Management Protocol of Newborn "s Handbook ‘Tab Digoxin (Lenoxin:1 tab=0.25mg) 0.05mg/ml Inj Digoxin (Dixin:| amp~Oggmgias!) 0.25mg/mt Preierar Term W ‘Ont IV] Oral 0.03*wi/.25=TDD | werysay Tool digitalizing dose(TDD) | 15-25 3030 [O30 [B35 Wiintenance dose % ris [38 [610 TDD is to be divided 172, 14 and Wlevery 8 hrs (Oral dose is 28% higher than IVdose Frusemide+ Spironolactone Frasemide= Img/ig/dose Tr hrly or once daily Spironolactone=1-2mg/ke/dose (Frulac/asilactone:} tab=20/50mg) Caplopa TO1-0.05mpkgidose Biz hey (Acetor,Cardopri:1 tab=25mg) Touproven INPDA Contra-indications: DI:1Omg/kg/dose.orally Urine output:<0,6mV-kg/hr (Syp inflame, profen:100mg/Sml)_ | 192:Smg/kp/dose S creatinine:>1.8mg/dl D3-Smpykg/dose PLT -<60,000/mm3 GIT bleeding, NEC IVH ‘Siena 05-2 mplkgilose 6-12 hy (Edegra:1 tab =S0mg) Tay Frusemide Tmp/ke/dose =1Ounit/kg/dose (Lasin:20mg/2ce) Tevouthyroxine 10-I5ugikelday ‘once daily (1 tab50 ne) Inj. Amiodarone 150mg/3ml MD: Smicrogm/kg/min with 24ml NS lV @1ml/hr Inj. Adenosine (6mg/2ml) .05mg/kg stat IV rapidly with NS flash Asap 189 Scanned with CamScannerCuoice of antibiotics: Stage | Antibiotics 1 Line Ampicilin + Gentamicin 2™ Line Ceftazidime + Amikacin 3” Line (Reserve) Meropenem, Ciprofloxacin, Vancomycin, | Cefepime, Clarithromycin, Netilmicin, Imipenem, Piperaillin+ Tazpbactum, Colistin In case of suspected Cefotaxim + Amikacin or Meropenern + meningitis Amikacin | a) Inj Doripenem 15 mg/kg/ dose - 12 hourly. Inj Penta globulin ~ | 7ml/kg/hr for 3hrs for 3days. Inj Insulin 2-3 unit Kehr for 6hr Tab Cdegra 2mg/Kg/dose Scanned with CamScannerInj. Levofloxacin 500mg/100m! 6 month-5 year: 10mg/kg BD >5 year: Once daily Management Protocol of Newborn Doctor's Handbook Tay Ciprofloxacin 7 Smphkg/dose Tahely ~3.75ccfke/dose (Neofloxacin:200mg/100e¢ Infuse over 30 minutes Try Clarithromicin Tamereg/dose Tahrly =0.1Scc/kp/dose (Klaricid:500mg/10ce) Alway's infuse over I hr Try Colistin 25,G0OuniVKg/dose Bhriy =0.2Scefkp/dose (CImittion=10,00000univ10ce) =25univke/dose(by 100 unit Infuse over 30 minutes insulin syringe) Tay Cefepime ‘SOme/kg/dose Tahly =leokkg/dose (Tetracef,ceftipime:$00mg/10cc) In meningitis: Dose& Frequency | Infuse over 30 mimues same Taj PiperaclineTavabactam ‘8Omg/kg/dose(piperacilin T2hrly ‘component) Range:$0-100mp/kp/dose (Zosyn:4.Sgm/20ce diluent) =0.dechkg/dose (piperacillin component) ; ~dOunivkg/dose Infuse over 30 mines Piperacillin:4gm <7 days: BD ‘Tazobactam:0,5gm > 7 days: TDS Taj Linezolid TOmp/kg/dose T2hrly (Arlin:600mg/300ml) Infuse over 30 mimues Taj Metronidarale Time kg done =D weeks = 1 Scc/kg/dose 0-28 days - 48 hourly (Filmet,Mez:500mg/100ec) > 28 days- 24 hourly 30-36 weeks: 0-14 days ~ 24 hourly 14 days- 12 hourly 37 weeks or more: 0-7 days- 24 hourly >7 days- 12 hourl Inj Acyclovir ‘2Omg/kg/dose Shrly =0.4ee/kg/dose (Xovir,Zovirax:500mg/Iflce) ‘=40univkg/dose Abways infuse over I he Inj Flucloxacillin (50 mp/kg/dose Whrly 0. Sce/kg/dose (Fluelos Phylopen:250mg/2.Sce,S00mg/Sec) | =SOunivkg/dose In Osteomyelitis: In Osteomyelitis: 100mp/kg/dose lechkg/dose hit for 46 wis Thy Phytomenadion (Inj Konakion;2mg/0.2cc) Prophylaxis At birth: 2mg=0.2ce=20units ‘Administer, Img=0.1cc=10units, IM stat Inj. Fluconazole 200mg/100m! 6mg/kg stat then 3 mg/kg OD for 7 days with IVF 188 Scanned with CamScannerManagement Protocol of New born Doctor's Handbo dk Loading =20me/kg/dose Inj Phenobarbitone =0.lochkp/dose (Barbit:200mp/ce) =10univkg/dose Maintenance=2. Smprkyydose T2hrly =1.Sunivkgidose N.B:10mg/kp/dose~Sunivkp/dose Loading ~30mp/kp/dose Inj Fosphenytoin =0.dcerkpidose (Fosphen:150mg/2ce) =s0uniuke/dose Maintenance=3,75me/kgidose Tahrly ~Sunivkpiidose N.B:1Smg/kg/dose=20univkg/dose Taj Midazotam ‘Continuous infusion: +<32 wks: 0.03 mg/kg/hr (Dormicum, Dormitot:15mg/ 3ee) | >32 wks: 0.06 mg/kg/h Range: 0.01-0.06 mp/kg/hr Tj Pyridoxine 30-100 mig IV single dose, followed bby 2.30 minutes observation period Vamp= mg/ ¢& Ifa response is seen, begin Vtab= mg ‘maintenance of 50-100 mg PO daily Range: 10-200 mg Inj Ranitidine Tmgfkg/tose They dunithkp/dose (Ranison,Neotack:SOmg/2cc) Loading __=Smg/kg/dose Inj Aminophyttin =20unitke/dose Maintenance=2.Smp/kg/dose (125mg/Sec) =10unitkp/dose Vhety ‘Requirement of Dopamine 2g Inj Dopamine Cardine:S-20g/kg/min baby N ‘Sn2x24%60=14400g"14 dmg= (200mg/Sec) 5 p/kg/min=1 8unittkg/24hrs 14.4mg*40=0.36ce~36unit 7.5 jug/kg/mi =27 unitikg/24hes 1Ong/kg/min =36 univ kg/24hes Inj Dopamine(200mg/Sce) 3Gunit+24ml LV Muid@t mUte Renal: 0.5-2hp/kg/min 190 Scanned with CamScannerManagement Protocol of Newhorn Doctor's Handbook inj Dobutamine S-20nghe/min Requirement of Dobutamine i 2k haby= 5+ 2+ 24% 60- 14400 ug (250mg/See) NB: = Medeng 14.4g50-03ce~ 30unit {ny Dopamine(250mg’See) Spfkg/min = 1Sunivkg/2dhrs 3Ounat+ 24m W fluid) mirhe 7.5 pelkg/min-22 5 unithke/2dhrs 1Oug/kg/min =30 univkg/24hrs Inj Adrenaline 011-03 miltkg 1V Tadication 10-30 univkg (Inj Adsin: 1 amp=1:1000 dilution) 1 ma mixed with 9 mt distilled 1120 to make a 1:10,000 dilution Taj Naloxane OS mig TFMOM received opiate within hrs of delivery (1 amp=0.4 mg/ tml) Taj Immunoglobin ‘SmUkg/dose ‘Once daily, 3-3 doses Pentaglobin:1 vial=10 mt Infusion rate:1,7 mlzkg/tr Taj 10% Calclum gluconate Prophylactic Preterm< 32 wks, sick IDM, severe asphyxia 40 me/kp/day for 3 days (Ammi/ap/day of 10% calcium sluconate ) Wor oral 11 Treatment is for 72 hours 1) Continuous infusion is better than bolus 11 Symptomatic babies treatment 4s 48 hrs continuous infusion “Anymptomatie # SO mp pAday for 48 Wrst mL /bg/day of 10% calcium gluconate ) © Taper to 40 mg/kg/day for cone day © Then stop. ‘ml/kg + same amount gf WIV ‘Symptomatic © Bolus of 2 mL/kg calcium gluconate 1:1 diluted with $ % dextrose over 10 minutes under cardiac monitoring + Followed by continuous infusion 80 mp/kg/day for 48 hrs © BmLAgiday of 10% calcium gluconate ) # Then taper to 40 mg/ke/day for one day ‘op Inj Sodium bicarbonate Total requirement=0.4> wt in Ke base excess eg. IFwt2 kg and ABG shows - 15 mmol ‘Total requirement=0.4%2*15= T2mmolf=12 ce © 1 18%dec mixed with same amount of distilled 1120 1V stat © 2 18% m4ee mixed with 24 brs IV Mid © Rest 13":Auto-correction, if renal functions is in ‘normal limit. 191 Scanned with CamScannerManagement Protocol of Newborn, Doctor's Handbook Taj Dexamethasone (Oradexon, Roxadex: lamp=Sme/t ml) For extubation, 0.25-Imp/kg/dose “This prior fo schedule extubation and then Shrly for 3 doses Inj Hydrocortisone Tn recurrent rypoglycemia: 2.5 mp/kg/dose, IV of PO T2 hrly for 24 to 48 hrs Recurrent / resistant hypoglycemia [When there is a failure to maintain ‘normal blood sugar levels despite a glucose infusion of 12 meykg/min oF ‘when stabilization is not achieved by 7 days of therapy.) ‘Syp Multivitamin (Tynisol, V-plex Panvit paed drop) Tab id (Folison: 1Tab=Smg) 6 drops PO once daily for 6months very aliemate day for 6months ‘Syp Iron (Compiron:SOmg/ce) Fomghkgyday ‘Total daily requirement(in drops) ‘Over Gmonths NB: Multi-vitamin, Folie acid, Iron ( Omidon, motigut): 2.Smg/Iml) swe? should be started in preterm babies From 45 days of Age aint Syp UDCA "7 Smplkg/ose Taksly (Syp Liconor250mg/Sec) Nystatin oral suspension Tee= 15 drops Ghily (candex Nystat: 0000011) Domperidone paed drop ‘Requirement: Per dose(in drops): Weel, 8 hrly Making of IVF 5 For 7.5%DBS: 5*7.5-25= 12.5ml of 25% glucose and 87.5 ml 5%DBS 192 Scanned with CamScannerInj. Fimoxyclav 600mg, 1.2gm 15mg, peeraoae BD if < 7days Management Protoco TDS if > 7 days o Working doses in NICU DRUGS DOSE INTERVAL ‘SOmg/kg/dose, =0.Scckkg/dose Inj Ampicillin. =S0unit/ke/dose 0-7days:I2hrly : >7 days: Shih (Pen-A: 250mg/2.Sce, S00mp/Sce) ‘In meningitis:75-1 Somg/ke/dose isin mpg dose, SToodgmronce daily ~0.Scoke/dose <<1000gm:36hrly Inj Gentamicin ‘=SOunitkg/dose Check trough level with fourth (Genacin, gentin: 20,80mg/2ce) dose SOmg/ke/dose O-Tdays 1ahily 70. Scolkg/dose >Tdays:8hrly Inj Ceftazidime/Cefotaxime =SOunitfke/dose In meningstis: 1O0mg/kg/dose (250mg/2.Sce, 500mp/Sec) errs TSmplkgdose Tahrly =0, IScc/kg/dose(calculated by {nj Amikacin 100mg/2cc) ‘=1Sunithke/dose (Kacin, Amikin: 100,250,500mg/2cc) DOmerka/dose O-adays: They 0 deckkg/dose Inj Meropenem =40unitfke/dose >14days:8hrly (I . Re 1S 00mg In meningitis:40mp/ke/dose Infuse aver 30 minutes (-penem, Ropenem, Specbac:500mg/10cc) '=0 Bccikp/dose nfs ates =80univke/dose Tomg/kg/dose ~4cc/ke/dose T2hry {nj Imipenen/ciasatin Infuse over 30 minutes " Us meninges: Does & (Should not select baby (500mg/100ce) ‘Frequency same) presented with seizure) TOmg/kg/dose 0-T4days:1 2hrly 0 2cchkg/dose >idays:Rhrly Inj Vancomycin '=20unit/ke/dose - Always infuse over Ihr (800mg/10ce) Ta meningitis: Smpky dose =0 3cc/kg/dose =30univkg/dose | (Check srough level with fourth dose) Taj Netiimicia DSmphkgidose (0-7days:12hrly 50mg/ml =0.025cc/kg/dosc (calculated by | >7days:8hrly {200,S0mg/2cc) 200mg/2cc) Check trough level with fourth =2 Sunivkg/dose dose Inj. Teo ay (Ti Hpac 200mg/3ml Témg/ g Stat and BD for 3 dose. 187 Theng 6- pee an OD with IVF Scanned with CamScanner