Julia Hum
ACH MV-NICU
4853L MEDICATION WORKSHEET
Brand Name 1. Vancocin
Generic Name vancomycin
Dose IV (Neonates 1 wk – 1 mo):
<1200 g: 15 mg/kg/day q 24
hr.
IV (Neonates <1 wk): <1200
g: 15 mg/kg/day q 24 hr.
Administration Route IV/IT
Classification Antibiotic
Action Binds to bacteria, killing it.
Gram + pathogens
Reason Pt. Receiving Systemic infection
Contraindications Hypersensitivity, renal
impairment.
MAJOR Adverse Side Ototoxicity, hypotension,
Effects nausea, vomiting,
nephrotoxicity, rashes,
leukopenia phlebitis, back and
neck pain, hypersensitivity
reactions including
anaphylaxis, chills, fever,
superinfection.
Nursing Responsibilities -Administer slowly
and Implications -Assess for infection
-Monitor IV site closely.
-Rotate infusion site.
-Monitor BP throughout IV
infusion.
-Monitor intake and output and
daily weight.
-Assess patients for signs of
superinfection .
-Assess for anaphylactic
reaction
2. Unasyn
ampicillin/sulbactam
IM, IV (Neonates <7 days):
200 mg/kg/day divided q 8
hr. IM, IV (Neonates >7
days): 300 mg/kg/day
divided q 6 hr.
IM/IV
Antibiotic
Binds to bacteria, killing it
Skin infections, Otitis
media, Sinusitis,
Respiratory infections,
Genitourinary infections,
Meningitis, endocarditis
Hypersensitivity to
penicillin.
Seizures, colitis, diarrhea,
nausea, vomiting. rash,
urticaria, blood dyscrasias,
anaphylaxis.
- Assess for infection
-Obtain specimens for
culture and sensitivity
-Assess bowel status
throughout therapy.
-Observe patient for signs
and symptoms of
anaphylaxis
-Assess skin for ampicillin
rash
-May cause elevated AST
and ALT
3. Diogent
gentamicin
IM, IV (Neonates full term
and/or > 1 wk): <1200 g:
2.5 mg/kg/dose q 18–24 hr.
IM, IV (Neonates premature
and/or <1 wk): <1000 g: 3.5
mg/kg/ dose q 24 hr.
IM/IV/IT
Antibiotic
Inhibits protein synthesis in
bacteria
Gram - pathogens
Treatment of bacterial
infections and infections
caused by staphylococci.
Products containing benzyl
alcohol should be avoided.
Take caution in neonates d/t
elevated risk of
neuromuscular blockade;
difficulty in assessing
auditory and vestibular
function; immature renal
function.
Ataxia, vertigo, ototoxicity,
nephrotoxicity, muscle
paralysis, hypersensitivity
reactions.
-Draw blood for peak levels
1 hr after IM injection and
30 min after a 30-min IV
infusion is completed.
-Keep patient hydrated
-Assess for infection
- Assess for tinnitus or
subjective hearing loss
occurs
-Monitor I&O
- May cause elevated BUN,
AST, ALT, serum alkaline
phosphatase, bilirubin,
creatinine, and LDH
concentrations.
4. Cafcit
caffeine citrate
IV, PO (Neonates):
5 mg/kg caffeine citrate
(2.5 mg/kg caffeine
base) q 24 hr.
IV/PO
CNS stimulant
Decrease in periods of
apnea
Short-term treatment of
apnea with prematurity
in infants.
Hypersensitivity
Caution: Serum caffeine
levels of >50mcg/mL,
monitor serum levels
and adjust dose as
needed.
Insomnia, irritability,
jitteriness, restlessness,
tachycardia, NEC,
feeding intolerance,
gastritis, dry skin, rash,
hypoglycemia,
hyperglycemia, muscle
tremors.
-Assess Respiratory
status frequently
-Monitor for signs of
necrotizing enterocolitis
-Monitor serum caffeine
levels, serum glucose
levels
-Assess Heart Rate
before administration
Therapeutic range:8–20
mcg/mL.
 Julia Hum
ACH MV-NICU

Brand Name 5. Vitamin D 6. Multivitamin 7. Avirax 8. Maxipime

Generic Name cholecalciferol poly-vi-sol acyclovir cefepime
Dose (Infants): Exclusively or 1 dose unit (dropperful)/day (birth– 3 mo): 20 mg/kg Neonates > 14 days):
partially breastfed — 400 or amount recommended by q8h for 14– 21 days. 50 mg/kg q12h
IU daily. individual manufacturer. (neonates, premature): 10 Neonates < 14 days):
mg/kg q12h for 14– 21 30 mg/kg q12h;
days.
Administration Route PO PO/IV IV IM/IV

Classification Vitamin Vitamin Antiviral Antibiotic

Action Activates liver & kidneys Prevent vitamin deficiencies Inhibition of viral Bactericidal action
to create active form of for those who are unable to replication against bacteria
Vit D. Promotes ingest oral feedings/vitamins.
absorption of calcium
Reason Pt. Receiving Tx/prevention of Tx/prevention of deficiencies Tx for Herpes Simplex Tx of infection
deficiencies
Contraindications Hypersensitivity, Hypersensitivity to Hypersensitivity to the Hypersensitivity to
Hypercalcemia. Vit D preservatives, colorants, or drug, neurologic, hepatic, cephalosporins &
toxicity, Mg antacids additives, including tartrazine, pulmonary, or fluid and Serious w/penicillins.
saccharin, and aspartame (oral electrolyte abnormalities &
forms) hypoxia

MAJOR Adverse Side headache, irritability, urine discoloration, allergic seizures, dizziness, headach seizures,
Effects somnolence, weakness. reactions to preservatives, e, hallucinations, encephalopathy,
conjunctivitis,arrhythmia additives, or colorants. hyperbilirubinemia, renal colitis, rashes, pruritus,
hypertension, (minimal S/E) failure, hematuria, hives, urticaria, hemolytic
constipation, dry mouth, rashes, sweating, steven anemia, neutropenia,
pancreatitis, polydipsia, johnsons syndrome, thrombocytopenia,
vomiting, weight loss, thrombocytopenia, pain, anaphylaxis
bone pain polydipsia.

Nursing Responsibilities -Assess pt for bone pain Overdose- tx includes -Assess for lesions before -Assess for infection at
and Implications or weakness before induction of emesis or gastric and daily during therapy beginning of and
therapy lavage, calcium gluconate IV -Monitor neuro status throughout therapy.
-Observe pt for signs of if hypocalcemic, and - Monitor BUN, serum -Observe patient for
hypocalcemia maintenance of high urine creatinine signs and symptoms of
(Chvostek’s or output. -elevated BUN and serum anaphylaxis
Trousseau’s sign), -Liquid preparations can be creatinine levels may -Monitor bowel
-raising and padding side dropped directly in mouth/ indicate renal failure. function. Diarrhea,
rails; keep bed in low mixed w/juice -Start asap &w/in 24h of abdominal cramping,
position. outbreak fever, and bloody
-Monitor serum calcium, -Give over 1 hr stools should be
phosphorus, and alkaline reported to health care
phosphatase periodically professional
- May cause positive
Coombs’ test in
neonates
-May cause inc serum
AST, ALT, bilirubin,
BUN, and creatinine.

Brand Name 9. Buprenorphine
Generic Name Belbuca, Probuphine
Dose (Neonates): adjust dose in
2-4 mg increments
Target Dose: 16 mg
sublingual / day
Max Dose: 24mg/day
Administration Route Sublingual
Classification Opioid partial
agonist-antagonist
Action Binding to the mu-opioid
receptors and
slow-dissociation kinetics
Reason Pt. Receiving To make withdrawal from
opioid dependency from
pregnancy less harsh.
Contraindications Patients in circulatory
shock, hypersensitivity to
buprenorphine
MAJOR Adverse Side Rash, itching, hoarseness,
Effects trouble breathing, trouble
swallowing, swelling of
hands, face, or mouth,
pruritus, erythema,
headache, depression,
constipation, nausea,
vomiting, back pain
Nursing Responsibilities and -Maintain a slow stimulus
Implications environment
-Dim lights, decrease noise
-Cluster Care
-Obtain comfort scores Q4
hours
-Swaddling
-Monitor liver enzymes,
serum bilirubin, serum
creatinine
10. Microzide
Hydrochlorothiazide
(Children <6 mo): Up to 2–
4 mg/kg/day in 2 divided
doses
PO
Antihypertensive, diuretics
(thiazide diuretic)
Lowering of BP and
diuresis with mobilization
of edema.
Tx HTN
Tx of edema associated w/
HF, Renal dysfunction,
Cirrhosis, Glucocorticoid
therapy
Anuria & hypersensitivity
Dizziness, drowsiness,
lethargy, weakness,
hypotension. cramping,
hepatitis, N/V, Steven
Johnsons Syndrome,
photosensitivity, rash, acute
myopia, hyperglycemia.
hypokalemia, dyscrasias
-Assess BP, I&O, daily wt,
and for edema daily
-Assess for rash, report
immediately (SJS)
-Monitor electrolytes, BS,
BUN, creatinine and uric
acid levels.
-administer in am
Julia Hum
ACH MV-NICU
11. Slo-Salt 12. Potassium chloride
Sodium Chloride (NaCl) KCl
Neonates): 1– 4 IV (Neonates): 2–6
mEq/kg/day. mEq/kg/day.
IV/PO IV/PO
mineral & electrolyte mineral & electrolyte
replacements/supplement replacements/supplement
Maintains sodium Replacement /
requirements Prevention of deficiency
Replacement in deficiency Tx/prevention of
potassium depletion.
Arrhythmias due to dig
toxicity.
NaCl preserved with benzyl Hyperkalemia, untreated
alcohol should not be used addison’s disease, severe
in neonates renal impairment
Heart failure, pulmonary, Confusion, restlessness,
edema, hypernatremia, weakness, arrhythmias,
hypervolemia, changes, irritation at IV
hypokalemia, irritation at site, paralysis,
IV site. paresthesia.
-Dose depends on age, wt, -Monitor pulse, BP, EKG
condition, fluid and throughout therapy
electrolyte balance, and -infuse slowly
acid-base balance. -assess for pain during
-Do not administer administration
bacteriostatic NaCl -Never administer as a
containing benzyl alcohol push
as a preservative to -Do not administer
neonates. undiluted
-Assess fluid balance
-Assess patient for S&S of hypokalemia or
symptoms of hyponatremia hyperkalemia
or hypernatremia, check
acid-base balance
periodically

Brand Name 13. Aldactone
Generic Name Spironolactone
Dose (Neonates): 1–3 mg/kg/day
divided q 12– 24 hr.
Administration Route PO
Classification Potassium sparing diuretic
Action Causes loss of sodium
bicarbonate and calcium
while saving potassium
Reason Pt. Receiving Management of primary
hyperaldosteronism, edema,
cirrhosis and nephrotic
syndrome.
Management of essential
hypertension.
Tx of hypokalemia
Contraindications Anuria, hypersensitivity to
aldactone
MAJOR Adverse Side Dizziness, clumsiness, HA,
Effects sedation, arrhythmias, inc
hair growth in females,
hyperkalemia,
hyponatremia,agranulocyto
sis, thrombocytopenia, drug
rash, steven johnsons
syndrome
Nursing Responsibilities and -Monitor I&O and daily wt
Implications -BP before administering
-Assess for skin rash
-Administer in am
14. Lasix
Furosemide
(Neonates): 1– 4
mg/kg/dose 1– 2 times/day
(Neonates): 1– 2
mg/kg/dose q 12– 24 hr.
PO/IV/IM
Diuretic
Inhibits the reabsorption of
sodium and chloride
Increases renal excretion of
water, sodium, chloride,
magnesium, potassium, and
calcium, decreases BP
Tx of edema due to heart
failure, hepatic impairment
or renal disease.
Hypertension.
Increased risk for renal
calculi and patent ductus
arteriosus in premature
neonates
Dehydration, hypocalcemia,
hypochloremia,
hypokalemia,
hypomagnesemia,
hyponatremia,
hypovolemia, metabolic
alkalosis, aplastic anemia,
agranulocytosis,
steven-johnson syndrome
-Assess fluid status.
- Monitor daily weights
-Monitor BP and pulse
before and during
administration.
-Assess for tinnitus and
hearing loss.
-Monitor electrolytes
15. Decadron
dexamethasone
Airway edema or
extubation: 0.5– 2
mg/kg/day divided q 6 hr;
Antiinflammatory: 0.08–
0.3 mg/kg/day
PO/IM/IV
Systemic corticosteroid
Suppression of
inflammation and normal
immune response.
TX for neonates with
bronchopulmonary
dysplasia to facilitate
ventilator weaning
Can cause significant and
persistent reductions in
cognitive functioning;
results in decreased growth
Increased intracranial
pressure, restlessness,
PUD, thromboembolism,
osteoporosis, Increased
susceptibility to infection.
-Give daily doses before
0900 to mimic normal peak
corticosteroid blood levels.
-Taper doses when d/c from
high dosage or long-term
therapy.
-Teach to avoid exposure to
infection during treatment
d/t immunosuppression
side effect.
Julia Hum
ACH MV-NICU
16. Erythromycin
Romycin, Ilotycin
1 cm strip in each
eyelid within 24 hours
of birth.
Ophthalmic ointment
Macrolide Antibiotic
Works to prevent the
growth of bacteria
associated with birth
caused by gonorrhea,
chlamydia and other
common bacteria.
Used in newborns for
TX and prevention of
infections caused by
gonorrhea, such as
neonatal conjunctivitis
and ophthalmia
neonatorum.
Patients with a
hypersensitivity to
erythromycin or
medications including
this ingredient (not
many
contraindications)
Associated with risk
of pyloric stenosis,
pruritus of skin, dry
skin, skin irritation,
stinging of skin,
abnormal
desquamation.
-Use within first 24
hours of birth
- Monitor the infant
for irritability
- Monitor for possible
effects on the
gastrointestinal flora,
such as diarrhea and
candidiasis
- Monitor for thrush

Brand Name 17. Survanta
Generic Name Beractant
Dose Intratracheal (Neonates):
5.8 mL/kg birth weight not
to exceed 4 doses in the
first 48 hr of life.
Administration Route Intratracheal
Classification Pulmonary surfactants
Action Provides replacement
pulmonary surfactant;
stabilizes alveoli from
collapse
Reason Pt. Receiving Prevention of Respiratory
Distress Syndrome (RDS)
Contraindications Frequent assessment is
necessary; modifications in
oxygen/ ventilatory support
may be required.
MAJOR Adverse Side O2 destat, bradycardia,
Effects pallor
Nursing Responsibilities -Monitor respiratory status
and Implications (lung sounds, oxygen
saturation) frequently
during therapy.
-Assess for bradycardia,
oxygen desaturation, reflux
of drug into ETT
-Administered by a
clinician trained in
intubation .
-Warm up vial for 15
minutes
18. Vitamin K
Ptyonadione
Neonates: 0.5 mg injection
Newborn: 1 mg injection
Given within 1 hour of birth
Intramuscular via vastus
lateralis muscle
Fat soluble vitamin,
Antifibrinolutc agent
Prophylaxis treatment of
hemorrhage in the newborn,
prevents low levels of blood
clotting factors that the
body naturally produces,
promotes liver formation of
the clotting factors II, VII,
IX, and X.
Prevention of developing
vitamin K deficiency
bleeding.
Blood thinner medications
such as warfarin, antacids,
certain antibiotics
Pain and edema may occur
at the injection site, rash
and urticaria
-Observe for bleeding
-Observe for sign of local
inflammation at injection
site
-Apply pressure to site of
injection after medication
administration to decrease
bleeding
-Give medication prior to
circumcision if applicable.
19. Dopamine
Inotropin
Less than 1 month: 1 to 20
mcg/kg/min by continuous
IV infusion, titrated to
desired response.
1 month or older: 1 to 20
mcg/kg/min by continuous
IV infusion, titrated to
desired response.
Maximum of 50
mcg/kg/min.
Intravenous
Inotropic, vasopressor
Dopamine occurs naturally
in the body, works to
improve pumping strength
of the heart and improves
blood flow to the kidneys
Used to treat hypotension
and poor perfusion,
increase blood pressure
Beta-blockers may
decrease effectiveness of
drug,
Irritation at IV site, may
cause tachycardia d/t
aggravating stress to
ventricles, irregular heart
beats, SOB
-Monitor hemodynamics-
BP, HR, EKG, CVP–
-Obtain parameters for
hemodynamic values
-Titrate to obtain
appropriate BP
Julia Hum
ACH MV-NICU
20. Versed
Midazolam
Neonates >32 wk:
Intubated patients
only—0.06 mg/kg/hr (1
mcg/kg/ min).
Neonates <32 wk:
Intubated patients
only—0.03 mg/kg/hr (0.5
mcg/kg/ min).
Intravenous
Antianxiety agents,
sedative/ hypnotic
CNS depression, calms
down nervous system
Short term sedation.
Antianxiety for transporting
neonates etc
Rapid injection in neonates
can cause severe
hypotension and seizures,
use of benzyl alcohol in
neonates
Apnea, Laryngospasm,
Respiratory depression,
cardiac arrest, IV site
phlebitis
-Assess level of sedation
and level of consciousness
-Monitor BP, pulse, and
respiration continuously
during IV administration.
-Oxygen and resuscitative
equipment should be
immediately available.
-The effects of midazolam
can be reversed with
flumazenil (Romazicon).