Narcotic Withdrawal Therapy: Combination of Morphine Sulfate & Phenobarbital: [DLC1]

 

 

I. Doses: A. Morphine Sulfate: Preparation:  0.5mg/0.5ml aqueous solution

Starting dose: 0.02 mg/kg/dose (0.02 ml/kg.

given with feeds every 3 to 4 hours

                        Increase the dose by 0.05 ml if score ≥ 8         

            Keep the dose the same if score is between 5 and 7

Decrease the dose by 0.05ml if score < 5 for 3 consecutive 8 hours.

                           B. Phenobarbital: To be started around the same time with morphine.

Loading dose: 30 mg/kg/ to be given 10 mg/kg every 12 hours.

Maintenance dose: 2.5 mg/kg /dose every 12 hours. First dose is given 12 hours after the 3^rd part of the loading dose.

Phenobarbital serum level (every Tues) to be maintained between 20 to 30 mcg/dl

          II. Discharge: A. The baby is sent home on Phenobarbital:

1.      No attempt is made to wean off this medication. (Unless discharge is ≥1-2 weeks away)

2.      Weaning will be done as an outpatient.

3.      At least 48 hours after the baby is taken off morphine with score < 5