Medication & Pharmacology

Hello Guys, I consider giving brief anaesthesia for administration of Lucentis in babies already imi-intensive ward . Do you rely only on local anaesthetic given by ophtalmologist ? Would oral 20 % glucose be sufficient, or perhaps some midazolam apart form local ? Thank you

Hi everybody. Which drugs/ doses/ rotation of sedatives do you use in extremely preterm infants on prolonged mechanical ventilation. We commonly use non-pharmacological strategies, fentanyl and dexmedetomidine, but after 1-2 weeks, they trend to tolerate them and need a progressive increase... We're managing now a 24weeker on HFOV wiht a severe pulmonary emphysema (after RDS and pulmonary hemorrhage on firts days), The weaning is not possible, and she is needing high doses of fentanyl and dexmedetomidine + extra bolus of fentanyl. Would anybody use benzodiacepines? Or rotate to morphine sulfate?

I'd like to discuss an old topic again. Which pain scale do you use for premature babies? And what are the consequences for you when dealing with pain in premature babies? We're currently having a discussion on this and I would be grateful for advice and discussion.

Hello again, as you know there are several surfactant brands around. Which surfactant do you use and why?

Hi, While working the past couple of weeks, there has been some discussion on the possible membrane stabilizing effects of hydrocortisone. Is this something you would consider in your practice, in which cases, and what dose would you use? Whats is the evidence and rationale behind it? Best, Gustaf

Hi Everyone! Our Pharmacy told us, that there is an rising shortage of phenobarbital. Being 1st line treatment for neonatal seizures again, this brings some problems with it. What would you prefer as 1st line treatment instead? - Guidelines are kind of favouring Phenytoin as an alternative - but has more significant sideefects. - Levetiracetam? Not that promising, right? Any alternatives? Best wishes, Bernhard

We have come across that medicinal products have become unavailable. Our three latest examples are dextrose gel used for hypoglycemia management (I think this is a food supplement, but still) iron drops for supplementation preterm infants (so, used a lot!) multivitamin drops for preterm infants (finally back on the shelf...) @Bernhard Csillag also posted about phenobarb (see link below) Do you share this experience in your various contexts? I understand that newborns and especially preterm infants are small patient groups for companies to "build business around", and that we have less "power" than say cardiologists working with much la…

I just came across some papers about etomidate for sedation - causing no haemodynamic problems, but I hardly find any paper or recommendation for or against using etomidate in neonates. What I learned so far: - No haemodynamic suppression - Not analgetic - very often onset of myocloni - High tone of pharyngeal muscels - so relaxation needed - Adrenal suppression - in a relevant duration? That one could be a relevant argument against using it in neonates. - 0,3 mg/kg/Dose - Don't know anything about neuroapoptosis. Any experiences? Thank you! best wishes, Bernhard

A cordial greeting from Ecuador. I would like to know if anyone has experience with the simultaneous administration of budesonide and surfactant to decrease the incidence or severity of bronchopulmonary dysplasia. Sincerely, Fernando Agama C. Neonatology Unit Enrique Garces Hospital Quito, Ecuador

Dear All, I wanted to know your unit’s antibiotic choice in 22-23 week babies. We use Benzyl Penicillin and Gentamicin. Dose of Gentamicin is 5 mg/kg/dose @ 36 hourly interval. However we’ve seen actuate kidney injuries with this dosage and we’re wondering whether to change to cefotaxime instead. Would be grateful for your input.