Common NICU Medications and Uses

This list provides an overview of the most common medications in the NICU. Each medication is carefully chosen and tailored to the infant’s specific needs, as their physiology differs significantly from older children and adults.

1. Respiratory or Breathing Support

Surfactant: Medications like Curosurf, Infasurf, or Survanta are used to treat or prevent respiratory distress syndrome (RDS) in preterm infants. They help by reducing surface tension in the lungs, allowing them to expand more easily. In other words, they help babies’ lungs stay open and make it easier for them to breath
Caffeine: Commonly used to manage apnea of prematurity, where infants periodically stop breathing. Caffeine stimulates the central nervous system to promote regular breathing. Just like it wakes adults up, it helps babies remember to breathe when they forget
Diuretics (e.g., Furosemide): Help remove excess fluid from the body, often used to improve lung function in infants with chronic lung disease or pulmonary edema.

2. Infection Management

Antibiotics: Medications like Ampicillin, Gentamicin, Vancomycin, and Cefepime are used to treat bacterial infections such as sepsis, pneumonia, or meningitis. These are started promptly when an infection is suspected.
Antifungals (e.g., Fluconazole, Amphotericin B): Used to treat fungal infections, which are more common in extremely preterm or immunocompromised infants. These may be started prophylactically if your baby is small and has an umbilical or peripheral line.

3. Cardiovascular / Heart Support

Prostaglandin E1 (PGE1): Keeps the ductus arteriosus, a vital blood vessel, open in infants with specific congenital heart defects until they can undergo corrective surgery.
Indomethacin or Ibuprofen: Used to close a patent ductus arteriosus (PDA), a vessel that normally closes shortly after birth but may remain open in premature infants, potentially causing complications.
Dopamine, Dobutamine, or Epinephrine: These medications support blood pressure and improve heart function in critically ill neonates with low blood pressure or cardiac dysfunction.

4. Nutritional Support

Parenteral Nutrition (PN): Custom solutions containing lipids, amino acids, vitamins, and minerals, delivered intravenously to provide essential nutrition when enteral feeding is not yet possible.
Iron Supplements (e.g., Ferrous Sulfate): Given to preterm infants to support the production of red blood cells and prevent anemia of prematurity.
Vitamins and Minerals: Supplements like Vitamin D, Calcium, and Phosphate help support bone development and prevent conditions like rickets.

5. Pain Management and Sedation

Morphine or Fentanyl: Strong analgesics used to manage pain in neonates, particularly after surgery or during invasive procedures.
Midazolam: A sedative occasionally used to keep neonates calm and comfortable, especially when they require prolonged mechanical ventilation.

6. Neurological Support

Phenobarbital: A long-standing treatment for neonatal seizures, it helps stabilize electrical activity in the brain.
Levetiracetam: A newer option for managing seizures in neonates, known for its favorable safety profile.

7. Miscellaneous Treatments

Corticosteroids (e.g., Dexamethasone, Hydrocortisone): Used to treat inflammation in chronic lung disease or adrenal insufficiency in critically ill neonates.
Vitamin K: Given shortly after birth to prevent bleeding disorders caused by vitamin K deficiency. Most effective when given as an injection
Antivirals (e.g., Acyclovir): Used to treat certain viral infections like neonatal herpes.