Medication & Pharmacology

Hello, I am a NICU nurse in training and for my study I have an assignment. For this assignment I want information from as many NICU's as possible about priming the infusion sets before starting the insulin infusion. Does this happen in your NICU, and if so, how? Do you have protocols I can use? Which concentrations are used and which flow rate

Hi all! I was trained to use morphine as premed before (semi-planned) intubation but our protocol and practise has changed to fentanyl as analgesic drug (in addition to atropin, pento and +/- celocurin) What is your experience with stiffening of the chest and laryngospasm? If you use fentanyl, what is your dose and over how many minutes do you inject it?

We are a pair of neonatologists working in Poland and Hungary. We have created a questionnaire to asses the use of premadication for neonatal intubation. Despite existing recommendations, a wide variation in frequency and type of specific drugs used forpremedication for neonatal intubation still exists among neonatal practitioners. The aim of our questionnaire is to assess the true rate of utilisation of premedication for non-emergency neonatalintubation in different countries across Europe. Furthermore, attitudes and experiences in regards to safety, side effects and efficiency will be evaluated. Please find the attached link to the questionnaire…

Greetings to all members of this esteemed forum and thank you in advance for your response(s). As a medical student and during my residency training, it was routine to administer vitamin k to every newborn. However, it appears the practice is being abandoned in my part of the world. What is the position in your country regarding this practice? In addition to your responses, if there are recent material(s) to support the position in your country or locality, I will be glad to have have them. Looking forward to hearing from as many members as possible. Dr Okposio Matthias Nigeria

Dear colleagues, Are there any differences with antibiotics' dosing for infants with hydrops fetalis. Today having a boy 37 weeks 4340 g weight with profoung edema of head, neck and upper part of the trunk. About 200 ml was evacuated from both sides of the thorax. What bodyweight should we use to calculate antibiotics' dose -- 4340 g or 4130 g (minus fluid from thorax) or something else? He is on HFOV. Blood pressure is stabilizing by 10 + 10 mcg/kg per minute of Dopamine and Dobutamine. Diuresis is good and no signs of impaired periferal perfusion. Many thanks.

Hi all! We are updating our protocols on analgesia in preterm infants and we would like to know if in your services you use routine analgesia in ventilated preterm infants ,from the first days, and what is/are your preferences. thanks in advance 

Dear All, I would like to seek your help. I remember I read about differences between Fentanyl and Morphine action during cooling protocol in our NICU patients. Unfortunately, I cannot find the evidence now (may be I am looking wrong) whether Fentanyl or Morphine is better option. Both are metabolised slower during cooling and we have to be careful in administration. My knowledge is that Morphine was drug of choice due to better binding to pain receptors and a bit better action during cooling. I remember some article (from Pediatrics, Neoreview?) and there was mentioned even some protective effect of Morphine. Can you help me with sources or whether it is still true?…

What about leukotriene-antagonists in BPD? I only have a few reports on the treatment with these drugs. What is your experience? Are there any major studies on this topic?

With the current lack of magic bullets to treat BPD, some affected infants get a long list of pharmaceuticals... A new acquaintance for me is montelukast. A Pubmed-search did not convince me much, I found only two clinical studies: one positive and one negative. Also found an experimental study from 2016, suggesting that the idea of leukotrien-inhibition may be plausible though. Do you use it for BPD-treatment (manifest BPD)?

Caffeine has been used for over 30 years to treat episodes of apnea in preterm infants. Caffeine citrate is considered one of the most safety and effective drugs, with few or no side effects, used in our Neonatal Intensive Care Units (NICU). Many randomized studies describe the use and benefits of caffeine in the preterm population. Studies based on caffeine prophylactic use in preterm infants, as well as new indications out of apnea of prematurity have been recently published. Despite being one of the drugs most used in our NICU, are not yet available clinical practice guidelines and / or protocols in many of our NICU. Therefore, I invite you to participate in a…