Osmolality of Commonly Used Oral Medications in the Neonatal Intensive Care Unit.

Objective: The administration of hyperosmolar oral products in neonates has been associated with gastrointestinal complications. The American Academy of Pediatrics recommends a maximum osmolality of 450 mOsm/kg for formulas and enteral nutrition for term infants, and recent studies reported intolerance to enteral nutrition with osmolality above 500 mOsm/kg in low birthweight infants. The osmolality of medications administered to neonates is often not available in the literature or from manufacturers.

Observational Study of Drug Formulation Manipulation in Pediatric Versus Adult Inpatients.

Objectives: Medications often require manipulations to measure and administer the correct dose for pediatric patients. These manipulations pose medication safety risks. The objective of this study was to determine the frequency of drug formulation manipulations in the pediatric inpatient population and compare the findings to a parallel adult inpatient population.

Visceral Hyperalgesia: When to Consider Gabapentin Use in Neonates-Case Study and Review.

Visceral hyperalgesia refers to increased pain sensation in response to gastrointestinal sensory stimulus. In neonates with neurological impairments, gabapentin has been successfully used as a treatment for visceral hyperalgesia in neonates. The authors describe a preterm infant with myelomeningocele and persistent neuropathic pain that manifested as irritability, hypertonicity, poor weight gain, and feeding intolerance.

Neonatal abstinence syndrome: essentials for the practitioner.

The incidence of neonatal abstinence syndrome (NAS) has increased dramatically during the past 15 years, likely due to an increase in antepartum maternal opiate use. Optimal care of these patients is still controversial because of the available published literature lacking sufficient sample size, placebo control, and comparative pharmacologic trials. Primary treatment for NAS consists of opioid replacement therapy with either morphine or methadone.

Standard dose development for medications commonly used in the neonatal intensive care unit.

Objectives: To establish standardized, rounded doses of medications for neonates in the neonatal intensive care unit (NICU) through a multi-institutional peer-reviewed process.

Methods: Pediatric faculty and pediatric pharmacy residents from the Ernest Mario School of Pharmacy (Piscataway, NJ) conducted a systematic review of rounded, weight-based medication information for neonatal patients from September 2010 to April 2011. After initial review, an expanded workgroup of expert neonatal pharmacy clinicians from academic institutions throughout the United States were invited to conduct a final review.

Use of tincture of opium compared to oral morphine for the treatment of neonatal abstinence syndrome.

Objective: To evaluate the difference in time until medical clearance when comparing tincture of opium (TO) to oral morphine (OM) in the treatment of neonatal abstinence syndrome (NAS).

Design: Retrospective chart review conducted from May 2007 to July 2011.

Setting: Level III Neonatal Intensive Care unit at Morristown Medical Center in Morristown, New Jersey.

Y-site compatibility of medications with parenteral nutrition.

Providing parenteral nutrition to pediatric patients requiring various other intravenous products can be challenging. Evaluation of compatibility is essential; however, information is limited and sometimes conflicting. We strove to critically evaluate and present the available published data as a comprehensive and practical reference.