NPS NPS Pharmacology and Medications 1 — Questions and Answers
Question 1: What is the recommended dose of caffeine citrate loading dose for apnea of prematurity in neonates?
- 10 mg/kg IV
- 20 mg/kg IV (Correct answer)
- 5 mg/kg IV
- 30 mg/kg IV
Correct answer: 20 mg/kg IV
Caffeine citrate loading dose for apnea of prematurity is 20 mg/kg IV, followed by a maintenance dose of 5–10 mg/kg/day.
Question 2: Which surfactant is administered intratracheally as a natural bovine-derived preparation for neonatal RDS?
- Beractant (Survanta)
- Calfactant (Infasurf)
- Poractant alfa (Curosurf)
- All of the above (Correct answer)
Correct answer: All of the above
Beractant, calfactant, and poractant alfa are all natural animal-derived surfactants approved for intratracheal administration in neonatal RDS.
Question 3: When administering prostaglandin E1 (alprostadil) to a neonate with ductal-dependent congenital heart disease, which adverse effect requires immediate readiness?
- Hypertension
- Apnea (Correct answer)
- Bradycardia
- Hyperglycemia
Correct answer: Apnea
Apnea is the most critical adverse effect of prostaglandin E1 infusion in neonates, requiring intubation readiness at the bedside.
Question 4: What is the correct dose of epinephrine for neonatal cardiac arrest via the endotracheal route?
- 0.01–0.03 mg/kg
- 0.05–0.1 mg/kg (Correct answer)
- 0.1–0.3 mg/kg
- 0.3–0.5 mg/kg
Correct answer: 0.05–0.1 mg/kg
The ET dose of epinephrine in neonatal resuscitation is 0.05–0.1 mg/kg (higher than IV) due to poor absorption via the tracheal route.
Question 5: A preterm neonate requires indomethacin for PDA closure. Which lab value must be monitored most closely?
- Serum calcium
- Serum creatinine (Correct answer)
- Serum sodium
- Hemoglobin
Correct answer: Serum creatinine
Indomethacin reduces renal prostaglandin synthesis, causing decreased GFR and elevated serum creatinine; renal function must be monitored closely.
Question 6: Which antibiotic combination is considered first-line empiric therapy for early-onset neonatal sepsis in the US?
- Vancomycin and gentamicin
- Ampicillin and gentamicin (Correct answer)
- Cefotaxime and clindamycin
- Meropenem and fluconazole
Correct answer: Ampicillin and gentamicin
Ampicillin and gentamicin is the standard first-line empiric regimen for early-onset neonatal sepsis, covering GBS and gram-negative organisms.
NPS NPS Pharmacology and Medications 1
What is the recommended dose of caffeine citrate loading dose for apnea of prematurity in neonates?