**6.4.31 Levothyroxine**

328 Complementary Pediatrics

*Adverse Effects:* 1/100- 1 / 1000 Fever. Chills. Nausea. Redness of the skin. <1/1000 Allergic shock. Changes in the blood picture, which occur most frequently in infants. Increase or decrease in blood pressure. Rash. Changes in liver function. Shortness of breath. Long-term

It is MSS stimulator and vasoconstrictor of cerebral vessels. It is used for vascular headache and as analeptic. Neonatal apnea loading dose: 10 mg/kg, maintenance 5-10 mg/kg/day

General anesthetic, sedative, hypnotic, analgesic and amnestic. IV, IM. It protects cardiovascular functions. It improves lung compliance, has bronchodilator effect. As ketamine favorably alters the heart and respiratory functions it can be used as a sedative agent in patients who receive mechanical ventilation and have myocardial depression induced by benzodiazepines and opiates. It can be used in cases where spontaneous

*Uses:* Parental nutrition source of calories and essential fat acids.

ventilation is requested while sedation is provided (Biçer, 2008).

IV slow 0.5-2 mg/kg/dose IV Inf. Dose 0.5-1 mg/kg/h IM, SC 2 mg/kg/dose

is active against these phenomena (Biçer, 2008).

in intracranial pressure (Biçer, 2008).

Oral 5-8 mg/kg/dose (Anand, 2007).

*Sedation:* 0.5-2 mg/kg/dose IV, can be repeatedly administered at doses of 0.5 mg/kg/dose at 2-5 min. intervals or with 1-2 mg/kg/hour infusion until adequate sedation is achieved (Max. 5 mg/kg). 4-5 mg/kg/dose IM (if adequate sedation is not achieved within 10 minutes), one more dose of 2 mg/kg/dose can be administered. Rapid sequential intubation: 0.5-2 mg/kg/dose IV or 3-7 mg/kg/dose IM (1 dose). Caution: It acts fast; but slow. Aspiration and laryngospasm can be observed in patients who ventilate spontaneously in the unprotected airway. Atropine and glycopyrronium bromide are advised to use before ketamine as it increases saliva and bronchial secretions. It should not be administered in cases of increase in intracranial pressure, suspected head trauma and in convulsions whose etiology is unknown and where intracranial pressure may have increased. It can cause such reactions as hallucination and delirium and these phenomena increase by age and dose. The administration of benzodiazepines 5 minutes before ketamine

Side Effects: Laryngospasm, out-of-anesthesia reaction, tachycardia, hypertension, increase

painful erection (Young & Mangum, 2010).

**6.4.28 intralipid** 

**6.4.29 Caffein** 

(Biçer, 2008).

**6.4.30 Ketamine** 

*Neonatal Dose:* 

*Uses:* Treatment of hypothyroidism

*Dose:* PO: 10 to 14 mcg/kg. IV 5 to 8 mcg/kg

*Adverse Effects:* Prolonged over treatment can produce premature craniosynostosis and acceleration of bone age (Young & Mangum, 2010).
