libro neonatologia

NNeeoonnaattoollooggiissttss’’

PPoocckkeett DDrruugg RReeffeerreennccee

Fifth edition

2012

For suggestions and inquries

[email protected]

New in this edition

Revised drug dosage: reflecting recent changes in Neofax

2011, British National Formulary for Children 2011-2012

and Manual of Neonatal Care 2012.

Addition of New drugs: EMLA cream, Famotidine,

Hyalase, Lanzor, Noradrenaline and Vfend.

Neonatologists’ Pocket Drug Reference

Acetylcistein® Acetylcysteine 200 mg effervescent sachets

Dose: 200 - 400 mg PO up to 3 times daily if n ecessary. BNFC2011-12

ضاعت ٢٢/ بالفم ضم ... (ماء مقطز ضم ٤/ مجم ٢٠٠كظ) فوار اصتيل صضتايين

Solution concentration 50 mg/mL .

USES Meconium ileus. Mucolytic; lowers mucous viscosity and facilitates its removal by

the mucociliary action. It improves th e phagocytic cap acity of alveolar mac rophages.

ADVERSE EFFECTS / PRECAUTIONS Hypersensitivi ty-like react ions including rash es and an aphylaxis .

Mild increase in INR and P T. Avoid with peptic u lceration.

TREATMENT OF ACETAMINOPHEN TOXICITY N-acetylcysteine (use concentration of 40 mg/mL)

LD: 150 mg/kg in D5W IVI over 60 minutes. MD: 50 mg/kg IVI over 4h then 100 mg/kg over 16h until clinical

and biochemic al markers of hepatic injury improve (e.g. INR normaliz es).

In acetaminophen poisoning, givin g acetylcysteine by mouth [unlicensed route] is an alternative if intravenous access is not

possible. BNFC2011-12

Acyclovir (Zovirax®) 250 mg / 5 mL Vial or 200 mg / 5 mL Susp. Dose: 20 mg/kg/8h IVI over 1h, for 14 days ((iinn llooccaalliizzeedd HHSSVV iinnffeeccttiioonnss)) or 21 days ((iinn ddiisssseemmiinnaatteedd oorr CCNNSS iinnffeeccttiioonnss )). Neofax2011

In Chicke npox and Herpes Zoster Infection: 10-20 mg/kg/8h IVI over 1h for at least 7 days. B NFC2011 -12 In Prophylaxis of Chickenpox After Delivery: 10 mg/kg/8h IVI over 1h; continued until serological tests confirm absence of virus. BN FC2011-12

Prolong dosing interval to Q12h in PT <34 wk PMA, in RF or LCF.

يراكط .. ( ضم ٩+ ضم ٢( )ضم ٥/ مجم ٢٥٠) زوف دضاعاث ۸/ ضم. ت وري ـ ـع على ـمدى ضا

Infusion sol ution concentration 5 mg/mL.

Maximum Infusion solution concentration 7 mg/mL. Dilution should be used within 24h. Don’t refrigerate.

Compatible with D5W and NS.

For Chronic Suppression: 75 mg/kg/dose Q12h PO. Neofax2011

. ( ضم ٥/ مجم ٢٠٠) زوفيراكط شراب ضاعت ٢٢/ فمبال ضم..

Store oral suspension at room temperature.

REN AL IMP AIRMENT BNFC2011-12

Cr Cl 25-50 mL/min/1.73 m

2 IV dose Q12 h.

Cr Cl 10-25 mL/min/1.73 m2 IV dose Q24 h.

Cr Cl 10-25 mL/min/1.73 m2 For HZV PO Q8h.

Cr Cl < 10 mL/min/1.73 m2 For HZV or HSV PO Q12h.

USES Neonatal HSV, VZV infections with CNS and pulmonary involvement.

MONITOR Periodic CBC. SSeerruumm ccoonncceennttrraattiioonn 2h after dose is ~ 2 μg/mL. Renal and hepatic function.

IV site for phlebitis use more diluted infusion.

ADVERSE EFFECTS / PREC AU TION S Neutropenia (20%) dose or use Neupogen® if ANC remains < 500/mm3. Phlebitis at IV site (due to alkaline pH of 10). Transient renal dysfunction and crystalluria slow infusion rate, good

hydration.

USE IN PREGAN ANCY Not known to be harmful—manufacturers advise use only when potential

benefit outweighs risk.

Addamel N® Trace Elements

Contents Per mL

- Chromic Cl 5.33 mcg

- Copper Cl 0.34 mg

- Xylitol 300 mg

- FeCl3 0.54 mg

- K iodide 16.6 mcg

- Manganese Cl 99 mcg

- Na fluoride 0.21 mg

- Na molybdate 4.85 mcg

- Na selenite 10.5 mcg

- ZnCl2 1.36 mg

Adenocor® Adenosine 3 mg / mL vial Starting Dose: 50 µg/kg rapid IV push (1-2 sec)

Increase dose in 50 µg/kg increments Q2min until return of sinus rhythm.

Usual maximum dose: 250 µg/kg. Neofax2011

150 μg/kg; repeat injection Q1-2min increasing dose by 50–100 μg/kg until tachycardia terminated or max. single dose of 300 μg/kg given. BNFC2011-12

وكور جم ٣) اديى . (م م ضم ٥.٤+ ضم ½ ) (ضم/ م زطت بطزهجت اوطولين .. د ٢٠٠غ آلان وري

حطب الاضخجابت) ادة الجزعت وجكزارها كل دققخين خم س (و

Solution concentration 300 µg/mL. The injection should be administered by rapid IV injection into a central or large peripheral vein. Flush IV with saline immediately.

Don’t refrigerate; crystallization will occur.

Compatible with: D5W and NS

USES Acute treatment of ssuussttaaiinneedd ppaarrooxxyyssmmaall SSVVTT (adenosine sinus node

automaticity and AV node conduction with no negative inotropic effects; can be used safely with impaired cardiac function or postoperative arrhythmias).

ADVERSE EFFECTS / PREC AU TION S FFlluusshhiinngg,, ddyyssppnneeaa aanndd iirrrriittaabbiilliittyy (frequent but resolve within 1 min). TTrraannssiieenntt (duration < 1 min) aarrrrhhyytthhmmiiaass may occur between termination of

SVT and onset of normal sinus rhythm (discontinue if asystole or severe bradycardia occur).

HHyyppootteennssiioonn (discontinue if severe). AAppnneeaa (in preterms).

RReeccuurrrreennccee in 30% of treated patients.

Aminophylline/Theophylline and caffeine adenosine’ s effect by competitive antagonism.

Contraindications 2nd

or 3rd

degree AV block (unless pace maker fitted); long QT syndrome; severe hypotension; decompensated HF; asthma.

In SVT, adenosine is given by rapid IV. IV amiodarone, flecainide or a beta-

blocker can be tried. The use of d. c. shock and vagal stimulation also have a role in the treatment of SVT. Atenolol, sotalol and flecainide are used for the

prophylaxis of paroxysmal SVT.

USE IN PREGAN ANCY Large doses may produce fetal toxi city; manufa cturer advises use only if

essential.

Adrenaline 1 mg / mL 1

Severe brad ycardia, hypo tension: 0.1 - 0.3 mL /kg of 1:10,000 concentration ( equal to 0.01-0.03 mg/kg), IV push or IC.

Given v ia ETT in high doses up 0.05-0.1 mg/kg, followed immediately b y 1 mL NS.

Neofax2011

لـي ين ٣٠–٢٠ ( ضم ٩+ ضم ٢( )ضم ٢/ مجم ٢) ادريـىا وطول بطزهجت أ كجم / ٢٠٠غزطت

ثىاء اوعاع القلب)ورد (أ

لـي ين ٢٠ ( ضم ٢/ مجم ٢) ادريـىا وطول بطزهجت أ ت كجم / ٢٠٠غزطت حىجز في ألاهبوبت ال

لح ٢ ثم ب) ٪٩.٠ضم م م ثىاء اوعاع القل (أ

IVI: Start 0 .1 μg/kg/min , max. of 1 μg/kg/min .

Adjust to desired response. Neofax2011

لـي / كجم /ضم ٣.٠ضاعت بمعدل ٢٤ورد على مدى ( ضم٤٩+ ضم ٢( )ضم٢/مجم٢) ادريـىا

الى تاعالط بت د حطب الاضخجا لبدات وجش عت/ كجم / ضم ٣في ا لطا ا

Infusion solution concentration 20 μg/mL. Incomp atible w ith NaHCO3 . Protect from light . Compatible with dobutamin e, dop amin e, L asix

®, f entanyl ,

heparin , mid azolam and KCl. Maximu m infusion concentration 60 μ g/mL.

Aerosol Therapy: 0.05-0.15 mL of 1:1000 concentrat ion diluted with NS to 3 mL, Q½h, maximum 4 doses.

Gome lla2009

وطولين ٢٥ - ٥ بطزهجت أ ـى٢٠٠غزطت ــادري ـ لـي ــسرضم م م ٣+ ( ضم٢/مجم٢) ا ـــ ـوالي ـــ هبـي

a 1:100 (1%) solution contains 10 mg in 1 ml

a 1:1000 (1‰) solution contains 1 mg in 1 ml

a 1:10,000 solution contains 0.1 mg in 1 ml

USES AAccuuttee ccaarrddiioovvaassccuullaarr ccoollllaappssee; wh en adequ ate ventilation and

chest compression have f ailed to increase the HR > 60 bpm. Short-term use for ssyysstteemmiicc hh yyppootteennssiioonn. In older inf ants, may b e used SC to relief of bbrroonncchhoossppaassmm.

Adrenaline 1 mg / mL 2

MONITOR Heart rate, blood pressure and IV site for signs of infilt ration .

ADVERSE EFFECTS / PRECAUTIONS If possible correc t acidosis before administration of epin ephrin e to enhanc e the effec tiveness of the dru g. Hypokalemia and s erum lactate.

Hyperglycemia. Cardiac arrhythmias (premature ventricular complex es and VT) .

Renal vascular ischemia ( add low dose of dopamine with IVI). Bolus Severe hypertension with intracranial h emo rrhage . Myocardial oxygen requirement.

IV infiltration caus es tissue ischemia and necros is.

Amikin® Amikacin 500 mg / 2 mL 1

Dose: as table IVI over 30 min. Ne ofax2011

كي ــأمي . ( ضم٥.٢٤+ ضم ½( )ضم٢/مجم٥٠٠) ـ ى دــوري ضم ٢٠ضم كمل حتى .. على مد

عت ../ هصف ضا ت . ـ ـع ضا

كي ــأمي جم ٥٠٠) ـ . ( ضم ٢/ م بطزهجت اوطولين .. ل٢٠٠غزطت ت ٢٤/ ـعض ضاعــ

Infusion solution concentration 5 mg/mL.

Also available in 100 mg p er 2 mL vials IM injection is associated with variable absorption especially in

the very small inf ants. Compatible with : D5W, D10W, D20W and NS.

PMA (wk) Postnatal (d) Dose (mg/kg) Interval (h) ≤ 29 * 0-7

8-28

≥ 29

18 (3.6 mL) 15 (3 mL)

15

48 36

24 30-34 0-7

≥ 8

18

15

36

24

≥ 35 All 15 24 * or significant asphyxia, PDA or ttt with indomethacin.

USES G-ve Bacill i - resistant to oth er aminoglycosides - usually

combined with a β-lactam antibiotic (in sep arate infusion).

ADVERSE EFFECTS Patients with impaired ren al function, dehydration and those who receive high dosage or p rolonged therapy are at risk of toxicity.

Transient and reversible ren al tubular dysfunction urinary

loss of Na, Ca, and Mg. Vestibular and auditory ototoxici ty (irreversible). Neuro muscular blockade wh en used with p ancuronium and in

patients with hyp ermagn esemia. DC or adjust dose when there’s an evidenc e of oto- or

nephrotoxicity .

Amikin® Amikacin 500 mg / 2 mL

2

PRECAUTIONS The use of other oto- and neph rotoxic drugs (lasix / vancomycin) may thes e side effects.

SERUM LEVEL Measure wh en treating for > 48h.

Obtain peak conc entrat ion 30 minutes after end of infusion or 1 hour after IM injection and trough level just prio r to th e next dose, ref rigerate blood sample soon.

Peak: 20-30 µg/mL Trough : 2-5 µg/mL

INTERACTIONS WITH

Analgesics: plasma conc entration of amikac in and gentamicin possibly by indometacin.

Antib acterials: r isk of nephrotoxic ity and ototoxicity wh en given

with teicoplanin or vancomycin; possible risk of n ephrotoxicity

when given with cephalosporins .

Ampho tericin : risk of n ephrotoxicity.

Digoxin : gentamicin possibly plasma conc entration of digoxin.

Loop Diuretics: risk of otoxicity .

Amiodarone

Cordarone® 150 mg / 3 mL amp. 1

LD: 5 mg/kg IVI over 30-60 min, preferably in a c entral vein.

MD: 7-15 µg/kg/min (10-20 mg/kg/d ay). B egin at 7 µg/kg/min

and titrate b y monitoring effects.

Consider switching to o ral therapy w ithin 24-48h.

PO: 5-10 mg/kg Q12h. Ne ofax2011

ى ٢٠٠غزطت بطزهجت اوطولين ... (ضم ٣/ مجم ٢٥٠) كوردارون ضم ٢٤وحطخكمل حت

ت ٢ضاعت بمعدل ٢٤على مدى وريد ٪٥ج ضم في الطاع

Infusion So lution concentration should be < 2 mg/mL (unless using a central l ine). Dose: 5 mg/kg over at least 3 min (for VF or pulseless ventricular

tachycardia refrac tory to d efibrillation) BNFC2011-12

Compatible with D5W, NS at concentrations of 1-6 mg/mL,

heparin and NaHCO3 . Protect from light. Avoid benzyl alcohol containin g injections in neon ates.

PO: initially 5-10 mg/kg Q12h for 7-10 days, then reduced to MD of 5–10 mg/kg Q24h.

BNFC2011-12

ضاعت ٢٢ / بالرايلضم ... (م م ضم ٢٠ +قزص ½ ) (مجم ٢٠٠قزص )كوردارون

USES Class III antiarrhythmic used for life-threatening or drug-resistant refrac tory SVT, VT and postoperative junctional ectopic tachycardia (JET).

ADVERSE EFFECTS / PRECAUTIONS Short term to xicity:

1. Bradycardia and hypotension (possibly associated with rapid rates of infusion).

2. AV block (unless pacemaker fitted). 3. Polymorphic ventricular tachycardia. 4. Irritation to p eripheral vessels (concentrations > 2 mg/mL) .

5. May ex ac erbate an excit ing arrhyth mia.

Amiodarone


ADVERSE EFFECTS / PRECAUTIONS Long term toxic ity: 1. Hyperthyroidis m (due to inhibi tion of T4 and T3).

2. Hypothyroidism (due to high concentrations of inorganic iodine). Amiodarone contains iodine and can cause both hypothyroidism or

hyperthyroidism can. Laboratory tests (T3, T4 and TSH) should be

performed before treatment and every 6 months.

The thyrotoxicosis may be very refractory, and amiodarone should

usually be withdrawn at least temporarily to help achieve control;

treatment with carbimazole may be required.

Hypothyroidism can be treated with replacement therapy without

withdrawing amiodarone if it is essential. BNFC2011-12

3. Hepatitis and cholestat ic jaundic e (rare) . 4. Photosensitivity (10%), n ausea and vo mitin g (10%), optic

neuritis (4-9%) and pulmonary fibrosis (4-9%) have b een reported with prolonged oral use in adults.

MONITOR HR and blood pressure. ECG monitor and resuscitation facilities must be available durin g

IVI. Liver-function and thyroid-function tests required before

treatment and th en every 6 months. Measure seru m K

+ concentration b efore t reatment.

Pulmonary function tests and CXR required before treatment.

Acute porphyria.

Amiodarone


INTERACTIONS WITH AAmmiiooddaarroonnee hh aass aa lloonngg hh aallff--lliiffee;; tthh eerree iiss aa ppootteennttiiaall ffoorr ddrruu gg iinntteerraaccttiioonnss ttoo ooccccuurr ffoorr sseevveerraall wweeeekkss ((oorr eevveenn mmoonntthhss)) aafftteerr

ttrreeaattmmeenntt wwiitthh iitt hh aass bbeeeenn ssttooppppeedd.. Anti- arrh yth mics: myoc ardial depression.

Antib acterials (p arenteral erythromycin , co-trimoxazole): risk

of ventricular arrhyth mias - avoid concomitant use. Antico agulants : amiod arone inhibits metabolism of coumarins and phenindione ( antico agulan t eff ect). Antiepileptics: amiod arone inhibits metabolism of pphheennyyttooiinn (

plasma conc entrat ion). Beta-blockers : r isk of bradyc ardia, AV block and myoc ardial depression; risk of ventricular arrh ythmias when amiodaron e

given with sotalol - avoid concomitan t use. Cardiac Glycosides: amiodarone plas ma conc entration of

ddiiggooxxiinn (hhaallvvee ddoossee ooff ddiiggooxx iinn). Diuretics: c ardiac toxicity with amiodaron e if hypokalemia

occurs. Grapefruit Juice: plasma conc entration of amiodaron e is .

Human Albumin 20%

Dose 1 gm (5 mL)/kg/dose IVI o ver 2 hour.

Indications As a volume expand er (1:3 D5W)

For hypoalbuminemia (1:1 D5W)

Use vial w ithin 4h of openin g.

Indication IV Dosage Administration

Hypovolemia 0.5 g/kg/dose

Infuse 5% albumin over >60 min,

may be infused more rapidly (10-20 min) in hypovolemic shock,

repeat as needed

Hypoalbuminemia 0.5-1 g/kg/dose

Infuse 5% albumin over >2h,

repeat q1-2d. Dilutions may be made with NS or D5W in cases of Na restriction

MNC2012

USES Severe hypoalbu minemia associated with lo w plasma volu me and

gen eral ized edema where s alt and water.

Adjunct in treatment of hyp erbili rubinemia b y exch ange

transfusion.

Parac entesis of large volume ascites associated with portal

hypertension.

CONTRAINDICATIONS Cardiac f ailure. Severe an emia.

ADVERSE EFFECTS / PRECAUTIONS Hypersensitivi ty react ions (anaphylaxis and urtic aria) . Nausea and vomiting. Fever, tachyc ardia and chills .

Atropine 1 mg / mL IV (over 1 min) or IM: 0.01-0.03 mg/kg/dose Q10-15min to

achieve d esired effect with a maximum total dose of 0.04 mg/kg.

ET: 0.01-0.03 mg/kg/dose immediately follo wed by 1 mL N S.

PO: begin with 0.02 mg/kg/dose Q4-6h, may gradually to 0.09

mg/kg/dose. Ne ofax2011

)ضم ٢/ مجم ٢) ـــيروبــأث . ( قطزم اءضم م ٥.٩+ ضم ½( عضل.. أو .أو بالفم ضم ورد ..

Infusion solution concentration 0.05 mg/mL

Compatible with D5 W and NS.

Give IV dosage form PO .

USES Reversal of severe sinus bradycardia, particularly when parasymp ath etic influenc es on heart (digoxin, b eta-blockers,

hyperact ive carotid sinus reflex) p redominate. Th e muscarinic effects of n eostigmine wh en reversing

neuromuscular b lockad e. Duration of act ion is 6 hours.

MONITOR Heart rate.

ADVERSE EFFECTS / PRECAUTIONS Cardiac arrhythmias particularly during th e first 2 minutes following IV use.

Fever, especially in brain-d amaged infants. Abdominal distension with d ecreas ed bowel activity . Esophageal reflux ( esophageal sphincter ton e).

Mydriasis and cycloplegia.

Atrovent® Ipratropium Bromide 250-500 μg / 2 mL

Dose: 75-175 μg via jet nebulizer Q6-8h Neofax2011

Dose: 25 μg/kg/dose via nebulizer Q8h Gomella2009

والشر ( ضم م م ٢+ ضم ٦.٠) ( ضم ٢/ مكزوجزام ٢٥٠)روفىت ـاث ضاعــاث ۸ - ٦/ هب

والشر ( ضم م م ٢+ ضم ٣.٠) ( ضم ٢/ مكزوجزام ٥٠٠)روفىت ـاث عــاثضا ۸ - ٦/ هب

USES Anti-cholinergic bronchodilator for primary treatment of COPD and

adjunctive treatment of acute bronchospasm (peak effect within 1 -2h, duration of eff ect 4-6h). Not useful for bronchiolitis.

Bronchodilator effect may be potentiated when given with ß-2 agonist i.e. albuterol. Both drugs are compatible when admixed if given within 1 h.

ADVERSE EFFECTS Temporary blurrin g of vision.

Precipitation of narrow- angle glaucoma or eye p ain (if solution comes into direct contac t with the eyes).

Augmentin® Amoxycillin/Clavulanic acid 600 mg / 60 mL

IV Dose: 30 mg/kg Q12h. BNFC2011-12

Amo xycil lin Dose for Listerial Meningitis:

Neonate < 7 days: 50 mg/kg Q12h; dose may be doubled in meningitis. Neonate 7–28 days: 50 mg/kg Q8h; dose may be doubled in meningitis. BNFC2011-12

. ( ضم ٦٠/ مجم ٦٠٠)أوجمىتين ببطء.. ... ضم ورد عت / ـضا

Infusion solution concentration 10 mg/mL .

PO Dose: 0.25 mL/kg of the 156 mg/ 5 mL susp. Q8h. BNFC2011-12

لفم ضم ...( ضم ٥/ مجم ٢٥٦)شراب أوجمىتين ث ۸/ با ـضاعا

لوسن ( ضم/ مجم ٥.٦٢)أوجمىتين هقط المت ا عاث ۸/ بالقطارة عىد ع ـضا

USES Infections due to beta-lactamase-producing strains (where amoxicillin alone not appropriate) including respiratory-tract infections, bone and joint infections, genito-urinary and abdominal infections, cellulitis, animal bites.

ADVERSE EFFECTS / PRECAUTIONS Diarrhea, vomiting Hypersensitivity reactions, jaundice, fever. Pseudomembranous colitis

HEPATIC IMPAIRMENT Monitor hepatic function Cholestatic jaundice may occur either during or shortly after the use of co-amoxiclav, usually self limiting. The duration of therapy should not usually exceed 14 days.

RENAL IMPAIRMENT )IV ROUTE( Cr Cl 10-30 mL/min/1.73m2

use normal initial IV dose then half dose Q12h Cr Cl <10 mL/min/1.73 m2

use normal initial IV dose then half dose Q24h

RENAL IMPAIRMENT )PO ROUTE( GFR 10-30 mL/min/1.73m2

use normal dose Q12h

GFR<10 mL/min/1.7 3m2 use half nor mal dose Q12h

Azactam® Aztreonam 1 g / 50 mL Dose: 30 mg/kg/dose IVI over 5-10 min or IM.

Ne ofax2011

ضاعاث ۸/ ببطء غدد ضم ورد... ( ضم٥٠/ جم ٢) امــازكـت

Infusion solution concentration 20 mg/mL . Compatible with D5 W, D10W and NS.

PMA (weeks)

Postnatal (days)

Interval (hours)

≤ 29 0-28

>28

12

8 30-36 0-14

>14

12

8

37-44 0-7 >7

12 8

≥ 45 All 6

USES Bactericidal against aerobic G-ve organisms (e.g. E. coli , H. influenza, Pseudomonas, and Serratia). Usually used with ampicill in (empiric al) or amino glycosides (syn ergistic against

Pseudomonas and Enterob acteriac eae).

MONITOR Seru m glucose 1h after administration .

Periodic CBC, AST, AL T.

ADVERSE EFFECTS / PRECAUTIONS Provide adequ ate amounts of glucose to avoid hypoglycemia;

contains 780 mg L-arginine / g (23.4 mg/kg/dose). Eosinophilia. Seru m AL T, AST.

Phlebitis at th e injection site.

RENAL IMPAIRMENT Cr Cl 10-30 mL/min /1.73m

2 use normal initial dose th en ½

dose Cr Cl <10 mL /min /1.73m

2 use normal initial dose th en ¼ dose

Bebe-vit® Drops

Vitamin Per 1 mL

A 1.500 IU

D 400 IU

E 5 mg

C 40 mg

Thiamine (B1) 0.5 mg

Riboflavin (B2) 0.6 mg

Nicotinamide (B3) 8 mg

Pyridoxine(B6) 0.6 mg

ــبي ـــفي بيـ ـبالف ضم ٢ت ـ ــ ــ ــم أو بالزاـ ـــضاع ٢٤/ ل ـ ـ تـ

Sodium Bicarbonate 8.4 % 1 mEq NaHCO3 / mL (2 mOsmol / mL) Usual dose: 1 -2 mEq/kg IVI over at least 30 min.

Dose (in mEq) based on Base Deficit = 0.3 X Base deficit (mEq/L) X weight

(kg). Give ½ dose then assess need for remainder. Neofax2011

Dose (in mEq) based on HCO3 level = 0.5 X [24 - serum HCO3- (mEq/L) X

weight (kg)]. Give ½ dose then assess need.

Dose in RTA: 2-3 mEq/kg/day in divided doses for type I and IV. Proximal

RTA (type II) requires larger doses, as high as 10 mEq/kg/day. MNC2012

Can be administrated also by IVI or PO. ت ٪ ٥ ضم ج+ ... ضم ... ( ٪ ٤.۸)صوديوم بيكربوهات ورد على مدى هصف ضاع

Maximum Concentration 0.5 mEq/mL. Recommended Concentration 0.25 mEq/mL. Na Content is 1 mEq/mL. Also available as Sodium Bicarbonate 5 % (0.6 mEq/mL).

Compatible with D5W, D10W, NS, furosemide, heparin, insulin and KCl.

Incompatible with dobutamine, dopamine, epinephrine, MgSO4, midazolam and norepinephrine.

USES To correct nnoorrmmaall aanniioonn ggaapp mmeettaabboolliicc aacciiddoossiiss caused by renal or GI losses. NaHCO3 is not a recommended therapy in NRP. Administration during

prolonged resuscitation remains controversial – use only after adequate ventilation is established and there is no response to other therapies:

- Pulmonary vascular resistance. - Improves myocardial function.

- Response of myocardium to sympathomimetics.

MONITOR ABG.

Serum calcium, sodium and potassium.

ADVERSE EFFECTS IVH (with rapid infusion). PCO2 pH (i f given during inadequate ventilation).

Local tissue necrosis. Hypocalcemia.

Hypernatremia and hypokalemia.

Brufen® Ibuprofen 100 mg / 5 mL Syrup First dose 10 mg/kg

Second and third doses 5 mg/kg.

Administer at 24 h intervals. Ne ofax2011

Course may be rep eated after 48 hours if necessary. BNFC2011-12

ل ... ( ضم ٥/ مجم ٢٠٠)شراب بروفين بعد الزضاعت ضاـعت ٢٤/ بالزا

USES Closure of PDA.

Not indicated for IVH prophylaxis.

MONITOR Urine output.

Assess for ductal closure. Signs of bleeding.

ADVERSE EFFECTS Less severe d ecrease in UOP than indo meth acin. Inhibit platelet aggregation. Contraind icated in preterms with inf ection, active bleedin g,

thrombocytopenia or coagulation def ects, NEC, signific ant renal dysfunction and CHD with duct-depend ent systemic blood flo w.

INTERACTIONS WITH Antifun gals: plas ma conc entrat ion is by voricon azole.

INTERACTIONS WITH

Caffeinospire® Caffeine Citrate 20 mg / mL

LD: 20-25 mg/kg IV over 30 min or P O.

MD: 5-10 mg/kg/dose Q24h IV slowly or PO.

May consider an additional LD and high er MD if able to moni tor

serum concentrations. Ne ofax2011

ت ٢٤/ ضم بالفم بعد الزضاعت ... ( ضم/جمم٢٠)كافيىوصبير شراب ضـاعــ

ت ٢٤/ ورد على مدى هصف ضاعتضم ... ( ضم/جمم ٢٠) وريد كافيىوصبير ضـاعــ

Compatible with D5W and D50W.

USES Neonatal Apnea, including post-extub ation and post anesth esia (antagoniz es adenosine Respiratory center output,

chemorecepto r sensitivity to CO2, smooth muscle relaxation and COP). The rate of BPD fro m 47% to 36% if started du ring the 1

st 10

days of life in inf ants with B W of 500-1250 g. Also, improves the

rate of survival without n eurodevelop mental disabi lity at 18-21 months corrected age.

MONITOR Therapeutic serum trough le vel on D5 of therapy 5-25 μg/mL. Monitor HR; withhold dose if > 180 bpm.

Agitation.

ADVERSE EFFECTS Restlessness. Vomiting.

Functional cardiac symp toms. May be associated with NEC (not proved).

Calcium Chloride 10% Acute ttt of sympto matic hypoc alcemia: 0.35-0.7 mL /kg/dose IV . Dilute, th en infuse over 10-30 min whi le monitorin g for

bradycardia. Stop if HR < 100 bpm.

Mainten ance ttt : 0.75-3 mL/kg/d ay IVI for 3-5 days.

In exchan ge transfusion: 0.33 mL/100 mL blood exch anged, IVI over 10-30 min.

Ne ofax2011 ضاعاث ٦/ ورد ببطء غدد ٪٥ضم ج ...+ ضم ... ٪٠١كالضيوم كلورايد

Each 100 mg = 1 mL = 27 mg ele mental Ca Don’t give intra- arterially.

Compatible with D5W, D10W, N S, amikacin, amiod arone, dobutamine, dopamine, epinephrin e, hydrocortisone, mi lrinone,

morphine and prostaglandin E1. Incomp atible w ith amphotericin B, N aHCO3 and Mg sal ts.

USES Treatment and prevent ion of hypocalc emia ( ionized calcium < 4 mg/dL and total calciu m < 8 mg/dL).

Ne ofax2011

MONITOR Seru m Ca level ; measure ionized c alcium direct ly.

Check IV site for extravasation Correct Mg if pres ent.

Bradycardia (IV). GI tolerance (PO).

ADVERSE EFFECTS More likely than c alcium gluconate to caus e metabol ic acidosis. Bradycardia or cardiac standstill with rapid infusion.

Cutaneous necrosis or calcium d eposition occurs with extravasat ion.

Bolus infusion by UAC is associated with intestinal bleeding and lower-extremity t issue necrosis. Infusion by UVC may result in hep atic necrosis if it is lodged in a

branch of the portal vein.

Calcium Gluconate 10% Acute ttt of sympto matic hypocalcemia: 1-2 mL/kg/dose IV . Dilute, th en infuse over 10-30 min whi le monitorin g for bradycardia. Stop if HR < 100 bpm.

Mainten ance ttt : 2-8 mL/kg/day IVI for 3-5 days.

In exch ange transfusion : 1 mL/100 mL blood exchan ged IVI over 10 min.

Ne ofax2011 ضاعاث ٦/ ورد ببطء غدد ٪٥ضم ج ...+ ضم ... ٪٠١ جلوكوهاتكالضيوم

Each 100 mg = 1 mL = 9.3 mg elemental C a

Don’t give intra- arterially. Administration by continuous infusion is more efficacious than intermittent bolus dosing due to less ren al calc ium loss.

Compatible with D5W, D10W, N S, amikacin, amiod arone, dobutamine, dopamine, hep arin, epineph rine, hydrocortisone, milrinon e, mo rphine and prostaglandin E1.

Incomp atible w ith amphotericin B, N aHCO3 and Mg sal ts.

USES Treatment and prevent ion of hypocalc emia (ionized calcium < 4 mg/dL and total calciu m < 8 mg/dL)

Ne ofax2011

MONITOR Seru m ionized C a level .

Correct hypo magnesemia if pres ent. Check IV site for extravasation. Bradycardia (IV).

GI tolerance (PO).

Early hypocalcemia is common in asphyxiated infants, PT and

IDM. It may occur also with alkalosis or followin g exch ange transfusion.

Signs of hyp ocalce mia include muscle twitching, jitter iness, gen eral ized seizures, QTc above 0.4 sec .

Capoten® Captopril 25 mg tab. 1

Initial Dose: 0.01 - 0.05 mg/kg/dose PO Q8-12h. Adjust dose and

interval based on response. Administer 1 h before feeding. Neofax2011

Initial Dose:

PT infants: 0.01 - 0.05 mg/kg/dose PO Q8-12h.

FT infants : 0.05 - 0.1 mg/kg/dose PO Q8-24h.

Max. recommended dose: 0.5 mg/kg/dose PO q6-24h. MNC2012

ــكاـب . ( ضم ماء مقطز ٥.٢٢/ مجم ٢٥قزص ½)ن وثيـ . ين . وـطول زطت بطزهجـت ا م ٢٠٠ـغ بالـف

بطاعت عت ـعـض ٢٢/ قبل الزضا تـا

Solution concentration 1 mg/mL.

Onset of action is 15 min after a dose, with peak effects seen in 30-90 minutes. Duration of action is usually 2-6 hours, but may be significantly longer (>24 hours).

USES Moderate to severe hypertension. Afterload reduction in patients with CHF.

MONITOR Blood pressure, particularly after the first dose. Renal function and serum K+.

ADVERSE EFFECTS / PRECAUTIONS Hypotension, rash, fever. Eosinophilia, neutropenia. GI disturbances. Jaundice or elevated liver enzymes is a reason for immediate drug withdrawal. MNC2012 Cerebral blood flow (seizures, apnea, and lethargy). Renal blood flow (oliguria). K+ (if receiving K-sparing diuretics or K supplements).

Contraindicated in patients with bilateral renovascular disease or with unilateral renal artery stenosis in a solitary kidney.

Capoten® Captopril 25 mg tab. 2

INTERACTIONS WITH General Anesthetics: hypotensive effect. NSAIDs: risk of renal impairment, antagonize hypotensive effect. Antacids: absorption of ACE inhibitors possibly . Heparins: risk of hyperkalemia. Beta-blockers: hypotensive effect. Calcium-channel Blockers: hypotensive effect. Digoxin: captopril possibly plasma concentration of digoxin.

Corticosteroids: hypotensive effect of ACE-i is antagonized. Diazoxide: hypotensive effect. Diuretics: hypotensive effect; K+ with K+-paring diuretics and aldosterone antagonists (monitor K+ concentration). Potassium Salts: risk of severe hyperkalemia. Prostaglandins: hypotensive effect.

Ceclor® Cefaclor susp. 125 mg / 5 mL For child ren 1 m - 12 y: 20 mg/kg/d ay in 3 div ided doses, doubled

for severe inf ection (usual max. 1 g dai ly) . BNFC2011-12

..( ضم ٥/ مجم ٢٢٥)صيكلور شراب .ـضاعـاث ۸/ ضم .

USES Acute Otitis M edia Infect ion, H. Influenzae Pn eumonia, Lo wer

Respiratory Infect ions, Pharyngitis, Pneumonia, Skin Infect ion, Strept . Pneu monia, Tonsillitis, UR T Inf ection, U TI Infections.

RENAL IMPAIRMENT BNFC2011-2012 No dosage adjustment required .

ADVERSE EFFECTS Most Frequent: Seru m Sickn ess, Vulvovagin al Candidiasis .

Less Frequent: Abdominal Pain with Cramps, Diarrhea, Nausea, Oral Candidiasis, Vomiting.

Rare: Allergic Reactions, Anaphylaxis, Angio ed ema, Drug Fever,

Eryth ema, Erythema Multiforme, Hemolytic Anemia, Hypoprothrombinemia, Pruri tus of Sk in, Pseudo membranous Enterocol itis, R enal Diseas e, Seizure Disord er, Skin Rash, Stevens -

Johnson Syndrome.

Cefazolin® Cefazolin 1 g / 10 mL

Dose: 25 mg/kg/dose IV slow push or IM. Neofax2011

اثــضاع ۸/ ضم ورد ... ( ضم ٩+ ضم ٢( )ضم٢٠/جم ٢) صيفازولين

ضاعاث ۸/ ضم عضل ... ( ضم ٤/جم ٢) صيفازولين

Brands inc lude Totacef® and Zinol® 500 mg and 1 g vials.

Compatible with D5 W, D10W and NS.

PMA Weeks

Postnatal days

Interval hours

≤ 29 0-28 >28

12 8

30-36 0-14 >14

12 8

37-44 0-7 >7

12 8

≥ 45 All 6

USES It’s a bactericid al 1

stgeneration ceph alosporin, mainly G +ve with

poor CNS pen etration. Peri-operative inf ection prophylaxis .

UTI and soft tissue infections caus ed by e.g. penic illin r esistant Staph. aureus, Klebsiella and Proteus.

ADVERSE EFFECTS (RARE) Phlebitis

Eosinophilia

Cefdin® Cefdinir 125 mg / 5 mL susp.

Dose: 14 mg/kg/day PO.

Once-daily dosing is as effective as twice daily dosing.

ضــاعت ٢٢/ ضم بالـفم .. . ( ضم ٥/ مجم ٢٢٥) دي شرابـفيص

USES

A 3rd

gen erat ion cephalosporin that is active against G-ve organisms includin g H. influenza, Enterobacteriac eae, Citrob acter

sp., E. col i, Klebsiella and Proteus.

Active against G+ve organisms such as Staph. aureus, Staph. epidermidis, strept. pn eumonia and Strept. pyogen es.

ADVERSE EFFECTS (RARE) Diarrhea, loos e stools

Nausea, vomit ing, abdomin al pain Abnormal liver tests.

Allergic reactions.

Storage Keep suspension in th e frid ge for up to 10 days after

reconstitution.

Cetal® Acetaminophen 250 mg / 5 mL syrup

Oral Dose: LD 20-25 mg/kg MD 12-15 mg/kg/dos e. Ne ofax2011

Rectal Dose: LD 30 mg/kg MD 12-18 mg/kg/dose. Ne ofax2011

IV Dose: 7.5 mg/kg Q4-6h; max. 30 mg/kg/day . BNFC2010-11

Gestational Age Interval FT Q6h PT ≥ 32 wk PMA Q8h PT < 32 wk PMA Q12h

ال شراب ــ . (صم ٥ /مجم ٠٥١)صيـت ... ضم.. عت/ ضا

ال قطارة ــ . (صم ٠/ مجم ٠١١)صيـت طت بالفم .. . هق .. عت/ ضا

ال لبوش ــ .. (مجم ٠٠٥)أطفال صيـت .. جي لبوص غز . . عت/ ضا

ـان . (صم/ مجم ٠١)برفالـج ضم ورد على مدى ربع ضاعت..

Use Perfalgan® either undiluted or dilute to a concentration of 1 mg/mL in D5W or NS; use within 1h of dilution. Brands include: Paracetamol® 120 mg / 5 mL Rectal suppositories associated with erratic release.

USES Fever reduction. Mild to moderate pain.

MONITOR Signs of pain, Temperature. Liver function.

ADVERSE EFFECTS Liver toxicity (if prolonged administration > 48h or excessive dosing)

Rash, fever.

Thrombocytopenia, leucopenia and neutropenia Routine prophylactic use of acetaminophen at the time of vaccination is not

recommended because of a potentional reduction in antibody response.

TREATMENT OF TOX ICITY N-acetylcysteine (use conc. of 40 mg/mL) LD: 150 mg/kg in D5W IVI over 60 minutes. MD: 50 mg/kg IVI over 4h then 100 mg/kg over 16h until clinical and biochemical markers of hepatic injury improve (e.g. INR normalizes).

Chloral Hydrate 500 mg / 5 mL

Dose: 25-50 mg/kg/dose PO or PR. MNC2012

Onset within 10-15 min.

ـكل ـ ـــ ــ ــضم بالف... ورال هيدرات ــ شومم ــ ــد اللـــــ (هصف الوسن) عىــ

The preparation is light sensitive.

USES Sedative-Hypnotic for short term use only. No analgesic properties.

MONITOR Level of sedation.

ADVERSE EFFECTS / PRECAUTIONS Oral preparation should be diluted or administrated after a feeding to reduce gastric irritation. Paradoxical excitation in infants with pain. Allergic manifestations. Acute overdose: CNS, respiratory and myocardial depression, cardiac arrhythmias, ileus and bladder atony. Indirect hyperbilirubinemia. Contraindicated with significant hepatic or renal disease.

Ciprofloxacin Rancif® 200 mg / 100 mL

Dose: 6-10 mg/kg/dose Q 12h IVI over 60 min for complicated UTI

or severe respiratory and GI t racts infec tions. BNFC2011-12

Dose for Pseudomonal lower respiratory-tract infection in cystic

fibrosis in inf ants > 1 mo : 10 mg/kg IV Q8h. BNFC2011-12

ضاعت ٢٢/ ضاعت ضم ورد على مدى... ( ضم ٢٠٠/ جم ٢٠٠)برو ــص


USES Mainly G-ve; salmon ella, shigella, c ampylob acter, neisseria and pseudomonas. Moderate activity against G+ve; Strept. pn eumoniae (not used for

pneumococcal pn eumonia) and Entercoccus faecalis. Chlamydia and some mycobacteria.

Most anaerobes are not susceptible. Avoid use with MRSA (resistant).

MONITOR Liver function

ADVERSE EFFECTS / PRECAUTIONS Nausea, vomit ing, and diarrhea Skin rash, o r abnormal liver function.

Quinolones caus e arthropath y in the weight-bearing joints of immature animals and are th erefo re gen erally not reco mmended

in children and growin g adolescents. However, the signific ance of this effect in humans is uncertain and in some specific circumstances short term use of a quinolon e in children is justified.

BNFC2011-12

RENAL IMPAIRMENT Cr Cl <20 mL /min /1.73m

2 use half normal dose

Claforan® Cefotaxime 500 mg / 5 mL

Dose: 50 mg/kg/dose IVI over 30 min , or IM. Neofax2011

Dose may b e doubled in severe infect ion and meningitis . Disseminated Gonococcal Infectio ns: 25 mg/kg/dos e IVI over 30

min, or IM Q12h for 7 days, with a duration of 10-14 days if meningitis is documented.

Ne ofax2011 ــكالف ـض .../ على مدى هصف ضاعت ورد ضم... ( ضم٥/مجم ٥٠٠) ورانــ اعتــــ

Infusion solution concentration 100 mg/ml. Compatible with D5 W, D10W and NS.

ــكالف ــض .../ عضل٢٠٠غزطت بطزهجت اوطولين ... ( ضم٢/مجم ٥٠٠) ورانــ اعتـــ

PMA (wks) Postnatal (D) Interval (h)

≤ 29 0-28 >28

12 8

30-36 0-14

>14

12

8

37-44 0-7 >7

12 8

≥ 45 All 6

USES Neonatal menin gitis and sepsis by G-ve organisms (e.g. E. coli, H. influenza and Klebsiella). Disseminated gonococcal inf ections.

MONITOR Periodic CBC.

RENAL IMPAIRMENT Cr Cl <5 mL/min/1.73m

2 use usual initial IV dos e then h alf dose

ADVERSE EFFECTS (RARE) Rash, Phlebitis and Diarrh ea

Leucopenia, granulocytop enia, and eosinophilia.

Clexane® Enoxaparin sodium (LMWH) 100 mg / mL

Initial Treatment of Thrombosis: Neofax2011

FT inf ants 1.7 mg/kg/dose Q12h SC.

PT inf ants 2 mg/kg/dose Q12h SC.

Infants > 3 mo of age 1 mg/kg/dose Q12h SC .

Adjust dose to maintain anti-factor Xa level between 0.5-1 units/mL.

Low Risk Prophylaxis: Neofax2011

Dose 0.75 mg/kg/dose Q12h SC .

Infants > 3 mo of age 0.5 mg/kg/dose Q12h SC.

Adjust dose to maintain an ti-fac tor X a level 0 .1-0.4 units/mL . ضاـعت ٢٢/ د غزطت جحت الجل... ( ضم/ مجم ٢٠٠)كلكضان

Compatible with N S and sterile water.

USES Anticoagulation.

MONITOR Anti-factor Xa 4h after a dose. After at tainin g target level, dose adjustment is needed 1-2 times/month.

Signs of bleeding and thrombosis.

ADVERSE EFFECTS Bleeding (even in therapeut ic ran ge) 4 %. Hematoma at administration site. Compartment syndro me.

IC and GI h emorrhage.

Colimex® Colistin Sulphate 50.000 unit / mL

Dose: 0.75 mL/kg/dose PO Q8h.

ضاـعاث ۸/ ضم بالـفم ... ( ضم/ وحدة ٥٠٠٠٠)كوليمكط شراب

USES Not used for GI infections by oral route but used for gut sterilizat ion.

Cymevene® Ganciclovir 500 mg / 10 mL

Dose: 6 mg/kg/dose Q12h IVI over 1h for a minimum of 6 weeks.

Chronic oral suppression: 30-40 mg/kg/dose Q8h PO

ـد على ـمدى ضاـعت ... ( ضم ٩+ ضم ٢( )ضم ٢٠/ مجم ٥٠٠)صيميفين / ضم ور

ضاـعت ٢٢

Infusion solution concentration 10 mg/ml.

USES Prevention of progressive hearing loss and lessening of developmen tal delays in babies with symptomatic congenital CMV

infection involvin g the CNS.

MONITOR CBC every 2-3 days durin g 1

st 3 weeks, th en weekly if stable.

ADVERSE EFFECTS Significant neutrop enia in majo rity of p atients. R educe the dos e by half if < 500 cel ls/mm

3. Stop if not resolved .

Anemia and thrombocytop enia.

Dalacin-C® Clindamycin 600 mg / 4 mL

Dose: 5-7.5 mg/kg/dose IVI over 30 minutes, or P O. Neofax2011

ورد على مدى ضم … ( ضم ٥.٢٤+ ضم ٥.٠( )ضم ٤/ مجم ٦٠٠)س ي -دالاصين

ضاعاث ۸/ هصف ضاعت

Infusion solution concentration 5 mg / mL. Compatible with D5 W, D10W and NS.

PMA weeks

Postnatal days

Interval hours

≤ 29 0-28 >28

12 8

30-36 0-14

>14

12

8

37-44 0-7

>7

12

8

≥ 45 All 6

USES Bacteriostatic fo r bacteremia, pulmonary and d eep tissue infections by anerobic bacteria and some G+ve cocci . Should NOT b e used in ttt of meningitis (poor CSF pen etration).

MONITOR Liver function, G I status.

Therapeut ic serum level ran ges from 2-10 µg/mL .

HEPATIC IMPAIREMENT Increase dosing interval.

ADVERSE EFFECTS Pseudomembranous colitis (Bloody diarrh ea, abdominal p ain, and fever) discontinue, bo wel rest, TPN and consider oral

metronid azole.

Decadron® 8 mg/2 mL amp.

Orazone® 0.5 mg /5 mL syrup

Dexamethasone 1

DART (Dexamethasone: A Rando mized Trial) P rotocol Ne ofax2011

0.075 mg/kg/dose Q12h for 3 days

0.05 mg/kg/dos e Q12h for 3 days

0.025 mg/kg/dose Q12h for 2 days

0.01 mg/kg/dos e Q12h for 2 days Given IV slow push or PO Total of 10 days.

Extub ation/ airway edema: 0.25-0.5 mg/kg onc e. May repeat

Q8h for a total of 4 doses starting 4h b efore extub ation. MNC2012

. ( ضم م م ٣+ ضم ٢( ) ضم ٢/ مجم ۸) ديكادرون عت ٢٢/ ببطء ورد .. ضا

Infusion solution concentration 1 mg/mL. زون ا .. ( ضم ٥/ مجم ٥.٠)غزاب أور ـم . لفـ عت ٢٢/ ـضم با ضا

Phenadone® Syrup contains 0.5 mg Dex amethasone and 2 mg

Chlorpheniramin e maleate per 5 mL

Courses For Severe BPD MNC2008 Begin tre atment after D7 but before D14 of life.

Short Course D1 0.1 mg/kg Q12h D2 0.075 mg/kg Q12h D3 0.05 mg/kg Q12h

May repeat weekly if nec essary

Long Course D1 0.1 mg/kg Q12h D2 0.1 mg/kg Q12h If no response after 48-72h, Stop.

If respond, Continue D3 0.075 mg/kg Q12h D4 0.075 mg/kg Q12h

D5 0.05 mg/kg Q12h D6 0.05 mg/kg Q12h

D7 0.05 mg/kg Q12h D8 Off D9 0.05 mg/kg Q12h

D10 End



Dexamethasone 2

USES Anti-inflammato ry us ed to f acilitate extubation and improve lung

function in infants at high er r isk for developin g CLD. 1. Treat only those at high risk . 2. Use lower doses.

3. BBeeggiinn tt rreeaattmmeenntt aafftteerr DD77 bbuutt bbeeffoorree DD1144 ooff lliiffee. 4. Don’t give with indomethacin.

ADVERSE EFFECTS Risk of CP. No in r isk of ROP.

GI perforat ion and hemorrh age occur more in patients treated beginning in D1 and in those treated concurrently with

indomethac in. Hyperglycemia and glycosuria. DKA?

Hypertension, Na+ and water retention.

Cardiac effects on D14 of therapy include LV wall thickn ess

with outflow tract obstruction, transient impairment of LV filling

and ST s egment d epression. Hypokalemia, hypocalc emia, Hypertriglyceridemia. Risk of sepsis.

Renal ston es (in patients rec eivin g Lasix®).

Osteopenia and inhibit ion of gro wth

Adren al insuffieciency due to pituitary suppression.

MONITOR Blood pressure and hyperglyc emia durin g acute illn ess.

Lipid profile (hyp erlipid emia). Guaiac gastric aspirate. EEcchhooccaarrddiiooggrraapphhyy iiff tt rreeaattiinngg lloonnggeerr tthhaann 77 dd aayyss..



Dexamethasone 3

INTERACTIONS ACE Inhibitors: corticosteroids antagoniz e hypotensive effect . Analgesics: risk of GI bleeding and ulceration wh en given with

NSAIDs. Antib acterials: metabolis m is possibly inhibited by erythromyc in. Antiepileptics: metabolism is by phenytoin ( effec t) Risk of hypokalemia when given with amphotericin - avoid

concomitant use unless cort icosteroids n eed ed to control react ions. Barbiturates: metabolism is by b arbiturates ( eff ect).

Beta-blockers : corticosteroids antagonise hypotensive eff ect. Calciu m Salts : corticosteroids absorption.

Cardiac Glycosides: risk of hypokalemia.

Diazoxide: corticostero ids antagonise hypotensive effect . Diuretics: cort icosteroids antagoniz e eff ect; risk of hypokalemia

when given with ac etazolamid e, loop diuretics or thiazides and related diu retics. Sodium Benzoate: corticosteroids possibly effects. Theophyll ine: risk of hypokalemia.

Vaccines: high doses imp air immune response to vaccines; avoid

concomitant use with l ive vaccin es. Hydralazine: corticosteroids antagonize its hypotensive effec t.

Diamox® or Cidamex® Acetazolamide 250 mg tab. Diuretic: 5 mg/kg/dose Q24h IV or P O.

Anticon vulsant: 4-16 mg/kg/day PO divid ed every 6-8h (not to exceed 30 mg/kg/d ay or 1 g/day).

To alkalin ize urine: 5 mg/kg/dose PO 2-3 times over 24h.

To CSF production: 5 mg/kg/dose IV or PO Q6h increased by 25

mg/kg/day to a maximum of 100 mg/kg/day. L asix® may be used

in combination.

ل ...( ضم ٢٠/ مجم قزص ٢٥٠)دياموكط ثضـاـع ٦/ بعد الزضاعت بالزا ا

USES Mild diuretic .

Anticonvulsant in ref ractory n eonatal seizures (retards abnormal discharge f rom CNS n eurons). Decrease CSF production in PHH.

Renal tubular acidosis.

MONITOR Seru m electro lytes (contraindicated in K

+ and Na

+) .

Plasma pH and Chlo ride.

ADVERSE EFFECTS / PRECAUTIONS GI irritation.

Anorexia. Transient hypokalemia. Hyperchloremic metabolic acidosis .

Growth retardation. Bone marro w suppression, thro mbocytopen ia, hemolytic anemia,

pancytopenia and leucopenia. Drowsiness, paresthesias.

Diflucan® Fluconazole 2 mg / mL IV or 5 mg / mL PO

1

Invasive Candidiasis LD 12-25 mg/kg MD 6-12 mg/kg/dose

IVI over 30 min or PO Neofax2011

Consider higher doses for treating severe infections.

2 mg/mL .. ( ضم٢/ممج٢) ديفلوكان ى ضـاعت ( ٪٥ضم ج+...ضم). م آلانورد على مد ث

.. .. ضم ). عت ( ٪٥ضم ج + . تـضاع …/ ورد على مدى ـضا

Compatible with D5W and D10W.

Prophylactic in VLBW infants at high risk for invasive fungal disease

3-6 mg/kg/dose twice weekly.

IVI over 30 min or PO Neofax2011

2 mg/mL . ( ضم٢/ممج٢) ديفلوكان ــين ورد على مدى ـضاعت ( ٪٥ضم ج+...ضم).. ـــ مزج

ا ــــ ـ أضبوع

Thrush LD 6 mg/kg on D1

MD 3 mg/kg/dose/24h PO Neofax2011

5 mg/mL الاول ثم ... شراب( ضم/ مجم ٥) ديفـلوكان وم ل لـفم في ا .. ضم با م . لـف ضم با

عــض ٢٤/ تــا

GA (wk) Postnatal (d) Interval (h)

≤ 29 0-14 >14

48 24

30 and older 0-7 >7

48 24

USES Systemic infect ions, meningitis and s evere superficial mycoses caused by Candida species.

MONITOR Renal function.

AST, ALT and direct bilirubin especially in patients on the h igher doses.

Periodic CBC for eosinophilia.

Diflucan® Fluconazole 2 mg / mL IV or 5 mg / mL PO

2

ADVERSE EFFECTS / PRECAUTIONS Reversible AST, ALT (in 12 %).

Interf ere with metabolism of barbiturates and phenytoin , aminophyllin e, c affein e, th eophyllin e and midazolam.

Adjust dosage for imp aired renal function.

RENAL IMPAIRMENT Use extend ed dosing intervals wh en s erum c reatinin e > 1.3 mg/dL .

Cr Cl < 50 mL/min/1.73m2 usual initial dose then halve

subsequent doses.

INTERACTIONS WITH Analgesics: fluconazole possibly plasma concentrat ion of

fentanyl.

Antib acterials: metabolism of fluconazole acc elerated by rifampicin ( plasma concentration).

Antiepileptics: fluconazole plasma conc entration of phenytoin (consider dose of phenyto in).

Antifun gals: triazoles possibly antagonise effects of

amphotericin. Anxio lyt ics and Hypno tics: fluconazole plasma concentration of

midazolam (risk of prolonged s edation). Cisapride: precipitates life-threatenin g arrhythmias (contraindicated). Theophyll ine: plasma concentration of theophylline .

Digibind® Digoxin immune Fab (38 mg per vial)

Dose (number of vials) =

Each vial contains 38 mg and will bind 0.5 mg digoxin.

Once ad ministered, d igoxin serum concentrations c an no longer be determined accurately.

USES

Life threatening digoxin toxicity.

ADMINISTRATION

The contents in each vial to be us ed should be dissolved with 4 mL of Sterile Water for Injection, by gentle mixin g, to give a clear,

colorless, approx imately isosmotic solution with a protein concentration of 9.5 mg/mL.

Reconstituted product should be used promptly.

If it is not used immediately, it may be stored under refrigeration

at 2-8°C for up to 4 hours.

Digibind® is ad ministered by IVI over 30 minutes. If cardiac arrest is immin ent, i t can b e given as a bolus injection.

STORAGE Refrigerate at 2° to 8°C.

Unreconstituted vials c an b e stored at up to 30°C for a total of 30 days.

Dobutamine Dobuject® 250 mg / 5 mL Dose: 2-25 μg/kg/min IVI.

Begin lo w and titrate by monito ring effect . Neofax2011

Volume of drug needed per day =

(if using

Dobuject®) or =

(if using Dobutrex®) is add ed

to 24 mL D5W, D10W, N S or LR, given as IVI at a rate of 1 mL/h .

ضم ج ٢٤+ ٢٠٠غـزطت بطزهـجت اوـطولين ... ( ضم ٥/ مجم ٢٥٠) وجيكتدوبي

الطاـعت/ ضم ٢ضاـعت بمعدل ٢٤ ورد على مدى ٪٥

Brands inc lude: Dobutrex® 250mg/20mL. 10 μg/kg/min dose is equal to 0.29 mL/kg/24h of Dobuject® 250 mg / 5 mL

10 μg/kg/min dose is equal to 1.15 mL/kg/24h of Dobutrex® 250 mg / 20 mL

Incomp atible w ith NaHCO3 and Lasix®.

Compatible with Alp rostadil, dop amin e, epin ephrine, f entanyl , heparin , insulin, MgSO4, midazolam, KCl , D5W, D10W, LR and N S.

USES Hypoperfusion and hypotension, especially if related to

myocardial dysfunction. Onset of act ion is 1-2 min after IVI with peak effect in 10 min .

serum half-l ife is several minutes.

MONITOR Heart rate and Blood pressure. IV sites for extravas ation.

ADVERSE EFFECTS / PRECAUTIONS Hypotension if patient is hypovolemic. Volume load ing is recommend ed before starting th erapy.

Tachyc ardia at high dosage. Arrhyth mias, hyp ertension and cutan eous vasodilatation .

Increases myoc ardial oxygen consumption. Tissue ischemia occurs with infiltration. Contraind icated in idiopathic h ypertrophic subaortic stenosis.

Dopamine Intropin® 200 mg / 5 mL Dose: 2-20 μg/kg/min IVI. Begin low and titrate by monitoring effect. Neofax2011

Volume of d rug needed per d ay =

then add ed to

24 mL D5W and given as IVI at a rate of 1 mL /h.

٪٥ضم ج ٢٤+ ٢٠٠ت بطزهـجت اوـطولين غـزط... ( ضم ٥/ مجم ٢٠٠)دوـبامين

الطاـعت/ ضم ٢ضاـعت بمعدل ٢٤ ورد على مدى

5 μg/kg/min is equal to 0.18 mL/kg/24h of Intropin® 200 mg/5 mL

Incomp atible w ith NaHCO3 , Insulin and L asix®.

Compatible with Dobutamine, epin ephrine, fentanyl, h eparin , MgSO4, midazolam, KCl , PGE1 , D5W, D10W, LR and N S.

Diluted solutions are stable for 24h. Admixtures exhibitin g a color chan ge should not be used.

USES Hypotension.

MONITOR Heart rate Blood pressure

Urine output and periph eral perfusion. IV sites for blanching and infiltration.

ADVERSE EFFECTS / PRECAUTIONS Tachyc ardia and arrhythmias. May increase pulmonary artery pressure. Reversible suppression of prolactin and th yrotropin sec ret ion.

Tissue sloughing may occur with IV infil trat ion. Use higher doses with caution in p atients with PPHN.

Contraind icated in Pheochro mocytoma, tachyarrythmias or hypovolemia. Us e with caution in pulmonary hypertension.

Dormicum® or Midathetic® Midazolam 15 mg / 3 mL 1

SED ATIVE DOSE: Neofax2011

IV (or IM) : 0.05-0.15 mg/kg over at least 5 minutes, repeat as

required, usually Q2-4h.

IVI: 0.01-0.06 mg/kg/h ( after several days of therapy due to

tolerance or clearance).

Intranas al: 0.2-0.3 mg/kg/dose using in jectable form.

Sublingu al: 0.2 mg/kg/dose using injectable form mixed with a

small amount of flavo red syrup .

ANTICON VULSAN T DOSE: Ne ofax2011

LD: 0.15 mg/kg IV over at least 5 min, follo wed by

Mainten ance IVI: 0.06-0.4 mg/kg/h (1-7 µg/kg/min).

وطولين ٢٠( )ضم ٣/ جم م ٢٥)دورميكم جت ا الى ٢٠٠غزطت بطزه ج ٢٠٠مزكش وجكمل غزطت

٥٪ ) .. وطولين . بطزهجت ا زطت ضاعاث ٤ -٢/ دقائق ٥على مدى وريد ٢٠٠غ


Incomp atible w ith Albu min, L asix® and NaHCO 3.

Compatible with D5W, NS, steri le water for injection, dopamine, dobutamine, epinephrin e, fentanyl, hep arin, insulin, mi lrinone,

morphine and KCl.

USES Sedat ive, hypnotic (duration of action is 2-6h, and quite variable,

up to 22h, in premature bab ies and those with imp aired hep atic function).

Anesthesia induction. Treatment of refractory s eizures.

Dormicum® or Midathetic® Midazolam 15 mg / 3 mL 2

MONITOR Respiratory status and Blood pressure . Hepatic function.

Signs of withdrawal after prolonged th erapy.

ADVERSE EFFECTS Respiratory depression and respiratory arrest especially wh en

used for sedation in non-crit ical c are settin gs. Severe hypotension and seizures with bolus infusion.

Burning sensation with n asal ad ministration. Seizure-like myoclonus (8% of P T inf ants receiving continuous infusion).

Edemex® Bumetanide 0.5 mg / 2 mL

Dose: 0.005-0.1 mg /kg/dose IV slo w push, IM , or PO . Neofax2011

Given Q24h in th e 1st 2 months of life then Q12h afterwards.

Infants with lun g diseas e and normal kidneys should be started

on a low dos e. Inf ants with CHF or RF will n eed a higher dose.

ضاعت ٢٢/ وريد ٢٠٠ غزطت بطزهجت اوطولين... ( ضم ٢/ مجم ٥.٠( ديمكطإ

Compatible with D5 W, NS, lasix®, mil rinone and morphin e.

Incomp atibe with dobutamin e and midazolam .

USES Potent loop diuretic used in R F, CHF or significant ed ema that is

refrac tory to L asix®.

MONITOR Seru m electro lytes and UOP. Seru m K

+ level (esp. if rec eiving digoxin concurrently) .

Weigh t changes.

ADVERSE EFFECTS Water and electrolytes imbalances; hyponatremia, hypokalemia

and hypochloremic alkalosis. Potentially ototoxic (less than Lasix®).

May displac e bilirubin fro m albumin binding sites when given in high doses or for prolonged periods.

Eltroxen® Levothyroxine T4 50 μg tab.

Initial Oral Dose: 10-14 μg/kg/dose PO Q24h (37.5-50 μg/ dose for an average term infant). Dosage is adjusted in 12.5 μg increments.

Initial IV Dose: 5-8 μg/kg/dose Q24h. Neofax2011

ذاب في ٥٠قزص )التروكضين كزوجزام ضم بالفم كل ... ( ماء مقطز ضم ٥م

ضاـعت ٢٤

Use immediately.

USES Hypothyroidism

MONITOR After 2 weeks of treatment Serum TT44 level should be in th e high

normal range (10-16 μg/dL) and should b e maintained in this range for the first year of l ife. TT33 level should be normal (70-220 ng/dL)

and TTSSHH should have d eclined f rom initial valu e. After 12 weeks of treatment Seru m TTSSHH should be in the normal range (< 15 mU /L).

Measure TT44 and TTSSHH at 2 weeks of age, then every 1-2 months or 2 weeks after any chan ge in dosage. Signs of hypo thyro idism: lethargy, poor f eedin g, prolon ged

neonatal jaundic e, constipation, intermittent cyanosis . Signs of thyro toxicosis: hyp eractivity, altered sleep pattern,

tachycardia, tachypnea, f ever, exophthalmos and go iter. Growth, d evelopment and bon e-age advanc ement.

ADVERSE EFFECTS Prolonged o vertreatment can p roduce p remature craniosynostosis

and acceleration of bone age.

EMLA® cream Lidocaine 2.5% and Prilocaine 2.5%

Apply 1-2 gm to distal half of penis then wrap with the occlusive

dressing. Allo w dressing to remain intact for 60 -90 min, remove

and clean treated area completely prior to circumcision to avoid

systemic absorption . Ne ofax2011

USES Topical analgesia for ci rcumcision (applied 60-90 min before th e procedure) .

Not effective for h eel lancin g.

MONITOR Blood meth emo globin conentration.

ADVERSE EFFECTS Blanching and redn ess resolve without treatment . Methemoglobin emia ( with applic ation of > 3 gm)

Contraind icated with congenital or idiop athic meth emo globinemia, with oth er drugs c ausing meth emo globinemia: sulfonamid es, acetaminoph en, nitrates,

nitroglyc erin, n itroprusside, ph enobarbital and phenytoin .

Epanutin® or Ipanten® Phenytoin LD: 15-20 mg/kg IVI over at least 30 min. Neofax2011

MD: 4-8 mg/kg Q24h IV slow push or PO.

Up to: 8 mg/kg/dose Q8-12h after 1 week of age.

Flush IV with saline before and after administration.

Avoid use in central lines; may precipitate. Not to be given IM.

ـهوثين .. (٪٩.١لح م مضم ٩+ ـضم ٢( )ـضم ٥/ مجم ٢٥٠)إيـبا يدضم . هصف ور على مدى

.. ضاعت ثم ضاعت ٢٢/ ببطء وريدضم .

.. ( ـضم ٥/ مجم ٣٠)شراب ن هتإيـبا ـفمضم . ضاعت ٢٢/ بال

Maximum rate of infusion 0.5 mg/kg/min Infusion solution concentration 5 mg / mL Incompatible with D5W, D10W.

USES Anticonvulsant for seizures refractory to phenobarbital.

HEPATIC IMP AIRM EN T Reduce dose.

MONITOR Bradycardia, arrhythmias and hypotension during infusion. IV site for extravasation. Serum therapeutic level is 6-15 μg/mL in the 1 st weeks, then 10-20 μg/mL due to change in protein binding. Obtain initial trough level after 48h of IV LD. Bilirubin displaces phenytoin from protein-binding sites, resulting in increased free drug.

ADVERSE EFFECTS Extravasation inflammation and necrosis. Hypersensitivity reactions. High serum concentration is associated with seizures. With long term therapy: Arrhythmias, hypotension, gingivitis, nystagmus, rickets, hyperglycemia, and hypoinsulinemia.

Epoetin alpha Eprex® 2000 iu / 0.5 mL

Dose: 200-400 iu/kg/dose, 3-5 times per week for 2-6 weeks. Total dose per week is 600-1400 iu/kg.

Short course: 300 iu/kg/dose daily for 10 days.

Administer SC or IVI (over ≥ 4h or continuously in TPN).

Supplemental iron, adequate proteins and Vit-E should be initiated concurrently.

وم ... ( ضم ٥.٠/ وحدة ٢٠٠٠)ركطـايب وم بعد غزطت جحت الجلد

For IVI: Dilute in 2 mL of solutions containing at least 0.05%

protein and infuse over 4 hours. Stable for 24h.

USE Stimulate erythropoiesis and the need for PRBCs transfusion in

high risk preterms (the most likely to benefit are ELBW < 800 gm

with phlebotomy losses > 30 ml/kg).

MONITOR Weekly CBC to check for neutrop enia and RBC response.

ADVERSE EFFECTS / PRECAUTIONS

Neutropenia (rare, resolves with discontinuation of th e dru g).

STORAGE

Store b etween 2-8◦ c.

Don’t shake or f reeze.

Undiluted epo etin is stable plastic syringes for 2 weeks.

Erythromycin Erythrocin® 200 mg / 5 mL In Chlamydia trachomatis Conjunctivit is and Pneu monit is: 12.5 mg/kg/dose PO Q6h for 14 days.

For other infect ions and pro phylaxis : 10 mg/kg/dose P O Q6h.

In treatment and proph ylaxis of Pertussis: 12.5 mg/kg/dose P O Q6h for 14 days (Azithromycin is th e drug of choic e in n eonates).

Ne ofax2011

Dose for feeding intolerance due to dysmotility: 10 mg/kg/dose PO Q6h for 2 days followed by 4 mg/kg/dose PO Q6h for 5 days. Neofax2011

ثضاـع ٦/ مع الزضاعت باـلـفم ... ( ضم٥/ مجم ٢٠٠) اريثروصين شراب ا

For proph ylaxis of op hthalmia neon atoru m: ribbon of 0.5 % ointment instil led in each conjunctival sac.

Neofax2011

USES Infections by Chlamydia, Mycoplasma, and Ureaplasma. Treatment and prophylax is for Bordetella p ertussis .

Substitute for p enicillin in allergic intoleranc e. Prokinetic agent (moti lin-rec eptor agonist) in f eedin g intoleranc e.

MONITOR Diarrhea and abdomin al discomfort.

CBC for eosinophilia.

ADVERSE EFFECTS / PRECAUTIONS Loose stools. Intrah epatic cholestasis. x10 risk of h ypertrophic pyloric stenosis in n eonates under 2 wks

of age. Plasma clearance of midazolam (Dormicu m®) by 50% Serum conc entration of digoxin, midazola m, th eophyllin e and

carbamazepin e.

Famotidine Antodine® 20 mg / 2 mL amp. IV, slow push: 0.25-0.5 mg/kg/dose Q24h.

Ne ofax2011

Continuous IVI of the daily dose in adult provid es better gastric suppression than intermittent dos ing.

PO: 0.5-1 mg/kg/dose Q24h. Ne ofax2011

ضاعت ٢٤/ ورد ببطء ... (ضم ٩+ ضم ٢) (ضم ٢/ مجم ٢٠)أهتودي

Infusion Solu tion Conentration 1 mg / mL. Compatible with D5W, D10W, NS, calciu m gluconate, dobutamine,

dopamine, epin ephrine, hepain , insulin, MgSO4, mid azolam, morphine, KCl and N aHCO3.

تضاع ٢٤/ باـلـفم ... ( ضم ٢٠/ مجم ٢٠) أقزاص هتوديا

Solution Conentration 2 mg / mL.

USES Prevention and t reatment of stress ulcers and G I hemorrh age aggrevated by gastric ac id secretion.

MONITOR Gastric pH (> 4)

ADVERSE EFFECTS Increased risk of late-onset bacterial and fungal s epsis. Routine gastric ac id suppression in neonates should be avoided . In adu lts (<5%): h ead ache, dizziness, constipation and diarrh ea.

Fentanyl Fentanyl-Janssen® 50 μg / mL Sedation and Analgesia: 0.5-4 μg/kg/dose IV slow push, repeat as required, usually Q2-4h.

Infusion rate: 1-5 μg/kg/h (quickly develop tolerance).

Anesthesia: 5-50 μg/kg/dose. Neofax2011 ث ٤/ ورد ببطء ضم...( ضم ٢٢+ ضم ½( )ضم/ مكزوجزام ٥٠) فىـتاهـيل ضاعا

بأمز الطبب

Infusion solution concentration 2 μg / mL .

For a dose of 2 µg/kg, give 1 mL/ kg

Stable for 24h refrigerated after d ilution.

Protect from light. Compatible with D5 W, D10W and NS.

USES Analgesia, sedat ion.

Anesthesia.

MONITOR Respiratory and c ardiovascular status. Abdominal distension, loss of bowel sounds . Muscle rigidi ty.

ADVERSE EFFECTS / PRECAUTIONS Respiratory dep ression with an esthetic dose ( > 5 μg/kg).

Chest wal l rigidity (in 4% of neonates who rec eived 2.2-6.5 μg/kg/dos e) with laryngospasm, reversible with naloxone

®.

Urinary retention with continuous infusion. Tolerance to an algesic doses with prolonged use. Withdrawal symptoms after IVI for 5 days or lon ger.

Flagyl® Metronidazole 500 mg / 100 mL Vial LD: 15 mg/kg P O or IVI over 1h

MD: 7.5 mg/kg/dos e PO or IVI over 1h Neofax2011

م ٪٥ضم ج …+ ضم ... )ضم ٢٠٠/ مجم ٥٠٠)فالجـيل ورد على مدى ضاعت ث

ضاعت على مدى ضاـعت/ ... ورد ٪٥ضم ج …+ ضم … ضاعت... بعد

ضاعت .../ بالفمضم ... ( ضم ٥/ جم م٢٢٥)شراب فالجـيل

Na content is 14 mEq per 100 mL.

Infusion solution concentration 5 mg/ml. Compatible with D5 W and NS.

PMA (wk) Postnatal (d) Interval (h)

≤ 29 0-28 >28

48 24

30-36 0-14 >14

24 12

37-44 0-7

>7

24

12 ≥ 45 All 8

HEPATIC IMPAIRMENT Reduce total d aily dose to one third and give onc e daily

Use with c aution in h epatic enceph alopathy

USES Meningitis, ventriculit is and endocarditis caused by Bactero ides

fragilis and other anaerob es resistan t to penici llin. Serious intra-abdominal inf ections and C. difficile coli tis.

Trichomonas vagin alis infec tions.

ADVERSE EFFECTS / PRECAUTIONS Carcinogenic?!!

Seizures, sensory polyn europathy (in adults rec eivin g high doses over a prolonged period). Brownish discoloration of urin e.

Fludrocortisone Astonin-H® or Cortilon® 0.1 mg tab.

Dose: initially 0.05 mg PO once daily, adjusted according to response; usual range 0.05–0.2 mg/day; higher doses may be required. BNFC2011-12

ذاب في ... ( م مج ٢.٠) أقزاص -اصتوهين بالفمضم ماء مقطز وعطى ٥قزص

ت ضاع ٢٤/

USES Mineralocorticoid replacement in adrenocortical insufficiency.

MONITOR Blood pressure Serum electrolytes; Na+, K+ and Ca++. Body weight

ADVERSE EFFECTS / PRECAUTIONS Hypertension Na+ and water retention K+ and Ca++ loss

Folic Acid Folicap® 500 μg cap.

Dose: 15 μg/kg/dose or up to maximum 50 μg/day PO,

deep IM, IV or SC. Neofax2011

ضاعت ٢٤/ ضم بالفم ٢ ( ضم ٢٠٠/مجم ½) فوليك أصيد

Prevention of megaloblastic anemia associated with

ppyyrriimmeetthhaammiinnee and ssuullff aaddiiaazziinnee treatment of congenital

toxoplas mosis:

Neonate: 5 mg 3 times a week (increased up to 20 mg 3 times a

week if n eutrop enic).

Child 1 month-1 year: 10 mg 3 times a week. BNFC2010-11

USES Megaloblastic and macrocytic an emia as a result of folate deficiency.

MONITOR Hematocrit Hemoglobin

Reticulocyte

ADVERSE EFFECTS / PRECAUTIONS May mask hematolo gical def ects of Vit B12 deficiency, but it will

not prevent th e progression of irreversible neu rologic abnormalities. GI upset

Slight flushing May dec rease ph enytoin seru m concentration .

Contraind icated in pernicious, aplastic and normocytic an emia

Fortum® Ceftazidime 1 g / 40 mL

Dose: 30 mg/kg/dose IVI over 30 min, or IM . Neofax2011

PMA (wks) Postnatal (days) Interval (hrs)

≤ 29 0-28

>28

12

8

30-36 0-14 >14

12 8

37-44 0-7 >7

12 8

≥ 45 All 8

Another Dose Regimen MNC2012

Age Weight Dosage (IV/ IM) All neonates < 1,200 g 50 mg/kg/dose Q12h

Postnatal age ≤ 7d 1,200-2,000 g 50 mg/kg/dose Q12h

Postnatal age ≤ 7d > 2,000 g 50 mg/kg/dose Q8h

Postnatal age > 7d > 1,200 g 50 mg/kg/dose Q8h

ثام .. ( ضم م م ٤٠/ جم ٢)فور ي ضم. عت دــور هصف ضا .. على مدى ث/ . ضاعا

Infusion solution concentration 25 mg/ml.

Compatible with D5 W, D10W and NS. ثام .. ( ضم ٢/ مجم ٥٠٠)فور . عضــلضم . .. ث/ ضاعا

Also available as 250 mg and 1 g vials

USES Neonatal meningitis and sepsis by G-ve organisms (e.g. E. coli, H. influenza, Neisseria, Klebsiella, and Proteus species), esp. Pseudomonas aeruginosa.

Synergistic with aminoglycosides.

ADVERSE EFFECTS (UNCOMM ON) Rash, Eosinophilia

Diarrhea, Hepatic ALT, AST. False positive direct Coombs’ test.

Fungizone® Amphotericin-B 50 mg / 10 mL

1

Dose: 1-1.5 mg/kg IVI over 2-6h Q24h Ne ofax 2011

Dose: Gome lla 2 009

- Initial dose: 0.25-0.5 mg/kg IVI over 4-6h.

- MD: 0.5-1 mg/kg IVI over 2-6h Q24-48h for 2-6 wks or longer.

يزون )ضم ٢٠/ مجم ٥٠) فـىج ين ... ( ٪٥ضم ج ٥.٢٤+ ضم ½( ـد على ـمدي ـضاعخ ضم ور

.. بمـعدل ت ٢٤الـطاعـت كل / ضم . ـضاعـ

Infusion solution concentration 0.1 mg/mL. Compatible with D5 W, D10W, D15W and D20W. Don’t mix with NS.

Protect from light. Stab le for 24h at roo m temperature or 7 days in refrigerator.

USES Systemic fungal infections.

Severe superficial mycoses.

ADVERSE EFFECTS / PRECAUTIONS Hypokalemia (K

+ < 3 mmol/L) and t ransient in serum creatinin e

in ~16% of treated p atients. RBF and GFR by 20-60%.

K+

and Mg loss due to tubular injury, reabsorption of Na and

renal tubular acidosis. N a in take > 4 mEq/kg/day may prevent o r nephrotoxicity.

Concurrent use with oth er n ephrotoxic drugs may lead to additive nephrotoxic ity.

Anemia, thrombocytop enia. Consider analgesia befo re infusion. Fever, chi lls, nausea or vomitin g.

Cardiac arrest has occurred in patients who rec eived 10 times th e recommend ed dose.

Fungizone® Amphotericin-B 50 mg / 10 mL

2

MONITOR CBC, electrolytes, UOP, BUN and serum creatinine aatt lleeaasstt eevveerryy ootthheerr ddaayy..

IV sites for i rritation (phlebit is).

RENAL IMPAIRMENT If creatinine increases > 0.4 mg/dL from b aseline durin g therapy, hold dose for 2-5 days.

Neofax 2011

Altern ate-day dosing is recommend ed over decreasin g d aily dose in patients experiencing ren al toxici ty.

Ne ofax 2011

Discontinue if BUN > 40 mg/dL, s erum creatinin e is > 3 mg/dL, or

liver function tests are abnormal.

INTERACTIONS WITH Antib acterials: risk of nephrotox icity when given with aminoglycosides; possible risk of n ephrotoxicity when

amphotericin given with vancomyc in. Cardiac Glycosides: hypokalemia caused by amphotericin

cardiac toxic ity with cardiac glycosides. Corticosteroids: risk of hypokalemia when amphotericin given

with corticosteroids - avoid concomitant use unless needed to

control reactions. Diuretics: risk of hypokalemia when given with loop diuretics or

thiazides.

Garamycin® Gentamicin 40 mg / 4 mL

Dose: as chart IVI over 30 minutes. Ne ofax2011

ضم ورد على مدى ... ( ٪٥ضم ج ٤+ ضم ٢) )ضم ٤/ مجم ٤٠(جاراميضين

ضاـعت ٢٤/ هصف ضاعت

Infusion solution concentration 2 mg/mL. Compatible with D5 W, D10W and NS

IM injection is associated with variable absorption, especially in the very small inf ant.

PMA (wks) Postnatal (d) Dose (mg/kg) Interval (h)

≤ 29 *

0-7

8-28 ≥ 29

5

4 4

48

36 24

30-34 0-7 ≥ 8

4.5 4

36 24

≥ 35 All 4 24

* or significant asphyxia, PDA or ttt with indomethacin.

USES Aerobic G-ve Bacil li (e.g. Ps eudomonas, Klebsiella, E. coli).

Usually used in combin ation with a β-lactam antibiotic.

ADVERSE EFFECTS Transient and reversible ren al tubular dysfunction ( urinary loss

of Na, Ca, and Mg) .

Vestibular and auditory ototoxici ty. Increased n euromuscular blockade wh en us ed with p ancuronium

and in patients with hypermagnes emia. The use of gentamicin ointment for n ewborn ocular p rophylaxis has been associated with p eriocular ulc erative dermatitis.

SERUM LEVEL Obtain ppeeaakk concentration 30 minutes after end of infusion and ttrroouugghh level just prior to the next dose, refrigerate blood sample soon Peak: 5-12 µg/mL Trough: 0.5-1 µg/mL

Gastrazole® Omeprazole 20 mg cap.

Losec® Omeprazole 40 mg vial

Dose: 0.5 - 1.5 mg/kg/dose PO Q24h. Neofax2011 ث ٢٠/ مجم ٢٠)جاـصـترازول ـفم ... ( ٪ ٤.۸ضم صودوم بكزبوها ٢٤/ ضم بال

ضـاـعت


٢٠٠غزطت بطزهجت أوطولين ... ( ضم٩+ ضم ٢( )ضم ٢٠/ مجم ٤٠)لوصيك

ــد ضـاـعت ٢٤/ ببطء غدد ور

Infusion solution concentration 4 mg/mL. Dilute with D5W or NS. BNFC2011-12

USES Short-term (< 8 weeks) treatment of documented reflux esophagitis or duodenal ulcer refractory to conventional therapy.

OOnnsseett ooff aaccttiioonn within 1h with dduurraattiioonn ooff aaccttiioonn of 72h.

MONITOR Symptomatic improvement within 3 days. Intra-esophageal pH monitor to assess efficacy (pH > 4.0). ALT, AST if duration of therapy > 8 wks.

ADVERSE EFFECTS Hypergastrinemia. Mild ALT, AST elevation.

Geveskon® Na Alginate / Na Bicarbonate

Dose: 1-2 mL after feeding PO Q8h.

ضاعاث بعد الزضاعت ۸/ ضم بالفم ٢-٢جيفيضكون ـشراب

Each 5 mL contains 5 g sodium algin ate + 2.5 gm N aHCO3

USES NaHCO3 may, by acting as an antacid, control some of the symptoms of gastro-oesophageal reflux. Alginate reacts with gastric acid to form a viscous gel or ‘raft’ that then floats to the top of the stomach, acting as a mechanical barrier to oesophageal reflux.

ADVERSE EFFECTS / PRECAUTIONS Metabolic alkalosis Hypernatremia

Gaviscon® Infant Sachets Powder for oral suspension Each dose of Gaviscon® i nfant Sachets contains 225 mg of sodium alginate

and 87.5 mg magnesium alginate. Prepare immediately before use as directed below:

For breast-fed infants: < 4.5 kg, one dose and 2 doses if > 4.5 kg

Add 5 mL of cooled boiled water to the powder in a glass. Mix to a

smoothpaste and add another 10 mL water and mix. Give after each feed using a spoon or feeding bottle.

For bottle-fed infants: < 4.5 kg, one dose to be mixed into not less than 115 mL of each feed in

thebottle and shaken well.

> 4.5 kg, 2 doses to be mized into not less than 225 mL of ea ch fee d in thebottle and shaken well.

Young chil dren: 2 doses, prepared as breast-fed infsnts. To be taken after each meal.

Glucagon® Glucagon 1 mg vial

Dose: 0.2 mg/kg/dose IV push, IM or SC. Maximum dose: 1 mg. IVI: begin with 0.01-0.02 mg/kg/h. Rise in bloog glucose should occur within 1h of starting infusion. Neofax2011

حقن جحت الجلد مزة واحدة آلان (مجم ٢) لوكاجون ج

USES

Hypoglycemia: - Refractory to IV dextrose infusions - When dextrose infusion is unavailable - Documented glucagon deficiency.

Glucagon stimulates gluconeogenesis, inhibits small-bowel motility and gastric acid secretion. In high doses, it has a cardiac inotropic effect.

MONITOR Blood glucose concentration; rise in blood glucose will last

~2h. Rebound hypoglycemia

ADVERSE EFFECTS Nausea and vomiting. Tachycardia. Ileus. Hyponatremia. Thrombocytopenia.

Heparin 5000 i.u. / mL To maintain patency of peripheral and central vascular catheters: 0.5-1 units/mL of fluids to be infused.

Neofax2011

Heparin loc k for central lines: 1-2 mL of 10 units/mL solution Q4-

6h and as needed. MNC2012

Treatment of Thro mbosis: 75 units/kg bolus over 10 minutes,

followed by 28 units/kg/h IVI - Measure aP TT 44hh after initiat ing th erap y - Adjust dose to achieve aPTT of 60-85 seconds (corresponds to

an anti-facto r Xa level of 0.35-0.7). - Limit treatment to 10-14 days.

Ne ofax2011

اري وطولين ٥ (ضم ٩+ ضم ٢( )ضم/ وحدة ٥٠٠٠)هيب بطزهجت ا ضم ٥٠لكل ٢٠٠غزطاث

ل محال


USES To maintain patency of peripheral and c entral vascular cath eters (continuous infusions rather th an intermittent flushes). Treatment of thro mbosis.

MONITOR Platelet count every 2-3 days. aPTT (achieve aPTT of 60-85 seconds).

Signs of bleeding and thrombosis.

ADVERSE EFFECTS / PRECAUTIONS Heparin-induced thrombocytop enia (HIT) 1%.

Osteoporosis (with long-term use) Fatal hemorrhage with incorrect concentration used .

Contraind icated in infants with evid ence of intracranial or G I bleedin g or thro mbocytopenia (<50.000/mm

3).

Hepatitis B Immune Globulin Hepabig® 200 iu / mL Vial

Dose: 0.5 mL given in th e anterolateral thigh IM. Ne ofax2011

Don’t ad minister IV.

FT and PT with HBsAg +ve mother Given within 12h of birth.

FT and PT ≥ 2 kg with unknown status of mother’s HBsAg

Given as soon as it is determined that the mother is HBsAg +ve, within

7 days of birth.

PT < 2 kg with unknown status of mother’s HBsAg

Given within 12h of birth.

Uses Passive immuniz ation of newborns whos e mothers have active

hepatitis B infection at the time of delivery, or who are HBsAg +ve.

Infants born to moth ers who are HBeAg +ve have th e high est risk .

PRECAUTION FOR HBIG When given at the same time as th e first dose of H epB vaccine

Use a sep arate syr inge and a different site. Draw b ack on the plunger of th e syr inge before inject ion to b e certain the n eedle is not in a blood vessel.

ADVERSE EFFECTS / PRECAUTIONS Local pain and tend ern ess. Systemic reactions if given IV.

Use univers al prec autions with neonates born to HBsAg +ve mothers until they h ave been bathed c arefully.

Hepatitis B Recombinant Vaccine Euvax B® Dose: 0.5 mL given in th e anterolateral thigh IM.

Ne ofax2011

Store refrigerated at 2◦C to 8

◦C .

Don’t freeze-destroys potency.

Matern al HBs Ag +ve

Give 1st dose before 12h of birth

(regardless of birth weight). If < 2 kg, give 3 additional doses beginning at 1-2 months of age.

Matern al HBs Ag unknown

Give 1st dose before 12h of birth

(regardless of birth weight). IIff << 22 kkgg,, give HBIG within 12h of age.

IIff ≥≥ 22 kkgg,, give HBIG within 7 days of birth if mother tests HBsAg +ve.

Matern al HBs Ag -ve

Give 1st dose shortly after birth, b efore

hospital discharge.

IIff << 22 kkgg aanndd mmeeddiiccaallllyy ssttaabbllee,, give 1st

dose at 30d of chronologic age or at time

of hospital discharge if before 30d of chronologic age.

USES Immunoprophylaxis against h epatitis B . Safe for us e in infants born to HIV-positive mothers, although it may b e less effective.

USES Immunoprophylaxis against h epatitis B .

ADVERSE EFFECTS / PRECAUTIONS Soren ess at injection site. Fever > 37.7

◦C (in 1-6%).

Hyaluronidase Hyalase® 1500 iu amp.

Inject 1 mL (150 units) as 5 separate 0.2 mL SC injections around the

periphery of the extravasation site.

Use 25- or 26- gauge needle and change after each injection. Neofax2011

..ضم جحت الجلد ٢ (م م ضم ٢٠/ وحدة ٢٥٠٠) هياالز

Solution Concentration 150 units / mL Compatible with D5W, D10W and NS.

USES Prevention of tissue inju ry caus e by IV extravasat ion of drugs with hyperosmolarity or extreme pH (e.g. aminophylline,

amphotericin B, calciu m, ox acillin, ph enytoin , KCl, r ifampicin , NaHCO3, vancomycin, TPN and concentrated IV solutions). Not indicated for treatment of extravas ations of vasoconstrictive

agents (e.g. dopamine, ep inephrin e and norepin ephrine) .

ADVERSE EFFECTS / PRECAUTIONS Not recommended for IV use.

Hydralazine Slowapresoline® 50 mg tab Apresoline® 20 mg vial IV: begin with 0.1 - 0.5 mg/kg/dose Q6-8h. Increase gradually as required to a maximum of 2 mg/kg/dose Q6h.

PO: 0.25-1 mg/kg/dose Q6-8h, or approximately twice the required IV dose. Administer with food to enhance absorption. Neofax2011

ضاعاث ۸ - ٦/ وريدضم ... ( ضم م م ٢٠/ مجم ٢٠)هـيدرالازي


Compatible with N S To prepare an oral suspension, crush a 50 mg tablet in 4 mL of 5% mannitol then add 46 mL of sterile water to make a final concentration of 1 mg/mL. Stable for 7 days refrigerated. Neofax2011

ضم . .. ( ضم ماء مقطز ٤٦+ ٪٥ضم ماهخول ٤+ قزص مجم ٥٠) هـيدرالازي

ضاعاث ۸ - ٦/ مع الزضاعت بالفمNOTE: use with ß-Blockers the anti-hypertensive effect and the magnitude of the reflex tachycardia. This is expected to reduce hydralazine requirements to < 0.15 mg/kg/dose.

USES Mild to moderate hyp ertension.

Afterlo ad reduction in pat ients with CHF.

MONITOR Heart rate and Blood pressure. Guaiac stools. Periodic CBC for lon g term use.

ADVERSE EFFECTS / PRECAUTIONS Diarrhea, emesis.

Temporary agranulocytosis. Tachyc ardia, postural hypotension, headache, nausea, and a

lupus-like syndrome (10-20% of adults). GI irritation, bleeding, drug fever, rash, conjunctivit is, and bon e marro w suppression (in adults, unco mmon).

Hydrochlorothiazide Hydretic® 12.5 mg tab

PO: 1-2 mg/kg/dose Q12h. Neofax2011

Admi nister with food (improves absorption).

تضاع ٢٢/ مع الرضاعة بالفمضم ... ( ضم م م ٥/ جم م ٥.٢٢قزص ) هيدريتك

Solution concentration 2.5 mg/mL. Effects increased when used in combination with furosemide or spironolactone.

USES Mild to moderate edema. Mild to moderate hyp ertension.

May imp rove pulmonary function in patients with BPD.

Hydrochlorothiazide ren al excretion of calcium, inhibits

pancreatic release of insulin and displac es bilirubin from albumin .

MONITOR Seru m electro lytes, calciu m, phosphorus and glucose.

Urine output and blood pressure. Onset of action is within 1 hour.

ADVERSE EFFECTS / PRECAUTIONS Hypokalemia and oth er electrolytes abnormalities. Hyperglycemia.

Hyperuric emia. Contraind icated in patients with signific ant imp airment of ren al

or hepatic function.

Hydroferrin® or Ferose® Iron Polymaltose Complex For growing PT infants: 2 mg/kg/day (max. 15 mg/day), begin after 2 weeks of age. < 1.000 kg birth weight: 4 mg/kg/day.

If receiving erythropoietin: 6 mg/kg/day.

In 1 or 2 doses, diluted in formula. ضاـعت ٢٤/ ضم مع الزضاعت ... ( ضم ٥/ مجم ٥٠) شراب فــروز

ضاـعت ٢٤/ هقـطت مع الزضاعت ... ( ضم/ مجم ٥٠)هقط هيدروفيري

Each Hydroferrin® drop contains 1.67 mg elemental iron.

USES Iron supplementation for prevention and treatment of anemia.

MONITOR Hemoglobin and reticulocyte counts during therapy

Observe stools. Check for constipation.

ADVERSE EFFECTS / PRECAUTIONS In growing PT infants, iron supplementation should not be started until adequate vitamin E is supplied in diet: otherwise iron may hemolysis. Nausea, constipation, black stools, erosion of gastric mucosa. Lethargy. Hypotension.

Intravenous Immune Globulin GAMMARAAS® 5% (Human)

Usual Dose: 500-750 mg/kg/dos e (over 2-6h). Ne ofax2011

In Neonatal Alloimmune Thro mbocytopenia: 400 mg – 1 g/kg

Most studies have used a single dose, although addit ional doses

have b een given at 24h interval.

Regimen

0.01 – 0.02 mL /kg/min over 30 minutes th en th e

rest of the amount o ver 1½ h. Rate/h in 1

st 30 min = 0.02 X Wt (kg) X 60

.. نضم . عخين (صم ٠١/ جم ٠) اميىوجلوبلي . بمعدل ورد على مدى ضا . لطاعت/ ضم . في أول ا

بمعدل عت ثم .. هصف ضا عت خالل ضاعت وهصف/ ضم . الطا

Available as 1g in 20 mL – 2.5 g in 50 mL – 5 g in 100 mL

Compatible with D5 W and D15W.

USES Adjuvant t reatment of fulmin ant neonatal s epsis, hemolytic jaundice, neonatal alloimmun e thrombocytop enia. Total IgG titers in treated , septic neonates remain elevated for

~10 days.

MONITOR HR and BP. IV sites for phlebitis.

ADVERSE EFFECTS / PRECAUTIONS Hypoglycemia ( rare). Transient tachyc ardia and hypotension, resolved after stopping

the infusion. The risk of NEC may be increased in term and late preterm infants treated for isoimmun e h emolyt ic jaundic e.

Associated with ren al dysfunction, ARF and osmotic nephrosis; use minimu m concentration with minimu m rate of infusion in

patients predisposed to AR F.

Indomethacin Liometacen® 50 mg vial

1

Closure of PDA: as table IVI over at least 30 minutes. Usual ly 3 doses per course, maximu m 2 courses.

Give at 12-24h intervals with clos e monitor to UOP, if anuria or severe oliguria, d elay subsequent dose.

Longer treatment cou rses may be used: 0.2 mg/kg/24h for a

total of 5-7 days. Ne ofax2011

Prevention of IVH: 0.1 mg/kg Q24h, 3 doses start at 6-12h of age. Neofax2011

٢٤-٢٢/ على مدى هصف ضاعت ضم ورد ... ( ضم ٢٠٠/ مجم ٥٠) اصينتوميلي

ام ٣ملدة ضاعت أ

Stab le for 12d when stored at room temperature or refr igerated. Compatible with sterile water, D2.5W, D5W, NS, Lasix, insulin, KCl

and NaHCO3. Incomp atible w ith D7.5W, D10W, calcium gluconate, dobutamin e and dopamin e.

Age at 1st dose 1st 2nd 3rd < 48 h 0.2 mg/kg 0.1 0.1

2 – 7 d 0.2 0.2 0.2

> 7 d 0.2 0.25 0.25

USES Closure of PDA.

Prevention of IVH.

MONITOR Urine output, s erum electrolytes, c reatinin e and BUN . Blood glucose. Assess murmur and pulse pressure.

GI bleeding (gu aiacin g stools and gastric aspirate) . Platelet count or p rolonged bleeding fro m puncture sites.

Indomethacin Liometacen® 50 mg vial

2

ADVERSE EFFECTS If oliguria occurs, observe for hyponatremia and hypokalemia and

consider prolonging the dosing in terval of rreenn aallllyy eexxccrreetteedd dd rruuggss. Consider withholdin g feedings. Hypoglycemia ( avoid ed by GIR by 2 mg/kg/min).

Contraind icated in active bleedin g, significant thro mbocytopenia or coagulation def ects, NEC and significantly imp aired ren al

function. Avoid rapid infusion (< 5 min). GI perforation if used concurrently with steroids.

INTERACTIONS WITH ACE Inhib itors: risk of renal impairment, also hypotensive eff ect

antagoniz ed. Antib acterials: indometacin possibly plasma concentration of amikacin and gen tamicin in n eonates; possible risk of

convulsions when given with quinolones . Antiepileptics: NSAIDs possibly eff ects of phenytoin.

Beta-blockers and C alciu m-channel Bloc kers: NSAIDs antagoniz e

hypotensive effect . Cardiac Glycosides: NSAIDs possibly plasma conc entrat ion, possible exac erbation of heart failure and of renal function.

Corticosteroids: risk of GI bleeding and ulc erat ion.

Diazoxide: NSAIDs antagoniz e hypotensive effect . Diuretics: risk of n ephrotoxicity of NSAIDs by diu ret ics, also

antagonism of diuretic eff ect; indometac in antagoniz es eff ects of diuretics; risk of hyperkalemia when given with K

+-sparin g

diuretics and aldosteron e antagonists. Pentoxifyll ine: possible risk of bleedin g.

NSAIDs antagonize h ypotensive eff ect of hyd ralazine.

Inderal® or Mayestrotense® Propranolol 1 mg / mL

1

Hypertension and Tach yarrhythmias :

Starting IV Dose: 0.01 mg/kg Q6h over 10 min. Increase as needed to max.

0.15 mg/kg/dose Q6h.

Starting Oral Dose: 0.25 mg/kg/dose Q6h. Increase as needed to max. 3.5

mg/kg/dose Q6h. Neofax2011 Infantile Hemangio mas :

MD: 2-3 mg/kg/day PO in 3 divided doses.

Some recommends: starting dose of 0.3-1 mg/kg/day to assess tolerability

and then increasing to 2 mg/kg/day incrementally over several days.

Tapering periods have ranged from 2 weeks to 1 month. Neofax2011

جم ٢)اهــدرال .. ( ضم ٩+ ضم ٢( )ضم ٢/ م ث ٦/ دقائق ٢٠د على مدى ور. ضاعا

IV solution concentration 0.1 mg/mL.

Compatible with D5W and NS.

.. ( مقطز ءما ضم ٢٠/ مجم ٢٠)أقراص اهــدرال لفمب. ث ٦/ ا ضاعا

USE Tachyarrhythmias and hypertension. SVT especially if associated with Wolff-Parkinson-White syndrome.

Palliation of TOF and HOCM.

Adjuvant treatment of neonatal thyrotoxicosis. Infantile hemangiomas.

MONITOR Continuous ECG monitor. Vital signs and systemic blood pressure.

Blood glucose during initiation of treatment and after dosage changes. Assess for increased airway resistance.

ADVERSE EFFECTS / PRECAU TIONS Hypotension, bradycardia, bronchospasm and hypoglycemia. For infants receiving propranolol, regular, frequent food intake (Q3-4h) is an

important consideration with regards to risk for hypoglycemia. Contraindicated i n patients with cardiogenic shock, sinus bradycardia

greater than 1st degree block, reactive airway disease or diminished myocardial contractility.

A withdrawal syndrome (nervousness, tachycardia, sweating, hypertension) with sudden cessation of the drug.

Inderal® or Mayestrotense® Propranolol 1 mg / mL

2

INTERACTION S Cardiac Glycoside s: risk of AV block and bradycardia. Hypotensive effect of beta-blockers antagonized by corticosteroids.

Diazoxide: enhances hypotensive effect. Diuretics: enhances hypotensive effect.

Thyroid Hormones: metabolism of propranolol is accelerated. Hydralazine: enhances hypotensive effe ct.

Human Insulin, Short-acting Actrapid® 100 Units / mL

1

Continuous IVI: 0.01-0.1 unit/kg/h.

Intermittent SC dose: 0.1-0.2 unit/kg Q6-12h. Ne ofax2011

For hyperkalemia: initial IVI dextrose (0.5 g/kg/h) and regular insulin (0.1-0.2 u/kg/h). D extrose and insulin dosages are adjusted b ased on s erum glucose and potassium conc entrat ion .

Ne ofax2011

For hyperkalemia: begin with a bo lus of insulin (0.05 u/kg) with 2 mL/kg of D10W followed by IVI of D10W at 2-4 mL/kg/h and

regular insulin (0.1 u/mL) at 1 mL /kg/h. Th e two solutions may b e prepared individual ly to allo w adjustments in infusion rate in

response to hyp er- or hypoglycemia. MNC2012

To absorption of insulin to IV solution bag or tubing, flush the

line with solution, wait 20-30 min then flush the line again with solution prior to initiation. Th e actual amount of insulin bein g

administrated could be less than the apparent amount . So, adjustment of the insulin rate should be based on the eff ect and not solely on th e apparent insulin dose.

Gome lla2009 and Ne ofax2011

لخخلص من ( ٪ ٥ضم ج ٥٠ + ٢٠٠غزطاث بطزهجت ٥) (اوضولين مائي) اكتــرابيد ضم ٢٥وخم ا

عت بمعدل ٢٤ثم عطى على مدى ءبدالمن خالل جهاس الورد قبل ـعت/ ضم ... ضا لـطا ا

Infusion solution concentration 0.1 u/mL.

Maximu m solution concentration 1 u/mL. Compatible with D5W, D10W, NS, dobutamin e, h eparin , midazolam, milrinon e, KCl and NaHCO3.

Incomp atible w ith dopamine.

زطاث بطزهجت ٢٠)( اوضولين مائي)اكتــرابيد ين غ وطول .. ( ضم ماء مقطز ٢٠+ ٢٠٠ا غزطت .

ضاعت ...جحت الجلد كل ٢٠٠بطزهجت أوطولين

SC solution concentration 0.5 - 1 u/mL DW or NS. Neofax2011

Human Insulin, Short-acting Actrapid® 100 Units / mL

2

USES

Hyperglyce mic inf ants with persistent glucose into lerance :

- Glucose > 250 mg/dL despite GIR by 2 mg/kg/min Q4-6h.

- Prolonged restriction of IV glucos e with required calor ies.

Routine use in VLBW to pro mote gro wth in nnoott warranted. Adjuvant th erapy for hyp erkalemia.

MONITOR

Blood glucose concentration Q15-30 minutes after startin g

infusion and after ch anges in infusion rate.

ADVERSE EFFECTS / PRECAUTIONS Hypoglycemia. Insulin resistanc e.

Euglyc emic hyp erinsulinemia due to exogenous insulin administration may caus e metabol ic acidosis. Glucose level gradually to avoid rapid fluid shifts.

Kayexalate® Sodium Polystyrene Sulfonate

DOSE: 1 g/kg/dose PO Q6h via NGT or PR Q2-6h صاعات ٦كايكضاالت حقىة شرجية كل

For PO use: Dilute in 3-4 mL fluid per g of resin; 10% sorbitol, water, or syrup may be used as diluent. For PR use: Dilute in water or 25% sorbitol at a concentration of 0.3-0.5 g/mL; retain enema for at least 30-60 min or several hours if possible The Na+ content is ~100 mg/g (4.1 mEq/g) of the drug Also available as Sorbisterit® (calcium polystyrene sulfonate)

USES Treatment of hyperkalemia

ADVERSE EFFECTS Hypokalemia Sodium retension Hypocalcemia and hypomagnesemia Fecal impaction

Klacid® Clarithromycin 250 mg / 5 mL

Dose: 7.5 mg/kg/dose PO Q12h. BNFC2011-12 ضاعت ٢٢/ ضم ... ( ضم ٥/ مجم ٢٥٠)كالصيد شراب


USES Clarithromycin acts like erythromycin and has a similar spectrum of antibacterial activity i.e. mainly against G+ve organisms, although it is usefully more active aga inst Haemophilus influenzae. It’s used for respiratory tract infections including atypical pneumonias and soft tissue infections.

ADVERSE EFFECTS Macrolides are enzyme inhibitors and interfere with the metabolic inactivation of some drugs, e.g. theophylline, increasing their effects.

Konakion® Vitamin K1 10 mg / ml

Prophylaxis at birth: 0.5 - 1 mg IM (0.05-0.1 mL).

PT < 32 wk (> 1 kg) : 0.5 mg IM (0.05 mL).

PT < 32 wk (< 1 kg) : 0.3 mg IM (0.03 mL).

Severe hemorrh agic disease: 1-10 mg IV slow push. Ne ofax2011 عضل ٢٠٠غزطاث بطزهجت اوطولين ٢٠ – ٥ ( ضم ٢/ مجم ٢٠)كوهاكيون

ا ببطء وريدضم ٢ ( ضم٩+ ضم ٢( )ضم٢/ مجم ٢٠)كوهاكيون مزجين اضبوع

IV infusion rate should not exceed 1 mg/min . Protect from light.


USES Prophylaxis and th erap y of hheemmoorrrrhhaaggiicc ddiisseeaassee ooff nn eewwbboorrnn . HHyyppoopprrootthhrroommbbiinneemmiiaa; s econdary to facto rs limiting absorption

or synthesis of vitamin K1. IInnffaannttss rreecceeiivv iinngg TTPPNN aanndd iinnffaannttss rreecc eeiivviinngg aannttiibbiioott iiccss ffoorr >> 22 wweeeekkss should b e given at least 0.5 mg of vitamin K1 (IM or IV)

weekly to prevent vitamin K d epletion.

MONITOR PT (wh en treat ing clottin g abnormali ties) after 2-4 h.

ADVERSE EFFECTS Pain and swellin g at IM site. Efficacy is d ecreased in liver disease.

Ineffective in hereditary hypoprothro mbinemia or

hypoprothrombinemia caused by s evere liver disease. MNC2012

Vitamin K1 may require 3h or more to stop active bleeding so FFP (10 mL/kg) may b e nec essary wh en bleeding is severe.

The dru g has no antagonistic effects against heparin.

L-Carnitine® (300 mg / ml Oral Liquid) or (1 g / 5 ml IV)

IV (included in TPN): Gomella2009 Starting dose of 10 mg/kg/day

PO: 25 mg/kg/dose Q6h.

Primary deficiency and organic acidemias: BNFC2011-12

PO: 50 mg/kg Q12h, higher doses up to 200 mg/kg daily occasionally required.

IVI: initially 100 mg/kg over 30 minutes followed by a continuous infusion of 4 mg/kg/h.

Slow IV injection over 2–3 minutes: 100 mg/kg/daily in 2–4 divided doses

USES L-Carnitine is used in the management of a range of rare genetic conditions associated with carnitine deficiency.

It is essential for the entry of long-chain fatty acids into the mitochondria, where they are oxidized.

ADVERSE EFFECTS Nausea, vomiting, abdominal pain and diarrhea. Fishy body odour Side-effects may be dose-related - monitor tolerance during first week and after any dose increase.

Lanoxin® Digoxin 500 μg / 2 mL 1

LD “Digitalization ”: G en eral ly used only when treatin g

arrhyth mias and acute CHF. Give o ver 24h as 3 divided doses IV slow push over 5-10 min.

Oral Doses: should be 25% greater than IV doses.

Don’t administer IM Ne ofax2011

طخكمل الى ... ( ضم ٤ +ضم ٢( )ضم ٢/ مكزوجزام ٥٠٠)الهوكضين أضعاف ٤.... )و

عطى ( ٪٥كمت الجزعت ج ت …/ ببطء غدد يدورو ضاـع

Infusion solution concentration 0.05 mg/mL .

.. ( ضم٢/ مكزوجزام ٥٠)الهوكضين شراب ين . وطول م ٢٠٠غزطت بطزهجت ا ـعت …/ بالف ـضا

Total Load ing Dose Mainten ance Doses PMA wks

IV μg/kg

PO μg/kg

PMA wks

IV μg/kg

PO μg/kg

Interval hours

≤ 29 15 20 ≤ 29 4 5 24

30-36 20 25 30-36 5 6 24

37-48 30 40 37-48 4 5 12 ≥ 49 40 50 ≥ 49 5 6 12

Divide into 3 doses over 24h Titrate based on clinical response

USES Heart f ailure caus ed by dimin ished myoc ardial contrac tility . SVT, atr ial flutter and AF.

MONITOR HR, Rhythm and Periodic ECG (to assess desired effects and signs of toxicity). Seru m K

+, Ca, Mg ( esp. with diuretics or amphotericin B) ; K

+,

Ca, M g predispose to toxicity .

Renal function. TThheerraappeeuutt iicc sseerruu mm lleevveell (1-2 ng/mL). Be aware of d rug interac tions.

Lanoxin® Digoxin 500 μg / 2 mL 2

ADVERSE EFFECTS / PRECAUTIONS Toxic Cardiac Effects: - PR interval prolongation. - Atrial or nodal ectopic beats.

- Sinus bradycardia or SA block. - Ventricular arrhythmias.

Non Toxic Cardiac Effects: - QTc interval shortening. - T-wave amplitude dampening

- ST segment sagging. - HR slowing.

Feeding intolerance, vomiting and diarrhea. Lethargy.

INTERACTIONS ACE Inhibitors: plasma concentration possibly by c aptopril. Analgesics: plasma conc entration possibly by NSAIDs, also

possible exac erbation of heart failu re and reduction of ren al function. Antib acterials: plasma conc entrat ion possibly by gentamicin and trimethoprim; plasma concentration possibly by rif ampicin ; plasma conc entrat ion by macrolid es ( risk of toxici ty).

Antiepileptics: plasma conc entration possibly by phenytoin. Ampho tericin : cardiac tox icity if hypokalemia occurs. Corticosteroids: risk of hypokalemia.

Diuretics: cardiac toxicity if hypokalemia occurs with

acetazolamid e, loop diuretics o r thiazides and related d iuret ics; plasma conc entrat ion by spironolacton e.

Lanzor®

Lanzoprazole 15 and 30 mg cap.

Dose: 0.73 - 1.66 mg/kg/dose PO Q24h. Neofax2011

ل ضم ... ( ضم ٤٠/ مجم ٢٥) كبطول الهـــسور ضاعت ٢٤/ بالزا

Solution concentration 0.375 mg/mL.

The contents of a capsule can be mixed in 40 mL of apple juice and administrated by NG tube. Do not use other liquids. The NG tube should be flushed with additional apple juice after administration. Neofax2011

USES Reflux esophagitis.

OOnnsseett ooff aaccttiioonn within 1h with dduurraattiioonn ooff aaccttiioonn of 72h.

MONITOR Symptomatic improvement within 3 days. Intra-esophageal pH monitor to assess efficacy (pH > 4.0). ALT, AST if duration of therapy > 8 wks.

ADVERSE EFFECTS Hypergastrinemia. Mild ALT, AST elevation.

Lasix® Furosemide 40 mg / 4 mL

1

Initial dose: 1 mg/kg IV slow push, IM or PO.

Maximum of 2 mg /kg/dose IV or 6 mg/kg/dose PO.

Initial intervals: PT Q24h – FT Q12h – FT > 1m Q6-8h

Consider alternate-day therapy for long term use. Neofax2011

ت ٢٢/ عضلأو وريد ٢٠٠غزطت بطزهجت اوطولين ... ( ضم٤/ مجم ٤٠)الزكط ـضاـع

ت ٢٢/ بالفم ٢٠٠ اوطولين غزطت بطزهجت... ( ضم ٢٠/ قزصمجم ٤٠)الزكط ـضاـع

Compatible with NS and sterile water for injection. Acidic solutions (pH < 5.5) as D 5W, D10W cause Lasix® to degrade when they are mixed for several hours.

Brands include: SSaalluurriinn®® 5 mg / 5 mL Syrup (not available in Egypt) The injectable solution may also be used for oral administration. Neofax2011 Controlled IVI is recommended for high-dose parenteral therapy. Compatible with NS, D5W, D10W, and sterile water for injection.

USES Diuretic that may also improve pulmonary function.

HEPATIC IMPAIRMENT K+ may precipitate coma (K+ sparing diuretics prevent this).

RENAL IMPAIRMENT May need high doses. Deafness and tinnitus may follow rapid IV injection.

MONITOR Urine output and weight changes. Serum and urine electrolytes and renal function periodically. Serum K+ at initiation, in patients receiving other diuretics or digoxin concurrently. Consider renal US for PT infants as furesmide may precipitate nephrocalcinosis/nephrolithiasis.

Lasix® Furosemide 40 mg / 4 mL

2

ADVERSE EFFECTS Water and electrolyte imbalances especially Na+, K+ and hypochloremic alkalosis. Risk for K+ is increased with brisk diuresis, inadequate oral intake,

presence of cirrhosis, concomitant therapy with corticosteroids, ACTH, or prolonged use of laxatives. May lead to increased hyponatremia and a significant rise in serum creatinine in patients receiving indomethacin for PDA closure. Hypercalciuria, renal calculi and development of bone demineralization (long term use). Ototoxic (tinnitus and reversible or irreversible hearing impairment); especially with rapid injection, severe renal impairment, higher than recommended doses, hypoproteinemia, or concomitant therapy with aminoglycosides or other ototoxic drugs. Cholestatic jaundice and Cholelithiasis (in PT infants receiving long-term TPN and lasix). Hypotension, fatigue, nausea and muscle cramps. Contraindicated in patients with anuria.

Lipovenös® Fat Emulsion 20% Starting Dose: 0.5 g/kg/day IVI

Increased By: 0.5 g/kg/day

Maximum 3 g/kg/day

Infusion rate: should not > 0.15 g/kg/h

24h infusion time is preferred. Neofax2011

(TPNضاف الي )ضم ... (ضم ٥/ جم ٢( )٪٢٠) ليبوفيىوش

USES Parenteral nutrition source of calories “2 kcal/mL” and essential fatty acids.

MONITOR Seru m triglyc erid es (< 200 mg/dL) Liver function test

Platelet count, G lucose, Bil irubin, Albumin

ADVERSE EFFECTS Hypertriglyc erid emia and hyp erglyc emia. Extravasat ion may cause tissue inflammation and n ecrosis.

Use minimum dose in s evere hyperbi lirubin emia, sepsis or severe pulmonary dysfunction.

Destabilization of lipid emulsions (flocculat ion and s eparation) may occur wh en th ey are co-infused with D ex/AA solutions containg c alcium and high concentration of h eparin (> 1 u/mL).

This may be d ecreased b y: - Minimizing th e contact time.

- Using low ( ≤ 1 u/mL) conc entrations of heparin. - Adding a multivi tamin preparation to th e Dex /AA solution.

Neofax2011

Magnesium Sulphate MgSO4 10% Resuscitation (Pulseless Torsade s): 25-50 mg/kg IV/intraosseous rapid infusion (over several minutes).

Hypomagnesemia:

25-50 mg/kg IVI over 30-60 min; repeat dose as necessary. For hypomagnesemia/torsades with pulses, an infusion time of 10 -20 min is

recommended.

Daily Maintenance Requirements (TPN): 0.25-0.5 mEq/kg/24h IVI. Neofax2011

In PPHN:

LD: 200 mg = 2 mL = 1.6 mEq/kg IVI over 20-30 min BNFC2011-12

MD: 20-75 mg= 0.2-0. 75 mL = 0.16 -0.6 mE q/kg/h IVI to maintain plasma-Mg

concentration between 8.5-13.4 mg/dL (3.5-5.5 mmol/L), given for up to 5 days. . ٪ ٠١ماغيضيوم صلفات ... ضم .. م ٪٥ضم ج + عت ورد ث على مدى هصف ضا

.. د/ ضم ٢بمعدل ٪ ٥ضم ج ٢٤ضم كمل حتى . لور لطاعت با ا

1 mL MgSO4 10 % = 100 mg Mg = 0.8 mEq Mg Compatibility with D5W, NS, LR, dobutamine, heparin sodium, insulin, milrinone,

morphine and KCl.

Incompatible with calcium chloride and NaHCO3

USE Torsades de pointes (polymorphi c ventricular tachycardia associated with long QT interval). Hypomagnesemia

PPHN ?!

MONITOR Monitor serum magnesium, calcium, and phosphate levels. Renal function (periodically). Infuse IV magnesium sulfate over several hours.

ADVERSE EFFECTS / PRECAU TIONS Hypotension and bradycardia (with rapid infusion). Flushing

Depression of reflexes Depressed cardiac function, CNS and respiratory depression.

Contraindicated in heart block, myocardial damage or renal failure.

Signs of hypomagnesemia include tetany, cardiac arrhythmia, decreased bone stability, apathy and increased susceptibility to epileptic seizures.

Maxical-D® Calcium Carbonate 150 mg / 5 mL Dose: 20-80 mg elemental Ca/kg/day PO in divided doses. Neofax2011

تاعض ٢٢/ رايلبال ضم... ( ضم ٥/ مجم ٢٥٠) ماكضيكال شراب

Each 5 mL contains: 150 mg elemental calcium, 173.25 mg magnesium and 100 IU Vit D3.

Each 2.5 mg Ca Carbonate contains: 1 mg elemental Ca.

Each 5 ml of Hi-Cal® contains: 1.2 gm calcium glubionate equivalent to 87 mg elemental calcium.

USE Non-acute hypocalcemia in babies able to tolerate oral medications (absorption in small intestine).

MONITOR Periodic serum Ca++ level. Assess GI tolerance. Assess serum phosphorous and vitamin D levels when indicated.

ADVERSE EFFECTS / PRECAUTIONS Gastric irritation and diarrhea (hypertonic). Use with caution in infants who are at risk for NEC. Interferes with absorption of levothyroxine.

Maxipime® Cefepime 1 g Vials

Dose: as table, IVI over 30 minutes, or IM. Neofax2011

ضاعت ٢٢/ على مدى هصف ضاعت وريدضم … ( ٪٥ضم ج٢٥/جم ٢) ماكضبيم

Infusion solution concentration 40 mg/mL (max. 160). Compatible with D5W, D10W, D5LR and NS.

.ضاعت ٢٢/ عضلضم … ( ضم ٤/جم ٢) ماكضبيم

IM solution concentration 250 mg/mL. Stable for 24h at room temperature and 7 days refrigerated.

DOSE Neofax2011 FT, PT ≤ 28 days 30 mg/kg Q12h FT, PT > 28 days 50 mg/kg Q12h Meningitis and severe infections with pseudomonas or enterobacter

50 mg/kg Q12h

USES G-ve organisms (e.g. E.coli, H.influenza, Enterobacter, Klebsiella, Morganella, Neisseria, Serratia and Proteus species), esp. Pseudomonas aeruginosa that is resistant to 3rd generation cephalosporins. G+ve organisms (e.g. Strep pneumonia, Strep pyogenes, Strep agalactiae and Staph aureus).

ADVERSE EFFECTS (UNCOMMON) Rash, Eosinophilia Diarrhea, Hepatic ALT, AST.

Meronem® Meropenem 500 mg / 100 mL Dose In Sepsis: 20 mg/kg/dos e IVI over 30 min

PT < 32 wks GA, ≤ 14 days PNA Q12h

PT < 32 wks GA, > 14 days PNA Q8h

PT ≥ 32 wks GA, ≤ 7 days PNA Q12h

PT ≥ 32 wks GA, > 7 days PNA Q8h

Dose in Meningitis and Pseudomonas Infection , all ages: 40

mg/kg/dose IVI over 30 min Q8h

ضاعاث ۸/ ضم ورد على مدى هصف ضاعت ... )ضم م م٢٠٠/مجم ٥٠٠( ميروهام


Longer infusion times (up to 4h) may be associated with improved therap eutic effic acy.

USES Pneumococcal meningitis and other G-ve organisms resistant to other an tibiotics, especially extended spectrum β –lactamase

producing Klebsiella pn eumoniae.

MONITOR Periodic CBC for eosinophilia, thrombocytosis. Assess IV sites for signs of inflammation. AST, AL T.

RENAL IMPAIRMENT Cr Cl 26-50 mL/min /1.73m

2 us e normal dose Q12h

Cr Cl 10-25 mL/min /1.73m2 us e half normal dose Q12h

Cr Cl < 10 mL /min/1.73m2 use h alf normal dose Q24h

ADVERSE EFFECTS / PRECAUTIONS Diarrhea (4%), nausea and vo miting (1%).

Rash (2%). Inflammation at injection site. Risk of pseudomembranous colitis and fungal infections

Minophylline® Aminophylline 250 mg / 10 mL

LD: 8 mg/kg IVI over 30 min or PO. Neofax2011

MD (8-12h Later): 1.5-3 mg/kg/dose PO or IV slow push Q8-12h.

.. ( ضم م م ٤+ ضم ٢( )ضم ٢٠/ مجم ٢٥٠) ميىوفيللين على مدى هصف وريدصم .

.. ثم ضاعت ث ۸/ ببطء وريد ٠١١شرطة لضرهجة أوضولين . ـعا ضا

Infusion sol ution concentration 5 mg/mL

ن م ٥.٩ +ضم ½ ( )ضم ٥/ مجم ٥٠٠) ميىوفيللي . ( ضم م . دضم . لوري ى هصف با على مد

.. ثم ضاعت ث ۸/ ببطء وريد ٠١١شرطة لضرهجة أوضولين . ـعا ضا

Infusion sol ution concentration 5 mg/mL Compatible with D5W, D10W and NS.

.. ( ضم ٥/ مجم ٥٠) ميىوفيللين شراب وطولين . بطزهجت أ زطت ث ۸/ رايلبال ٢٠٠غ ضاعا

If changing from IV aminophylline to PO theophylline, no adjustment.

USES Neonatal Apnea, including post-extubation and post-anesthesia and

prostaglandin E1-induced. Bronchodilator, may improve respiratory function.

MONITOR Heart rate (wwiitthhhhoolldd nneexxtt ddoossee iiff >> 118800 bbppmm). Periodic blood glucose. Agitation. Feeding intolerance.

Therapeutic level iinn aappnneeaa ooff pprreemmaattuurriittyy 7-12 μg/mL and iinn bbrroonncchhooss ppaassmm 10-20 μg/mL.

ADVERSE EFFECTS GI irritation. Hyperglycemia. CNS irritability and sleeplessness. Renal calcifications when used with Lasix® and/or dexamethasone.

TOX ICITY Signs: sinus tachycardia, failure to gain weight, vomiting, jitteriness, hyperreflexia and seizures.

Treatment: activated charcoal 1 g/kg by gavage tube Q2-4h. Avoid sorbitol-containing preparations; may cause osmotic diarrhea.

Milrinone Primacor® 1 mg / mL LD: 75 µg/kg IVI over 60 min, immediately followed by …

Neofax2011

MD: 0.5-0.75 µg/kg/min.

Adjust infusion rate based upon hemodynami c and clinical response.

Premature infants < 30 weeks GA:

LD: 135 µg/kg IVI for 3h, immediately followed by …

MD: 0.2 µg/kg/min Neofax2011

ى ( ضم٤٩+ ضم ٢( )ضم٢/مجم٢) بريماكور ى مد د عل ة ٠٤وري عالط/ضم ...بمعدل صاع ت ا

دل الى ملدة صاعة لطاعت/ كجم / ضم ٢٥.٢ – ٥.٢ثم حع ا

ى ( ضم٤٩+ ضم ٢( )ضم٢/مجم٢) بريماكور ى مد د عل ة ٠٤وري . بمعدل صاع عالط/ضم.. ت ا

عت/ كجم / ضم ٦.٠ثم حعدل الى اتصاع ٣ملدة الطا

Maximum concentration for infusion 200 µg/mL.

Compatible with dopamine, dobutamine, epinephrine, fentanyl, heparin, insulin, calcium chloride, calcium gluconate, KCl, NaHCO3, D5W, NS and LR. Incompatible with Lasix®.

USE Short term (<72h) treatment of acute low cardiac output after cardiac

surgery or due to septic shock.

- Improves myocardial contractility without oxygen requirements

(unlike catecholamines)

- Enhancing myocardial diastolic relaxation

- Vascular resistance

MONITOR Continuous monitoring of BP, HR and rhythm. Cardiac output. Fluid and electrolyte changes and renal function.

Platelet count.

ADVERSE EFFECTS / PRECAU TIONS Assure adequate vascular volume before therapy.

BP will fall 5-9% after LD but will gradually to baseline by 24h. HR by 5-10% (common). Thrombocytopenia. Arrhythmia (occasionally).

Morphine Sulphate (10 mg /mL) Dose: 0.05-0.2mg/kg/dose IV over at least 5 minutes, IM or SC repeat as required, usually Q4h. Neofax2011 IVI: LD 100-150 µg/kg over 1h followed by 10-20 μg/kg/h. Opioid dependence: begin at most recent IV morphine dose equivalent. Taper to 10-20% per day as tolerated. PO dose is ~ 3-5 times IV dose. Neofax2011 Initial treatment of neonatal narcotic abstinence: 0.03-0.1 mg/kg/dose PO Q3-4h. Wean dose by 10-20% every 2-3 day based on abstinence scoring (the Finnegan score should be <9). Use the 0.4 mg/mL oral morphine solution. Neofax2011

. ( ضم٥.٩+ ضم ٥.٠)( ضم/ مجم ٢٠) مورفين بأمز الطببضاعاث ٤/ ددغ ببطء وريدضم ..

Infusion solution concentration 0.5 mg / mL. .. ( ضم/ مجم ٤.٠) مورفين شراب الفمضم . ضاعاث ٤/ ب

A 0.4 mg/mL oral morphine solution may be made by adding 0.4 mL of concentrated injectable solution to 9.6 mL of NS. Stable for 7 days refrigerated and protected from light. Neofax2011 For continuous infusions of morphine containing heparin: use only NS; mmaaxxiimmuumm mmoorrpphhiinnee ccoonncceennttrraattiioonn 5 mg/mL.

USES Analgesia, sedation. Treatment of opioid withdrawal and abstinence

MONITOR Respiratory and cardiovascular status. Abdominal distension, loss of bowel sounds Consider urine retention if UOP is decreased

ADVERSE EFFECTS Naloxone should be readily available to reverse adverse effects Respiratory depression ( responsiveness of the RC to CO2 tension) Hypotension and bradycardia Transient hypertonia Ileus and delayed gastric emptying Urine retention Tolerance – wean slowly

Motinorm® Domperidone 5 mg / 5 mL

Dose: 0.1-0.3 mg/kg/dose Q4-6h PO 15 min before feeds BNFC2011-12

ب موثيىورم .. ( ضم ٥/ مجم ٥) شرا عت بالفم ضم . ثضاعا ٦/ قبل الزضاعت بزبع ضا

USES

Management of severe gastro-esophageal reflux.

Mucosolvan® Solution for oral or inhalation use

Ambroxol hydrochloride 15 mg / 2 mL

Dose: 1.2-1.6 mg/kg/d ay (4-5 drops/kg/day) P O or inh alation .

.. ( ضم ٢/ مجم ٢٥)ميوكوصولفان لـفم هقطت . عت ٢٢/ با ضا

. (ضم ٢/ مجم ٢٥)ميوكوصولفان طت .. ضاعت ٢٢/ هبـيوالـيسر ضم م م ٢+ هق

1 mL = 25 drops

USES Mucokinetic and secretolytic.

Mycostatin® Nystatin 100.000 U / mL

PO: 1 mL (PT) to 2 mL (FT) divided and applied with swab to each side of mouth Q6h. Continue for 3 days after symptoms have subsided.

Topical: Apply Q6h. Continue for 3 days after symptoms have subsided.

Prophylaxis: 1 mL PO or via oro/nasogastric tube 3 times per day. Neofax2011

ضاعاث ٦/ ـضم مسحت بالـفم ٢-٢( ضم/ وحدة ٢٠٠٠٠٠) ميكوصتاثين قطارة

ث ٦/ دهان مكان الحفاظ ( جم/ وحدة ٢٠٠٠٠٠) ميكوصتاثين بيبي كريم ضاعا

USES Mucocutaneous candida. Prophylaxis against invasive fungal infections in high risk VLBW infants.

MONITOR Response to drug.

ADVERSE EFFECTS / PRECAUTIONS Skin rash caused by vehicle in cream/ointment.

Narcan® Naloxone 0.4 mg / mL Dose: 0.1 mg/kg IV push or IM, if adequate perfusion. Neofax2011

ــــه عضل وأ ريدو ٢٠٠غزطت بطزهجت اوطولين ... ( ضم ٢/ مجم ٤.٠) اركانـ

(لكل كجم ٢٠٠غزطت بطزهجت اوطولين ٢٥)

Doses needed to reverse narcotic induced depression may be as low as 0.01 mg/kg. Tracheal administration is not recommended. Store at room temperature and protect from light.

USES Narcotic antagonist (onset within minutes after IV dose and within 1h, if given IM). Adjuvant therapy for customary resuscitation efforts for narcotic-induced respiratory (CNS) depression.

MONITOR Respiratory effort Neurologic status

ADVERSE EFFECTS No short-term toxicity reported.

Nebcin® Tobramycin 80 mg / 2 mL

Dose: as table. IVI over 30 min. Neofax2011

كمل حتى ... ( ضم م م ٩+ ضم ٢) (ضم ٢/ مجم ۸٠) هبضين ضم م م ٢٠ضم

ت/ ... ورد على مدى ضاعت ضاعــ


ــــثوب اثــضاع ٤ ين كلــزة للعـــقط ٪٣.١ (بريكطثو )ري

ــــثوب ـضاع ۸ين كل ــم للعـــمزه ٪٣.١ (ثوبريكط)ري اثـTobrin® or Tobrex® 0.3% Ophthalmic use: instill 1-2 drops i nto each eye Q4h or more often if severe infe ction, or apply a small amount of ointment

into each eye 2-3 times/day or for severe infections Q3-4h.

PMA (wks) Postnatal (d) Dose (mg/kg) Interval (h)

≤ 29 * 0-7 8-28

≥ 29

5 4

4

48 36

24

30-34 0-7

≥ 8

4.5

4

36

24

≥ 35 All 4 24 * or significant asphyxia, PDA or ttt with indomethacin.

USES Aerobic G-ve Bacilli (e.g. Pseudomonas, Klebsiella, E.coli). Usually combined with a β-lactam antibiotic (in separate infusion).

THERAP EUTIC SERUM C ONCEN TRATIONS Peak: 5-12 μg/mL Trough: 0.5-1 μg/mL

ADVERSE EFFECTS Transient and reversible renal tubular dysfunction ( urinary loss of Na, Ca,

and Mg). Vestibular and auditory ototoxicity (irreversible). Increased neuromuscular blockade when used with pancuronium and in patients with hypermagnesemia.

Neomaint Solution Contents per 1000 mL

Glucose 120 gm/L

NaCl 1.7535 gm/L KCl 0.7445 gm/L

K 10 mEq/L

Na 30 mEq/L Cl 40 mEq/L

Osmolarity 746.7 mOsm/L

Neupogen® (Filgrastim 300 µg/mL)

Granulocyte Colony-Stimulating Factor (G-CSF) Dose: 10 µg/kg/dose SC once a day BNFC2011-12

/ جحت الجلد ٢٠٠غزطت بطزهجت اوطولين ... ( ضم/ مكزوجزام ٣٠٠) هيـبوجين

ضاـعت ٢٤

كزوجزام ٣٠٠) هيـبوجين الى وجضاف ٢٠٠غزطاث بطزهجت اوطولين ... ( ضم/ م

الطاعت / ضم ٢٠بمعدل ورد على مدى هصف ضاعت ٪ ٥ ضم ج ٢٠

For subcutaneous or IVI, dilute with Glucose 5% to a concentration

of not <15 μ g/mL; to di lute to a conc entrat ion of 2 –15 μg/mL, add albumin to produce a final albumin solution of 2 mg/mL; not

compatible with NaCl solutions. BNFC2011-12

Brands inc lude Geneleukim®

USES Filgrastim has been used to treat sepsis -induced neutrop enia in preterm neon ates. There is no clear evid ence that G-CSF imp roves survival or long-term outco mes.

Monitor CBC and Neutrophil Count. Discontinue if WBCs count exc eeds 50 X 10

9/L.

BNFC2010-11

ADVERSE EFFECTS (UNCOMMON) Fever Vomiting

,

Noradrenaline Levophrine® 4 mg / 4 mL amp.

Dose: 0.05-0.1 μg/kg/min , titrate to desired effect ; max . dose 1-2

μg/kg/min. MNC2012

Dose: 0.02-0.1 μg/kg/min IVI adjusted according to response; max . 1

μg/kg/min. BNFC2011-12

د على مدى ( ٪٥ضم ج ٢٨+ ضم ٢( )ضم ٤/ مجم ٤) هورادريىالين ضاعت ٢٤ور

الطاعت/ ضم ... بمعدل

Infusion Solu tion Concentration 0 .1 mg/mL

Dilute in D5W (dilution in N S is not reco mmended). Infuse throu gh CVC.

MNC 2012

Incomp atible w ith bicarbonate or alkal ine solutions.

1 mg of noradrenalin e acid tartrate is equivalent to 500 micrograms of the base. Dose expressed as the b ase.

USES Treatment of shock that p ersists after adequ ate fluid vo lume

replac ement ; severe hypotension; card iogenic shock. MNC2012

Acute hypotension (septic shock) or shock secondary to excessive vasodilation.

Monitor HR, UOP and peripheral p erfusion.

Blood pressure.

ADVERSE EFFECTS/PRECAUTIONS Blood/volume depletion should be corrected , if possible, before norepinephrine th erapy.

Extravasat ion may cause s evere tissue nec rosis. Hypertension. Bradycardia and arrhythmias.

Peripheral isch emia Contraiond icated with p eripheral o r mesenteric vascular thrombosis

(ischemia may be increased and th e area of infarct ex tend ed). MNC2012

NuTriVene-D® Cap. Daily Supplement

Dose: as table. Divid e dosage and administer P O 2-3 times p er d ay.

Weight Dose < 20 lbs < 9 kg 2 Cap.

21 – 40 lbs 10 – 18 kg 4 Cap.

41 – 60 lbs 19 – 27 kg 6 Cap.

61 – 80 lbs 28 – 36 kg 9 Cap.

> 80 lbs > 37 kg 12 Cap.

USES Trisomy 21.

INGREDIENTS (Per 12 Cap.) Total fat < 1 g Vit. A (Mixed Carotinoids) 3000 iu

Vit. A (Palmitate) 5000 iu Vit. D3 (Cholecalciferol) 300 iu

Vit. E (Succinate) 400 iu Biotin 200 μg

Folic acid 400 μg Folinic acid (Folinate) 400 μg

Niacinamide 125 mg Pantothenic acid 45 mg

Vit. B1 45 mg Vit. B12 (Cyanocobalamin) 90 μg

Vit. B2 (Riboflavin) 45 mg Vit. B6 (Pyridoxine) 35 mg

Vit. C (Na Ascorbate) 1000 mg Calcium (Citrate) 100 mg

Chromium (Cl) 75 μg Iodine (K Iodide) 7 μg

Mg (Oxide) 150 mg Mn (Gluconate) 1.5 mg

Molybdenum 75 μg K (KCl) 15 mg

Selenium 90 μg Zinc 30 mg

Acetyl-L -Carnitine 45 mg Choline Bitartrate 800 mg

L-Citrulline 70 mg L-Glutathione (reduced) 150 mg

L-Histidine 25 mg Alpha-Keto glutaric acid 500 mg

L-Methionine 150 mg L-ornithine 100 mg

L-Proline 100 mg L-Serine 150 mg

L-Tryp tophan 50 mg L-Tyrosine 100 mg

Betaine 500 μg Bioflavonoids 150 mg

Blue berry Powder 150 mg Bromelain 5 mg

Coenzyme 30 mg Curcumin 150 mg

Lutein 6 mg Lycopene 6 mg

Meso. Insositol 75 mg Paba 75 mg

Papain 5 mg R-Lipoic acid 25 mg

Tau rine 200 mg

NuTriVene-D® Cap. Daily Enzyme Formula

Dose: as table. Administer PO 3 times per day.

Weight Dose Infants to 15 lbs <6.8 kg ¼ Cap.

15 – 25 lbs 6.8 – 11.3 kg ⅓ Cap.

25 – 35 lbs 11.3 – 15.9 kg ½ Cap.

35 – 50 lbs 15.9 – 22.7 kg ⅔ Cap.

50 – 70 lbs 22.7 – 31.3 kg ¾ Cap.

70 – 100 lbs 31.3 – 45.3 kg 1 Cap.

> 100 lbs > 45.3 kg 1 – 1⅓ Cap.

USES Trisomy 21.

INGREDIENTS (Per 1 Cap.) Lipase 25 mg

Lactase 1 mg

Cellulose 1 mg

Alpha-Amylas e 25 mg

Orelox® Cefpodoxime 40 mg / 5 mL susp. Dose in infants 15 d - 6m: 4 mg/kg/dose PO Q12h.

BNFC2011-12

ضــاعت ٢٢/ ضم بالـفم ... ( ضم ٥/ مجم ٤٠) شراب أوريلوكط

USES Upper respiratory tract infect ions (but in pharyngitis and tonsillitis reserved for infect ions which are recurrent , chronic, or

resistant to oth er antibacterials). Lower respiratory tract inf ections (including bronchitis and

pneumonia). Skin and soft tissue inf ections. Uncomplicated urinary tract infec tions.

RENAL IMPAIRMENT GFR 10-40 mL/min/1.73m

2 dos e interval to Q24h.

GFR <10 mL /min /1.73m2 dose interval to Q48h.

ADVERSE EFFECTS Most Frequent: Seru m Sickn ess, Vulvovagin al Candidiasis.

Less Frequent: Abdominal Pain with Cramps, Diarrhea, Nausea, Oral Candidiasis,

Vomiting.

Rare: Allergic Reactions, Anaphylaxis, Angio ed ema, Drug Fever,

Eryth ema, Erythema Multiforme, Hemolytic Anemia, Hypoprothrombinemia, Pruri tus of Sk in, Pseudo membranous Enterocol itis, R enal Diseas e, Seizure Disord er, Skin Rash, Stevens-

Johnson Syndrome.

Storage Keep suspension in th e frid ge for up to 10 days after reconstitution.

Pediamaint Solution Contents per 1000 mL

Glucose 100 gm/L NaCl 2.164 gm/L KCl 1.49 gm/L Ca Gluconate 4 gm/L

K 20 mEq/L Na 37 mEq/L

Penicillin G Sodium® Benzylpenicillin 1,000,000 units Vial

Meningitis: 75,000 to 100,000 units/kg/dose IVI over 30 min or IM

Bacteremia: 25,000 to 50,000 units/kg/dose IVI over 15 min or IM Neofax2011

GBS infections: 200,000 units/kg/day for bacteremia and 500,000 units/kg/day for meningitis, in divided doses at more frequent intervals.

Congenital Syphilis: 50,000 units/kg/dose IVI over 15 min Q12h for 1 st 7 days of life then Q8h thereafter, irrespective of GA. Treat for 10 days.

ون وحدة)بيضيللين ج مائي . ( ضم م م ٥.٤+ ضم ½( )ضم م م ٢/ مل ضم م ٢٠ضم كمل حتى ..

عت رم و ضاـعت ٢٢–۸/ د على مدى هصف ضا

Na content is 2 mEq per 1 million units (600 mg). Infusion solution concentration 50,000 units/mL. Compatible with D5W, D10W and NS.


≤ 29 0-28 >28

12 8

30-36 0-14 >14

12 8

37-44 0-7

>7

12

8 ≥ 45 All 6

USES Congenital $, gonococci, streptococci (non enterococcal).

MONITOR Serum Na+ and K+ when using high doses with RF. Observe IV site for signs of extravasation.

ADVERSE EFFECTS Cardiac arrest (with high doses infused rapidly). BM depression, granulocytopenia. Hepatitis. Hypersensititvity has not been seen in neonates.

Phentolamine Rogitine® 10 mg / 1 mL

1-5 mL of a 0.5 mg/mL solution is injected SC into affected area (depending on the size of the infiltrate).

جحت الجلدضم ... (ضم٩+ ضم ½( )ضم ٢/ مجم ٢٠) ينجيترو

Solution concentration 1 mg / mL.

Don’t exceed 0.1 mg/kg o r 2.5 mg total . Brands inc lude Rogitamin e®

USES Alpha-blocker agent us ed for prevent ion of dermal n ecrosis and sloughing caused by extravasation of vasoconstrictive agents e.g.

dopamine.

MONITOR Assess affected area for revers al fo ischemia. Blood pressure.

ADVERSE EFFECTS / PRECAUTIONS Hypotension (if very large dose is used).

Consider using top ical 2% nitroglycerin ointment if affected extremity is significant ly swollen.

Polyvit® Drops Vitamin Per 1 mL (20 drops) A 10.000 IU D 2.000 IU (100/drop) E 2 mg C 25 mg Thiamine (B1) 25 mg Riboflavin (B2) 1 mg Nicotinamide (B3) 20 mg Pyridoxine (B6) 3 mg

ضاعت٢٤/ هقط بالفم أو بالزال ... بولي فيت

Polyvital® Drops Vitamin Per 1 mL A 5000 iu D3 300 iu E 2.5 mg C 60 mg Thiamine (B1) 1.5 mg Riboflavin (B2) 1.7 mg Nicotinamide (B3) 19 mg Pyridoxine (B6) 2.2 mg

Medical Management of Persistent Cholestasis

Clinical Impairment Management

Malabsorption of dietary long-chain triglycerides

Replace with dietary formula or supplements containing medium-chain triglycerides

Fat-Soluble Vitamin Malabsorption: Vitamin A deficiency (night blindness, thick skin) 10,000–15,000 IU/day as Aquasol A

Vitamin E deficiency (neuromuscular degeneration)

Replace with 50–400 IU/day as oral α -tocopherol or TPGS

Vitamin D deficiency (metabolic bone disease )

5,000–8,000 IU/day of Vit-D2 or 3–5 μg/kg/day of 25-hydroxycholecalci ferol

Vitamin K deficiency

(hypoprothrombine mia) 2.5–5.0 mg every other day as water-

soluble derivative of menadione

Micronutrient deficiency Calcium, phosphate, or zinc

supplementation Deficiency of water-soluble vitamins

Twice the RDA

Retention of Biliary Constituents such as Cholesterol:

Itch or Xanthomas Choleretic bile acids and

ursodeoxycholicacid, 15–20 mg/kg/day

Progressive Liver Disease; Portal Hypertension: Variceal bleeding, Ascites and

hypersplenism Interim management (control bleeding;

salt restriction; spironolactone)

End-Stage Liver Disease: Liver failure Transplantation

TPGS, D-tocopherol polyethylene glycol 1000 succinate , RDA, recommended

daily allowance

Potassium Chloride (KCl 15%)

Initial o ral replacement therapy: 0.5-1 mEq/kg/day divided and

administrated with f eedin gs. Acute treatment of sympto matic hypo kalemia: b egin with 0.5-1

mEq /kg IV over 1 hour th en reassess. Neofax2011

(او املحالل TPNضاف الي )ضم ... ( ٪٢٥) بوثاصيوم كلورايد

The injectable form may b e given in divid ed doses PO and diluted in the infant ’s formula.

Gome lla2009

Maximu m Peripheral IV solution concentration 40 mEq/L . Maximu m Central IV solution concentration 80 mEq/L .

Potassium M® 165 mg / 5 mL ضاعاث ۸/ مع الزضاعت بالفمضم ... ( ضم ٥/ مجم ٢٦٥)بوثاصيوم شراب

Each 5 mL contains about 2.2 mEq K+

1 mEq K+ = 74.6 mg KCl (0 .5 mL KCl 15%)

MONITOR Seru m K

+ and renal function.

Continuous ECG monitor (if IVI) .

Check IV site for extravasation and assess GI toleranc e.

ADVERSE EFFECTS / PRECAUTIONS AArrrrhhyytthh mmiiaass (peaked T- waves, wid ened QRS, flatten ed P waves, bradycardia, h eart block and cardiac arrest).

Thrombophlebitis and pain at site of infusion. GI irri tation (diarrh ea, vo miting, and bleedin g) divid e dose and

administer with feeding.

Use with caution (if at all) in patients rec eiving K+-sparin g

diuretics e.g. spironolacton e.

Effects of K+ include neuromuscular weakn ess, paralysis, ileus,

urine retention, EECCGG cchh aannggeess ( ST d epression, low voltage T-wave, appearanc e of U wave) and digitalis toxicity .

Prostigmine® Neostigmine 12.5 mg / 5 mL

Myasthenia gravis: 0.1 mg IM. Given 30 min before feeding. 1 mg PO (Given 2h before feeding). Dose may be increased.

Reversal of neuromuscular blockade: 0.04-0.08 mg/kg IV. In addition to atropine 0.02 mg/kg. Neofax2011

غزطت بطزهجت ... ( ضم ماء مقطز ٤+ ضم ٢( )ضم ٥/ مجم ٥.٢٢) بروصتيجمين

ورـيد ٢٠٠اوطولين

Infusion solution concentration 0.5 mg/mL (1:2000).

USES Neonatal transient or p ersistent (congenital) myasth enia grav is Reversing effects of neuro muscular blocking drugs.

Monitor Respiratory and C ardiovascular status.

ADVERSE EFFECTS Contraind icated with urinary or intestinal obstruction, bradycardia

or hypotension. Use cautiously in patients with bronchospasm or arrythemia. Muscle weakn ess, tremors

Bradycardia, hypotension Respiratory dep ression, bronchospasm

Diarrhea and exc essive sal ivation .

Prostin-VR® Prostaglandin E2 500 μg / mL 1

Initial Dose: 0.05-0.1 μg/kg/min IVI.

Titrate to response - oxygenation versus adverse effects

MD: as lo w as 0.01 μg/kg/min IVI.

May be given via UAC position ed near ductus arter iosus. Neofax2011

Initial Dose: 0.05 μ g/kg/min.

MD: 0.01-0.4 μg/kg/min.

Higher doses are not likely to produc e addition al ben efits and

have a high er incid ence of side effects. MNC2012

. ( ضم ٢/ مكزوجزام ٥٠٠) بروصتين زطت بطزهجت أوطولين .. د ٪٥ضم ج ٢٤+ ٢٠٠غ ـ ور

بمعدل ت ق الطزهجت الكهزب .. عن طز عت /ضم . الطا

Volume of drug needed per day =

is added to 24

mL D5W or NS and given as IVI at a rate of 1 mL /h.

Minimu m Infusion solution concentration 10 μg/mL.

Maximu m Infusion solu tion concentration 20 μ g/mL. Must be refr igerated. Prep are fresh infusion solutions every 24h. Compatible with dopamin e, dobutamin e, epin ephrin e, L asix

®,

heparin , mid azolam, fentanyl and KCl. Compatible with D5 W and NS.

USES Promote dilatation of ductus arteriosus in inf ants with CHD

depend ent on ductal shunting for ox ygenation /perfusion. Maximum effect s een within 30 min in c yanotic lesions, may take

several hours in acyanotic lesions.

Monitor Respiratory and C ardiovascular status. Improvement in oxygen ation.

Ensure reliable IV access. Temperature.

Infusion site for extravasation and tissue nec rosis.

Prostin-VR® Prostaglandin E2 500 μg / mL 2

ADVERSE EFFECTS Be prepared to intubate / resuscitate .

Extravasat ion may cause tissue sloughing and necrosis. Common (6-15%):

- AAppnneeaa (consider t reatment with aminophylline) , seen most often in n eonates < 2kg at birth and usual ly appears during th e 1

st h of drug infusion.

MNC2012

- Hypotension, cutan eous flushing and bradyc ardia. - Fever and leu kocytosis. - Hypokalemia with long term therapy ( > 20 days), especially

with doses > 0.05 μg/kg/min . - Gastric outlet obstruction and reversible cortical proliferatio n

of long bones after prolonged ttt (> 120h). Uncommon (1-5%): - Seizures.

- Hypoventilation. - Tachyc ardia.

- Cardiac arrest. - Edema. - Sepsis, diarrhea and DIC .

Rare ( <1%): - Urticaria and bronchospasm.

- Hemorrh age. - Hypoglycemia and hypocalc emia. Musculoskeletal ch anges:

- Widen ed fontanels - Pretibial and soft tissue swel ling of the extremities may occu r

after 9 d ays of therapy. - Cortical hyperostosis and periostitis may occur with long term

use (> 3 months).

- These chan ges resolve over weeks after discontinuation of therap y.

Protam® Protamine Sulfate 10 mg / mL Dose according to time since last heparin dose given:

<30 min: 1 mg / 100 units of heparin given.

30-60 min: 0.5-0.75 mg / 100 units of heparin given

60-120 min: 0.375-0.5 mg / 100 units of heparin given

>120 min: 0.25-0.375 mg / 100 units of heparin given

Maximum dose: 50 mg

IV Infusion rate should not exceed 5 mg/min. Neofax2011 Compatible with D5W and NS.

USES HHeeppaarriinn aannttaaggoonniisstt (combines ionically with heparin to form a stable complex devoid of anticoagulant activity).

MONITOR Vital signs Clotting functions Blood pressure (continuously). Bleeding

ADVERSE EFFECTS / PRECAUTIONS Excessive doses can cause serious bleeding problems (protamine is an anticoagulant when given alone). Hypotension, bradycardia, dyspnea, and transitory flushing (in adults).

Pulmicort® Respules Budesonide 0.5 mg / mL

BPD with assisted ventilation by aerosol inhalation:

0.4 mg twice daily. BNFC2011-12

BPD with spontaneous respiration by inhalation of

nebulizer suspension: 0.5 mg twice daily. BNFC2011-12

صاـعة ٠٠/ صم م م ٠+ صم ... ( صم/مجم ½)بلمكورث هبوالشر

USES May prevent or treat ventilator-induced chronic lung disease. Postnatal steroid treatment should only be considered in babies who are ill and ventilator dependent more than a week after birth.

Rifampicin Rifocin® 250 mg / 3 mL or Rimactane® 2% Dose: 5-10 mg/kg/dose IVI over 30 min Q12h

Ne ofax2011

.. ( ٪٥ضم ج ٢٤+ ضم ٢()ضم ٣/ مجم ٢٥٠)ريفوصين لورد . ى ٢٢/ با عت على مد ضا

ـعت هصف ضا

Don’t ad minister IM or SC. Compatible with D5 W and NS.

Dose: 10-20 mg/kg/dose PO Q24h. Ne ofax2011

May ad minister with feedings.

ضاـعت ٢٤/ بالفم ... ( ضم ٥/ مجم ٢٠٠)شراب ريمكتانProphylaxis for high risk contacts

of invasive N. meningitidis 5 mg/kg/dose PO Q12 for 2d

ومين ٢٢/ بالفم ... ( ضم ٥/ مجم ٢٠٠)شراب ريمكتان ضاـعت ملدة Prophylaxis for high risk contacts

of invasive H. influenza type b 10 mg/kg/dose PO Q24 for 4d

ام ٤ضاـعت ملدة ٢٤/ بالفم ... ( ضم ٥/ مجم ٢٠٠)شراب ريمكتان أ

USES Used in combination with vancomycin or aminoglycosid es for ttt of persistent staphylococcal inf ection.

Prophylaxis against N. men ingitidis and H. influenzae type b.

MONITOR AST, AL T and bili rubin. CBC for thrombocytop enia. IV sites for phlebitis.

ADVERSE EFFECTS / PRECAUTIONS Orange/red discoloration of body secretions. Extravasat ion may cause local i rritation and inflammation . Potent CP450 enzyme inducer; Eff ect of aminophyllin e,

fluconazole, midazolam, morphine, phenobarbital, phen ytoin, propranolol and zidovudin e.

HEPATIC IMPAIRMENT Avoid use or don’t exc eed 8 mg/kg daily

Ringer’s Lactate Lactated Ringer’s is a solution that is isotonic with blood and intended for IV administration.

Contents:

Na 130 mEq/L K 4 mEq/L

Ca 2.7 mEq/L

Bicarbonate (as lactate) 28 mEq/L Cl 108.7 mEq/L

Osmolarity 273mOsm/L

Rocephin® Ceftriaxone 0.5 - 1 g Vials

In Sepsis: 50 mg/kg Q24h IVI over 30 min, or IM.

In Meningitis: 100 mg/kg LD then 80 mg/kg Q24h. Neofax2011

In Disseminated gonococcal infection: 25-5 0 mg/kg Q24h IVI over 30 min,

or IM in a single daily dose for 7 days with a duration of 10 -14 days i f meninigitis is documented.

Gonococcal Infection, Prophylaxis: 25-50 mg/kg (maxi mum 125 mg) IVI or IM single dose.

In Uncomplicate d Gonococcal Ophthalmia: 25-5 0 mg/kg (maximum 125 mg) IVI or IM single dose.

Neofax2011

د روصفين مقطز ٢٠/ جم ٢) وري .. ( ضم ماء عت ضم ورد. هصف ضا .ضاعت ٢٤/ على مدى

Infusion sol ution concentration 100 mg/mL.

Compatible with D5W, D10W and NS.

. ( ضم ٢/ جم م ٥٠٠) عضل روصفين عت ٢٤/ عضلضم .. .ضا

IM solution concentration 250 mg/mL.

Max. IM solution concentration 350 mg/mL. MNC2012 Brands Include Ce fotrix® (250, 500, 1000 mg vials)

USES Neonatal sepsis and meningitis by G-ve organisms (e.g. E. coli, Pseudomonas, Klebsiella, H. influenza).

Gonococcal infections.

MONITOR CBC.

Serum electrolytes, BUN and creatinine.

AST, ALT and bilirubin. Consider abdominal US.

ADVERSE EFFECTS / PREC AU TION S Not recommended for use with hyperbilirubinemia; it displaces bilirubin from albumin binding sites.

Concurrent use of Ca-Contai ning solutions or products is contraindicated within 48h of the last administration of ceftriaxone. Eosinophilia, thrombocytosis and leuckopenia. Rash, Bleeding time.

Diarrhea, transient GB precipitations (± colicky abdominal pain, nausea and vomiting), AST, ALT.

BUN and serum creatinine.

Sandostatin® Octreotide 0.1 mg / mL amp.

For hyperinsuline mic hypo glycemia: Initially 1 µg/kg/dose Q6h SC or IV. Tit rate upward to desired effect . Initial response should

occur within 8h; tachyphylaxis may occur within several d ays. Maximu m dose: 10 µg/kg/dose Q6h.

Ne ofax2011

For chylothorax : Init ially 1 µg/kg/h IVI. Tit rate up ward as necessary based on reduction in chyle production; dosage

increas es of 1 µg/kg/h Q24h have been used. Maximu m dose: 10 µg/kg/h.

Neofax2011

دوصتاثين . ( ضم ٢/ مجم ٢.٠ ) صاه ولين لدثحت الجغزطت .. ثضاع ٦/ ٢٠٠بطزهجت اوط ا

Compatible with D5 W and NS. For SC injection, use undiluted drug. For IVI, dilute to 10-25 µg/mL .

Ne ofax2011

USES Refracto ry hyp erinsulinemic hypoglycemia. Adjunctive treatment of congenital and post-operative chylothorax.

MONITOR Blood glucose. Signs and sympto ms of NEC.

ADVERSE EFFECTS / PRECAUTIONS Vomiting, diarrhea, abdomin al distension and steato rrhea. Pulmonary hyp ertension (in PT with CLD).

Hyperglycemia in patients treated for chylothorax. NEC has been reported in term neonates.

Salbutamol® Albuterol Ventolin® Farcolin® 5 mg / mL

Salamol® 5 mg / 2.5 mL

Dose: 0.1-0.5 mg (0.02-0.1 mL)/kg/dose Q2-6h via nebulizer .

PO: 0.1-0.3 mg/kg/dose Q6-8h. Ne ofax2011

For Hyperkale mia: 0.4 mg (0.08 mL) /kg/dose Q2h via nebulizer.

.اثضاع ٦( / ضم م م ٢+ غزطت( ) ... ضم٢/ مجم ٥) صالبيوثامول هبيواليسر

A 0.1 mg/mL dilution for inhalation c an be made b y addin g 0.5

mL of SSaallbbuuttaammooll®® (5mg/mL) to 24.5 mL of NS. Label for inhalation only . Stable for 7 days refrigerated.

Modif ied fr om Neofax2011

.ضاعاث ٨ - ٦/ بالفم ضم ... ( ضم ٥/ مجم ٢) فىتولين شراب

Well absorb ed after PO. OOnnsseett ooff aaccttiioonn is 30 min; dduurraattiioonn ooff

aaccttiioonn is 4-8h. Toleranc e may d evelop.

USES Bronchodilator.

Hyperkalemia.

MONITOR Degree of bronchospasm. Continuous ECG monitor. Stop if HR > 180 bpm.

Seru m K+.

ADVERSE EFFECTS Tachyc ardia, arrhythmia.

Tremor. Hypokalemia (drives K

+ intrac ellularly).

Irritable b ehavior.

Simethicone® 2% Activated Dimethicone drops or emulsion Dose: 21 mg with or after each feed (max. 6 doses in 24h); may be add ed to bottle feed

ضاعاث ۸-٤/ ضم بالفم بعد الزضاعت ٢ هقط ٪٢ضامثكون

Dentinox® Colic Drops Simeticone

Dose: 2.5 mL with or after each feed (max. 6 doses in 24 hours);

may b e add ed to bottle f eed.

USES Colic or wind pain

Solu-Cortef® vial

Hydrocortisone-Roussel® tab

Hydrocortisone

1

Physiologic replacement: 7 -9 mg/m2/day IV or PO in 2-3 doses

Chorioamnionitis -exposed E LBW i nfants to decrease risk of CLD : 0.5

mg/kg/dose IV Q12h for 12 days, then 0.25 mg/kg Q12h for 3 days. Neofax2011

CAH: 3-5 mg/m2 PO Q8h, adjusted according to response.

Acute adrenocortical insufficiency (Addisonian crisis): initially 10 mg as a

slow IV injection then 100 mg/m2/day IVI or IV in divided doses Q6–8 h;

adjusted according to response; when stable reduce over 4–5 days to PO

maintenance dose.

Adrenal hypoplasia, Addison’s disease, chronic maintenance or

replacement therapy: 8–10 mg/m2/day PO in 3 divided doses; higher doses

may be needed. BNFC2011-12

Hypotension resistant to inotropic treatment and volume replacement: initially 2.5 mg/kg IV repeated if necessary after 4h, then 2.5 mg/kg Q6h for 48h or until BP recovers, then dose reduced gradually over at least 48h. BNFC2011-12

Hypoglycemia: 5 mg/kg/day IV in two divided doses if remains hypoglycemic

despite GIR of 12-15 mg/kg/min. The dose can then be rapidly tapered over

the course of a few days. Before administration, measure glucose, i nsulin

and cortisol levels at a time when the serum sugar is low <40 mg/dL. MNC2012

BPD: a suggested regimen is a starting dose of 5 mg/kg/day for 3 days tapered over 7-10 days. If no response is seen by 2-3 days, treatment is

stopped. MNC2012

Vasopressor-resi stant Hypotension: MNC2012

Day 1 initial dose 1 mg/kg/dose IV Q8h X 3 doses

Day 2 follow in 12 h with 0.5 mg/kg/dose IV Q12h X 2 doses

Day 3 follow in 12 h with 0.25 mg/kg/dose IV Q12h X 2 doses Day 4 follow in 24 h with 0.125 mg/kg/dose IV X 1 dose

If BP i mproves and other vasopressors have been weaned off, treatment

may stop after 24 hours.

Solu-Cortef® vial

Hydrocortisone-Roussel® tab

Hydrocortisone

2

ضاعت ٢٢ – ۸ /ضم ورد ... (ضم ٢٠/ مجم ٢٠٠) صوليوكورثيف


Solution Co mp atibi lity D5W, D10W and NS. ى ٢٠٠بطزهجت اوطولين غزطت... ( ضم ٢/ مجم ٢٠٠) صوليوكورثيف وحطخكمل حت

..ورد ٪ ٥غزطت ج ٢٠٠

BSA ( m2) = (0.05 X Kg) + 0.05

Ne ofax2011

Brands include SSiiggmmaaccoorrttiinn®® 500 mg and or FFlleebbooccoorrttiidd®® 100 mg vials

USES CCoorrttiissooll ddeeffiicciieennccyy.

PPrreessssoorr--rreessiissttaanntt hhyyppootteennssiioonn (hypotensive babies who are cortisol deficient ( < 15 µg/dL) are most likely to respond, BP will within

2h of 1st dose).

Adjunctive therapy for pp eerrssiisstteenntt hhyyppooggllyycc eemmiiaa IImmpprroovvee ssuurrvviivvaall aanndd CCLLDD iinn EELLBBWW iinnffaannttss eexxppoosseedd ttoo

cchhoorriiooaammnniioonniittiiss..

MONITOR Blood pressure and Blood glucose during acute il lness.

ADVERSE EFFECTS Hyperglycemia. Hypertension, salt and water retent ion. Risk of GI perforation when used with indomethacin .

Risk of disseminated C andida inf ections.

Early, low dose hydrocortison e treatment was not associated with

increas ed CP. Treated infants had indicato rs of improved developmen tal outco me.

Ne ofax2011

Soluvit N® Water-Soluble Vitamins

Contents Per Vial Thiamine nitrate 3.1 mg, Sodium riboflavine phosphate 4.9

mg (corresponding to Vitamin B2 3.6 mg), Nicotinamide 40 mg, Pyridoxine

hydrochloride 4.9 mg (corresponding to Vitamin B6 4.0 mg), Pantothenic acid

15.0 mg, Sodium ascorbate 113 mg (corresponding to Vitamin C 100 mg)

Biotin 60 microgram, Folic acid 400 micrograms, Cyanocobalamin 5.0

microgram, Glycine 300 mg, Edetate sodium 500 micrograms, (with

preservative, 500 micrograms methyl hydroxybenzoate).

Sominaletta® Phenobarbital

1

LD: 20 mg/kg IV slo wly over 10-15 min, with refractory seizures

add 5 mg/kg dos es, up to a to tal of 40 mg/kg.

MD: 3-4 mg/kg/d ay (12-24 after LD) IV, IM, P O or PR. Given daily

(Q12h probably unnecessary). Neofax2011

Neonatal Abstinence Syndro me

LD: 16 mg/kg P O on D1.

MD: 1-4 mg/kg/dose PO Q12h Based on abstinenc e scoring, weanin g can b e ach eived by

decreasing dose 20% every other day. Neofax2011

ا اليت كل كجم ٢ ( ٪٥م ج ض ٣+ ضم ٢( )ضم/ مجم ٤٠) صوميـى كل كجم ½ثم ضم ل ضم ل

عت ٢٢جزعاث ثم بعد ٤بحد أقص ى .. ضا وطولين . بطزهجت ا د ٢٠٠غزطت كل وري ببطء ـغدد

ضاعت ٢٢

بالفـمضاعت ٢٢/ ضم... ( ضم ٥/ مجم ٢٥) شراب صوميـىاليتا

Infusion solution concentration 10 mg/mL. Compatible with D5W, D10W and NS.

USES Anticonvulsant. May improve outcome in severely asphyxiated infants, used prior to onset of seizures (40 mg/kg IVI over 1h) Neofax2011 Neonatal abstinence syndrome in nonopiate- or polydrug-exposed infants. May enhance bile excretion in patients with cholestasis before 99Tc-IDA scanning.

MONITOR Therapeutic level 15-40 μg/mL. Sedation occurs at serum concentration of 40 μg/mL and respiratory depression at concentrations > 60 μg/mL. Altered (usually) serum concentrations if used with phenytoin or

valproate. In neonatal abstinence syndrome, serum concentrations of 20-30 μg/mL are associated with adequate symptom control.

Sominaletta® Phenobarbital

2

RENAL IMPAIRMENT Use with caution.

HEPATIC IMPAIRMENT May precipitate coma. Avoid in severe impairment.

Because of a prolonged serum half-life, which may be increased by hepatic and renal dysfunction, serum levels need to be monitored and maintenance dosing adjusted accordingly. MNC2012

ADVERSE EFFECTS SSeeddaattiioonn at serum level > 40 μg/mL. RReessppiirraattoorryy ddeepprreessssiioonn at serum level > 60 μg/mL. Irritating to veins.

INTERACTIONS Analgesics: possibly CNS effects of opioid analgesics. Antibacterials: metabolism of chloramphenicol, doxycycline and metronidazole ( plasma concentration); phenobarbital possibly plasma concentration of rifampicin. Plasma concentration of phenobarbital often by phenytoin, plasma concentration of phenytoin often but may be . Possibly plasma concentration of propranolol. Cardiac Glycosides: metabolism of digitoxin ( effect). Corticosteroids: metabolism of corticosteroids ( effect). Diuretics: risk of osteomalacia when phenobarbital given with

carbonic anhydrase inhibitor. Theophylline: metabolism of theophylline ( effect). Thyroid Hormones: metabolism of thyroid hormones (may requirements for thyroid hormones in hypothyroidism). Vitamins: barbiturates possibly requirements for vitamin D.

Spironolactone Aldactone® 25 mg tab.

Dose: 1 - 3 mg/kg Q24h PO. Neofax2011

٢٤/ بالفم ٢٠٠غزطت بطزهجت اوطولين ... ( ضم ٢٠/ مجم قزص ٢٥) الداكتون

.ضاعت

USES In combination with other diuretics in treatment of CHF and BPD (situations of aldosteron e secretion).

Ascites and edema.

Reduction of hypokalemia induc ed by diuretics or amphotericin.

Addit ion of spirono lactone to thiazide diu retic therapy in BPD

may yield little, if an y, addit ional benefit. Ne ofax2011

May require several days of therapy before effect is seen.

MONITOR Seru m K

+ in long term th erapy (discontinue if ).

Measuring u rinary K+ is a useful indicator of effectiven ess.

RENAL IMPAIRMENT Use with c aution.

Monitor K+ concentration; high risk of hyp erkalemia in RF

Avoid if rapidly d eteriorat ing or s evere ren al impairment.

ADVERSE EFFECTS Hyperkalemia, hyponatremia.

False positive ELISA screening for ccoonnggeennii ttaall aaddrreennaall hhyypp eerrppllaassiiaa. Rash.

Vomiting, diarrhea. Dose-dependent androgenic effect in f emales. Gynecomastia in males.

A tumorigen in chronic animal toxicity studies. Use with c aution in patients with impaired r enal function.

Sulperazon® Cefoperazone / Sulbactam 1.5 g / 25 mL Dose: 30 - 40 mg/kg/dose IV Q12h

*Could be given Q8h after 1 week of age

ـزاسونضــ ةـصاـع ٠٠/ ـصم وريد ... ( صم ماء مقطر ٠٥/ جم ٥.٠) لب


Cefobid® Cefoperazone 1 g/10 mL Dose: 25 - 50 mg/kg/dose IM Q12h

فوبد عةصا ٠٠/ صـم عضل ... ( صم ماء مقطر ٠١/ جم ٠) ضـ


MONITOR Renal function (if used with aminoglycosides). CBC. Liver enzymes.

ADVERSE EFFECTS Hypersensitivity, skin reactions, fever and a change in Coombs’ test. Reversible neutropenia, decreased hemoglobin or hematocrit, transient eosinophilia. Diarrhea or loose stools. Pseudomembranous colitis. Transient elevations of BUN and serum creatinine.

Survanta® Beractant, Intratracheal Suspension 4-8 mL vials

1

DOSE: 4 mL/kg/dose, int ratracheally , divid ed into 4 aliquots,

given as soon as possible after birth , preferably within 8 hours of

birth; may be rep eated within 48h at intervals of at least 6h for

up to 4 doses.

Each mL of Survanta® contains 25 mg of phospholipids.

It is an off-white to light bro wn liquid supplied in single-use glass vials containing 4 mL (100 mg phospholipids) or 8 mL (200 mg phospholipids).

USES

Prophylaxis (< 29wk gestation).

Rescue treatment of mod erate to s evere RDS. Respiratory failu re in mature infants due to MAS, pneu monia

and PPHN.

MONITOR ETT patency and position

O2 saturation , ECG and blood pressure. Impaired gas exchange caus ed by blockage of the airway. Frequ ent assessment of oxygenat ion / ventilation.

ADVERSE EFFECTS / PRECAUTIONS Dosing should be slowed or halted if :

- Infant beco mes dusky or agitated.

- HR slows. - O2 saturation f alls > 15% - Surfactant b acked up in the ETT.

Pulmonary h emorrhage (2-4%), mostly th e smallest infants with untreated PDA.


2

How To Use Survanta® Swirl the vial gently (DO NOT SHAKE) to redisperse settling.

Warm the vial by standing at room temperature for at least 20 minutes or

warm in the hand for at least 8 minutes. Artificial warming methods

shouldn’t be used. I f a prevention dose is to be given, preparation of

Survanta® should begin before the infant's birth.

Unopened vials of Survanta® that have been warmed to room temperature

may be returned to the refrigerator within 24h of warming, and stored for

future use. Survanta® should not be removed from the refrigerator for > 24

h. Survanta® should not be warmed and returned to the refrigerator > once.

Used vials with residual drug should be discarded.

Survanta® is administered intratracheally by instillation through a 5-F end-

hole catheter. The length of the catheter should be shortened so that the

tip of the catheter protrudes just beyond the end of the ET above the

infant's carina. Survanta® should not be instilled into a mainstem bronchus.

The catheter can be inserted into the infant's by briefly disconnecting the ET

from the ventilator. After administration of each quarter -dose, the catheter

is removed and the infant is ventilated for at least 30 seconds until stable.

To ensure homogenous distribution of Survanta® throughout the lungs, each dose is divided into four quarter-doses. Each quarter-dose is administered with the infant in a different position. The recommended

positions are:

- Head and body inclined 5-10° down, head turned to the right.

- Head and body inclined 5-10° down, head turned to the left.

- Head and body inclined 5-10° up, head turned to the right.

- Head and body inclined 5-10° up, head turned to the left .


3

Survanta® Dosing Chart

WEIGHT (gm)

TOTAL DOSE (mL)

WEIGHT (gm)

TOTAL DOSE (mL)

600- 650 2.6 1301- 1350 5.4

651- 700 2.8 1351- 1400 5.6

701- 750 3.0 1401- 1450 5.8

751- 800 3.2 1451- 1500 6.0

801- 850 3.4 1501- 1550 6.2

851- 900 3.6 1551- 1600 6.4

901- 950 3.8 1601- 1650 6.6

951- 1000 4.0 1651- 1700 6.8

1001- 1050 4.2 1701- 1750 7.0

1051- 1100 4.4 1751- 1800 7.2

1101- 1150 4.6 1801- 1850 7.4

1151- 1200 4.8 1851- 1900 7.6

1201- 1250 5.0 1901- 1950 7.8

1251- 1300 5.2 1951- 2000 8.0

Sutrim® (Co-trimoxazole) Trimethoprim+Sulfamethoxazole 40+200 mg / 5 mL

Dose in infants > 6 wks of age: 24 mg/kg/12h PO . BNFC2011-12

ضاعت ٢٢/ ضم بالفم ... ( ضم ٥/ مجم ٢٤٠)صتريم شراب

USES Cholera. Prevention and treatment of Pneu mocystis carinii infection.

Uncomplicated malaria and meningitis because of good tissue and CSF pen etration. Respiratory and urin ary tract infections

Severe systemic infec tion, possible comb ined immun e deficiency, or overt HIV, to reduce th e risk of b acterial infection.

AVOID IN BABIES WITH Severe liver dis ease. Serious unconjugated jaundice.

Acute porphyria.

ADVERSE EFFECTS / PRECAUTIONS Co-trimoxazole increases th e plas ma h alf life of phenytoin. Risk of hemolytic an emia in bab ies with G6PD deficiency

RENAL IMPAIRMENT GFR 15–30 mL/min/1.73m

2 Use h alf normal dose.

If GFR < 15 mL/min/1 .73m2 or if plasma level of sulfamethoxazole

can’t be monitored Avoid.

Targocid® Teicoplanin 200 mg / 5 mLNS

Dose: 16 mg/kg LD IV followed by 8 mg/kg IV or IM once Q24h.

Treat proven sept icemia for at least 7 days. Neofax2011

عضل أو جكمل ٢٠٠جت اوطولين غزطت بطزه... ( ضم ٣/ مجم ٢٠٠)ثارجوصـيد

ضاعت ٢٤/ ورد على مدى هصف ضاعت ضم وحعطى ٢٠حتى


USES Teicoplanin is active against many G+ve anerobes and is particularly potent against Clostridium species. It is also active against most Listeria, enterococci and staphylococci (including MRSA) although it may work more as a bacteriostatic drug than as a bactericidal drug. Vancomycin resistant organisms are sometimes sensitive to teicoplanin. Rifampicin may be synergistic in the management of staph. infection.

USES Teicoplanin is active against many G+ve anerobes and is particularly potent against Clostridium species. It is also active against most Listeria, enterococci and staphylococci (including MRSA) although it may work more as a bacteriostatic drug than as a bactericidal drug.

MONITOR CBC ALT, AST Renal and auditory function on prolonged administration during renal impairment or if other nephrotoxic or neurotoxic drugs given.

RENAL IMPAIRMENT Reduce dose on day 4: Use half normal dose if estimated GFR is 40-60 mL/min/1.73m2 Use ⅓ normal dose if estimated GFR is < 40 mL/min/1.73m2

ADVERSE EFFECTS Leucopenia and thrombocytopenia. Disturbances of liver function.

Tazocin® Piperacillin + Tazobactam 4.5 g / 90 mL

Dose: 50-100 mg/kg/dose IVI over 30 min Ne ofax2011

Na content is 11.16 mEq / 4.5 g vial BNFC2011-12

Piperacil lin : Tazobac tam = 8:1. Dose is calculated as for pip eracillin compon ent.

ضاعاث ۸/ ورد على مدى هصف ضاعت ضم ... ( ضم ٩٠/ جم ٥.٤)ثــازوصين



≤ 29 0-28 >28

12 8

30-36 0-14 >14

12 8

37-44 0-7 >7

12 8

≥ 45 All 8

USES Non-CNS infections, c aused by susceptible β-lactamas e producing bacteria (e.g. E. col i, Enterobacter, Klebsiel la, H.

influenzae, Proteus mirabilis, Pseudomonas spp., and Staph. aureus. Also eff ective against group B Streptococcus.

MONITOR Observe IV site for signs of extravasat ion.

ADVERSE EFFECTS Eosinophilia

Hyperbilirubin emia AST, AL T, BUN and seru m creat inine.

Tienam® Imipenem / Cilastatin 500 mg / 100 mL

Dose: 20-25 mg/kg/dose Q12h IVI over 30 min. Neofax2011

ضاعت ٢٢/ على مدى هصف ضاعت وريدـضم ... ( ضم م م ٢٠٠/ مجم ٥٠٠) يـىاماث

Infusion Solu tion concentration 5 mg/mL. Compatible with D5 W, D10W and NS.

USES Non-CNS infections caused by b acteria, primarily

Enterob acteriac eae and an erobes, resistant to other antibiot ics. Broad-spectrum of act ivity includes many G +ve and G-ve bacteria

and anerob es; Imipen em has good act ivity against Pseudomonas aeruginosa. Not active against MRSA and Enterococcus feciu m.

MONITOR Periodic CBC.

Liver enzymes. IV sites for ph elibitis.

RENAL IMPAIRMENT Not licensed for us e in children with renal impairment. Cr Cl < 70 mL /min/1.73m

2 R educe dose.

ADVERSE EFFECTS / PRECAUTIONS

Seizures in p atien ts with meningitis, preexisting CNS p athology, and severe ren al dysfunction. Local reaction at injection site.

Increased platelet count and Eosinophilia. Elevated liver enzymes.

Diarrhea (> 5 % of patients).

Tracrium® Atracurium besilate 10 mg / mL Initially 0.3 –0.5 mg/kg IV followed eith er by IV dose of 0 .1–0.2

mg/kg repeated as nec essary or by IVI 0.3–0.4 mg/kg/h adjusted according to response.

BNFC2011-12

م . ( ضم ٩ + ضم ٢( ) ضم ٢/ مجم ٢٠) أثراكيوري بضم ورد .. أمز الطب عىد اللشوم أو ب

Infusion solution concentration 1 mg/mL Compatible with D5 W and NS. Dilute 60 mg/kg bodyweight to a final volu me of 50 mL with D5W

or NS; minimum conc entration of 0.5 mg/mL, max. conc entration of 5 mg/mL; an IVI rate of 0.1 mL /h provid es a dose of 0.12

mg/kg/h. BNFC2011-12

Brands inc lude Atracurium®.

USES Neuromuscular blockad e (short to intermediate duration) for surgery o r during intensive care stay.

AAttrraaccuurr iiuumm und ergo es non-enzymatic metabolis m which is independ ent of liver and kidney function, thus allowing its use in

children with hep atic or ren al impairment.

ADVERSE REACTIONS / PRECAUTIONS Skin flushing, hypotension, tachycardia, bronchospasm, and very rarely anaphylactoid reactions.

Neonates may b e more sensitive to th e effects of atracu rium and lower doses may be required .

Unasyn® Ampicillin/Sulbactam 750 mg / 20 mL

Dose: 150 mg/kg/day IV Q8-12h.

Dose may b e doubled in meninigit is.

اعتضــ ٢٢–۸/ ضم ورـد ببطء ... (ضم ٢٠/ مجم ٧٥٠)يوهاصين

Infusion solution concentration 37.5 mg/mL .

PMA

weeks

Postnatal

Days

Interval

hours

≤ 29 0-28 >28

12 8

30-36 0-14

>14

12

8

37-44 0-7

>7

12

8

≥ 45 All 6

USES Broad-Spectrum bactericid al against GBS, Listeria monocytogen es and susceptible E. coli spec ies.

RENAL IMPAIRMENT Reduce dose o r frequency if estimated GFR < 10 mL/min/1.73m

2.

Rashes are mo re co mmon.

ADVERSE EFFECTS / PRECAUTIONS Very large doses may result in CNS excitation or seizure activity .

Hypersensitivi ty reactions are rare in n eonates (maculopapular rash, urtic arial rash or f ever).

Moderate prolon gation of bleedin g times (by ~60 seconds) may occur after rep eated doses.

Ursogall® Ursodeoxycolic acid 158.5 mg / 5 mL

Dose: 10-15 mg/kg/dose PO Q12h. Neofax2011 ضاعت ٢٢/ ضم بالفم ... (ضم ٥/ مجم ٥.٢٥۸)شراب أورصوجول

Solution concentration 31.7 mg/mL.

USES Cholestatsis associated with TPN, biliary atresia and cystic fibrosis. Dissolve cholesterol gallstones (may take several months).

MONITOR ALT, AST. Serum direct bilirubin.

HEPATIC IMPAIRMENT Avoid in chronic liver disease (but used in primary biliary cirrhosis).

ADVERSE EFFECTS / PRECAUTIONS Nausea, vomiting. Abdominal pain.

Constipation. Flatulence. Aluminum-containing antacids bind ursodiol and inhibit absorption.

Vancomycin

Vancocin® 500 mg / 100 mL 1

Meningitis : 15 mg/kg/dose IVI o ver 1h.

Bacteremia: 10 mg/kg/dose IVI over 1h. Ne ofax2011

ضاعاث ۸/ ضم ورد على مدى ضاعت ... (ضم ٢٠٠/ مجم ٥٠٠) فاهكوميضين

Infusion solution concentration 5 mg/mL. Solution co mp atibility D5W, D10W and NS.

IV form c an be used to prepare solu tion for o ral ad min istration .

PMA (wks) Postnatal (d) Interval (h)

≤ 29 0-14

>14

18

12

30-36 0-14

>14

12

8

37-44 0-7

>7

12

8

≥ 45 All 6

USES Bactericidal against aerobic and anero bic G +ve bacteria includin g methici llin-resistant S aureus and S epid ermidis and penic illin -

resistant pn eumococci. B acteriostatic for enterococci. However, there are reports of S aureus with susceptibility and

glycopeptid e resistant Enterococci.

Penetration in to C SF is poor.

MONITOR Renal function and IV sites for phlebitis.

RENAL IMPAIRMENT Reduce dose. Monitor plasma concentr ation and ren al function regularly.

Vancomycin

Vancocin® 500 mg / 100 mL 2

ADVERSE EFFECTS / PRECAUTIONS Nephrotoxicity (high er incid ence with serum trough concentration > 10 µg/mL) ; enh anced by amino glycoside th erapy. Ototoxicity (with prolonged serum peak concentration >40

µg/mL). Rash and hypotension (rreedd mmaann ssyynnddrroommee), resolves within minutes to hours infusion time.

Neutropenia (if ad ministrated > 3 wks). Phlebitis R ate, dilute dru g or rotate infusion sites.

SERUM LEVEL Should be measured after 3-4 doses if renal function is normal ,

earlier if there’s ren al impairmen t.

Trough : 5-10 µg/mL – 15-20 µg/mL wh en treating MRSA pneumonia, endocarditis or bon e/jo int inf ections (Draw 30 minutes prior to scheduled dos e).

Peak: 30-40 µg/mL when treat ing men ingitis (Draw 30 minutes after end of infusion).

INTERACTIONS WITH General Anesthetics: hypersensitivity-like reactions.

Aminoglycosides: risk of n ephrotoxicity and ototoxicity.

Ampho tericin : possible r isk of nephrotoxicity.

Loop diuretics: risk of otoxicity .

If staphylococci exhibit tolerance to the drug, combine it with an aammiinnooggllyyccoossiiddee, with or without rriiffaammppiicciinn.

Valium®

Diazepam 10 mg / 2 mL 1

IV dose: 0.3 mg/kg. Diazep am is most effective wh en given as IVI

at a rate of 0.3 mg/kg/h . MN C2012

Slow IV: 0 .3-0.4 mg/kg rep eated once after 10 min if n ecessary.

PR: 1.25-2.5 mg rep eated once after 10 min if n ecessary BNFC2011-12

آلان فقطببطء غدد ضم ورد ... (ضم ٢/ مجم ٢٠) فاليام


Avoid injections containing b enzyl alcohol in neon ates. Available also as Stesolid Rectal Tubes®2.5-5-10 mg per tube. Brands inc lude Epival® and N euril®.

USES Status epi lepticus.

Convulsions caused by poisoning.

ADVERSE EFFECTS / PRECAUTIONS Close observation is required unt il full recovery fro m sedation. When given IV, fac ilities for reversing respiratory dep ression with

mechanic al ventilation must b e at hand. Muscle weakn ess. Hypotension.

Gastro-intestinal disturbances, incontinenc e, urin ary retention. Blood disorders and jaundice reported; sk in reactions. IV in jection P ain and th rombophlebitis.

CONTRAINDICATIONS Respiratory depression or marked neu romuscular respiratory weakn ess including unstable myasthenia gravis.

Valium®

Diazepam 10 mg / 2 mL 2

1. Diazepam is rapidly redistributed after an IV dose and cleared from the b rain within minutes.

2. Diazepam has greater respirato ry and circulatory d epressan t effects (part icularly wh en used with a barbiturate).

3. The anticonvulsant effect of diaz epam lasts minutes, whereas

its sedative effect exceeds 24 hours 4. Sodium b enzoate, th e vehicle for IV diaz epam, uncouples

bilirubin from albumin, increasin g the r isk for kernicterus in

jaundiced inf ants. MNC2008

RENAL IMPAIRMENT Start with small doses.

Increased cereb ral s ensitivity .

HEPATIC IMPAIRMENT Dose; may precipitate coma.

Avoid in severe impairment.

Vfend® Voriconazole 50 mg tab. 1

LD: 6 mg/kg.

MD: 4 mg/kg/dose IV or PO Q12h. (B liss et al., 2003)

The reco mmended duration of th erapy is 2-3 weeks but has to b e individualized to the type of fungal species .

(Ste inbach and Benjamin, 2005)

د .. (مض ٢٠/ مجم ٥٠قزص ) فيفى ضاعت ٢٢/ للزاضم با.

Solution Concentration 5 mg/mL. د . (ضم م م ٥.٩+ ضم ٥.٠) (مض ٢٠/ مجم ٢٠٠) فيفى ــدضم .. كل اثضاع ٣على مدى وري

ضاعت ٢٢

Infusion Solu tion Concentration 0 .5 mg/mL . For IVI, reconstitute each 200 mg with 19 mL Water for Injections to produce a 10 mg/mL solution; dilute dose to concentration of

0.5-5 mg/mL with D5W or NaCl 0.9% and give at a rate not exceeding 3 mg/kg/h.

BNFC2011-12

USES Invasive aspergillosis; serious infections caused by Sc edosporium

spp., Fusarium spp., or in vasive fluconazole-resistant Candid a spp. (including C. krusei).

BNFC201 1-12

If voriconazole proves to b e as well tolerated in th e n eonate as in

children and adults, it will be a useful ant ifungal choic e for treatment of C andida infection in th e NICU . It has a b roader spectrum of activity and high er potenc y than fluconazole, and a

better safety profile than amphotericin B . (B liss et al., 2003)

MONITOR (B liss et al., 2003) Liver enzymes. Ca, Mg and K.

Seru m creatinin e.

HEPATIC IMPAIRMENT In mild to mod erate h epatic cirrhosis use usual initial dose th en halve subsequ ent doses.

BNFC2011-12

No information avai lable for severe hep atic cirrhosism,

manufacturer advises use only if potent ial b enefi t outweighs risk.

Vfend® Voriconazole 50 mg tab.

2

RENAL IMPAIRMENT IV formulation not recommend ed for patients with renal failure.

(B liss e t al., 2003)

IV vehicle may accumulate if estimated GFR < 50 mL/min/1.73 m

2,

use IVI only if potential ben efit outweighs risk, and monito r renal function; alternatively, use tablets (no dose adjustment required).

BNFC2011-12

ADVERSE EFFECTS Vomiting, diarrhoea, jaundic e, edema, hypotension, RDS,

hypoglycemia, hematuria, blood disorders (including an emia, thrombocytopenia, leucop enia, pancytop enia), AR F, hypokal emia,

visual disturbances, (including al tered p erc eption, blurred vision and photophobia), rash, photosensitivity, alopecia, cheilitis, injection site reactions.

Less commonly h epat itis, constipation , arrhythmias (including QT interval prolongation), raised s erum cholesterol, hyp ersensitivity

react ions (including flushing), n ystagmus, ad renocortic al insufficiency, arthritis, bleph aritis, optic n euritis, Stevens -Johnson syndrome.

Rarely pseudomembranous colitis, hearing disturb ances, convulsions, extrap yramidal eff ects, hyp ertonia, hypothyroidism,

hyperthyro idism, discoid lupus eryth ematosus, toxic epid ermal necrolysis, pseudoporphyria, retin al hemo rrhage, optic atrophy; also reported squamous cell c arcinoma of skin (particularly in

presenc e of phototoxicity). Contraind icated in acute porphyria

Bliss JM, Wellington M and Gigliotti F (2003): Antifungal pharmacotherapy for

neonatal candidiasis. Semin Perinatol; 27(5):365-74.

Steinbach WJ and Benjamin DK (2005): New antifungal agents under development in children and neonates. Curr Opin Infect Dis; 18:484-9.

Viagra® Sildenafil 50 mg tab. Dose: 0.5-2 mg/kg/dose PO Q6-12h. Maximu m of 3 mg/kg/dose

Q6h. Neofax 2011

Dose: Initially 0.25-0.5 mg/kg/dose Q4-8h, adjusted according to

response; max. 2 mg/kg/dose Q4h; start with lower dose and

frequency especially if used with other vasodilators; withdraw

gradually. BNFC2011-12

ضاعت ٢٢ - ٦/ للزاضم با... (مض٢٥/ مجم ٥٠قزص ½)فـياجرا

Final concentration of 1 mg/mL. Brands inc lude EErreecc®® 100 mg tab . and VViiaavvaagg®® 25 mg tab .

MONITOR Blood pressure and Oxygenation.

HEPATIC IMPAIRMENT Reduce dose if not tolerated in mi ld to moderate impairment;

avoid in severe impairment.

RENAL IMPAIRMENT Reduce dose if not tolerated.

ADVERSE EFFECTS Worsening oxygen ation and systemic h ypotension. Use with c aution in infants with sepsis. Risk of ROP, bleedin g??

INTERACTIONS WITH Fluconazole: significant in concentration (inhibits C YP3A4).

Vitalipid N® Fat-Soluble Vitamins Per mL Vitalipid N Adult Retinol 99 mcg, calciferol 0.5 mcg, α-tocopherol 0.91

mg, phytomenadione 15 mcg, fractionated soybean oil 100 mg, fractionated

egg phospholipids 12 mg.

Per mL Vitalipid N Infant Retinol 69 mcg, calciferol 1 mcg, α-tocopherol 0.64

mg, phytomenadione 20 mcg, fractionated soybean oil 100 mg, fractionated

egg phospholipids 12 mg.

Vitamin A Vitamin-A® 25000 u cap.

Parenteral Treatment of Vitamin A deficiency: 5000 units IM 3

times weekly for 4 weeks. Ne ofax2011

Prevention of deficiency in complete biliary obstruction: 50,000

units IM once a month.

USE To reduce r isk of CLD in high risk premature neonates with Vit- A

deficiency.

MONITOR Signs of toxicity full fontanel, lethargy, irritabi lity, h epato megaly , edema, mucocutan eous lesions and bony tenderness.

Consider measurin g plasma retinol concen trat ions if available, especially if th e patient is also receiving glucocoticoids; desired concentrations are 30-60 μg/dL.

CCoonncceennttrraattiioonnss << 2200 μμgg//ddLL indicate d eficien y while those >> 110000 μμgg//ddLL are potentially toxic.

ADVERSE EFFECTS / PRECAUTIONS Avoid coincident treatment with glucocorticoids.

Vitamin B group Bécozyme® amp.

Adjust doses as necessary BNFC2010-11

Thiamine; Vitamin B1 Maple syrup urine disease 5 mg/kg/day PO

Metabolic disorders includi ng congenital lactic acidosis

50-200 mg once daily (total dose

may alternatively be given in 2-3 divided doses) PO or by IVI over 30 min.

Riboflavin; Vitamin B2 Metabolic diseases 50 mg 1-2 times daily PO

Pyridoxine; Vitamin B6 Metabolic diseases includi ng cystathioninuria and homocystinuria

50-100 mg 1–2 times daily PO

Treatment of isoniazid-induce d

neuropathy 5-10 mg daily PO

Prevention of isoniazid -induced

neuropathy 5 mg daily PO

Pyridoxine-dependent seizures

Initial test dose 50–100 mg by IV injection, may be repeated; if

responsive followed by an oral maintenance dose of 50-10 0 mg once daily

Vitamin D Decal-B12

® Syrup or ViDrop® Drops 1

Supplementation in breastfed b abies: 10 μg/day (400 u/day) PO.

MNC2012

Treatment of Vit D defic iency: 1000 u/day PO. Ne ofax2011

ال ت ٢٤/ بالفمضم ٤ -٢ ( ضم ٥/ وحدة ٢٠٠٠)شراب ٠٠ب -ديـك ـضاعـ

ـعت ٢٤/ بالفمهقط ۸ - ٤ ( ضم/ وحدة ٢۸٠٠)دروب هقط -في ـضا

. ( ضم/ مكزوجزام ٢)ألفا هقط -وان الفمهقط .. ت ٢٤/ ب ـضاعـ

Decal-B12® = 1000 u Vit D3, 50 mg C a, 10 μg Vit B12 p er 5 mL

ViDrop® = 2800 u Vit D3 per 1 ml (= 28 drops)

IM Preparations

Devarol-S® 60.000 u / 2 mL amp. Sterogel® “H” 60.000 u / 1.5 mL amp.

Dose of One-Alpha® in neonates: 0.05-0.1 μg/kg/d ay; equ al to 1-2 drops/2kg/day (each drop = 0.1 μg alfacalcidol). With severe

hypocalcemia, up to 40 drops/2kg/day may be n eed ed. Product information leaflet

USE Vitamin D supplementat ion/ d eficiency, R efractory rickets.

MNC2012

For breastfed infan ts (wheth er exclusive or supplemented), AAP

recommends Vit-D supplementation to b egin within th e 1st

few days of life. Exclusively formula-fed infants rec eivin g at least 1000

mL/day of formula rec eive adequ ate amounts of Vit D without supplementation.

Neofax2011

Signs of Vit-D deficiency (25(OH)-D < 50 nmol/L) : symptomatic hypocalcemia (includin g seizures), gro wth f ailure, i rritability , lethargy and susceptibility for respirato ry infect ions.

Neofax2011

Vitamin D Decal-B12

® Syrup or ViDrop® Drops 2

MONITOR Seru m Ca

++ and phosphorus.

Alkal ine phosphatas e (Levels of ALP app roximately 7.5 times above th e adult ran ge indicates active dis ease) .

ADVERSE EFFECTS / PRECAUTIONS Acidosis, Hypertension and Arrhythmia Hypervitaminosis D (25(OH)-D > 250 nmol/L): hyperc alcemia, azotemia, serum creatinin e, mild hypokalemia, diarrh ea,

polyuria, metatstatic calcific ation and nephrocalcinosis. Neofax2011

Vitaphos® Elixir Appe tizer a nd General T oni c wi th Vita min B Complex

Each 15 mL contains

Vitamin B1 2 mg

Vitamin B2 1 mg

Vitamin B6 2 mg

Nicotinamide 10 mg

Calcium glycerophosphate 114.5 mg

Sodium glycerophosphate 114.5 mg

Potassium glycerophosphate 114.5 mg

Magnesium glycerphosphate 57 mg

Zantac® Ranitidine 50 mg / 2 mL PO: 2 mg/kg/dose Q8h (unreliable absorption), max . 3 mg/kg 3 times d aily.

FT IV dose: 1.5 mg/kg/dose Q8h slo w push.

PT IV dose: 0.5 mg/kg/dose Q12h slow push.

IVI: 0.0625 mg/kg/h, range 0.04-0.1 mg/kg/h. Neofax2011

ـد ببطءـضم ... ( ٪ ٥ ضم ج ٢٢+ ضم ½ ( )ضم ٢/ مجم ٥٠) زاهتـاك ت ٢٢-۸/ ور ـضاـع


Compatible with D5 W, D10W and NS. ـضاـعاث ۸/ رايلبالضم ... ( ماء مقطز ضم ٣٠/ مجم ٢٥٠) أقراص زاهتـاك

Solution concentration 5 mg/mL. Oral solution is stable for 28 days refrigerated.

USES Prevention and treatment of stress ulcers and GI h emorrhage

aggravated b y gastric acid s ecretion. Routine gastric ac id suppression in neonates should be avoided .

MONITOR Gastric pH to assess efficac y.

RENAL IMPAIRMENT Use ½ normal dose if G FR < 50 mL/min/1.73m

2.

ADVERSE EFFECTS The us e of H2 blockers in preterm inf ants has been associated with

an increased r isk for late-onset b acterial and fungal sepsis. Thrombocytop enia ? In adu lts: AST, AL T, leucopen ia and bradyc ardia.

Very rarely: interstitial n ephritis.

Zithromax® Azithromycin 200mg/5ml Susp. - 500 mg Vials

Dose for treatment and prophylaxis of Pertussis: 10 mg/kg/dose PO Q24h for 5 days

Neofax2011

IV Dose: 5 mg/kg/dose Q24h IVI over 60 min. limited to those who cannot be treated orally.

Neofax2011 قبل ٢٠٠غزطت بطزهجت اوطولين ... (ضم ٥/ جم ٢٠٠) شراب زيثروماكط

تضاع ٢٤/ باـلـفمالزضاعت بطاعت

Don’t refrigerate. Use within 10 days once bottle has been opened.

على مدى وريدضم ... (ضم ٥.٤٩+ ضم ½( )مض ٨.٤/ مجم ٥٠٠) زيثروماكط

ضاعت ٢٤/ ضاعت

Infusion solution concentration 1 mg/mL, dilute prior to use. Compatible with D5W, NS and LR.

USES Treatment and post-exposure prophylaxis against B . pertussis. As a substitute of pen icillin.

MONITOR GI Toleranc e.

HEPATIC IMPAIRMENT Avoid, jaundice reported.

RENAL IMPAIRMENT Use with c aution if estimated GFR is < 10 mL /min/1.73m

2.

ADVERSE EFFECTS / PRECAUTIONS Diarrhea and /or vo mitin g (5-12%).

Irritability , rash and blood in stool. Pyloric stenosis ?!

Zyvox®

Linezolid 200 mg / 100 ml 1

Dose: 10 mg/kg/dose Q8h IVI over 30-120 min.

Given Q12h in preterm n ewbo rns < 1 wk of age.

Treatment is usually continued for 2 wks. Ne ofax2011

على مدى ضاعت ضاعت ٢٢-۸/ ضم ورد... (ضم ٢٠٠/ مجم ٢٠٠) وكطزيف


USES Only used, on microbiolo gical advic e, to treat MR SA and VR E

infection. Active against a ran ge of G +ve bacteria, including MRSA, VR E and resistant strains of Strept . pneumoniae. Active against some

anerobes, including Clostr idium p erfrin gens, C lostridium difficile and Bacteroid es fragi lis.

Enterob acteriac eae and Pseudomon as aeruginosa are not susceptible. Not used as empiric treatment or in any patient with infect ions

caused by gram-n egative organisms.

MONITOR Blood pressure if rec eivin g sympatho mimetics.

Monitor CBC (including platelet count) weekly. AST and AL T.

HEPATIC IMPAIRMENT BNFC2011-12 No dose adjustment is nec essary but in severe h epatic imp airment

use only if potent ial b enefit outweighs risk .

RENAL IMPAIRMENT BNFC2011-12 No dose adjustment nec essary but metabolites may accumulate if estimated GFR < 30 mL /min/1.73 m

2.

Zyvox®

Linezolid 200 mg / 100 ml 2

ADVERSE EFFECTS / PRECAUTIONS Reversible thrombocytop enia ( when given for > 10–14 days). A higher incidenc e of blood disorders and optic neuropathy have

been reported in patients receiving Zyvo x® for more than th e maximum recommend ed duration of 28 days.

Diarrhea (antib iotic-associated colitis) and vo miting. Elevated transamin ases. Less commonly dry mouth, glossitis, stomatitis, tongu e

discoloration, abdominal pain, gastritis, constipat ion, pancreatitis, hyp ertension, fever, polyuria, anemia, leucopenia,

eosinophilia, electro lyte disturbanc es, blu rred vision, rash and injection-site reactions Very rarely renal failu re, pancytopenia and Stevens-Johnson

syndrome; lactic acidosis; peripheral and optic neu ropathy.

MILK PER 100 mL

TERM HUMAN MILK PRETERM HUMAN MILK En 68 kcal En 67 kcal Pr 1.05 g Pr 1.41 g Fat 3.91 g Fat 3.89 g CHO 7.2 g CHO 6.6 g Na 17.7 mg (0.77mEq) Na 24.8 mg (1.08mEq) K 53.1 mg (1.36mEq) K 57.0 mg (1.46mEq) Ca 27.9 mg (1.39mEq) Ca 24.8 mg (1.24mEq) PO3 14.3 mg PO3 12.8 mg Mg 3.47 mg Mg 3.09 mg

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En 67 kcal 67 kcal 66 kcal 69 kcal 74.4 kcal 80 kcal

Pr 1.21 g 1.4 g 1.3 g 1.6 g 1.93 g 2.4 g

Fat 3.4 g 3.5 g 3.5 g 3.4 g 4.09 g 4.4 g

CHO 7.4 g 7.5 g 7.3 g 8 g 7.66 g 7.8 g Na 15 mg 19 mg 24.5 mg

K 58 mg 68 mg 105.6 mg Cl 40 mg 41 mg 55.7 mg

Ca 36 mg 47 mg 78.2 mg

PO3 20 mg 26 mg 46.1 mg Mg 4.8 mg 5.1 mg 6.67 mg

Vit A 180 iu 342.2 iu Vit D 30 iu 52.1 iu

Vit B12 0.12μg 0.22μg Fe 0.54mg L-carnitine 0.74mg

libro neonatologia

Health & Medicine

Transcript of libro neonatologia