Anemia of Prematurity - Portal Neonatal

Drug Name
Pediatric Dose
Ipratropium bromide (Atrovent) -- A muscarinic antagonist with potent
bronchodilating effects. May improve pulmonary mechanics significantly
in infants with BPD. Inhaled ipratropium bromide is poorly absorbed
systemically.
0.025-0.08 mg/kg inhaled via nebulization q6h (dilute in 1.5-2 mL of
0.9% NaCl)
Contraindications Documented hypersensitivity
Interactions
Drugs with anticholinergic properties, such as dronabinol, may increase
toxicity; albuterol increases effects of ipratropium
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions
Not indicated for acute episodes of bronchospasm; caution in narrowangle
glaucoma, prostatic hypertrophy, and bladder neck obstruction
Drug Category: Corticosteroids -- Produced by the adrenal gland. Mineralocorticoids are produced
in the adrenal medulla and primarily affect fluid and electrolyte balance. Glucocorticoids possess
strong anti-inflammatory properties and affect the metabolism of many tissues.
Dexamethasone (Decadron) -- Has many pharmacologic benefits but
significant adverse effects. It stabilizes cell and lysosomal membranes,
increases surfactant synthesis, increases serum vitamin A
concentration, inhibits prostaglandin and leukotriene, decreases PE,
breaks down granulocyte aggregates, and improves pulmonary
Drug Name microcirculation. Adverse effects are hyperglycemia, hypertension,
weight loss, GI bleeding or perforation synthesis, cerebral palsy, adrenal
suppression, and death.
Routine use of dexamethasone in infants with BPD is not currently
recommended unless severe pulmonary disease exists.
Loading dose: 0.2-0.5 mg/kg PO/IV
Pediatric Dose
Maintenance dose: 0.1 mg/kg PO/IV q6-8h
Contraindications Documented hypersensitivity; active bacterial or fungal infection
Effects decrease with coadministration of barbiturates, phenytoin, and
Interactions rifampin; dexamethasone decreases effect of salicylates and vaccines
used for immunization
Pregnancy C - Safety for use during pregnancy has not been established.
Not routinely recommended for BPD secondary to possible detrimental
long-term effects on neurologic outcome; increases risk of multiple
complications, including severe infections; monitor adrenal insufficiency
when tapering drug; abrupt discontinuation of glucocorticoids may cause
Precautions
adrenal crisis; hyperglycemia, edema, osteoporosis, osteonecrosis,
myopathy, peptic ulcer disease, hypokalemia, euphoria, psychosis,
myasthenia gravis, growth suppression, and infections are possible
complications of glucocorticoid use