Medications Used In The Newborn
Module 1: Neonatal Emergencies
Adenosine
0.05-0.1mg/kg/dose rapid IV push (first dose)
0.1-0.2 mg/kg/dose (second dose)
Given by PIV preferentially in the right arm/central line or IO.
Follow by rapid normal saline flush 5-10 mL.
Indications: SVT
Amiodarone
5 mg/kg/dose loading dose, as bolus in cardiac arrest,
over 20-30 minutes for perfusing tachycardias.
Maintenance dose 5-10 ug/kg/min
Consultation with cardiologist.
Indications: Vfib, unstable Vtach,
SVT persistent after 3 doses Adenosine
Ampicillin
50-100 mg/kg/dose, dosing interval based on age.
Indications: Suspected neonatal sepsis,
(Group B strep and Listeria and some enterococci).
Atropine
0.02 mg/kg IV/IO, minimum dose of 0.1 mg
Indication: second and third degree heart block.
Bradycardia with hypotension after epinephrine and fluid bolus.
May be used prior to elective intubation.
Calcium chloride
20 mg/kg/dose or 2ml/kg/dose over 5 minutes
Indications: Hyperkalemia, hypocalcemia
Calcium gluconate
100 mg/kg/dose or 1 ml/kg/dose over 5 minutes
Indications: Hyperkalemia, hypocalcemia
Cefotaxime
50 mg/kg/dose, dosing interval based on age
Indications: suspected neonatal sepsis
Clindamycin
5-7.5 mg/kg/dose
Indications: infections with aerobic and anaerobic organisms, MRSA, Bacteroides, Fusobacterium, Actinomyces, Clostrididum perfringens and Clostridium tetani
Diazepam
0.25-0.5 mg/kg/dose slow IV push
0.5 mg/kg/dose rectal (over 6 months)
Indications; seizures, sedation
Dobutamine
3-10 microgram/kg/min
Indications: cardiogenic shock
Dopamine
5-10 microgram/kg/min
Indications: CHF
Epinephrine (1:10,000)
0.01 mg/kg/dose or 0.1 ml/kg/dose
0.03-0.1 mg/kg/dose via ETT
May repeat q5mins if needed
Indications: cardiac arrest, bradycardia,
Epinephrine (1:1000)
0.05-0.1 microgram/kg/min
Indications: hypotension
Fentanyl
2-5 microgram/kg/dose, slow IV push.
May repeat in 2-4 hours.
Indications: Analgesia
Fosphenytoin
20 mg/kg/dose slow IV (2 mg/kg/min)
Indications: Seizures
Furosemide
0.5 mg/kg/dose over 5 minus q8h 0r q12h
Indications: CHF
Gentamicin
3.5-5 mg/kg/doseover 10-30 mins
Check trough 30-60 mins before third dose
Check peak after end of infusion of second or third dose.
Indications: Suspected sepsis
Lidocaine
1% solution
1 mg/kg/dose or 0.1 mL/kg/dose and infusion at 1-1.5 mg/kg/hour
Indications: Ventricular tachycardia, local anesthesia
Lorazepam
0.05 mg/kg/dose IV over 2-5 mins
Indications: sedation, seizures
Meropenem
20 mg/kg/dose q8h or q12h depending on age
30-40 mg/kg/dose q8h for meningitis
Indications: Sepsis or infection with multi drug resistance
Midazolam
0.05 mg/kg/dose IV over 2-5 mins
Indications: Sedation, seizures
Milrinone
Loading dose 25 microgram/kg/dose IV or
50 microgram/kg/dose over 30 minutes
Continuous infusion start at 0.5 microgram/kg/min
Indications: cardiac or septic shock
Morphine
0.15-0.1 mg/kg/dose IV
Indications: analgesia, sedation, reducing pulmonary resistance (TOF)
Nafcillin
25 mg/kg/dose q6h to q12h
Meningitis 50 mg/kg/dose
Naloxone
0.1 mg/kg/dose
Indications: Opioid overdose or infant when maternal opioids < 4 hours prior to delivery
Noeepinephrine
0.05-0.1 microgram/kg/min
Indications: hypotension in shock
Phenobarbitol
20 mg/kg/dose over 20 minutes
Maintenance 3-5 mg/kg/dose q12h
Indications: neonatal seizures (first choice)
Prostaglandin
0.05-0.1 microgram/kg/min IV
Indications: suspected ductal dependent congenital heart disease
Sildanefil
0.3-1 mg/kg/dose q6h to q8
Indications: Persistent pulmonary hypertension
Sodium bicarb
(4.2% ) 1-2 mEq/kg/dose or
Calculate using equation
Indications: Metabolic acidosis
Surfactant
Indications: Respiratory distress syndrome (RDS)
Vancomycin
15 mg/kg/dose IV over 1 hour
Dosing q8h to q18h depending on age and weight
Check serum levels before and after the second dose
Indications: gram-positive pathogens such as coagulase negative and oxacillin resistant staphylococcus, Staph epidermidis, staph aureus MRSA
Vecuronium
0.1 mg/kg/dose
Indications: Intubation
Vitamin K1
Prophylaxis – 1 mg/dose IM
Treatment for high INR – 1-2 mg/day SQ or IV
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