Jump to content

Most used NICU meds?

Posted

Specializes in Med-Surg and Neuro.

Hi everyone. I have two interviews for NICU, and I'm not experienced in it. I'm wondering what meds you use most often so I can brush up. Thanks.

babyNP., APRN

Specializes in NICU. Has 13 years experience.

Probably the most common drugs are antibiotics, generally Gentamicin & Ampicillin to cover gram negative and positive bacteria.

After that...depends on why the baby is the NICU. Preemies usually go on caffeine and many are on medications for GERD like Lansoprazole or Zantac. If you get the job, I highly recommend the Neofax, which is a drug library for neonates on your phone. They don't publish a book anymore, but it's great for indications, dosing, and IV compatibility (most important, lol...j/k)

A lot of babies are also on multivitamin medicine, iron medicine and also things like sodium and potassium chloride. Antibiotics are pretty common such as benzylprnicillin and fluxclocillin (just check the spelling on that one though).

SharkPuppy

Specializes in NICU. Has 3+ years experience.

I've never been asked about medications when I've gone on an interview so I'll be curious to know if they actually ask any questions regarding that.

They can see by your resume that you don't have NICU experience so I wouldn't stress too much about learning medications. Focus more on what you can bring to the table as an experienced nurse. They wouldn't interview you if they didn't see something in your resume/application that they liked. :) Good luck!!!

SoaringOwl

Specializes in Med-Surg and Neuro.

I've never been asked about medications when I've gone on an interview so I'll be curious to know if they actually ask any questions regarding that.

They can see by your resume that you don't have NICU experience so I wouldn't stress too much about learning medications. Focus more on what you can bring to the table as an experienced nurse. They wouldn't interview you if they didn't see something in your resume/application that they liked. :) Good luck!!!

I have to pass a med calculation exam at this interview, so I wanted to get an idea of the types of meds I might see. Also, I have to shadow on the unit, so I don't want to appear as clueless as I am. What about heparin? Is that ever given?

Also I'm a new grad, not experienced. I did med-surg for preceptorship, I don't even have ICU experience. I want to do NICU, but I didn't expect to get a chance right out of school! Thanks again.

These are the most used Meds in my level 3 nicu...

1. Amp/gent

2. Caffeine

3. Fluconozole- every baby with a PICC has this until PICC is DC'd for prophylaxis

4. Polyvisol

5. Morphine

6. fentenyl

7. Versed

8. Ativan

9. Hydrocortisone

10. Iron

11. Dopa, dobutamine, and ePi drips

^^ Since I've been in nicu I've given heparin once... We don't use it unless absolutely necessary.

Also forgot to add insulin to my list both independent doses and as a drip.

SoaringOwl

Specializes in Med-Surg and Neuro.

These are the most used Meds in my level 3 nicu...

1. Amp/gent

2. Caffeine

3. Fluconozole- every baby with a PICC has this until PICC is DC'd for prophylaxis

4. Polyvisol

5. Morphine

6. fentenyl

7. Versed

8. Ativan

9. Hydrocortisone

10. Iron

11. Dopa, dobutamine, and ePi drips

Wow, thanks! So NICU babies are assumed to be in a lot of pain and stressed (ativan/fent/morphine)? Is the caffeine to keep their heart rate up? I would think caffeine and ativan would contraindicate each other, are they ever given together?

Yes... Being on a jet or oscillator is EXTREMELY painful and agitating!!! Imagine you having a tube placed in your throat that is beating into you upwards of 300 breaths a minute... oUCH! My biggest pet peeve is seeing Ativan and pain Meds not given to patients on one of these invasive respiratory machines... The kid isn't breathing on their own anyway... Idk what people are afraid of or if it is just laziness. Also we have a lot of post-surgical kiddos, so yes, we'd assume they would be in lots of pain, PDA ligations, gastroschisis closures, etc. Yes, caffeine is used to increase heart rate... Premies are excellent at becoming bradycardic... However Ativan is needed too... We don't want the kid to extubate!

Those drugs are given together all the time... Think about it our smallest peanuts need the caffeine bc they are the most at risk for bradying (we will wean them off of this med before they go home... We don't send a kid that's bradying home)... Similarly the smallest kids and most immature usually are the ones on the invasive respiratory machines and need the pain and agitation Meds... so yes, they are used together all the time!

Coffee Nurse, BSN, RN

Specializes in NICU. Has 10 years experience.

Caffeine isn't given to prevent bradycardia, it's to combat apnea of prematurity (of which bradycardia/desaturation is a secondary outcome).

OP, I wouldn't worry too much about specific medications that might appear on the med calculation test, it's more to ensure that your math skills are up to snuff. Just make sure you can work out dosages/volumes for individual doses and rates/concentrations for drips.

babyNP., APRN

Specializes in NICU. Has 13 years experience.

Yes... Being on a jet or oscillator is EXTREMELY painful and agitating!!! Imagine you having a tube placed in your throat that is beating into you upwards of 300 breaths a minute... oUCH! My biggest pet peeve is seeing Ativan and pain Meds not given to patients on one of these invasive respiratory machines... The kid isn't breathing on their own anyway... Idk what people are afraid of or if it is just laziness. Also we have a lot of post-surgical kiddos, so yes, we'd assume they would be in lots of pain, PDA ligations, gastroschisis closures, etc. Yes, caffeine is used to increase heart rate... Premies are excellent at becoming bradycardic... However Ativan is needed too... We don't want the kid to extubate!

Actually I've heard of many places getting away from it, my own included. Some kids don't really need it, they don't exhibit any signs of pain. Remember that sedatives are not without bad effects...learned that some can cause neuron apoptosis, which freaked me out when I learned about it in school. If you need to give it, totally give it, but not every single kid needs it.

One thing to keep in mind if you're going to be doing a med calc test during the interview is that all meds given in the NICU are based on the baby's weight. Think mg/kg. I used to work with adults too and if that's what most of your experience is in you are probably used to standard med dosages not weigh based dosages just like I was. When you are a new grad and not used to doing med calc, not remembering to slow down and realize they are looking for weight based can sometimes trip you up. Take a deep breath, you'll do great!

SoaringOwl

Specializes in Med-Surg and Neuro.

I ended up cancelling my NICU interviews. It sounds like a whole 'nother world, and after reading these posts I think there is too much of a learning curve for me. I've decided to start my career with adult acute care, and take it from there. Thanks for all the responses, though.

ThePrincessBride, BSN

Specializes in Med-Surg, NICU. Has 6 years experience.

I ended up cancelling my NICU interviews. It sounds like a whole 'nother world, and after reading these posts I think there is too much of a learning curve for me. I've decided to start my career with adult acute care, and take it from there. Thanks for all the responses, though.

I hate to sound rude, but I think you just shot yourself in the foot.

SoaringOwl

Specializes in Med-Surg and Neuro.

I hate to sound rude, but I think you just shot yourself in the foot.

Why? I was hired today for adult acute care. I'm glad I came here and realized I'm not ready for NICU. Isn't that better than getting in over my head?

Coffee Nurse, BSN, RN

Specializes in NICU. Has 10 years experience.

It depends on what your goals are. If you're happy working with adults, then you'll be fine. If you're more interested in NICU, though, it's not any easier to transition from adults than it is to start here as a new grad. Everything is different -- diagnoses, meds, reference ranges for labs and vital signs, and most importantly how you interact with your patients. NICU is its own world and nobody is ever "ready" for it straight out of school, but with a good preceptorship you learn to handle it.