Evidence-Based Neonatal Pharmacotherapy, An Issue of Clinics in Perinatology

Dan Ellsbury, Alan R. Spitzer

Description

Dr. Spitzer has created an issue devoted to the evidence-based pharmacologic care of the neonate. The issue opens with an important article on A Quality Improvement Approach to Modifying Medication Use in the NICU. The expert authors he has secured have contributed articles in the areas of therapeutic drug monitoring, off-label use of medications in the NICU, antenatal and post-natal corticosteroids, antibiotics, antifungals, and antivirals, as well as bronchodilators and nitric oxide. Other articles also present evidence-based use of oxygen, dopamine, anesthetics and analgesics, and erythropoetin.

Sujets

• Medical
• Médecine
• Pediatrics

Informations

• Publié par: Saunders
• Date de parution: 28 mars 2012
• Nombre de lectures: 0
• EAN13: 9781455743032
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Clinics in Perinatology , Vol. 39, No. 1, March 2012
ISSN: 0095-5108
doi: 10.1016/S0095-5108(12)00006-1

Contributors
Clinics in Perinatology
Evidence-Based Neonatal Pharmacotherapy
Alan R. Spitzer, MD
The Center for Research, Education, and Quality MEDNAX Services/Pediatrix Medical Group/American Anesthesiology, 1301 Concord Terrace, Sunrise, FL 33323, USA
Dan L. Ellsbury, MD
Clinical Quality Improvement MEDNAX Services/Pediatrix Medical Group/American Anesthesiology, 1301 Concord Terrace, Sunrise, FL 33323, USA
ISSN  0095-5108
Volume 39 • Number 1 • March 2012

Table of Contents
Cover
Contributors
CME Accreditation Page and Author Disclosure
Forthcoming Issues
The Challenge of Managing Drugs Safely in the Newborn
Preface
A Quality Improvement Approach to Optimizing Medication Use in the Neonatal Intensive Care Unit
Drug Studies in Newborns: A Therapeutic Imperative
Therapeutic Drug Monitoring–the Appropriate Use of Drug Level Measurement in the Care of the Neonate
Obstetric Interventions Beneficial to Prematurely Delivering Newborn Babies: Antenatal Corticostetroids, Progesterone, Magnesium Sulfate
Evidence-Based Neonatal Pharmacotherapy: Postnatal Corticosteroids
Antibiotic Use and Misuse in the Neonatal Intensive Care Unit
The Use of Antiviral Drugs During the Neonatal Period
The Use of Antifungal Therapy in Neonatal Intensive Care
Metoclopramide, H 2 Blockers, and Proton Pump Inhibitors: Pharmacotherapy for Gastroesophageal Reflux in Neonates
Evidence-Based Use of Indomethacin and Ibuprofen in the Neonatal Intensive Care Unit
Evidence-Based Methylxanthine Use in the NICU
Pulmonary Vasodilator Therapy in the NICU: Inhaled Nitric Oxide, Sildenafil, and Other Pulmonary Vasodilating Agents
The Use and Misuse of Oxygen During the Neonatal Period
Hematological Interventions in NICU Care: the Use of rEpo, IVIG, and rG-CSF
Management of Neonatal Thrombosis
Neonatal Diuretic Therapy: Furosemide, Thiazides, and Spironolactone
Neonatal Blood Pressure Support: The Use of Inotropes, Lusitropes, and Other Vasopressor Agents
Anesthesia and Analgesia in the NICU
Index
Clinics in Perinatology , Vol. 39, No. 1, March 2012
ISSN: 0095-5108
doi: 10.1016/j.clp.2012.02.001
CME
CME Accreditation Page and Author Disclosure

Goal Statement
The goal of Clinics in Perinatology is to keep practicing neonatologists and maternal-fetal medicine specialists up to date with current clinical practice in perinatology by providing timely articles reviewing the state of the art in patient care.

Accreditation
The Clinics in Perinatology is planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Virginia School of Medicine and Elsevier. The University of Virginia School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The University of Virginia School of Medicine designates this enduring material activity for a maximum of 15 AMA PRA Category 1 Credit (s) ™ for each issue, 60 credits per year. Physicians should only claim credit commensurate with the extent of their participation in the activity.
The American Medical Association has determined that physicians not licensed in the US who participate in this CME enduring material activity are eligible for a maximum of 15 AMA PRA Category 1 Credit (s) ™ for each issue, 60 credits per year.
Credit can be earned by reading the text material, taking the CME examination online at http://www.theclinics.com/home/cme , and completing the evaluation. After taking the test, you will be required to review any and all incorrect answers. Following completion of the test and evaluation, your credit will be awarded and you may print your certificate.

Faculty Disclosure/Conflict of Interest
The University of Virginia School of Medicine, as an ACCME accredited provider, endorses and strives to comply with the Accreditation Council for Continuing Medical Education (ACCME) Standards of Commercial Support, Commonwealth of Virginia statutes, University of Virginia policies and procedures, and associated federal and private regulations and guidelines on the need for disclosure and monitoring of proprietary and financial interests that may affect the scientific integrity and balance of content delivered in continuing medical education activities under our auspices.
The University of Virginia School of Medicine requires that all CME activities accredited through this institution be developed independently and be scientifically rigorous, balanced and objective in the presentation/discussion of its content, theories and practices.
All authors/editors participating in an accredited CME activity are expected to disclose to the readers relevant financial relationships with commercial entities occurring within the past 12 months (such as grants or research support, employee, consultant, stock holder, member of speakers bureau, etc.). The University of Virginia School of Medicine will employ appropriate mechanisms to resolve potential conflicts of interest to maintain the standards of fair and balanced education to the reader. Questions about specific strategies can be directed to the Office of Continuing Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia.
The faculty and staff of the University of Virginia Office of Continuing Medical Education have no financial affiliations to disclose.
The authors/editors listed below have identified no professional or financial affiliations for themselves or their spouse/partner:
Marta Aguar, MD; Robert Boyle, MD (Test Author); Maria Cernada, MD; Robert D. Christensen, MD; C. Michael Cotten, MD, MHS; Javier Escobar, PhD; Raquel Escrig, MD; M. Paige Fuller, PharmD, BCPS; George P. Giacoia, MD; Maria Gillam-Krakauer, MD; R. Whit Hall, MD; Kerry Holland, (Acquisitions Editor); Lucky Jain, MD, MBA (Consulting Editor); Palmer G. Johnston, MD; Nicolas F.M. Porta, MD; Jeff Reese, MD; Matthew A. Saxonhouse, MD; Jeffrey L. Segar, MD; Shahab Noori, MD; Robin H. Steinhorn, MD; Perdita Taylor-Zapota, MD; Daniela Testoni, MD; Nidhi Tripathi, BS; Máximo Vento, MD, PhD; Kristi Watterberg, MD; and Anne Zajicek, MD.
The authors/editors listed below identified the following professional or financial affiliations for themselves or their spouse/partner:
Daniel K. Benjamin, Jr, MD, PhD, MPH is a consultant for Astellas Pharma US, Johnson & Johnson, Pfizer, Inc., Biosynexus, and Cerexa, Inc.; and is an industry funded research/investigator for Astellas Pharma US, Astra Zeneca, and UCB Pharma, Inc.
C. Andrew Combs, MD, PhD is an industry funded research/investigator for KV Pharmaceuticals.
Dan L. Ellsbury, MD (Guest Editor) is employed and owns stock with Pediatrix Medical Group.
Thomas J. Garite, MD is employed by the Pediatrix Medical Group.
William F. Malcolm, MD is on the Speakers’ Bureau for Abbott Nutrition.
Istvan Seri, MD, PhD receives grant support from Somanetics, Inc.
P. Brian Smith, MD, MPH, MHS is a consultant for Astellas Pharma, Johnson and Johnson, and Cubist Pharmaceuticals; and is on the Advisory Committee/Board for Pfizer, Inc.
Alan R. Spitzer, MD (Guest Editor) is employed by and owns stock in MEDNAX, Inc.
Robert Ursprung, MD is employed by Pediatrix Medical Group, and is on the Speakers’ Bureau and Advisory Board for Vermont Oxford Network.
Richard J. Whitley, MD is on the Advisory Committee/Board for Gilead Sciences, Inc., and is a consultant for Chimerix, Inc.
Thomas E. Young, MD is a consultant for Cornerstone Therapeutics.
Disclosure of Discussion of Non-FDA Approved Uses for Pharmaceutical Products and/or Medical Devices
The University of Virginia School of Medicine, as an ACCME provider, requires that all faculty presenters identify and disclose any off-label uses for pharmaceutical and medical device products. The University of Virginia School of Medicine recommends that each physician fully review all the available data on new products or procedures prior to clinical use.

To Enroll
To enroll in the Clinics in Perinatology Continuing Medical Education program, call customer service at 1-800-654-2452 or visit us online at www.theclinics.com/home/cme . The CME program is available to subscribers for an additional fee of $196.00.
Clinics in Perinatology , Vol. 39, No. 1, March 2012
ISSN: 0095-5108
doi: 10.1016/S0095-5108(12)00009-7

Forthcoming Issues
Clinics in Perinatology , Vol. 39, No. 1, March 2012
ISSN: 0095-5108
doi: 10.1016/j.clp.2011.12.020

Foreword
The Challenge of Managing Drugs Safely in the Newborn

Lucky Jain, MD, MBA
Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA
E-mail address: [e-mail]


Lucky Jain, MD, MBA, Consulting Editor
The challenge of safe and appropriate use of drugs in the neonatal period is a daunting one and is complicated by the glaring lack of evidence-based data that should guide decision-making. Clinicians struggle with a meager choice of drugs that have not been rigorously tested in the tiniest newborns; they often complicate this issue with their own unacceptably high variation in drug usage, which precludes collection of meaningful outcomes data. The result is an unsatisfactory state of either too much or too little use of drugs, and an industry that has yet to embrace pediatric drug development as an essential part of their overall strategy. 1 Newborns worldwide continue to suffer with plenty of blame to be passed around and few ready to shoulder the responsibility.
These significant issues notwithstanding, clinicians have an obligation to optimize drug therapy in neonates and track outcomes. Many institutions have begun this process using advanced quality improvement methodology tools, but the vast majority