Medication & Pharmacology

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?

Dear Colleagues, i am currently concerned to see a new hype in managing preterm infants who are intubated and ventilated with no form of analgesia... For the last 5 years i can rememder we used to manage theese infants with morphine and midazolam by continuous infusion pumps (Morphine with 10micr/KG/h). We have had no problems with delayed extubations or children with respiratory depressions. Nowadays our children have to undergo all medical & nursing interventions without Morphine or Midazolam. Midazolam is no longer in use because of it`s effects on brain development. Althought i believe that we would get similar results for any other medication which makes o…

Does anyone have any experience with using Dexmedetomidine for sedation in the ventilated premature infant? This drug is being used more frequently in the adult population. Dexmedetomidine is a short acting alpha 2-agonist with anxiolytic, anesthetic, hypnotic and analgesic properties. The advantage to the medication is that it does not affect the respiratory drive and therefore does not interfere with weaning from mechanical ventilation. Because of this characteristic, infusions of dexmedetomidine can be continued after extubation without the risk of respiratory failure, a complication that can occur with propofol, lorazepam and midazolam.

Hallo. Which drugs do You use before intubation the neonates, and what doses? I notised that in every hospital people use different drugs. I wonder which drug is the most common.

Dear all, I'm a new member here. In my department an internal assestment is having place, in order to introduce iNO therapy. Beyond economic and clinical aspects, we are now focusing on risk management. In case of device break down during the treatment, the sudden interruption of NO delivery can lead to important injuries for our little patients, in particular if just one device is present within the hospital (I know that several gas companies don't provide an emergency back-up system). Did someone of you encounter the same trouble? How did you solve it? Many thanks, JP

hi all, is there any role of giving antifugals iv prophylactically in lbws or vlbws ? if yes which one is preferred?

Use of anesthetic agents in neonates and young children. Mellon RD, Simone AF, Rappaport BA. Anesth Analg. 2007 Mar;104(3):509-20. Review. LINK TO DOWNLOAD

I found a good recent review of antibiotic use in NICU. The Link is: http://www.jchemother.it/cgi-bin/digisuite.exe/product?ID=1555&IDCategory=128 It is freely available...just click "Read the full text in Adobe FlashPaper (SWF)" to read the full article...You can print it out for your personal use and reference I hope you all will find it useful