Neonate Pharmacology (Mod 4) Flashcards
EMLA Cream drug class and function
Topical anesthetic for local analgesia
- For ABGs, not useful in analgesia for heal-pokes
Lidocaine drug class and function
Local anesthetic
- Used for certain procedures (circumcision)
Tylenol drug class and function
analgesic and antipyretic
Morphine drug class and function
Used as an analgesic and in neonatal abstinence
- can cause respiratory depression and may effect pulmonary mechanics in neonates
Fentanyl drug class and function
Opioid Analgesic
- Can cause respiratory depression and chest wall rigidity in neonates
Methadone drug class and function
Potent opioid analgesic
- less commonly used,
- neonatal abstinence (NAS)
Ibuprofen drug class and function
NSAID
- used for to close PDAs
- pain control
Ketamine drug class and function
Dissociative anesthetic
- Causes bronchodilation
- Sedation (especially procedural) and analgesia
Dexmedetomidine drug class and function
Sedative with no respiratory depression
- Hypnotic, analgesic, anxiolytic
- Facilitates early extubation
Propofol drug class and function
Sedation (less common in neonates/children than adults
- fast acting, but strong.
Lorazepam drug class and function
Benzodiazepine
- sedative, hypnotic anxiolytic, and anticonvulsant
Midazolam (versed) drug class and function
Benzodiazepine
- sedative, hypnotic anxiolytic, and anticonvulsant
Phenobarbital drug class and function
Barbiturate
- Anticonvulsant used for seizures control
- CNS depressant, from mild sedation to total anesthesia anxiolytic, hypnotic, anticonvulsant, poly-pharmaceutical neonatal withdrawal syndrome
- Sedative, anxiolytic, anticonvulsant, lack of evidence about analgesic effects (less important point)
Pancuronium drug class and function
Paralytic
- stops all muscle movement
- avoid if possible (same w/adults)
- can cause third spacing
What are common NICU inotropes used for hypotension?
- Dopamine
- Dobutamine
- Epinephrine
How is inhaled Nitric Oxide (iNO) administered?
Inserted into vent. circuit
- RT’s manage
What do Pulmonary Vasodilators treat?
Treat increased pulmonary vascular resistance
- for neonates it’d treat PPHN
Why is Nitric Oxide preferred from other vasodilators?
- How is it used?
selective for pulmonary system so it doesn’t vasodilator systemically
- see if its making a difference immediately
- see during inhalation
- start at 20ppm and should see increasing stat and decreasing
SpO2 requirements, approved for used in neonate use
What is Sildenafil used for in neonates?
To manage Pulmonary hypertension of the newborn (PPHN)
- Causes pulmonary vasodilation
- Improves oxygenation by reducing resistance to blood (allows better flow)
What drug keeps the PDA open?
Prostaglandin E1
What drug closes the PDA?
Ibuprofen and Indomethacin
- other NSAID’s way work as well.
What Respiratory Stimulants are used on neonates?
Methylxanthines
- Caffeine
- Aminophylline
- Theophylline
What is the purpose and uses of Methylxanthines
- Stim the resp. center and increase metabolic rate.
- Reduces Apnea (aids in weaning)
- Improved brain development
- Apnea of Prematurity
- Reduction in chornic lung disease
- Diuretic effect
What are Pulmonary Vasodilators used to treat?
Increased pulmonary vascular resistance (used for reduction)
- for neonates it’d treat PPHN
- iNO
Thiopental drug class and use?
Barbiturate
- used for seizure control but is the less commonly used one.
Primary Bronchodilator used for neonates?
Salbutamol (Ventolin)
what is Salbutamol (Ventolin) used for neonates?
Bronchopulmonary dysplasia (BPD)
- SABAs are used in this scenario as supportive therapy to enhance O2 delivery.
- Reduces airway smooth muscles and airway resistance (relaxes airways or dilates them if they’re inflamed)
- enhances O2 delivery (opens constricted airways)
How are bronchodilators given for neonates?
Given via MDI/Mask or bagged in if on CPAP
How are inhaled corticosteroids given for neonates?
Given via MDI/Mask or bagged in if on CPAP
What is the primary inhaled corticosteroid used for neonates?
- What does it manage?
Pulmicort/Flovent
- manages bronchopulmonary dysplasia (BPD)
What is required if neonates/kids are given respiratory meds give via MDI?
A spacer if MDIs are used
How do diuretics help the respiratory system?
Reduces pulmonary edema and improves lung mechanics
What drug class is controversial whether or not they are a viable therapy for BPD?
Steroids
What effect would Antireflux drugs have on the respiratory system?
Treats GERD (acid reflux)
- may improve symptoms of BPD
What is a Tocolytic?
A drug that delays the progression of pregnancy and contractions.
- Progesterone
What are the usual Tocolytic agents used?
- Magnesium Sulfate (MgSO4)
- Progesterone
- Nitrates
- Salbutamol
What approach should pregnant ladies with asthma take to their asthma medication treatment?
Inhaled corticosteroid dose may have to be increased during pregnancy.
Are babes affected by inhaled corticosteroids if mom has asthma?
No, Inhaled corticosteroids have low systemic absorption, meaning that only a small fraction of the medication enters the bloodstream.
What is Pentamidine?
Anti-infective (fungal/protozoal) class of drug
- used to manage Pneumocystis pneumonia, leishmaniasis, and trypanosomiasis.
