New Drugs-Pediatric Style

Sheila Fallon-Friedlander, MD

Dr Friedlander provides us with her clinical pearls on new drugs–pediatric style…

• Propranolol has revolutionized the treatment of problematic infantile hemangiomas
  • The most common side effect is sleep disturbance; next acral cyanosis
  • Hypoglycemia can occur but unlikely if baby is eating appropriately
  • The drug can be given BID
  • Infants with large segmental hemangiomas should be evaluated for PHACES prior to instituting propranolol therapy
• Timolol is highly effective for superficial hemangiomas & can obviate the need for systemic therapy
• Nadolol is a beta blocker which does not cross the blood-brain barrier; it can be useful in kids with CNS effects (e.g severe sleep disturbance)
• Rapamycin is useful both systemically & topically in the treatment of disorders involving the mTor pathway
• This includes Tuberous Sclerosis, Lymphatic malformations, and some mixed veno-lymphatic abnormalities