Pharmacotherapy Bundle

This is a series of three presentations designed for pharmacology credit. The series begins with a review of basic pharmacokinetics, then a discussion on antibiotic stewardship as these are the most common drug class exposure in the preterm neonate and it concludes with a discussion of renal structure and functional immaturity which significantly impacts pharmacotherapy in the preterm neonate.


1. Outline three pharmacokinetic and pharmacodynamic principles in neonates.

2. Compare and contrast two considerations for medication administration in the preterm infant versus term infants or children.

3. Describe two specific precautions and monitoring recommendations for preterm drug therapy.

4. Identify two physiologic systems in the preterm infant that disrupt pharmacokinetics.

5. Recall two risks of using antibiotics in small babies.

6. State two factors that can improve the accuracy of infection diagnosis in a small baby.

7. List three ways an NICU nurse can participate in their unit-based Antibiotic Stewardship Program.

8. Describe three strategies that have been used to reduce antibiotic exposure in the small baby.

9. State two functions of the kidney.

10. Describe two characteristics of renal development that place the preterm neonate at risk for poor renal function.

11. Define Acute Kidney Injury (AKI).

Total CE: 3.4

NCC Code NNP 2 = 1; NNP 4 = 1.6 or 7

NCC Code NIC 2 =1; NIC 3 = 1.6 or 7

NCC Code LRN 3 = 1; LRN 4 = 1.6 or 7

Rx = 2.6

*These presentations were included in the Small Baby Care Specialist® Program

Last updated: December 2021

Your Instructor

Letitia DeLaine, Linda Lefrak, Mindy Morris
Letitia DeLaine, Linda Lefrak, Mindy Morris
Letitia DeLaine, Pharm.D., BCPPS graduated with a Doctor of Pharmacy degree in 2013 from the University of Maryland Eastern Shore School of Pharmacy. After graduation, she began a Pharmacy Practice Residency at the Children’s Hospital of San Antonio. After four years at Children’s, she found a new home at Holy Cross Health as the Women & Children’s Clinical Pharmacy Specialist managing the clinical and pharmacy operations for the busiest birthing hospital and the largest Level III NICU in the state of Maryland. She is Board Certified as a Pediatric Pharmacy Specialist and has worked closely the NICU team to develop polices, protocols, staff education and guidelines with special focus on the Tiny Baby Unit

Linda Lefrak is a Neonatal Clinical Nurse Specialist. Her education included an undergraduate degree from Indiana University in nursing. In the early 70's she completed one of the first Neonatal Nurse Practitioner programs in the country at the University of Arizona. In 1984 she completed a Clinical Nurse Specialist graduate program at the University of California in San Francisco. She has worked at five children's hospitals during her forty eight years of practice and participated in state and national neonatal collaboratives. Her interests include neonatal nutrition, patient safety, infection risk reduction, neonatal abstinence syndrome, pain management, and ethics.

Mindy Morris is a doctoral prepared neonatal clinician with an aptitude for application of evidence into practice. Her foundational core is an enthusiasm for quality and improving the patient, family, and team experience in the NICU. She is a faculty member for the Vermont Oxford Network (VON) Quality Improvement Collaborative. Care of the Extremely Low Birth Weight Infant is Mindy’s ardent focus. Her respect for the resiliency of the ELBW infant inspires her to share her extensive knowledge and expertise by designing programs and tools to improve the multidisciplinary team’s model of care for this vulnerable population.

Course Curriculum

  Instructions and Handouts
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  Renal Development, Function and Preterm Neonate Characteristics
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  Pharmacotherapy QI Considerations & Suggested Reading
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Frequently Asked Questions

When does the course start and finish?
The course starts as soon as you enroll. You will have access to this course (videos) for two months. Please be sure to download lecture handouts for ongoing access to the content presented. You must complete and submit the Evaluation at the end of the course to receive CE.
How can I communicate any questions, comments, or feedback?
We would love to hear from you. Please e-mail us at: [email protected]

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