Dose: 20-25 mg/kg/dose Q12h IVI over 30 min.
Neofax2011
/ ... ) / (
Infusion Solu tion concentration 5 mg/mL.
USES
Non-CNS
infections
caused
by
b acteria,
primaril y
Enterob act eriac eae and an erobes, resistant to other antibiot ics.
Broad-spectrum of act ivity includes many G +v e and G-ve bact eri a
and anerob es; Imipen em has good act ivity against Pseudomonas
aeruginosa. Not active against MRSA and Enterococcus feciu m.
MONITOR
Periodic CBC.
Liver enzymes.
IV sites for ph elibitis.
RENAL IMPAIRMENT
Not licensed for us e in children with renal impai rment.
2
Cr Cl < 70 mL /min/1.73m R educe dose.

Seizures in p atien ts wi th meningitis, preexisting CNS p athology ,
and sev ere ren al dysfunction.
Local reaction at injection site.
Increased platel et count and Eosinophilia.
Elevat ed liv er enzymes.
Diarrhea (> 5 % of patients).
Tracrium
Atracurium besilate 10 mg / mL
Initiall y 0.3 0.5 mg/kg IV followed eith er by IV dose of 0 .10.2
mg/kg repeated as nec essary or by IVI 0.30.4 mg/kg/h adjust ed
BNFC2011-12
according to response.
... ) + ( ) / (
Infusion solution concentration 1 mg/mL
Dilute 60 mg/kg bodyweight to a final volu me of 50 mL with D 5W
or NS; mini mum conc entration of 0.5 mg/mL, max. conc entration
of 5 mg/mL; an IVI rate of 0.1 mL /h provid es a dose of 0.12
BNFC2011-12
mg/kg/h.
Brands inc lude Atracurium.
USES
Neuromuscular blockad e (short to intermediat e duration) for
surgery o r during intensiv e care st ay.
Atracur ium und ergo es non-enzymatic metabolis m which is
independ ent of liver and kidney function, thus allowing its use in
children with hep atic or ren al i mpairment.
ADVERSE REACTIONS / PRECAUTIONS

Skin flushing, hypotension, t achycardi a, bronchospasm, and very
rarely anaphyl actoid reactions.
Neonat es may b e more sensitiv e to th e effects of atracu rium and
lower doses may be requi red .
Unasyn
Ampicillin/Sulbactam 750 mg / 20 mL
Dose: 150 mg/kg/day IV Q8-12h.
Dose may b e doubled in meninigit is.
/ ... ) / (
Infusion solution concentration 37.5 mg/mL .
PMA
weeks
29
30-36
37-44
45
Postnatal
Days
0-28
>28
0-14
>14
0-7
>7
All
Interval
hours
12
8
12
8
12
8
6
USES
Broad-Spect rum
bact ericid al
ag ainst
monocytogen es and susceptibl e E. coli spec ies.
RENAL IMPAIRMENT
GBS,
Listeri a
Reduce dose o r frequency if estimat ed GFR < 10 mL/min/1.73m .

Rashes are mo re co mmon.

Very large doses may result in CNS excit ation or seizure activity.
Hypersensitivi ty reactions are rare in n eonat es (maculopapul ar
rash, urtic arial rash or f ev er).
Moderat e prolon gation of bl eedin g times (by ~60 seconds) may
occur after rep eated doses.
Ursogall
Ursodeoxycolic acid 158.5 mg / 5 mL
Dose: 10-15 mg/kg/dose PO Q12h.
Neofax2011
/ ... ) / . (

USES
Cholestatsis associated with TPN, biliary atresia and cystic
fibrosis.
Dissolve cholesterol gallstones (may take several months).
MONITOR
ALT, AST.
Serum direct bilirubin.
HEPATIC IMPAIRMENT
Avoid in chronic liver disease (but used in primary biliary
cirrhosis).

Nausea, vomiting.
Abdominal pain.
Constipation.
Flatulence.
Aluminum-containing antacids bind ursodiol and inhibit
absorption.
Vancomycin
Vancocin 500 mg / 100 mL

Meningitis : 15 mg/kg/dose IVI o ver 1h.
Bacteremia: 10 mg/kg/dose IVI over 1h.
Ne ofax2011
/ . . ) / (
Solution co mp atibility D 5W, D 10W and NS.
IV form c an be used to prepare solu tion for o ral ad min istration .
PMA (wks)
29
30-36
37-44
45
Postnatal (d)
0-14
>14
0-14
>14
0-7
>7
All
Interval (h)
18
12
12
8
12
8
6
USES
Bactericidal ag ainst aerobic and anero bic G +ve bact eria includin g
methici llin-resist ant S aureus and S epid ermidis and penic illin resistant pn eumococci. B acteriostatic for ent erococci.
Howev er, there are reports of S aureus with susceptibilit y and
glycopeptid e resistant Enterococci.
Penetration in to C SF is poor.
MONITOR
Renal function and IV sit es for phlebi tis.
RENAL IMPAIRMENT
Reduce dose.
Monitor plasma concentr ation and ren al function regul arly.
Vancomycin
Vancocin 500 mg / 100 mL

Nephrotoxicity (high er incid ence with serum t rough
concentration > 10 g/mL) ; enh anced by amino glycoside th erapy.
Ototoxicity (with prolonged serum peak concentration >40
g/mL).
Rash and hypotension (rred man s ynd ro me), resolv es within
minutes to hours infusion time.
Neutropeni a (if ad ministrated > 3 wks).
Phlebitis R at e, dilut e dru g or rot ate infusion sites.
SERUM LEVEL
Should be measured after 3-4 doses if renal function is normal ,
earlier if theres ren al i mpairmen t.
Trough : 5-10 g/mL 15-20 g/mL wh en treating MRSA
pneumonia, endocarditis or bon e/jo int inf ections (Draw 30
minutes prior to scheduled dos e).
Peak: 30-40 g/mL when treat ing men ingitis (Draw 30 minutes
after end of infusion).
INTERACTIONS WITH
General Anesthetics: hypersensitivit y-like reactions.
Aminoglycosides: risk of n ephrotoxicity and ototoxicit y.
Ampho tericin : possible risk of nephrotoxicit y.
Loop diuretics: risk of otoxicity.
If staphylococci exhibit tolerance to the drug, combine it with an
amin ogl yco s id e, with or wi thout rif a mpicin.
Valium
Diazepam 10 mg / 2 mL
IV dose: 0.3 mg/kg. Diazep am is most effectiv e wh en given as IVI

MN C2012
at a rat e of 0.3 mg/kg/h .
Slow IV: 0 .3-0.4 mg/kg rep eat ed once aft er 10 min if n ecessary.
BNFC2011-12
PR: 1.25-2.5 mg rep eat ed once aft er 10 min if n ecessary
... ) / (
Avoid injections containing b enzyl alcohol in neon ates.
Avail abl e also as Stesolid Rectal Tubes2.5-5-10 mg per tube.
Brands inc lude Epiv al and N euril.
USES
Status epi lepticus.
Convulsions caused by poisoning.

Close observ ation is required unt il full recov ery fro m sedation.
When giv en IV, fac ilities for rev ersing respiratory dep ression with
mechanic al v entil ation must b e at hand.
Muscle weakn ess.
Hypotension.
Gastro-intestinal disturbances, incontinenc e, urin ary ret ention.
Blood disorders and jaundice report ed; skin reactions.
IV in jection P ain and th rombophlebi tis.
CONTRAINDICATIONS
Respiratory depression or marked neu romuscular respiratory
weakn ess including unstable myasthenia gravis.
Valium
Diazepam 10 mg / 2 mL
1. Diazepam is rapidly redistribut ed after an IV dose and cleared

from the b rain within minutes.
2. Diazepam has great er respirato ry and circul atory d epressan t
effects (part icularl y wh en used with a barbi turat e).
3. The anticonvulsant effect of diaz epam lasts minut es, whereas
its sedativ e effect exceeds 24 hours
4. Sodium b enzoate, th e v ehicl e for IV diaz epam, uncoupl es
bilirubin from albumin, increasin g the risk for kernicterus in
MNC2008
jaundiced inf ants.
RENAL IMPAIRMENT
Start with small doses.
Increased cereb ral s ensitivity.
HEPATIC IMPAIRMENT
Dose; may precipit ate coma.
Avoid in sev ere i mpairment.
Vfend
Voriconazole 50 mg tab.
LD: 6 mg/kg.
(B liss et al., 2003)
MD: 4 mg/kg/dose IV or PO Q12h.
The reco mmended duration of th erapy is 2-3 weeks but has to b e
(Ste inbach and Benjamin, 2005)
individualized to the t ype of fungal speci es .
/ ... ) / (
Solution Concentration 5 mg/mL.
... ) . + .( ) / (

Infusion Solu tion Concentration 0 .5 mg/mL .
For IVI, reconstitute each 200 mg with 19 mL Wat er for Injections
to produce a 10 mg/mL solution; dilut e dose to concentration of
0.5-5 mg/mL with D 5W or NaCl 0.9% and giv e at a rate not
BNFC2011-12
exceeding 3 mg/kg/h.
USES
Invasiv e aspergillosis; serious infections caused by Sc edosporium
spp., Fusarium spp., or in vasiv e fluconazole-resistant Candid a
BNFC201 1-12
spp. (including C. krusei).
If voriconazol e prov es to b e as well tolerat ed in th e n eonat e as in
children and adults, it will be a useful ant ifungal choic e for
treatment of C andida infection in th e NICU . It has a b roader
spectrum of activity and high er potenc y than fluconazol e, and a
better safety profil e than amphot ericin B .
MONITOR
Liver enzymes.
Ca, Mg and K.
Seru m creatinin e.
HEPATIC IMPAIRMENT
In mild to mod erate h epatic cirrhosis use usual initial dose th en
BNFC2011-12
halve subsequ ent doses.
No information avai labl e for sev ere hep atic cirrhosism,
manufacturer advises use onl y if potent ial b enefi t outwei ghs risk.
Vfend
Voriconazole 50 mg tab.
RENAL IMPAIRMENT
IV formul ation not recommend ed for patients with renal failure.
(B liss e t al., 2003)

2
IV vehicl e may accumulate if estimat ed GFR < 50 mL/min/1.73 m ,

use IVI only if pot ential ben efit outwei ghs risk, and monito r renal
function; alternativel y, use tabl ets (no dose adjustment required).
BNFC2011-12
ADVERSE EFFECTS
Vomiting, diarrhoea, jaundic e, edema, hypot ension, RDS,
hypoglycemia, hematuri a, blood disorders (including an emi a,
thrombocytopeni a, leucop enia, pancytop enia), AR F, hypokal emi a,
visual disturbances, (including al tered p erc eption, blurred vision
and photophobia), rash, photosensitivit y, alopeci a, cheilitis,
injection sit e reactions.
Less commonly h epat itis, constipation , arrhythmi as (including QT
interv al prolongation), raised s erum chol esterol, hyp ersensitivity
react ions (including flushing), n ystagmus, ad renocortic al
insufficiency, arthritis, bleph aritis, optic n euritis, St evens -Johnson
syndrome.
Rarely pseudomembranous colitis, hearing disturb ances,
convulsions, extrap yramidal eff ects, hyp ertonia, hypothy roidism,
hyperthyro idism, discoid lupus eryth ematosus, toxic epid ermal
necrolysis, pseudoporphyria, retin al hemo rrhage, optic atrophy;
also report ed squamous cell c arcinoma of skin (particularly in
presenc e of phototoxicity).
Contraind icated in acut e porphyri a
Bliss JM, Wellington M and Gigliotti F (2003): Antifungal pharmacotherapy for

neonatal candidiasis. Semin Perinatol; 27(5):365-74.
Steinbach WJ and Benjamin DK (2005): New antifungal agents under development in
children and neonates. Curr Opin Infect Dis; 18:484-9.
Viagra
Sildenafil 50 mg tab.
Dose: 0.5-2 mg/kg/dose PO Q6-12h. Maximu m of 3 mg/kg/dose
Neofax 2011
Q6h.
Dose: Initially 0.25-0.5 mg/kg/dose Q4-8h, adjusted according to
response; max. 2 mg/kg/dose Q4h; start with lower dose and
frequency especi ally if used with other vasodil ators; withdraw
BNFC2011-12
gradually.
- / ... ) / (
Final concentration of 1 mg/mL.
Brands inc lude Er ec 100 mg tab . and Viav ag 25 mg tab .
MONITOR
Blood pressure and Oxygenation.
HEPATIC IMPAIRMENT
Reduce dose if not tol erat ed in mi ld to moderat e i mpairment;
avoid in sev ere i mpairment.
RENAL IMPAIRMENT
Reduce dose if not tolerat ed.
ADVERSE EFFECTS
Worsening oxygen ation and systemic h ypotension.
Use with c aution in infants with sepsis.
Risk of ROP, bl eedin g??
INTERACTIONS WITH
Fluconazole: significant in concentration (inhibits C YP3A4).
Vitalipid N
Fat-Soluble Vitamins
Per mL Vitalipid N Adult Retinol 99 mcg, calciferol 0.5 mcg, -tocopherol 0.91
mg, phytomenadione 15 mcg, fractionated soybean oil 100 mg, fractionated
egg phospholipids 12 mg.
Per mL Vitalipid N Infant Retinol 69 mcg, calciferol 1 mcg, -to copherol 0.64
mg, phytomenadione 20 mcg, fractionated soybean oil 100 mg, fractionated
egg phospholipids 12 mg.
Vitamin A
Vitamin-A 25000 u cap.
Parenteral Treatment of Vitamin A deficiency: 5000 units IM 3
Ne ofax2011
times weekl y for 4 weeks.
Prevention of deficiency in complete biliary obstruction: 50,000
units IM once a month.
USE
To reduce risk of CLD in high risk premature neonat es with Vit- A
deficiency .
MONITOR
Signs of toxicity full fontanel, l ethargy, irritabi lity, h epato megaly ,
edema, mucocutan eous lesions and bony t enderness.
Consider measurin g pl asma retinol concen trat ions if av ail able,
especially if th e patient is also recei ving glucocoticoids; desired
concentrations are 30-60 g/dL.
Con cen tration s < 2 0 g/dL indicat e d eficien y while those > 1 0 0
g/d L are potentially toxic.

Avoid coincident treat ment with glucocorticoids.
Vitamin B group
Adjust doses as necessary

BNFC2010-11
Bcozyme amp.
Thiamine; Vitamin B1
Maple syrup urine disease
Metabolic disorders includi ng
congenital lactic acidosis
5 mg/kg/day PO
50-200 mg once daily (total dose
may alternatively be given in 2-3
divided doses) PO or by IVI over
30 min.
Riboflavin; Vitamin B2
Metabolic diseases
50 mg 1-2 times daily PO
Pyridoxine; Vitamin B6
Metabolic diseases includi ng
cystathioninuria and
homocystinuria
Treatment of isoniazid-induce d
neuropathy
Prevention of isoniazid -induced
neuropathy
Pyridoxine-dependent seiz ures
50-100 mg 12 times daily PO

5-10 mg daily PO
5 mg daily PO
Initial test dose 50100 mg by IV
injection, may be repeated; if
responsive followed by an oral
maintenance dose of 50-10 0 mg
once daily
Vitamin D
Decal-B12 Syrup or ViDrop Drops
Supplementation in breastfed b abies: 10 g/day (400 u/day) PO.

MNC2012
Treatment of Vit D defic iency: 1000 u/day PO.
Ne ofax2011
/ - ) / ( -
/ - ) / ( -
/ ... ) / ( -
Decal-B12 = 1000 u Vit D 3, 50 mg C a, 10 g V it B 12 p er 5 mL
ViDrop = 2800 u Vit D 3 per 1 ml (= 28 drops)
IM Preparations
Devarol-S 60.000 u / 2 mL amp.
Sterogel H 60.000 u / 1.5 mL amp.
Dose of One-Alpha in neonates: 0.05-0.1 g/kg/d ay ; equ al to 12 drops/2kg/day (each drop = 0.1 g alfacalcidol). With sev ere
hypocalcemia, up to 40 drops/2kg/day may be n eed ed.
Product information leaflet
USE
MNC2012
Vitamin D supplementat ion/ d eficiency , R efractory rickets.

For breastfed infan ts (wheth er exclusiv e or supplement ed), AAP
st
recommends Vit-D supplementation to b egin within th e 1 few
days of life. Exclusiv ely formul a-fed infants rec eivin g at least 1000
mL/day of formula rec eiv e adequ ate amounts of Vit D without
Neofax2011
supplement ation.
Signs of Vit-D deficiency (25(OH)-D < 50 nmol/L) : sy mptomatic
hypocalcemia (includin g seizures), gro wth f ailure, i rrit ability,
Neofax2011
lethargy and susceptibilit y for respirato ry infect ions.
Vitamin D
Decal-B12 Syrup or ViDrop Drops
MONITOR
++
Seru m Ca and phosphorus.

Alkal ine phosphatas e (Lev els of ALP app roximately 7.5 times
above th e adult ran ge indicat es activ e dis ease) .

Acidosis, Hypert ension and Arrhythmia
Hypervitaminosis D (25(OH)-D > 250 nmol/L): hyperc alcemia,
azotemi a, serum creatinin e, mild hypokal emia, diarrh ea,
Neofax2011
polyuria, metatst atic calcific ation and nephrocalcinosis.
Vitaphos Elixir
Appe tizer a nd General T oni c wi th Vita min B Com plex
Each 15 mL contains
Vitamin B1
2 mg
Vitamin B2
1 mg
Vitamin B6
2 mg
Nicotinamide
10 mg
Calcium glycerophosphate
114.5 mg
Sodium glycerophosphate
114.5 mg
Potassium glycerophosphate
114.5 mg
Magnesium glycerphosphate
57 mg
Zantac
Ranitidine 50 mg / 2 mL
PO: 2 mg/kg/dose Q8h (unreliabl e absorption), max . 3 mg/kg 3
times d aily.
FT IV dose: 1.5 mg/kg/dose Q8h slo w push.
PT IV dose: 0.5 mg/kg/dose Q12h slow push.
Neofax2011
IVI: 0.0625 mg/kg/h, range 0.04-0.1 mg/kg/h.
- / ... ) + ) ( / (
/ . . ) / (

Oral solution is stabl e for 28 days refri gerat ed.
USES
Prev ention and treat ment of stress ulcers and GI h emorrhage
aggrav ated b y gastric acid s ecretion.
Routine gastric ac id suppression in neonat es should be avoided .
MONITOR
Gastric pH to assess efficac y.
RENAL IMPAIRMENT
Use normal dose if G FR < 50 mL/min/1.73m .
ADVERSE EFFECTS
The us e of H2 blockers in preterm inf ants has been associated with
an increased risk for lat e-onset b acterial and fungal sepsis.
Thrombocytop enia ?
In adu lts: AST, AL T, leucopen ia and bradyc ardia.
Very rarely: interstitial n ephritis.
Zithromax
Azithromycin 200mg/5ml Susp. - 500 mg Vials
Dose for treatment and prophylaxis of Pertussis: 10
Neofax2011
mg/kg/dose PO Q24h for 5 days
IV Dose: 5 mg/kg/dose Q24h IVI over 60 min. limited to
Neofax2011
those who cannot be treated orally.
. . ) / (
/
Dont refrigerate. Use within 10 days once bottle has been opened.
. . ) . + ) ( . / (
/
Infusion solution concentration 1 mg/mL, dilute prior to use.

Compatible with D 5W, NS and LR.
USES
Treat ment and post-exposure prophy laxis against B . pertussis.
As a substitute of pen icillin.
MONITOR
GI Tol eranc e.
HEPATIC IMPAIRMENT
Avoid, jaundice report ed.
RENAL IMPAIRMENT
Use with c aution if estimated GFR is < 10 mL /min/1.73m .

Diarrhea and /or vo mitin g (5-12%).
Irrit ability, rash and blood in stool.
Pyloric stenosis ?!
Zyvox
Linezolid 200 mg / 100 ml
Dose: 10 mg/kg/dose Q8h IVI ov er 30-120 min.
Given Q12h in preterm n ewbo rns < 1 wk of age.
Treat ment is usuall y continued for 2 wks.
Ne ofax2011
- / ... ) / (
USES
Only used, on microbiolo gical advic e, to treat MR SA and VR E
infection.
Active against a ran ge of G +ve bact eri a, including MRSA, VR E and
resistant strains of Strept . pneumoni ae. Active against some
anerobes, including Clostridium p erfrin gens, C lostridium difficil e
and Bact eroid es fragi lis.
Enterob act eriac eae and Pseudomon as aeruginosa are not
susceptible.
Not used as empiric treat ment or in any patient with infect ions
caused by gram-n egativ e organisms.
MONITOR
Blood pressure if rec eivin g sympatho mimetics.
Monitor CBC (including platel et count) weekl y.
AST and AL T.
HEPATIC IMPAIRMENT
BNFC2011-12
No dose adjust ment is nec essary but in sev ere h epatic imp airment
use only if potent ial b enefit outweighs risk.
RENAL IMPAIRMENT
BNFC2011-12
No dose adjustment nec essary but metabolit es may accumul ate if

2
estimated GFR < 30 mL /min/1.73 m .
Zyvox
Linezolid 200 mg / 100 ml

Rev ersible thrombocytop enia ( when giv en for > 1014 days).
A higher incidenc e of blood disorders and optic neuropathy have
been report ed in patients recei ving Zyvo x for more than th e
maxi mum recommend ed duration of 28 days.
Diarrhea (antib iotic-associat ed colitis) and vo miting.
Elevat ed transamin ases.
Less commonly dry mouth, glossitis, stomatitis, tongu e
discoloration,
abdominal
pain,
gastritis,
constipat ion,
pancreatitis, hyp ert ension, fever, polyuri a, anemia, l eucopenia,
eosinophilia, electro lyt e disturbanc es, blu rred vision, rash and
injection-site reactions
Very rarely renal failu re, pancytopeni a and Stev ens-Johnson
syndrome; lactic acidosis; peripheral and optic neu ropathy .
MILK
PER 100 mL
Ca
PO3
Nan-1
Mg
En
Pr
Fat
CHO
Na
K
Cl
Ca
PO3
Mg
Vit A
Vit D
Vit B12
Fe
L-carnitine
67 kcal
1.21 g
3.4 g
7.4 g
15 mg
58 mg
40 mg
36 mg
20 mg
4.8 mg
180 iu
30 iu
0.12g
0.54mg
0.74mg
Na
K
Ca
PO3
Mg
67 kcal
1.4 g
3.5 g
7.5 g
66 kcal
1.3 g
3.5 g
7.3 g
19 mg
68 mg
41 mg
47 mg
26 mg
5.1 mg
69 kcal
1.6 g
3.4 g
8g
0.22g
74.4 kcal
1.93 g
4.09 g
7.66 g
24.5 mg
105.6 mg
55.7 mg
78.2 mg
46.1 mg
6.67 mg
342.2 iu
52.1 iu
Bebelac
Premature
Bebelac-AR
Na
Fat
CHO
Bebelac-EC
Fat
CHO
67 kcal
1.41 g
3.89 g
6.6 g
24.8 mg (1.08mEq)
57.0 mg (1.46mEq)
24.8 mg (1.24mEq)
12.8 mg
3.09 mg
Pr
Aptamil-1
Pr
PRETERM HUMAN MILK

En
68 kcal
1.05 g
3.91 g
7.2 g
17.7 mg (0.77mEq)
53.1 mg (1.36mEq)
27.9 mg (1.39mEq)
14.3 mg
3.47 mg
Similac
Neosure
TERM HUMAN MILK

En
80 kcal
2.4 g
4.4 g
7.8 g

Neonatal Drugs Section Fifth Edition2012 PDF

Enviado por

Dados do documento

Título original

Direitos autorais

Formatos disponíveis

Compartilhar este documento

Compartilhar ou incorporar documento

Opções de compartilhamento

Você considera este documento útil?

Este conteúdo é inapropriado?

Direitos autorais:

Formatos disponíveis

Neonatal Drugs Section Fifth Edition2012 PDF

Enviado por

Direitos autorais:

Formatos disponíveis

Neonatologis ts

For suggestions and inquries

New in this edition

Neonatologists Pocket Drug Reference

ADVERSE EFFECTS / PRECAUTIONS

TREATMENT OF ACETAMINOPHEN TOXICITY

For Chronic Suppression: 75 mg/kg/dose Q12h PO.

REN AL IMP AIRMENT

Cr Cl 25-50 mL/ min/1.73 m IV dose Q12 h.

ADVERSE EFFECTS / PREC AU TION S

Neutropenia (20%) dose or use Neupogen if ANC remains < 500/mm3 .

USE IN PR EGAN ANCY

Chromic Cl 5.33 mcg

- Na molybdate 4.85 mcg

Acute treatment of sust ained paroxy smal S V T (adenosine sinus node

ADVERSE EFFECTS / PREC AU TION S

USE IN PR EGAN ANCY

Severe brad ycardia, hypo tension: 0.1 - 0.3 mL /kg of 1:10,000

Compatible with dobutamin e, dop amin e, L asix , f entanyl ,

ADVERSE EFFECTS / PRECAUTIONS

Dose: as tabl e IVI ov er 30 min.

Trough : 2-5 g/mL

LD: 5 mg/kg IVI ov er 30-60 min, preferabl y in a c entral v ein.

ADVERSE EFFECTS / PRECAUTIONS

ADVERSE EFFECTS / PRECAUTIONS

Human Albumin 20%

1 gm (5 mL)/kg/dose IVI o ver 2 hour.

As a volume expand er (1:3 D 5W)

Use vial w ithin 4h of openin g.

ADVERSE EFFECTS / PRECAUTIONS

ADVERSE EFFECTS / PRECAUTIONS

Bronchodilator effect may be potentiated when given

IV Dose: 30 mg/kg Q12h.

ADVERSE EFFECTS / PRECAUTIONS

RENAL IMPAIRMENT )IV ROUTE(

RENAL IMPAIRMENT )PO ROUTE(

GFR 10-30 mL/ min/1.73m2 use normal dose Q12h

Dose: 30 mg/kg/dose IVI ov er 5-10 min or IM.

Infusion solution concentration 20 mg/mL .

ADVERSE EFFECTS / PRECAUTIONS

Cr Cl 10-30 mL/min /1.73m use normal initial dose th en

Sodium Bicarbonate 8.4 %

Antifun gals: plas ma conc entrat ion is by voricon azole.

Calcium Chloride 10%

Calcium Gluconate 10%

Each 100 mg = 1 mL = 9.3 mg elemental C a

Initial Dose: 0.01 - 0.05 mg/kg/dose PO Q8-12h. Adjust dose and

ADVERSE EFFECTS / PRECAUTIONS

General Anesthetics: hypotensive effect.

for severe inf ection (usual max. 1 g dai ly).

No dosage adjustment required .

Its a bact ericid al 1 generation ceph alosporin, mainly G +ve with

ADVERSE EFFECTS (RARE)

A 3 gen erat ion cephalosporin that is activ e against G-ve

ADVERSE EFFECTS (RARE)

TREATMENT OF TOX ICITY

Chloral Hydrate 500 mg / 5 mL

ADVERSE EFFECTS / PRECAUTIONS

or severe respiratory and GI t racts infec tions.

Infusion solution concentration 2 mg/mL.

ADVERSE EFFECTS / PRECAUTIONS

Cr Cl <20 mL /min /1.73m use half normal dose

Dose: 50 mg/kg/dose IVI ov er 30 min , or IM.