The role of a NICU pharmacist

At Sharp Mary Birch Hospital for Women & Newborns, a team of pharmacists in the Neonatal Intensive Care Unit (NICU) ensures the tiniest and most fragile of patients get the right medications they need to grow and thrive.
It’s a medical profession that requires special expertise, says Emilie Abalos, a neonatal pharmacist in the hospital’s Level III NICU, one of the largest in Southern California.
Babies in the NICU can be smaller than 1 pound or have a variety of serious medical issues. Their tiny bodies may not be able to absorb or eliminate medications as easily as babies born healthy, which can present significant challenges, including:

• Sizing — Medications for neonatal patients are dosed by weight, age or surface area. This means each medication is meticulously and individually prepared.

• Oral medication — Because neonatal patients cannot swallow tablets or capsules, oral medications need to be in liquid form.

• Intravenous medications — Neonatal patients have small vascular systems, so medications given through an IV may need to be diluted. NICU pharmacists also face situations in which they can’t access a baby’s veins, or a baby may not have enough muscle yet to receive medications typically given in the muscle.

• Volume — For very small babies, NICU pharmacists must also consider the amount of medication. They may have to provide more concentrated doses to avoid too much fluid going into a baby’s body.

With its large, 84-bed NICU, Sharp Mary Birch is a prime location for research on dosing of neonatal medications, Abalos says. The hospital is home to the Neonatal Research Institute, comprised of a multidisciplinary team of caregivers working to discover novel, evidence-based treatments and practices to improve the health of newborns everywhere.
“The ability to provide care to the youngest, most vulnerable patients — in order to give them the best start in life — is exhilarating,” Abalos says. “Our shared hope is that our patients can transition from the hospital to a caring and loving home, and that they continue to thrive, grow and live their best life.”

Emilie talks about her role in providing care for Baby Saybie, the world’s smallest baby, in this video from Sharp HealthCare.