Adjunctive pharmacotherapy in neonates with respiratory failure.
Whereas oxygen, continuous positive airway pressure (CPAP) and mechanical ventilation are the mainstays of treatment of pulmonary conditions in newborns, there are a number of adjunctive therapies that may improve the pulmonary function of these infants. These include the use of bronchodilators and diuretics given either systemically or through the inhaled route, mucolytic agents, and anti-inflammatory agents. This chapter gives an overview of the use of the most-studied agents including aerosolized bronchodilators, systemic and inhaled diuretics, and systemic and inhaled corticosteroids in the treatment and prevention of, where appropriate, respiratory distress syndrome, bronchopulmonary dysplasia, and meconium aspiration syndrome. Evidence on the use of mucolytic agents including acetylcysteine and deoxyribonuclease, and the anti-inflammatory agents including the macrolide antibiotics, cromolyn, pentoxyfylline, and recombinant human Clara cell protein are also reviewed.
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Zone, China.
Tai-Fai
TF
Fok
D000280:Administration, Inhalation; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy; D004232:Diuretics / Q000627:therapeutic use; D005100:Expectorants / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy; D010102:Oxygen Inhalation Therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D004232:Diuretics; D005100:Expectorants