January 3, 2019
Amanda Capino is a clinical assistant professor of pharmacy practice at the University of Mississippi School of Pharmacy and a practicing pharmacist in the UMMC NICU. When she is not teaching on the school’s Jackson campus, she is helping infants born prematurely or who need special care in the NICU, providing guidance on their medication and precepting student pharmacists. The School of Pharmacy spoke with Capino about her work in the NICU.
Amanda Capino: The NICU is a very unique and rewarding practice setting where we have the opportunity to care for babies with a variety of issues, including babies born prematurely, born with a congenital anomaly, or born with sepsis.
UMMC’s NICU is a Level IV, which means it provides the highest possible level of care for infants. The NICU has 102 beds and four medical teams, including neonatologists, medical students and residents, nurses, nurse practitioners, dietitians, respiratory therapists, social workers, clinical pharmacists and student pharmacists.
I round with one of the interdisciplinary teams. During rounds, we discuss each patient as a team and I provide my recommendations and answer any questions the team may have.
I prepare for rounds every day by reviewing each patient’s profile and determining any medication-related changes I would like to recommend, often with regard to antibiotics and patients’ TPN (total parenteral nutrition). Medications are dosed by weight in pediatric pharmacy, so I calculate all doses of medications to make sure they are appropriate as the babies gain weight. One of the most important things for our patients who are born prematurely is to make sure they grow so they can get stronger! I work closely with the NICU dietitians to make sure we are maximizing nutrition for our babies.
One of the most unique and rewarding aspects of serving as a pharmacist in the NICU is being able to care for patients who are in the NICU for an extended period of time. Oftentimes, a premature baby must fight through several complications associated with prematurity. We use medications to treat many of these complications and go over questions regarding what the team has tried in the past. It is definitely challenging to see a baby go through so many ups and downs, but I enjoy doing my part to help the patient, whether it be by recommending changes in antibiotics, adjusting sedatives or analgesics to help the baby be more comfortable, or helping to taper off medications to manage or prevent drug withdrawal.
Although there are sad outcomes in the NICU, there are also miracles. There have been times when I didn’t know if a patient would make it, but then several months later, I had tears in my eyes as parents were able to take their baby home for the first time after a very long stay in the NICU!