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Iowa Neonatology Handbook : Pharmacology
Pharmacologic Therapy for Neonatal Systemic Hypertension
Jeffrey L. Segar, MD
Peer Review Status: Internally Peer Reviewed
- Definition (not fully clear):
- Term infants: > 90/65 mm Hg
- Preterm infants: > 80/45 mm Hg (Liberman)
- Management should be directed towards correcting the underlying etiology.
It is uncertain whether moderate hypertension associated with bronchopulmonary
dysplasia requires therapy, since it is mostly transient. Renovascular hypertension
can be managed pharmacologically.
|
Agent |
Dosage |
Toxicity |
|
Hydralazine |
0.1-0.5 mg/kg/dose
q 4-6 h IV |
hypotension |
|
Propranolol |
0.25 - 1.0 mg/kg/day
q 6-12 h PO |
hypoglycemia,
hypotension |
|
Captopril |
0.05 -0.1 mg/kg/dose
q 6-8 h PO |
neutropenia, proteinuria, renal failure
|
|
Methyldopa |
10 mg/kg/day q 6-12 h,
followed by increments of 5-10 mg/kg/day every 2-4 days up to 65 mg/kg/day |
hepatitis, leukopenia |
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