Anemia of Prematurity - Portal Neonatal

Pediatric Dose
Dependent on EGA and postnatal age
29 weeks' EGA and 14 d: 3-6 mg/kg/d PO/IV qd
Contraindications Documented hypersensitivity
Interactions
Levels may increase with hydrochlorothiazide; fluconazole levels may
decrease with chronic coadministration of rifampin; coadministration of
fluconazole may decrease phenytoin clearance; inhibits CYP2C19 and
CYP3A4; may increase concentrations of theophylline, tolbutamide,
glyburide, and glipizide; effects of anticoagulants may increase with
fluconazole coadministration; increases in cyclosporine concentrations
may occur when administered concurrently
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
Use caution in impaired renal function, dosage may require adjustment;
monitor liver enzymes and liver function tests during protracted therapy;
discontinue use if clinical signs of hepatic failure develop
Drug Category: Vasopressors -- Babies with serious illness may progress to shock and require
pharmacologic blood pressure support.
Drug Name
Dopamine (Intropin) -- An adrenergic agonist that increases blood
pressure by stimulating alpha-adrenergic vascular receptors resulting in
vasoconstriction. Has some inotropic effects via beta1 cardiac receptors
and, at low doses, increases glomerular filtration via renal dopaminergic
receptors. Useful for babies with hypotension not responsive to volume
repletion.
May be mixed in dextrose so that glucose delivery is not compromised.
Adult Dose 1-5 mcg/kg/min IV; not to exceed 30 mcg/kg/min
Pediatric Dose 1-20 mcg/kg/min IV; titrate to effect
Contraindications Documented hypersensitivity; pheochromocytoma; ventricular fibrillation
Interactions
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
Drug Name
Extravasation can cause tissue necrosis, treat with phentolamine as
quickly as possible after the event; correct hypovolemia before infusion
Dobutamine (Dobutrex) -- Adrenergic agonist with specific effects on
beta1-receptors in the heart, resulting in increased contractility. Has
minimal alpha-adrenergic activity. Can be used for babies in shock,
usually adjunctively with dopamine, to increase cardiac output.
May be mixed in dextrose so that glucose delivery is not compromised.
Adult Dose 1-20 mcg/kg/min IV
Pediatric Dose Administer as in adults
Contraindications
Interactions
Documented hypersensitivity; idiopathic hypertrophic subaortic stenosis;
atrial fibrillation or flutter
Beta-adrenergic blocking agents antagonize effects; general anesthetics
may increase toxicity
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions Hypovolemic state should be corrected before using this drug