Neonatal Clinical Pharmacology and Therapeutics (eBook)

Front Cover 1
Neonatal Clinical Pharmacology and Therapeutics 4
Copyright Page 5
Table of Contents 6
Contributors 8
Preface 12
Chapter 1. Pharmacological principles and kinetics 14
Drug-handling processes 14
Drug handling by the fetus 22
Pharmacokinetics and clinical relevance 23
Practical problems of drug delivery 34
References 37
Chapter 2. Placental transfer of drugs 39
Factors determining fetal dose 39
Measurement of placental transfer rate 44
Transfer of drugs in commonly presenting problems 49
Summary 51
References 51
Chapter 3. Drug therapy in pregnancy 54
Teratogenesis 54
Other effects of maternal drug therapy 55
Drugs affecting the cardiovascular system 57
Antimicrobials 58
References 58
Chapter 4. Tocolytics and oxytocin 62
Tocolytics 62
Magnesium Sulphate 64
Prostaglandin Synthetase Inhibitors 65
Calcium channel blockers 66
Alcohol 67
Oxytocin 68
References 70
Chapter 5. Maternal drug use and neonatal withdrawal 73
Drugs of abuse 73
Drug abuse and fertility 74
The risks of drug abuse to the pregnant mother 74
The risks of drug abuse to the fetus 75
The management of addiction in pregnancy 76
The management of labour 77
Neonatal withdrawal syndromes 77
Hepatitis and HIV 79
Breast Feeding 80
The children after discharge 80
The need for continuing research 80
References 80
Suggested further reading 81
Chapter 6. Prophylaxis for hyaline membrane disease 82
Primary prevention of prematurity 82
Pharmacological acceleration of lung development 84
References 90
Chapter 7. Maternal analgesia and anaesthesia and their effect on the newborn 94
Assessment of the neonate 94
Analgesia in labour 96
Anaesthesia 98
Sedatives in labour 103
References 104
Chapter 8. Treatment of neonatal apnoea 108
Methylxanthines: caffeine and theophylline 108
Doxapram 115
Almitrine 119
Other drugs 121
General considerations 121
References 122
Chapter 9. Prostaglandins and the perinatal pulmonary and systemic circulation 129
Prostaglandin synthesis 129
The arterial duct in the preterm infant 134
References 136
Chapter 10. Treatment of cardiac disorders in the neonate 139
Circulatory failure 140
Arrhythmias 152
Management of SVT 154
References 160
Chapter 11. Pharmacology of antibiotics in the newborn 166
Pharmacology of antibiotics in the newborn 166
Absorption, distribution and elimination of antibiotics 169
Pharmacokinetics 172
Therapeutic implications 174
Conclusion 175
References 175
Chapter 12. Drugs and neonatal jaundice 179
Drug treatment of unconjugated hyperbilirubinaemia 179
Drugs as contributors to jaundice 181
Effect of maternally-administered drugs 185
References 185
Chapter 13. Investigation and management of hypoglycaemia 189
Normal perinatal blood glucose metabolism 189
Hypoglycaemia 190
References 198
Chapter 14. Anticonvulsant drugs 200
Principles of anticonvulsant use 200
Drugs 203
References 209
Chapter 15. Pharmacology of vitamins A, D, E and K 212
Vitamin A 212
Vitamin D 214
Vitamin E (see also pp. 216-217) 216
Vitamin K 219
References 221
Chapter 16. Oxygen transport by the blood, haematinics and blood cell component therapy in the neonate 224
Problems of oxygen supply from the blood and oxygen demand in term and preterm babies 224
The role of the haematinics in haemopoiesis 16-18 226
Use of blood products 14.17.18.34-36 230
References 234
Chapter 17. Analgesia and muscle relaxants 237
Pain and the newborn baby 237
Muscle relaxation 241
References 243
Chapter 18. Absorption of drugs through the skin 246
Mechanism of percutaneous absorption 1-3 246
The drug 247
Measurement of percutaneous drug absorption in the newborn 247
Hazards of percutaneous absorption 252
Percutaneous drug therapy 256
References 259
Chapter 19. Parenteral nutrition 262
The aims of parenteral nutrition 262
Indications for parenteral nutrition 263
Parenteral nutrition in very low birth weight babies 265
Parenteral nutrient requirements 265
Practical considerations 267
References 278
Chapter 20. Drugs in breast milk 283
Milk formation and composition 283
Passage of drug into milk 283
Distribution of drug within milk 284
Pharmacokinetic considerations in the infant 285
Assessment of the risk of drug ingested in milk 285
Assessment of risk 287
Acknowledgement 289
References 289
Index 292