Medication & Pharmacology

Dear fellow-members! Together with a student, Isa Sundell, I try to collect national guidelines for neonatal pain management. With helpful support from many professionals in neonatology worldwide, we have received several examples, and have compiled a list of the result so far (see short list below). I now turn to you: maybe there are new guideIines or updates we are not aware of. It would be a great help to us if you could send information about such guidelines in your country. Absolutely best would be to recieve an electronic copy or a web-link, or in printed form to adress below, but second best would be a reply to the following questions: 1 Country: 2 Year o…

Dear Colleagues, what is your experience about the efficacy of oral agar as a treatment of Neonatal Jaundice, is there any updated data about this issue thanks

Dear Colleagues, I am an adult neurologist and actually consult one of my myasthenic patients and her newborn with the department of gynecology and our perinatal intensive care unit. The mother is free of symptoms, she is on Mestion five times /day. The newborn has a neontal (transient) myasthenia. She is 3,5 kg, 52 cm. Fortunately she does not have severe atonic generalised weakness but has bulbar symptoms. No problem with the swallowing at rest, but crying and sucking is week and she has relatively early fatigue when she is on breast. She has a good reaction for pyridostigmine but the main problem is the drug supply. When we give the drug before the breast …

Inspired by the EBNEO meeting I asked myself: why do we give caffeine? To reduce central apnoea - yes, but does it really reduce mortality or morbidity regarding the prevention of apnea? I know caffeine has been shown to reduce BPD morbidity and other endpoints but I'm only after the positive effects on central apnea - do fewer prematures die from apnoeic spells? I don't find conclusive literature on this. Can you enlighten me on the subject?

Hi, I wonder how often you meet hypertension in newborn and if you have special guidelines for therapy, because we have newborn born in term with renovascular hypertension, we give ACE inhibitors but blood pressure after one hours goes up. we give it every 8 hours. Please help.

I am a new member to the group and am focused on Neonatal Palliative and Bereavement Care at a tertiary/quaternary hospital. We utilize several methods of comfort for our babies who are dying, and I am interested in the perceptions of others. Our optimal- morphine, midazolam, fentanyl, either IV continuous or bolus depending on the situation/baby, as well as morphine/ativan sublingually and recently ativan intranasally. We also use acetamenophen as an adjunct and try to work the med regime specific to each baby and family needs. Any thoughts would be valued. Thanks in advance. Lori Ives-Baine, RN, MN, CPB Palliative Care and Bereavement Coordinator …

What is the best way of weaning Pyridostigmine in a 4 weeks old infant with Neonatal Transient Myasthenia Gravis ? the patient is tolerating his po feed but whenever we try to taper down Pyridostigmine, he can not suck well, and desaturates ! and when do you consider start weaning? P.S: pt is 3.8 kg on Pyridostigmine 5 mg po Q6 hrs, Atropine 0.02 mg/kg po q8hrs.

We are having an ongoing discussion on our ward about blood pressure drops when changing catecholamine infusions (dopamine, adrenaline..). We often observe that even if new infusions are slowly started while slowly discontinuing the old infusion (over a couple of hours) we encounter drops in blood pressure every so often. Some argue that it is best to just quickly exchanging the syringe is just as effectful in mainting adequate pressure. What are your experiences with that? how do you deal with this issue?

What concentration do you dilute to in your practice, and do you have references to support that dilution? Neofax does not state a dilution, nor does Lexicomp except less than max of 10 mg/mL... Thank you.

Which analgesic would suit better for term stable neonates with fractures?