Assuntos
Guias como Assunto/normas , Cuidado do Lactente/normas , Pediatria/normas , Sono , Sociedades Médicas , Decúbito Dorsal , Humanos , Lactente , Recém-Nascido , Decúbito Ventral , Fatores de Risco , Síndromes da Apneia do Sono/epidemiologia , Síndromes da Apneia do Sono/etiologia , Síndromes da Apneia do Sono/prevenção & controle , Morte Súbita do Lactente/epidemiologia , Morte Súbita do Lactente/etiologia , Morte Súbita do Lactente/prevenção & controleRESUMO
To better understand patterns of medication use in neonatal intensive care, we examined data collected prospectively over a recent 9-year period in the newborn intensive care units of two large teaching hospitals. Among 2690 infants studied, 91% received at least one drug; 99% of infants weighing less than 1500 gm were exposed to drugs, compared with 90% of infants weighing more than 1500 gm. Among treated infants, the median number of drugs received was eight; the number of drugs administered was inversely related to birth weight and directly related to both length of hospital stay and the complexity of the infant's clinical condition. Within categories of length of hospital stay, the number of drugs received per day was greatest during the first week in the neonatal intensive care unit and fell to a relatively stable lower level during the second week. The most commonly used single drug was gentamicin (71% exposed), followed by sodium chloride (60%), potassium chloride (59%), heparin (58%), and packed erythrocytes (45%). Between 1978-1979 and 1985-1986 the prevalence of use increased substantially for some drugs (ampicillin, morphine, calcium salts, and acetates of sodium and potassium) and decreased for others (kanamycin, sodium bicarbonate, and blood products). These data document the dynamic nature of drug therapy in the neonatal intensive care unit and provide information that can guide cost-benefit assessments in this setting.
Assuntos
Tratamento Farmacológico , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Antibacterianos/uso terapêutico , Peso ao Nascer , Transfusão de Sangue , Boston , Uso de Medicamentos , Feminino , Hidratação , Humanos , Tempo de Internação , Masculino , Nutrição ParenteralAssuntos
Anormalidades Induzidas por Medicamentos/etiologia , Hidantoínas/efeitos adversos , Teratogênicos , Epilepsia/tratamento farmacológico , Feminino , Transtornos do Crescimento/induzido quimicamente , Humanos , Hidantoínas/uso terapêutico , Deficiência Intelectual/induzido quimicamente , Troca Materno-Fetal , Gravidez , Complicações na GravidezRESUMO
The occurrence of pupillary constriction in children comatose as a result of the acute ingestion of common drugs has been studied in a large pediatric hospital by reviewing records of patients admitted between 1965 and 1974. Among 94 patients with an acute drug ingestion, the frequency of miosis in relation to the cause of coma was 88% for narcotics, 72% for phenothiazines, 35% for ethanol, and 31% for barbiturates. In contrast, miosis was noted in only 3% of 105 patients with coma from head injuries or infection of the central nervous system. Miosis was associated with all four drug ingestions among patients in deep coma and with narcotic and phenothiazine ingestions among patients in light coma. The frequency of miosis was found to increase with increasing depth of coma in patients with all four drug overdoses, particularly among patients with phenothiazine and barbiturate ingestions.