Which two pharmacologic supports are commonly used in the NICU to address respiratory drive and hemodynamic stability, and what is a key side effect for each?

• A. Theophylline to stimulate respiration (tachycardia); Norepinephrine to support blood pressure (hypertension).
• B. Morphine to stimulate breathing (respiratory depression); Epinephrine to support blood pressure (tachycardia).
• C. Caffeine citrate to stimulate respiration (tachycardia or jitteriness); Dopamine to support blood pressure (tachyarrhythmias or extravasation risk).
• D. Albuterol to stimulate respiration (tachycardia); Dobutamine to support blood pressure (hypotension).

Answer: (C)

In the NICU, caffeine citrate is used to stimulate the immature respiratory drive and reduce apnea of prematurity, while dopamine is used to support blood pressure and improve perfusion in hypotensive neonates. Caffeine citrate commonly causes tachycardia or jitteriness as its main side effects. Dopamine’s notable risks include tachyarrhythmias and potential tissue injury from extravasation if the IV line leaks.