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Drug monographs 

Drug monographs
Author(s):

Sean Ainsworth

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date: 06 August 2021

Among babies admitted to a neonatal intensive care unit over 90% will be prescribed a drug that is either unlicensed or used in an ‘off-label’ way (i.e. the medicine is licensed but is used outwith the terms of that licence). Informed use of some unlicensed medicines or licensed medicines for unlicensed applications is necessary in paediatric and neonatal practice. This section provides reliable and up-to-date information on any medicine that may be prescribed, dispensed, or administered to a child from birth until its first birthday. Prematurity brings its own challenges with changes in physiology and drug metabolism that occur in a short period of time. This section provides information on the pharmacology, safe prescribing, and administration of over 250 medications during the perinatal period up until the first birthday. Each monograph is fully referenced and many are supplemented with additional online material that covers extended use, particularly in the uses of a drug off-license. Potentially harmful excipients in some preparations are highlighted so that the reader can make an informed choice whether to seek out an alternative. Adjustments to dosing due to prematurity and postnatal age are highlighted as is any dose adjustment if the drug is used during therapeutic hypothermia. Management of toxicity, with details of appropriate antidotes, is discussed, and treatment of extravasation injuries is covered. Besides medicines, monographs also include blood products, vaccines, and formula milks for premature infants and those infants with allergies and intolerances. Links are provided to relevant Cochrane reviews and to national guidelines.

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