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Neonatal Intensive Care Drug Manual
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| bet | 123/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Dose adjustments
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Therapeutic hypothermia: no information.
ECMO: no information.
Renal: commence on a low dose in infants with renal impairment and adjust according to response.
Hepatic: not applicable.
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Maximum dose
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Neonatal abstinence syndrome: 12 microgram/kg/day. [7]
Hypertension: 25 microgram/kg/day has been reported. However, it is recommended to use in combination with other antihypertensive agents rather than at higher dose as a single agent. [2]
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Total cumulative dose
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Route
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IV
Oral
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Preparation
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IV infusion:
Step 1:
Draw up 1 mL (150 micrograms) of Clonidine and add to 4 mL of Normal Saline 0.9% to make a final volume of 5 mL with a concentration of 150 microgram/5mL or 30microgram/mL.
Step 2:
From the above solution draw up 1.7 mL/kg (50 microgram/kg) and further dilute with sodium chloride 0.9% to make a final volume of 50 mL with a concentration of 1 mL/hour = 1 microgram/kg/hour.
Oral:
Tablet: Disperse 100 microgram tablet in 20 mL sterile water. Tablet will disperse within 2 minutes. Shake or stir until an even dispersion is formed and then measure the required dose immediately.
IV clonidine (ampoule) may be given orally as either neat or diluted with water prior to administration to give a suitable dose volume.
Solution or suspension: Compounded by pharmacy in-house (check which strength is stocked with Pharmacy Department).
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Administration
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IV infusion.
Use a dedicated infusion line to avoid boluses.
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Monitoring
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Neonatal abstinence syndrome: monitor Neonatal Abstinence Syndrome scores, cardiorespiratory observations and intermittent blood pressure.
Sedation of infants on mechanical ventilation: continuous electrocardiogram (ECG) and/or oxygen saturation and continuous or intermittent blood pressure, pain and comfort scores.
Hypertension: For initial treatment, continuous ECG and/or oxygen saturation, and continuous or intermittent blood pressure monitoring.
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