BOOK
Evidence-Based Neonatal Pharmacotherapy, An Issue of Clinics in Perinatology - E-Book
Alan R. Spitzer | Dan Ellsbury
(2012)
Additional Information
Book Details
Abstract
Dr. Spitzer has created an issue devoted to the evidence-based pharmacologic care of the neonate. The issue opens with an important article on A Quality Improvement Approach to Modifying Medication Use in the NICU. The expert authors he has secured have contributed articles in the areas of therapeutic drug monitoring, off-label use of medications in the NICU, antenatal and post-natal corticosteroids, antibiotics, antifungals, and antivirals, as well as bronchodilators and nitric oxide. Other articles also present evidence-based use of oxygen, dopamine, anesthetics and analgesics, and erythropoetin.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Clinics in Perinatology | i | ||
| Copyright Page | ii | ||
| Table of Contents | vii | ||
| Contributors | iii | ||
| Foreword: The Challenge of Managing Drugs Safely in the Newborn | xv | ||
| Preface | xvii | ||
| Chapter 1. A Quality Improvement Approach to Optimizing Medication Use in the Neonatal Intensive Care Unit | 1 | ||
| THE KNOWLEDGE AND IMPLEMENTATION GAP IN NEONATAL INTENSIVE CARE UNIT MEDICATION USE | 1 | ||
| FIRST, DO NO HARM | 1 | ||
| WHAT ARE THE RISKS AND BENEFITS | 3 | ||
| DOES THE NICU CLINICAL CONTEXT MODIFY THE RISKS AND BENEFITS | 3 | ||
| DOES THE INDIVIDUAL PATIENT’S CLINICAL CONTEXT MODIFY THE RISKS AND BENEFITS | 4 | ||
| PERCEPTION VERSUS THE REALITY OF NICU MEDICATION USE | 4 | ||
| IDENTIFYING THE ROOT CAUSES OF MEDICATION MISUSE | 5 | ||
| MAKING AND TESTING CHANGES | 6 | ||
| SUMMARY | 7 | ||
| REFERENCES | 7 | ||
| Chapter 2. Drug Studies in Newborns: A Therapeutic Imperative | 11 | ||
| THE NEWBORN AS A DRUG RECIPIENT | 12 | ||
| DEVELOPMENTAL CHARACTERISTICS (23–42 WEEKS) OF THE POPULATION | 12 | ||
| NEONATAL DISEASES/INDICATIONS | 13 | ||
| RARE DISEASES OF THE NEWBORN | 17 | ||
| NUMBER OF DRUGS USED IN THE NICU AND STANDARDS OF PRACTICE | 17 | ||
| FACTORS THAT LIMIT AND PREVENT THE DEVELOPMENT AND IMPLEMENTATION OF NEWBORN DRUG STUDIES | 18 | ||
| LACK OF PHARMACOKINETIC STUDIES AND ABILITY TO LEVERAGE PRIOR KNOWLEDGE IN OLDER CHILDREN AND ADULTS | 19 | ||
| LACK OF APPROPRIATE PHARMACODYNAMIC MEASUREMENTS, SPECIFIC ENDPOINTS, AND BIOMARKERS | 19 | ||
| SEARCH FOR EVIDENCE: REGULATORY VERSUS SCIENTIFIC VIEWPOINTS | 19 | ||
| SAFETY ISSUES | 20 | ||
| CHANGE OF PARADIGM: PROMOTE RATIONAL THERAPEUTICS FOR THE MOST VULNERABLE POPULATION | 20 | ||
| SUMMARY | 20 | ||
| REFERENCES | 21 | ||
| Chapter 3. Therapeutic Drug Monitoring–the Appropriate Use of Drug Level Measurement in the Care of the Neonate | 25 | ||
| NEONATAL PHARMACOKINETIC CONSIDERATIONS | 25 | ||
| SPECIFIC MEDICATIONS | 26 | ||
| SPECIAL CIRCUMSTANCES THAT MAY REQUIRE TDM | 29 | ||
| SUMMARY | 29 | ||
| REFERENCES | 30 | ||
| Chapter 4. Obstetric Interventions Beneficial to Prematurely Delivering Newborn Babies: Antenatal Corticostetroids, Progesterone, Magnesium Sulfate | 33 | ||
| ANTENATAL CORTICOSTEROIDS | 34 | ||
| MAGNESIUM SULFATE TO REDUCE CP | 37 | ||
| PROGESTERONE TO PROLONG PREGNANCY | 38 | ||
| REFERENCES | 42 | ||
| Chapter 5. Evidence-Based Neonatal Pharmacotherapy: Postnatal Corticosteroids | 47 | ||
| ACTIONS OF CORTICOSTEROIDS | 47 | ||
| BPD | 49 | ||
| SUMMARY OF CURRENT EVIDENCE-BASED RECOMMENDATIONS FOR BPD | 52 | ||
| REFERENCES | 54 | ||
| Chapter 6. Antibiotic Use and Misuse in the Neonatal Intensive Care Unit | 61 | ||
| BACTERIOLOGY | 62 | ||
| COMMONLY USED ANTIBIOTICS: BACTERIAL SUSCEPTIBILITY AND RISKS | 62 | ||
| RISKS ASSOCIATED WITH EMPIRIC BROAD-SPECTRUM ANTIBIOTIC TREATMENT | 63 | ||
| ADVERSE EFFECTS WITH PROLONGED DURATION OF ANTIBIOTIC THERAPY | 63 | ||
| PERINATAL GBS PREVENTION: OPPORTUNITIES MISSED | 65 | ||
| SUMMARY | 66 | ||
| REFERENCES | 66 | ||
| Chapter 7. The Use of Antiviral Drugs During the Neonatal Period | 69 | ||
| THERAPY FOR HSV INFECTIONS | 69 | ||
| AVAILABLE THERAPIES FOR HSV AND VZV INFECTIONS | 71 | ||
| TREATMENT OF CMV INFECTIONS | 73 | ||
| SUMMARY | 78 | ||
| ACKNOWLEDGMENTS | 78 | ||
| REFERENCES | 78 | ||
| Chapter 8. The Use of Antifungal Therapy in Neonatal Intensive Care | 83 | ||
| POLYENES | 84 | ||
| NUCLEOSIDE ANALOGUES | 85 | ||
| TRIAZOLES | 86 | ||
| ECHINOCANDINS | 87 | ||
| SUMMARY | 92 | ||
| DISCLOSURES | 92 | ||
| REFERENCES | 92 | ||
| Chapter 9. Metoclopramide, H2 Blockers, and Proton Pump Inhibitors: Pharmacotherapy for Gastroesophageal Reflux in Neonates | 99 | ||
| THICKENING AGENTS | 100 | ||
| MOTILITY AGENTS | 101 | ||
| GASTRIC ACID REDUCERS | 103 | ||
| SUMMARY | 105 | ||
| REFERENCES | 106 | ||
| Chapter 10. Evidence-Based Use of Indomethacin and Ibuprofen in the Neonatal Intensive Care Unit | 111 | ||
| PHARMACOLOGY OF INDOMETHACIN AND IBUPROFEN | 112 | ||
| TREATMENT OF hsPDA | 113 | ||
| ADVERSE EFFECTS | 118 | ||
| PROPHYLACTIC TREATMENT TO PREVENT IVH OR hsPDA | 121 | ||
| OBSERVATIONAL TREATMENT OF PDA | 125 | ||
| SUMMARY | 126 | ||
| REFERENCES | 126 | ||
| Chapter 11. Evidence-Based Methylxanthine Use in the NICU | 137 | ||
| METHYLXANTHINE TREATMENT OF APNEA: HISTORICAL ASPECTS | 138 | ||
| USES OF METHYLXANTHINES IN THE NICU | 141 | ||
| RECOMMENDATIONS | 143 | ||
| SUMMARY | 146 | ||
| REFERENCES | 147 | ||
| Chapter 12. Pulmonary Vasodilator Therapy in the NICU: Inhaled Nitric Oxide, Sildenafil, and Other Pulmonary Vasodilating Agents | 149 | ||
| PULMONARY HYPERTENSION | 150 | ||
| ENDOGENOUS REGULATORS OF PULMONARY VASCULAR TONE | 150 | ||
| PHARMACOTHERAPY FOR PULMONARY HYPERTENSION | 152 | ||
| SUMMARY | 160 | ||
| REFERENCES | 160 | ||
| Chapter 13. The Use and Misuse of Oxygen During the Neonatal Period | 165 | ||
| INTRODUCTION | 165 | ||
| AEROBIC METABOLISM | 165 | ||
| FETAL TO NEONATAL TRANSITION | 168 | ||
| OXYGEN DURING NEONATAL CARE IN THE NICU | 171 | ||
| EVOLVING OXYGEN NEEDS IN THE FIRST WEEKS OF LIFE AND NEW METABOLIC INDICES | 172 | ||
| GOING HOME ON OXYGEN | 173 | ||
| REFERENCES | 174 | ||
| Chapter 14. Hematological Interventions in NICU Care: the Use of rEpo, IVIG, and rG-CSF\r | 177 | ||
| RECOMBINANT ERYTHROPOIETIN | 178 | ||
| INTRAVENOUS IMMUNOGLOBULIN | 180 | ||
| RECOMBINANT GRANULOCYTE COLONY-STIMULATING FACTOR | 182 | ||
| A “CONSISTENT APPROACH” TO THE USE OF rEPO, IVIG, AND rG-CSF IN THE NICU | 185 | ||
| REFERENCES | 185 | ||
| Chapter 15. Management of Neonatal Thrombosis | 191 | ||
| THE NEONATAL HEMOSTATIC SYSTEM | 191 | ||
| TYPES OF NEONATAL THROMBOSES | 191 | ||
| RISK FACTORS FOR NEONATAL TE, INCLUDING APPROPRIATE LABORATORY EVALUATION | 196 | ||
| MANAGEMENT OF THROMBOSIS | 198 | ||
| SUMMARY | 203 | ||
| REFERENCES | 203 | ||
| Chapter 16. Neonatal Diuretic Therapy: Furosemide, Thiazides, and Spironolactone | 209 | ||
| FUNCTIONAL DEVELOPMENT OF THE KIDNEY | 209 | ||
| SODIUM AND CHLORIDE REABSORPTION IN THE KIDNEY | 210 | ||
| DIURETICS: CLASSES AND MECHANISMS OF ACTION | 211 | ||
| LOOP DIURETICS | 211 | ||
| ADVERSE EFFECTS OF FUROSEMIDE | 212 | ||
| FUROSEMIDE AND PATENT DUCTUS ARTERIOSUS | 212 | ||
| FUROSEMIDE AND RESPIRATORY DISEASE | 213 | ||
| FUROSEMIDE AND FLUID OVERLOAD | 214 | ||
| FUROSEMIDE AND AKI | 215 | ||
| THIAZIDE DIURETICS | 215 | ||
| SPIRONOLACTONE | 216 | ||
| SUMMARY | 216 | ||
| REFERENCES | 217 | ||
| Chapter 17. Neonatal Blood Pressure Support: The Use of Inotropes, Lusitropes, and Other Vasopressor Agents | 221 | ||
| MECHANISMS OF ACTION OF INOTROPES, LUSITROPES, AND VASOPRESSORS | 222 | ||
| DOPAMINE | 224 | ||
| DOBUTAMINE | 228 | ||
| EPINEPHRINE | 230 | ||
| VASOPRESSIN | 231 | ||
| MILRINONE | 232 | ||
| LEVOSIMENDAN | 233 | ||
| SUMMARY | 233 | ||
| REFERENCES | 234 | ||
| Chapter 18. Anesthesia and Analgesia in the NICU | 239 | ||
| NEONATAL PAIN ASSESSMENT | 240 | ||
| NONPHARMACOLOGIC METHODS | 241 | ||
| PHARMACOLOGIC METHODS | 242 | ||
| COMMON PROCEDURES | 246 | ||
| FUTURE DIRECTIONS | 248 | ||
| REFERENCES | 248 | ||
| Index | 255 |