Anemia of Prematurity - Portal Neonatal

Drug Name
Hydrochlorothiazide (Esidrix, HydroDIURIL) -- Inhibits reabsorption
of sodium in distal tubules, causing increased excretion of sodium
and water as well as potassium and hydrogen ions. Good second
agent to add to ACE inhibitor or vasodilator therapy.
Adult Dose 25-100 mg PO qd; not to exceed 200 mg/kg/d
Pediatric Dose 2-3 mg/kg/d PO divided bid
Contraindications Documented hypersensitivity; anuria; renal decompensation
Interactions
Thiazides may decrease effects of anticoagulants, antigout agents,
and sulfonylureas; thiazides may increase toxicity of allopurinol,
anesthetics, antineoplastics, calcium salts, loop diuretics, lithium,
diazoxide, digitalis, amphotericin B, and nondepolarizing muscle
relaxants
Pregnancy D - Unsafe in pregnancy
Precautions
Drug Name
Caution in renal disease, hepatic disease, gout, diabetes mellitus,
and erythematosus
Spironolactone (Aldactone) -- Potassium-sparing diuretic. Used for
management of hypertension. May block effects of aldosterone on
arteriolar smooth muscles.
Adult Dose 25-200 mg/d PO in 1-2 divided doses
Pediatric Dose 0.5-1.5 mg/kg/dose PO bid; not to exceed 3.3 mg/kg/d
Contraindications Documented hypersensitivity; anuria; renal failure; hyperkalemia
Interactions
May decrease effect of anticoagulants; potassium and potassiumsparing
diuretics may increase toxicity of spironolactone
Pregnancy D - Unsafe in pregnancy
Precautions Caution in renal and hepatic impairment
Drug Category: Central agonists -- Decrease central adrenergic output.
Drug Name
Adult Dose
Pediatric Dose
Clonidine (Catapres) -- Stimulates alpha2-adrenoreceptors in brain
stem, activating an inhibitory neuron, which, in turn, results in
reduced sympathetic outflow. These effects result in a decrease in
vasomotor tone and heart rate.
Initial: 0.1 mg PO bid
Maintenance: 0.2-1.2 mg/d in 2-4 divided doses; not to exceed 2.4
mg/d
Not established for neonates, limited data suggest 0.05-0.1 mg/dose
PO bid/tid
Contraindications Documented hypersensitivity
Interactions
Tricyclic antidepressants inhibit hypotensive effects of clonidine;
coadministration of clonidine with beta-blockers may potentiate
bradycardia; tricyclic antidepressants may enhance hypertensive
response associated with abrupt clonidine withdrawal; hypotensive
effects of clonidine are enhanced by narcotic analgesics
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
Adverse effects include dry mouth and sedation; rebound
hypertension with abrupt discontinuation; caution in cerebrovascular
disease, coronary insufficiency, sinus node dysfunction, and renal
impairment