Bronchopulmonary dysplasia (BPD) is a chronic lung disease of babies, which develops most commonly in the first four weeks after birth. It mostly occurs in babies who are born more than four weeks before their due dates, though sometimes the babies are full term. In BPD, the lungs do not work properly and the babies have trouble breathing. They need extra oxygen and may even need help from a breathing machine. Doctors think babies get BPD because their lungs are sensitive to something damaging in the environment, such as oxygen, a breathing machine, or an infection.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Albuterol, Dexamethasone, Furosemide, Ipratropium
Congenital adrenal hyperplasia (CAH) is a group of recessive disorders resulting from the deficiency of one of the five enzymes required for the synthesis of the hormone cortisol in the adrenal cortex. The most frequent is steroid 21-hydroxylase deficiency, accounting for more than 90% of cases. A severe form may have symptoms that include to alterations in sexual maturation.
Commonly Prescribed (On-Label) Drugs: Betamethasone, Cortisone, Dexamethasone, Fludrocortisone, Methylprednisolone, Prednisolone, Prednisone, Triamcinolone
Off-Label Prescription Drugs Breakthrough Options: Flutamide, Hydrocortisone, Testolactone
Intraventricular hemorrhage (IVH) is bleeding inside or around the ventricles, the spaces in the brain containing cerebral spinal fluid. Intraventricular means within the ventricles, and hemorrhage means excessive bleeding. Intraventricular hemorrhage is most common in premature babies, especially very low birth-weight babies weighing less than 1,500 grams (three pounds, four ounces).
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Indomethacin
The standard definition of apnea is cessation of inspiratory gas flow for 20 seconds, or for a shorter period of time if accompanied by bradycardia (heart rate less than 100 beats per minute), cyanosis, or pallor. Apnea has been classified into three types depending on whether there is activity of the muscles that act during inspiration, also known as inspiratory muscle activity. If inspiratory muscle activity fails following an exhalation, it is termed Central Apnea. If inspiratory muscle activity is present without airflow, this is termed Obstructive Apnea. If both central and obstructive apnea occurs during the same episode, this is termed Mixed Apnea.
Before a diagnosis of apnea of prematurity (AOP) is made, and treatment initiated, all causes of secondary apnea must be ruled out. Treatment will depend on the cause as well as effectiveness and tolerability of the treatment by the child. The primary goal of any treatment of AOP is to prevent the frequency of apnea lasting greater than 20 seconds and/or those that are shorter, but associated with cyanosis and bradycardia.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Theophylline
The ductus arteriosus is a normal fetal structure, allowing blood to bypass circulation to the lungs. Since the fetus does not use his/her lungs (oxygen is provided through the mother’s placenta), flow from the right ventricle needs an outlet. The ductus provides this, shunting flow from the left pulmonary artery to the aorta just beyond the origin of the artery to the left subclavian artery. The high levels of oxygen it is exposed to after birth causes it to close in most cases within 24 hours. When it does not close, it is termed a patent ductus arteriosus (PAD).
Commonly Prescribed (On-Label) Drugs: Indomethacin
Off-Label Prescription Drug Breakthrough Option: Ibuprofen
Respiratory distress syndrome (RDS) is a life-threatening lung disorder that commonly affects premature infants. RDS results from insufficient levels of surfactant, a foamy fluid substance produced by the body between the 34 and 37 week of pregnancy. Surfactant is essential for the expansion of the alveoli or air sacs of the lungs. When an infant is born prematurely, his or her lungs have not produced the necessary amount of surfactant. Without surfactant, the lungs cannot inflate, resulting in RDS.
Commonly Prescribed (On-Label) Drugs: Beractant, Calfactant, Colfosceril, Poractant Alfa
Off-Label Prescription Drug Breakthrough Option: Methylprednisolone
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