Regularly assess respiratory rate, heart rate, and blood pressure. Monitor for changes in oxygen saturation. Cardiac echocardiograms should be performed before treatment initiation and at regular intervals to assess for changes in ventricular function and pulmonary vascular resistance.
Laboratory Monitoring
Observe complete blood counts (CBC) to detect potential hematologic side effects. Liver function tests (LFTs) and renal function tests (RFTs) are recommended periodically to detect potential organ toxicity. Regularly check serum electrolytes to manage potential imbalances.
Clinical Observations
Carefully observe the neonate for signs of increased feeding tolerance, improved weight gain, and reduced breathlessness. Document any changes in activity levels and sleep patterns. Note any gastrointestinal side effects such as diarrhea or vomiting. Assess for visual changes, such as blurry vision or photophobia.
Dosage Adjustments
Adjust the sildenafil dose based on the clinical response and tolerance. If adverse effects appear, consider dose reduction or cessation of treatment. Closely collaborate with a neonatologist experienced in managing pulmonary hypertension.
Safety Considerations
Always prioritize safety. Promptly address any concerning changes in vital signs or clinical status. Be aware of potential drug interactions and adjust therapy accordingly. Regularly review the treatment plan with the family, addressing their questions and concerns.
