Anemia of Prematurity - Portal Neonatal

MEDICATION Section 7 of 10
Drug Category: Adrenergic agonists -- Cardiovascular performance deteriorates and cardiac
output falls if effective therapy is not administered. These agents improve the hemodynamic status
by increasing myocardial contractility and heart rate, resulting in increased cardiac output. They also
increase peripheral resistance by causing vasoconstriction. Increased cardiac output and increased
peripheral resistance lead to increased blood pressure.
Drug Name
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.
Adult Dose 5-20 mcg/kg/min IV
Pediatric Dose Administer as in adults
Contraindications Documented hypersensitivity;pheochromocytoma;ventricular fibrillatio
Interactions
Phenytoin, alpha- and beta-adrenergic blockers, general anesthesia,
and MAOIs increase and prolong effects
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
Drug Name
Closely monitor urine flow, cardiac output, pulmonary wedge
pressure, and blood pressure during infusion; prior to infusion, correct
hypovolemia with either whole blood or plasma, as indicated;
monitoring central venous pressure or left ventricular filling pressure
may be helpful in detecting and treating hypovolemia
Dobutamine (Dobutrex) -- Produces vasodilation and increases
inotropic state. At higher dosages, may cause increased heart rate,
exacerbating myocardial ischemia.
Adult Dose 5-20 mcg/kg/min IV
Pediatric Dose Administer as in adults
Contraindications
Interactions
Documented hypersensitivity; idiopathic hypertrophic subaortic
stenosis; atrial fibrillation or flutter
Beta-adrenergic blockers antagonize effects of dobutamine; general
anesthetics may increase toxicity
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions
Drug Name
Adult Dose 1-10 mcg/min IV
Following MI, use with extreme caution; correct hypovolemic state
before using drug
Epinephrine (Adrenaline) -- Has alpha-agonist effects that include
increased peripheral vascular resistance, reversed peripheral
vasodilatation, systemic hypotension, and vascular permeability. Betaagonist
effects include bronchodilatation, chronotropic cardiac activity,
and positive inotropic effects.
Pediatric Dose 0.05-1 mcg/kg/min IV
Contraindications
Interactions
Documented hypersensitivity; cardiac arrhythmias; angle-closure
glaucoma; local anesthesia in areas such as fingers or toes
(vasoconstriction may produce sloughing of tissue); use during labor
(may delay second stage of labor)
Increases toxicity of halogenated inhalational anesthetics and beta-
and alpha-blocking agents