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Neonatal Intensive Care Drug Manual
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| bet | 275/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Drug Interactions
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Drugs that induce hepatic enzymes such as phenobarbitone, phenytoin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response.
Ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity.
Increased GI toxicity with concurrent use of indomethacin.
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Adverse effects
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Hyperglycaemia, glycosuria.
Hypertension after 24−48 hours.
Vomiting, diarrhoea, gastric irritation, gastrointestinal ulceration and bleeding.
Use of hydrocortisone in preterm infants in the first week is associated with intestinal perforation, particularly when treating concurrently with indomethacin.
Salt and water retention.
Hypokalaemia.
Hypocalcaemia and long-term exposure increases the risk of osteopenia.
Inhibits immune function and decreases resistance to infection. May mask symptoms of infection.
Neutrophilia, thrombocytopenia.
Irritability.
Acute withdrawal after use > 14 days can lead to acute adrenal insufficiency with fever, hypotension, hypoglycaemia and shock.
Long-term use can adversely affect somatic growth.
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Compatibility
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Fluids: Glucose 5%, glucose 10%, Hartmann’s, sodium chloride 0.9%
Y-site: Amino acid solutions. Aciclovir, amifostine, aminophylline, anidulafungin, atracurium, atropine, aztreonam, bivalirudin, calcium gluconate, caspofungin, chlorpromazine, cisatracurium, dexamethasone, digoxin, dopamine, doripenem, droperidol, fentanyl, filgrastim, foscarnet, frusemide, granisetron, hyoscine hydrobromide, lignocaine, linezolid, magnesium sulfate, morphine sulfate, neostigmine, noradrenaline, oxytocin, pancuronium, pethidine, piperacillin-tazobactam (EDTA-free), remifentanil, sodium bicarbonate, suxamethonium, vecuronium.
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