Dr. Sheila Fallon-Friedlander

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