Anemia of Prematurity - Portal Neonatal

Interactions
Benzodiazepines, cimetidine, fluconazole, isoniazid, metronidazole,
miconazole, phenylbutazone, succinimides, sulfonamides, omeprazole,
trimethoprim, and valproic acid may increase phenytoin toxicity
Phenytoin effects may decrease when taken concurrently with
barbiturates, diazoxide, rifampin, antacids, charcoal, carbamazepine,
theophylline, and sucralfate
Phenytoin may decrease effects of acetaminophen, corticosteroids,
doxycycline, haloperidol, carbamazepine, cardiac glycosides, quinidine,
theophylline, methadone, valproic acid
Pregnancy D - Unsafe in pregnancy
Precautions
Drug Name
Pediatric Dose
Contraindications
Interactions
Monitor serum concentrations, which should be 6-15 mcg/mL; monitor for
bradycardia, arrhythmias, and hypotension during infusion; highly
unstable in IV solution, avoid using in central lines because of risk of
precipitation; incompatible in D5W or D10W or with dextrose plus amino
acids and lipids, most antibiotics, heparin, insulin, and many other drugs
(consult compatibility text); drug extravasation at IV site may lead to
severe local necrosis
Lorazepam (Ativan) -- Second DOC for acute control of seizures
refractory to phenobarbital.
By increasing the action of gamma-aminobutyric acid (GABA), which is a
major inhibitory neurotransmitter in the brain, may depress all levels of
CNS, including limbic and reticular formation.
0.05-0.1 mg/kg/dose IV slow push; doses repeated on basis of clinical
response
Documented hypersensitivity; preexisting CNS depression and
hypotension
CNS toxicity increases when used concurrently with alcohol,
phenothiazines, barbiturates, or MAOIs
Pregnancy D - Unsafe in pregnancy
Precautions
May cause respiratory depression and rhythmic myoclonic jerking in
premature infants receiving lorazepam for sedation
Drug Category: Cardiovascular (inotropic) agents -- Increase BP and combat shock. Drugs in this
category act primarily by increasing systemic vascular resistance, cardiac contractility, and stroke
volume, thus increasing cardiac output. Most inotropic agents also have dose and gestational agedependent
effects on vessels, particularly those of the renal and GI systems. For the most part, these
effects are beneficial but, at higher doses, the systemic side effects may be unpredictable.
No clear information is available on the effects of these drugs on CBF in neonates.
Drug Name
Pediatric Dose
Contraindications
Interactions
Dopamine (Intropin) -- Stimulates both adrenergic and dopaminergic
receptors. Hemodynamic effect is dependent on the dose. Lower doses
predominantly stimulate dopaminergic receptors that in turn produce
renal and mesenteric vasodilation. Cardiac stimulation and renal
vasodilation produced by higher doses.
2-20 mcg/kg/min IV continuous infusion; begin at lower doses, increase
on basis of systemic BP appropriate for age and gestational age
Documented hypersensitivity; pheochromocytoma or ventricular
fibrillation
Phenytoin, alpha- and beta-adrenergic blockers, general anesthesia, and
MAOIs increase and prolong effects of dopamine
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
May cause tachycardia and arrhythmias; may increase pulmonary artery
pressure; may reversibly suppress prolactin and thyrotropin secretion