Anemia of Prematurity - Portal Neonatal

Drug Name
Pediatric Dose
Contraindications
Interactions
Aminophylline (Aminophyllin) -- Stimulates central respiratory drive and
peripheral chemoreceptor activity; may increase diaphragmatic
contractility. Aminophylline salt is 78.9% theophylline, and theophylline
PO is 80% bioavailable; dose adjustment may be necessary when
changing from IV aminophylline to PO theophylline. Aminophylline is
significantly interconverted to caffeine; if changing from IV to PO
aminophylline, increase dosage by 20%. IV and PO aminophylline is
effective in 80% of infants with central apnea.
Loading dose: 4-6 mg/kg PO or IV infusion over 30 min
Maintenance dose: 1.5-3 mg/kg/dose PO q8-12h or slow IVP q8-12h
(start maintenance dose 8-12 h after loading dose)
Therapeutic serum concentration (trough) for AOP: 7-12 mcg/mL
Documented hypersensitivity; uncontrolled arrhythmias; peptic ulcers;
hyperthyroidism; uncontrolled seizure disorders
Incompatible with cefotaxime, ceftriaxone, clindamycin, dobutamine,
epinephrine, hydralazine, insulin, isoproterenol, methadone,
methylprednisolone, penicillin G, and phenytoin; aminoglutethimide,
barbiturates, carbamazepine, ketoconazole, loop diuretics, charcoal,
hydantoins, phenobarbital, phenytoin, rifampin, isoniazid, and
sympathomimetics may decrease effects of theophylline; theophylline
effects may increase with allopurinol, beta-blockers, ciprofloxacin,
corticosteroids, disulfiram, quinolones, thyroid hormones, ephedrine,
carbamazepine, cimetidine, erythromycin, macrolides, propranolol, and
interferon
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
Drug Name
Pediatric Dose
Caution in peptic ulcers, hypertension, tachyarrhythmias,
hyperthyroidism, and compromised cardiac function; do not inject IV
solution >25 mg/min; greater risk of toxicity in pulmonary edema or liver
dysfunction because of reduced clearance; monitor heart rate and blood
glucose periodically; consider withholding next dose if heart rate >180
bpm; may produce GI irritation, hyperglycemia, CNS irritability, and
sleeplessness; may be associated with renal calcifications when used
concurrently with furosemide and/or dexamethasone; signs of toxicity
include sinus tachycardia, failure to gain weight, vomiting, jitteriness,
hyperreflexia, and seizures
Caffeine citrate (Cafcit) -- Increases respiratory center output,
chemoreceptor sensitivity to CO2, and cardiac output; serum half-life is
40-230 h; half-life is prolonged in cholestatic hepatitis.
Loading dose: 20-40 mg/kg PO or IV over 30 min; equivalent to 10-20
mg/kg of caffeine base
Maintenance dose: 5-8 mg/kg PO qd or slow IVP; equivalent to 2.5-4
mg/kg of caffeine base; start maintenance dose 24 h after loading dose
Contraindications Documented hypersensitivity; products containing sodium benzoate
Interactions
Cimetidine may impair caffeine hepatic metabolism, increasing
clearance and half-life; phenytoin induces hepatic metabolism of
caffeine, decreasing its half-life and increasing clearance; increases
metabolism of phenobarbital; increases its own metabolism; can reduce
theophylline clearance by 25% and increase elimination half-life; may
enhance cardiac inotropic effects of beta-adrenergic stimulating agents;
slightly increases urine levels of VMA, catecholamines, and 5hydroxyindoleacetic
acid
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
Restlessness, vomiting, and functional cardiac symptoms (eg,
tachycardia, extrasystoles, palpitations) possible