Neonatal Drug Formulary Santosh T Soans, Murali Keshava Sarpangala
Agents that can safely be administered in therapeutic doses to glucose-6-phosphate dehydro- genase deficient patients 41
Agents to be avoided in glucose-6- phosphate dehydrogenase deficient patients 41
Amniotic fluid analysis 78
Analyses of cerebrospinal fluid 76
Analyses of feces 77
Antenatal drugs for surfactant production 62
Antibiotic guidelines in neonatal infection 14
Antihypertensive agents for the newborn 58
Antimicrobial agents 1
dosages and intervals of administra- tion 1
organisms generally susceptible to cephalosporins 13
organisms generally susceptible to penicillins 11
Antimicrobials requiring adjustment in renal failure 47
Apgar score 81
Approach to a bleeding neonate 73
hemoglobin F mean (SD)% total Hb 73
hemoglobin Nadir in babies in the first year of life 73
Kleihauer-Betke test 73
mean hematologic values in preterm and term newborns 73
Approach to indirect hyperbilirubi- naemia in healthy term infants without hemolysis 87
Arterial blood gas 67
Average daily nutritional requirements 52
Bed side evaluation of apnea 62
Behavioural pain score for full-term infants undergoing interven- tions or postoperative care 66
Bilirubin (total) 68
Blood pressure for weight percentiles 93
Blood volume 85
elective blood transfusion 85
electrolyte requirements in newborn 86
estimated blood volumes 85
factors affecting water loss (IWL) in preterm infants 85
fluid requirement changes in different conditions 86
IV fluid requirement of LBW neonates 85
Bone marrow differential counts; mean percent changes with age (range) 71
Calcium total 68
Causes of apnea 62
Clinical correlation of jaundice in skin and levels of serum bilirubin 87
Clinical interventions in neonatal apnea 62
Coagulation factor assays 71
reference values for coagulation inhibitors in healthy prema- ture infants during the first month of life 72
reference values for coagulation tests in healthy premature infants (30 to 36 weeks of gestation) during the first month of life 71
reference values for coagulation tests in the healthy full-term infant during the first month of life 72
reference values for the inhibition of coagulation in the healthy full- term infant during the first month of life 72
Cofactor/limiting amino acid therapy 54
Commercial formulas and foods 55
composition of human milk, standard infant formulas, and some specialized formulas 55
formulas for metabolic disorders 55
formulas free of lactose and or cow's milk protein and special milk based (casien-hydrolysate) formulas 56
formulas with altered fat, protein, and carbohydrates 56
Commercial vitamin preparations 32
Commonly used intravenous solutions composition per litre 86
Comparison of thrombolytic agents 60
Composition of various milks 52
Concentration and duration of few infusions 40
Congestive heart failure 51
Creatinine 68
Creatinine phosphokinase 69
Crib (clinical risk index for babies) score 83
Determining endotracheal tube size 80
Dose of intravenous indomethacin in premature infants with patent ductus arteriosus 63
Drug formulary 18
Drug loss during exchange transfusion 40
Drugs in breastfeeding 42
Drugs requiring no adjustment 50
Drugs that cause significant displace- ment of bilirubin from albumin in vitro 51
Drugs to be used with special precau- tion in breastfeeding women or drugs contraindicated 42
Drugs used in resuscitation 33
Effect of change in ventilatory para- meters on the blood gas 64
Evaluation of transudate vs exudates 79
Examination of sweat 79
Exchange transfusion table 88
early indications for exchange blood transfusion in infants with Rh- hemolytic disease of the newborn 88
Fetal antiarrhythmic agents 60
First line antibiotics 16
Gamma-glutamyltransferase 69
Glasgow coma scale 82
ABG score 82
best motor response (total points 6) 82
best verbal response (total points 5) 82
Downe's score 82
eye opening (total points 4) 82
Silverman-Anderson retraction score 82
Guidelines for the initial ventilatory settings disease-wise 65
Guidelines for the modes of providing fluids and feeding 53
Health indicators of India (UNICEF 2000) 79
Indices to differentiate between pre- renal and intrinsic renal failure and SIADH 77
Infant and child mortality rates (NFHS survey) 79
Initial dosing of enoxaprin, age- dependent 59
Initial ventilator settings 64
Inotropic and vasoactive agents commonly used in shock 35
Intrapartum monitoring fetus 80
interpretation 81
Intubation sedation guidelines 34
Iron supplementation guidelines in the premature infant 54
Leukocyte count and differential count during the first two weeks of life 74
Local site-directed thrombolytic therapy 59
Metabolic acidosis 68
Monitoring and dosage adjustment of enoxaparin based on anti- factor Xa level measured 4 hours after dose of enoxaparin 60
Neonatal infant pain scale 66
Neonatal pulmonary physiology by disease state 65
Neonatal ventilation 64
Neutrophilia values predictive of neonatal bacterial infection 74
Non-antimicrobials requiring adjust- ment in renal failure 49
Normal blood chemistry values, term neonates 75
normal blood chemistry values, low birth weight neonates, first day 75
Normal blood gas values in term newborns 80
Normal electrocardiographic values 60
Normal longitudinal blood pressure in full-term infants 58
Normal values of blood fractions 70
Nutritional needs of low birth weight infants 52
Oral dietary supplements available for use in infants 54
Osmolality of fluid 86
Oxygen delivery devices 63
Oxygen dissociation curve 94
Passage of antibiotics across the placenta 45
Pathological states 46
gastrointestinal diseases 46
kidney disease 47
liver disease 47
Peak and trough levels of antibacterial agents 39
Pharmacokinetics 46
Pharmacotherapy for neonatal apnea 62
Phototherapy guidelines for neonatal hyperbilirubinemia 92
Phototherapy table 88
Physiologic basic types of apnea 61
Primitive reflexes 84
Protamine dosage to reverse heparin therapy 59
Protein electrophoresis 70
Prothrombin time 75
Recommended daily allowances of vitamins and minerals 53
Reference laboratory values 67
Risk estimation of icterus 91
Safe medicine 39
Sarnat and sarnat stages of hypoxic- ischemic encephalopathy 63
Score for neonatal acute physiology (snap) 83
Septic risk scoring 15
Serum iron and iron-binding capacity 75
Significance of blood culture isolates 14
Some important metabolic conditions 55
Special nutrition 52
Specific antibiotic therapy in early- onset neonatal septicemia 15
Specific antibiotic therapy in late-onset neonatal septicemia 15
Specific therapeutics 58
Standard IV infusion routinely prepared 36
Standard TPN regimen 57
Suggested antibiotic regiments for sepsis and meningitis 15
Suggested intakes of parenteral vitamins in infants 57
Suggested maximum indirect serum bilirubin concentrations in preterm infants 87
aliquots used in exchange transfusion 87
calculated using the formula 2 × blood volume + 50 ml 87
exchange transfusion 87
Systemic thrombolytic therapy 59
Teratogenicity 44
Therapeutic range of various drugs 39
Thermoneutral environment 88
Thrombin time 75
Thrombolytic therapy 59
Thyroid disease 51
Time table for elective surgical repair 58
Transport 88
medications used on transport 89
supplies used by transport teams 89
transport team equipment 88
Treatment guideline in icterus 95
Tube feeding guidelines 53
Urinary biochemical values 76
Urine metabolic screening 84
Venous platelet counts in normal low birth weight infants, range (X 10,000) 74
Ventilator manipulations to increase oxygenation 64
Ventilator manipulations to increase ventilation and decrease PaCO2 65
Ventilatory calculations 65
Viral infection therapy 17
Chapter Notes

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1Neonatal Drug Formulary2
3Neonatal Drug Formulary
Santosh T Soans MBBS MD DCH Professor and Head, Department of Paediatrics AJ Institute of Medical Sciences Mangalore Murali Keshava Sarpangala MBBS DNB (Paediatrics) Registrar AJ Institute of Medical Sciences Mangalore
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3 EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
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Neonatal Drug Formulary
© 2006, Santosh T Soans, Murali Keshava Sarpangala
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition: 2006
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd, Sector 60, Noida
Neonatology has progressed in leaps and bounds in the last three decades. Major advances have been made in the treatment of various neonatal disorders. A number of highly beneficial new drugs have been developed and it is important that authentic information regarding the proper administration of these drugs is readily at hand for the use of the pediatrician/neonatologist.
Hence, we thought to bring out this book which the postgraduates and residents working in the department of neonatology can have as a ready reference to prescribe in the NICU.
In this volume, we have covered commonly used antimicrobial agents used in the NICU with dosages and side effects. We have also covered standard IV infusion, safe medications in lactation along with separate chapters on Special Nutrition, Neonatal Ventilation and Reference Laboratory Values.
We hope this book will be useful for pediatricians and neonatologists alike in day-to-day practice.
Santosh T Soans
Murali Keshava Sarpangala6
Bringing out a well researched book like this is never an easy task and many people have helped in their own ways and made it possible for this book to see the light of day. I hereby wish to acknowledge a few of my colleagues and friends who have provided me help, inspiration and motivation: Sanjeev Rai, Pavan Hegde, Diwaker Rao, Bharath Raj, Habib Khan, Prakash Saldanah, Manjunath Hegde, Mahesh Nayak.8