The document provides information on commonly used drugs for children, including paracetamol, ibuprofen, midazolam, salbutamol, gaviscon infant, cefotaxime, caffeine citrate, morphine, and flucloxacillin. It discusses the uses, who can receive each drug, how it is administered, cautions, and side effects. Research is cited showing medication errors can occur in up to 17.8% of hospitalized children and identifying reasons for adverse drug reactions is important for prevention strategies.
Different medications must be absorbed to be effective. For absorption, the drug must be administered in proper manner. To choose a route of administration we need to relate the dosage form, the advantages and disadvantages etc.
Pediatric Drug calculations |drug calculation formulasNEHA MALIK
Most drugs in children are dosed according to body weight (mg/kg) or body surface area (BSA) (mg/m2). Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight. Doses are often expressed as mg/kg/day or mg/kg/dose, therefore orders written "mg/kg/d," which is confusing, require further clarification from the prescriber.
definition and normal values and all if more info. needed comment below.
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Different medications must be absorbed to be effective. For absorption, the drug must be administered in proper manner. To choose a route of administration we need to relate the dosage form, the advantages and disadvantages etc.
Pediatric Drug calculations |drug calculation formulasNEHA MALIK
Most drugs in children are dosed according to body weight (mg/kg) or body surface area (BSA) (mg/m2). Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight. Doses are often expressed as mg/kg/day or mg/kg/dose, therefore orders written "mg/kg/d," which is confusing, require further clarification from the prescriber.
definition and normal values and all if more info. needed comment below.
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DRUG DOSAGE CALCULATION IN PEDIATRICS BY MANISHA THAKURManisha Thakur
DRUG DOSAGE CALCULATION IN PEDIATRICS:
PEDIATRIC DOSAGE DIFFERENT FROM ADULTS
FORMULAS: YOUNG, CLARK, DILLING, FRIED RULES
BASED ON AGE, BASED ON BODY SURFACE AREA, WEIGHT
EXAMPLES.
DRUG DOSAGE CALCULATION
DAILY FLUID REQUIREMENT
CALCULATION OF DRIP RATE
INFUSION PUMP FLOW RATE CALCULATION.
baby born before 37 weeks of gestation calculating from the first day of last menstural period is defined as preterm baby/ premature baby.
These babies are known as preemies
This slide contain detail description of basic terminologies, neonatal (head to toe examination) assessment, neonatal reflexes, minor physiological handicaps of newborn
This slides contain description about breast feeding, anatomy of breast, types of human milk, good position for latching, holding for the baby, advantages of breast feeding, contraindication of breast feeding, barriers and problems associated with breast feeding with their management
Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
DRUG DOSAGE CALCULATION IN PEDIATRICS BY MANISHA THAKURManisha Thakur
DRUG DOSAGE CALCULATION IN PEDIATRICS:
PEDIATRIC DOSAGE DIFFERENT FROM ADULTS
FORMULAS: YOUNG, CLARK, DILLING, FRIED RULES
BASED ON AGE, BASED ON BODY SURFACE AREA, WEIGHT
EXAMPLES.
DRUG DOSAGE CALCULATION
DAILY FLUID REQUIREMENT
CALCULATION OF DRIP RATE
INFUSION PUMP FLOW RATE CALCULATION.
baby born before 37 weeks of gestation calculating from the first day of last menstural period is defined as preterm baby/ premature baby.
These babies are known as preemies
This slide contain detail description of basic terminologies, neonatal (head to toe examination) assessment, neonatal reflexes, minor physiological handicaps of newborn
This slides contain description about breast feeding, anatomy of breast, types of human milk, good position for latching, holding for the baby, advantages of breast feeding, contraindication of breast feeding, barriers and problems associated with breast feeding with their management
Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
To sum up, the risk/benefit ratio should be always weighed before prescribing antibiotics.
Appropriately selected patients will benefit from systemically administered antibiotics.
A restrictive and conservative use of antibiotics is highly recommended in endodontic practice, but indiscriminate use is contrary to sound clinical practice
Future generations will thank us for today’s conscientious and judicious use of antibiotics
PPT presentation supporting education for the NHS SEC SCN Acute Care Pathways: Fever, Bronchiolitis, Diarrhoea and Vomiting, Head Injury and Acute Asthma
Dr. Maria Hordinsky provides an informative, straightforward presentation of everything you need to know about alopecia areata, including risks and benefits of current and evolving off-label treatment options. Dr. Hordinsky is Professor and Chair of the Department of Dermatology at the University of Minnesota and is recognized for her clinical expertise in alopecia areata.
Osa in children by DR shashidhar tatavarthySHASHIDHAR T B
Management of OSA in children. evaluation tools, contraversies , surgeries and challenges in OSA made by Dr Shashidhar Tatavarthy. head of ENT at artemis hospitals
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. Introduction – Drugs and Children
• This presentation identifies some of the drugs
children are given in nursing. We look at the drugs
uses, how it is given, and who can and can’t be given
it.
• Medication dosing errors occur in up to 17.8% of
hospitalized children.
• Pirmohamed et al (2004) research suggested that
ADR’s in children were a large burden on the NHS
relating to morbidity, mortality and extra costs.
• Rashed et al (2012) also suggested that the
importance of identifying the reasons behind ADR’s
is to create prevention strategies for the future.
3. Paracetamol
(Acetaminophen)
The Most Commonly used medication both in
hospitals and in the community
• Uses - To relieve pain and lower raised
temperature.
• Who can have it – From neonates (28 weeks)
onwards.
• How is it given – most commonly by mouth, also
given rectally and by IV
• Who can’t have it - alcohol dependents
4. Paracetamol - Is It All Good??
• Pre-emptive administration before
vaccinations is thought to reduce antibody
response.
• Mounting evidence linking use of paracetamol
to the increases in prevalence of childhood
asthma.
• Should only be used for comfort not to
reduce fever – no evidence to show that it
reduces risk of febrile convulsions.
5. Ibuprofen
• Uses – To relieve pain, lower raised
temperature and reduce inflammation of
soft tissue injuries, also in NICU to close
patent ductus arteriosus
• Who can have it – From one month
• How is it given – By mouth or IV
• Who can’t have it – Not to asthmatics,
those with renal failure, gastrointestinal
problems, lupus, liver problems, low platelets
(oncology) also caution with cardiac
impairment.
6. Ibuprofen – Is It
All Good?
• It is now recommended it be used with
caution to close ductus arteriosus –
moderate sized duct usually doesn’t need to
be closed until the age of 1 or 2 years.
• Significant hypothermia has been
documented after therapeutic use or an
overdose.
• Renal toxicity – many febrile children will be
mildly dehydrated which is difficult to
detect.
7. Ibuprofen and/or Paracetamol?
• No evidence that reducing fever reduces mortality – in fact
current evidence suggests may actually adversely affect
outcome.
• Little is known about long term effects.
• NICE 2007
– antipyretic agents do not stop febrile convulsions and should not be
used specifically to reduce temperature.
– Not to administer the 2 drugs at the same time, but to consider the
alternative if child does not respond to first drug.
• Little evidence of any benefit or harm (either with fever or
comfort) of using both together.
• Combination of both can have summative effect and lead to
hypothermia.
• Complacent use in hospitals directly affects the
administration of these medicines in the home – age related
dosage at home may lead to under or over dosing.
8. Midazolam /benzodiazapine
• Uses – Given to children with convulsions
lasting > 5mins also a sedative for
procedures, pre med and anti epilepsy
medication
• Who can have it – From neonate
• How is it given – By I.V and buccal cavity
• Side Effects – respiratory depression
• Warning in a few patients can cause opposite
affect to sedation
9. Salbutamol
(Albuterol)
• Uses – To manage brochoconstriction and
asthma
• Who can have it –from 1 month
• How is it given – By I.V, aerosol (inhaler),
nebulised inhalation or dry powder
• Side effects - tremor (very common),
headache, sweats and tachycardia (fast heart
rate)
• Advise caution in diabetics due to potassium
regulation however remember ABC
10. Salbutamol
• The use of intravenous salbutamol in
patients with acute respiratory distress
syndrome is unlikely to be beneficial and
could worsen outcome - 34% of patients in
the salbutamol group died compared with
23% in the placebo group.
• Use of inhalers with spacers and
nebulisers have same outcome as long as
staff are properly trained in use of spacer.
11. Gaviscon Infant
• Uses – To relieve gastro oesophageal
reflux and dysphagia
• Who can have it – From neonate
• How is it given – Given by mouth, mixed
with feeds or water for breast fed babies
• Who can’t have it - Not where water loss
is likely or if there is an intestinal
obstruction.
12. Cefotaxime (pronounced with a K)
• Uses – An antibiotic usually first line on
most wards (broad spectrum antibiotic
covers anaerobes and aerobes).
• Who can have it – neonate - based on
weight
• How is it given – By I.M, I.V
13. Caffeine base/citrate
• Uses – respiratory stimulant – reduces the
frequency of neonatal apnoea and need for
mechanical ventilation during the first seven days
of treatment. Used in management of preterm
infants up to 44 weeks (or as long as required)
• Any babies born and started on ventilation will have
caffeine.
• How is it given – Given PO or IV
• Caution - with those with gastro oesophageal
reflux, cardiovascular but ABC comes first so
caffeine would be used to help respiratory
• Lots of research on caffeine and babies and used
in Canadian NICU as matter of course (according to
the QA neonatal consultant)
14. Morphine
• Uses – For pain or sedation
• Who can have it – From neonates
• How is it given – Given PO, IV or IM. If given by
injection diamorphine is preferable due to it being
more soluble can be given in smaller volume (The
equivalent subcutaneous dose is approximately a
third of the oral dose of morphine)
• Caution – respiratory depression, hypotensions,
shock
• Side effects – nausea, vomiting, hallucinations
(especially in the elderly)
15. Flucloxacillin (penicillin)
• Uses – Bacterial infections such as skin infections,
umbilical flare in NICU
• Who can have it – From neonates
• How is it given – Given by PO, I.M, I.V
• Who can’t have it - Contraindications – liver or
kidney problems
• Caution - Check allergy to penicillin -
hypersensitivity which causes rashes and
anaphylaxis and can be fatal. Allergic reactions to
penicillin’s occur in 1–10% of exposed individuals;
anaphylactic reactions occur in fewer than 0.05%
of treated patients. May cause diarrhoea
16. References
• NICE 2007
• BNF children 2012
• Pirmohamed, M., James, S., Meakin, S., Green C. (2004). Adverse drug reactions as
cause of admission to hospital: prospective analysis of 18 820 patients. BMJ, 2004.
• Rashed, A., Wong, I., Cranswick, N., Tomlin, S., Rascher, W., & Neubert, A. (2012).
Risk factors associated with adverse drug reactions in hospitalised children:
international multicentre study. European journal of clinical pharmacology, 68 (5).
• Nurse Prescribing, 2012 Jan; 10 (1): 48-9 (journal article - pictorial) ISSN: 1479-9189
• Hoyle JD; Davis AT; Putman KK; Trytko JA; Fales WD; Prehospital Emergency Care,
2012 Jan-Mar; 16 (1): 59-66 (journal article - research) ISSN: 1090-3127 PMID:
21999707
• Mecklin M; Paassilta M; Kainulainen H; Korppi M; Acta Paediatrica, 2011 Sep; 100
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• Hammerman, Cathy; Bin-Nun, Alona; Kaplan, Michael; Seminars in Perinatology,
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