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 PEDIATRIC ACUTE CARE
DOPAMINE DRIP
Desired: 2.5-10mcg
I. Not Pre-Mixed
Ugtts/min= desired mcg x BW
13.3 single dose or 26.6 double dose

Order: D5W 250ml + Dopamine 200mg/amp single dose or

400mg/2 amp at __ugtts/min

I. For Pre-Mixed for Neonates

DOBUTAMINE DRIP
Desired: 2.5-20mcg
I. Not Pre-Mixed
Ugtts/min: desiredmcg x BW
16.6 single dose or 33.2 double dose
Order: D5W 250ml + Dobu 25omg/ amp single dose or 500mg/2amps
double dose at __ ugtts/ min
I. for Neonates using Dobujet
(Wt x dose e.g 5mcg x 6 constant) divide 2 = ml of
Dobutamine to be incorporated
50 to make 50ml
of D5W (50ml d5W –ml dobu)

RATE: wt in kgs x 5 x 60 = ml/ hr

Conc 2500

LEVOPHED Prep: 4mg/4ml

2mg/2ml
1mg/1ml
e.g. using 4mg/4ml
make 4ml + 96ml diluents to make 100cc
run at 0.05mcg/kg/hr upto 1mcg/kg/hr at ___ cc/hr
 PEDIATRIC ACUTE CARE
I. MECHANICAL VENTILATOR SETTING
for Adult wt: Tidal Volume: 5-8 x wt
FiO2: 60-100%
RR: 40-60
PIP: 14-23 (for Premature below 1 kg: 13-14)
PEEP: 4-6 (for Premature below 1kg: 4)
II. ET CPAP
FiO2: 40-60%
PEEP: 4-6
III. NCPAP
FiO2: 40-60%
TFR
PA/CA
IV. O2 Hood
FiO2:
12 to 10li: 50%
8li: 35-40%
6li: 31%
4li: 28%
V. O2 Cannula
4li: 28%
2li: 21%
VI. O2 Funnel
2li to 0.5li
Tube Depth (Birth Wt in kgs + 6) ET Size (age in yrs/4 + 4)
1kg: 7cm ET size >6 are cuffed tubes
2kgs: 8cms For <8 y/o: use uncuffed
3kgs: 9cms
Newborn: 9cms Ave ET Tube Length (at gumline)
1 y/o: 10-11cms = 3 x ETT size
Adult size: size x 3
 PEDIATRIC ACUTE CARE

NCPAP Computation
I. Compute for the TFR
= Wt x IE Ratio (1-2) x RR (60) x TV (6-10) + 2000
1000
II. Compute for the Compressed Air
= (100- desired FiO2) x TFR
79
III. compute for the Pure Air
= TFR – CA
To counter check:
FiO2: CA (2) + PA
TFR
 TOTAL PARENTERAL NUTRITION

TOTAL PARENTERAL NUTRITION

TERM: 60cckd until 150cckd (increment of 10cc per day)
PRETERM: 80cckd until 150cckd (increments of 10cc per day)
I. Amino Acid
Wt x AAdose x reverse prep= ml per day needed ( divide into
6 if to be given q4 via soluset)
e.g. 2.7kgs x 0.5 x 100/6= 22.5ml per day (3.7ml in soluset to
be filled q6hrs)
I. Ca Gluconate
Wt x Ca dose x reverse prep= ml per day (divide into 6 if to be
given q4 via soluset)
e.g.2.7kgs x 100x 1/100= 2.7ml (0.45ml q4)
I. D50/50 convert to D10
Dextrosity Factor
5 0
75 0.055
10 0.11
12.5 0.17
15 0.22
17.5 0.28
20 0.33
50 1
wt x TFR x Factor= ml per day (ml divide 6 to be filled q4)
e.g. 2.7kgs x 130 x 0.11= 38.61 (6.4ml q4)
I. D5IMB
[TFR(130) x wt= ml per day (divided into 6 to be filled q4)] – (I
+ II + III) = ml in soluset q6

DOSE PREP
Sodium 2-3 mEq 2.5mEq/ml
Potassium 1-2 mEq 2mEq/ml
Calcium 100-300 100mg/ml
Amino Acid 0.5-3 6% 6/100ml
 GLUCOSE INFUSION

GLUCOSE INFUSION
Dose: 0.5gm- 1gm/kg IV or IO
D5W 10-12cc/kg * for peripheral infusion
D10W 5-10cc/kg maximum peripheral is Dext 12.5
D25W 2-4cc/kg * for central line infusion
D50W 1-2cc/kg maximum if bolus: D25W
For newborn: D10W 2cc/kg

GLUCOSE INFUSION RATE

GIR (mg/kg/min) = vol(ml/kg/d) x gluc conc
1.44
GIR= IV rate ml/hr x dext conc x 0.167
Wt in kgs
Short cut: TFR x dext
144
Normal Value: 6-8
 ELECTROLYTE COMPUTATION

POTASSIUM CORRECTION
I. MAINTAINANCE POTASSIUM Normal
Range: 2-3mEq/day
Formula= wt x 2meq/day- A
e.g. 19.5kgs x 2 meq/day= 39
I. DEFICIT POTASSIUM
Formula= wt x Total Body K x Factor B E.g.
Actual K= 2.9
Factor: < 3meq/L = 0.05 19.5kg x 90cckd
x 0.05= 87.75
<2.5 meq/L = 0.10 TBK: 50
<2 meq/L =0.20
I. A + B = __K___
TFR per day 100ml PNSS
e.g. 39 (A) + 87.75 (B) = ___K__
90cc/kg 1755ml 100ml PNSS
= 0.72mEq or 7.2 meq per 100ml PNSS per day
*drop rate will follow the TFR computed per body wt

TO GET THE INFUSION RATE:

= 7.2meq/ 24hrs/ wt in kgs
=0.01meq/kg/hr
I. MAXIMUM INFUSION RATE: 0.2- 0.3 mEq/kg/hr
<6mEq/100ml using Peripheral Line
<8 mEq/100ml using Central Line

Repeat K after > 8hrs incorporation

 ELECTROLYTE COMPUTATION

SODIUM CORRECTION NV: 135-145mEq/day

Prep: 2.5mEq/ml amp
I. MAINTAINANCE SODIUM Desired: 2-3 mEq/kd/day
Formula: wt x desired
e.g. : 10kgs x 2meq/day= 20 A
I. DEFICIT Example
Actual: 120meq
Formula: (Desired – Actual) x wt x 0.6
Desired: 140
= (140-120) x 10kgs x 0.6
= 120 B
I. A+B
20 + 120= 140 mEq per 24hrs usually ½ is given to
correct in12- 24hrs
I. IF YOU WILL USE JUST D5LRS FOR CORRECTION (w/o
INCORPORATION)
ml needed of D5LRS
140 meq x 130meq of N in D5LRS
X 1000ml
X= 1076ml

RATE TFR for

10kgs: 75cckd
= 1076ml of D5LRS is needed
750 (TFR)
= 1.43 days
= 1 x 24hrs + 0.43 x 24hrs
= 34 hrs run D5LRS to meet the needed Sodium
Maximum is 10meq/day
Do not over correct nor do fast correction
May cause Central Pontine Myelosis
 ELECTROLYTE COMPUTATION

CALCIUM CORRECTION
I. 10% Calcium Gluconate (2-5 mkd)
Wt in kgs x 5= ml needed
e.g. 2.7kgs x 5= 14ml
II. Add same amount of Sterile Water (14ml)
III. Get TFR (2.77kg x 55cckd= 150)
to Get D10( multiply by Factor)
150ml x 0.11= 17ml of D50/50

IV. Compute for D5IMB Needed

150 - (I + II + III)= ml needed using D5IMB

BICARBONATE CORRECTION (1: 1 dilution)

= Base Excess x wt in kgs x 0.6 (Bicarbonate in meqs + same amount
of diluents)
Another Formula:
(15 – intial HCO3) x VD x Wt in kgs

Serum HCO3 Vd
>10 meq 0.5
10-5 meq 0.75
<5meq 1
 NURSERY NOTES

• 6th Hour of life- best time to get CBC; If taken <6 hours (
elevated ANC) due to stress of labor
• Hypoglycemia- <40mg/dl Hgt
• Not Advisable to give oral meds to newborn because:
• Absorption to oral meds is not good
• Liver is still premature
• Physiologic weight loss: <10% BW by 3-5 days but will regain
in 10days
• Apt’s Test
• -Determines if coffee ground material is maternal or fetal ion
origin
• Fetal Hgb ( 2 alpha and 2 gamma chains) resistant to
denaturation w/ NaOH remains pink
• Adult Hgb ( 2 alpha and 2 Beta chains) cause denaturation
w/ NaOH turns brown

Infant of DM Mother
- do Hgt upon birth
- early feed
- if hyoglycemic may give 3 doses of 2cc/kg D10W
- monitor Hgt q30mins
-if not responsive, hook to D10W 80cckd

Jaundice
• Manifest if Bilirubin is atleast 5mg/dl
• Coomb’s Test
-test for Hemolytic Anemia (e.g. RH incompatibility, ABO
Incompatibilty)
- Direct: use pxt’s RBC, to test for antibody
-Indirect: use serum from pxt that contains Antibody
 NURSERY NOTES
MATERNAL HISTORY
DM Congenital Thyroid Goiter
anomalies Hypothyroidism
Still Birth Hyperthyroidism
RDS
Hypoglycemia
UTI Prematurity Heart/Lung SGA
Sepsis Still Birth
Prematurity
Thrombocytopeni SGA Still Birth
a Still Birth Anemia
Asphyxia Jaundice
Prematurity Hydrops
Hydrops
Polyhydramnios Anencephaly Isoimmunization IUGR
CNS disorder Placental
Neuromuscular Insufficiency
Problems w/ Post Maturity
swallowing Fetal Demise
Chylothorax Intrapartum Distress
Diaphragmatic Renal Agenesis
Hernia Pulmonary
Omphalocoele Hypolpasia
Gastroschisis Deformities
Maternal DM
Post Maturity Congenital Prematurity RDS
Anomalies ICH
Perinatal Infection
Depression
MAS
Hypoglycemia
Hypo Ca
Polycythemia
PPHPN
Intrapartum Death
Meconium stained Still birth
Asphyxia
MAS
PPHPN
 DRUG FORMULARY

DRUG DOSING
I. DIRECT METHOD
(Wt in kgs x mkd x reverse prep of meds) = ml
frequency
I. REVERSE METHOD
(Amt given in ml x frequency x preparation) = mkd
Wt in kgs

INSULIN INFUSION
0.05mcg/kg/hr

FUROSEMIDE DRIP Dr. Ninalga Dose: 1-2mg/kg

Formula: Wt in kgs x 2
e.g 12kgs x 2= 24ml
Add same amount of diluent to make 24 ml to run at 1ml/hr for
24hours ( 1cc/hr)
FUROSEMIDE DRIP Dr. Bumanglag Dose: 0.1-
0.2mg/kg/hr
I. Formula: dose x wt x 8hours= mg of Furosemide
II. mg of Furosemide x 1 = ml of Furosemide
10
e.g. (12 x 1) /10= 1.2ml of Furosemide
III. Add D5W to make 16cc to run at 2cc/hr for 8 hours
CARDIOLOGY
 CARDIOLOGY

ECG READING
P: 0.04-0.06 Prolonged: enlarged Atrium RATE (read from lead II)
PR: 0.12 Prolonged: 1st degree AV 1500 or # of R in 6secs x 10
QRS: 0.08 block, AF # small sq
QT: Prolonged: enlarged Ventricle R-R
ST: Prolonged: HypoCa
Usually no ischemia for pedia
R: usually N RHYTHM (read from lead II)
upto 35 Same rhythm on all R-R or P-P
T wave: N If <1/3: Flat T waves Sinus Tachycardia/ Tachyarrhythmia
upto 2/3 or R Inverted T N upto 3mos-6yo Sinus Bradycardia/ Bradyarrthymia
If upward: abnormal
Transition I, AVL: lateral AXIS AVF AVL + LAD
Phase II, III, AVF: posterior + AVR
-6-8 y/o VI-V2: Septal I -----------------------------------------I O
+
-heart turns V3-V4: Anterior
left V5-V6: Lateral AVR -RAD III + 90 +
II + 45
NV:
RAE: peak P NB: 0-120
LAE: biphasic draw line and
Up to 6y/o: 0-105 get midline
Adult: 0-90%
 CARDIOLOGY
LANOXIN/ DIGOXIN DIGITALIZING MAINTAINANCE
PREP: caps: 50, 100,
200mcg
Tab: 125, 250 mcg
Elixir: 50mcg/ml (60ml)
Inj: 100, 250 mcg/ml
PREMATURE PO: 20mcg/kg/d 5
IV/IM: 15 3-4
FULL TERM PO: 30 8-10
IV/IM: 20 6-8
<2y/o PO: 40-50 10-12
IV/IM: 30-40 7.5-9
2-10y/o PO: 30-40 8-10
IV/IM: 20-30 6-8
>10 y/o and <100kgs PO: 10-15 2.5-5
IV/IM: 8-12 2-3
INITIAL
½ TDD then ¼ TDD q8-18hrs x 2doses
Obtain ECG 6hrs after dose to assess toxicity
MAINTAINANCE
<10y/o: give maintainance dose ÷BID
>10y/o: give maintainance dose OD
LANOXIN COMPUTATION: Dr. Ninalga
I. Loading (oral)
Mg tab =wt in kgs x 0.04 divide 4
Elixir( syr)= [wt in kgs x 0.04] divide 0.05 then divide 4 (total ml per dose
q6 x 4 doses)

Hold Lanoxin for HR <<100bpm

Then check after 1 hour, resume for >100 bpm
After 4th dose maintain
II. Maintainance Dose

Tablet= wt x 0.004 per dose q12

Elixir= wt x 0.004 ml per dose q12
0.05
INFECTIOUS
 IV-IG INFUSION

IVIG INFUSION ml needed = Wt x 2gms x MONITORING

NV: 2gm/kg 50ml
Prep: 2.5mg/50ml 2.5
# of vials= wt x 2
2.5
e.g. 9.8kgsx2mgs x 50ml
=392ml
2.5
1. 0.5ml x wt for 2hrs 0.5ml x 9.8 = 2ugtts/min 1st 2hrs: VS q 15-30mins
2hrs

2. 1ml x wt x 1hr 1 x 9.8kgs =9-10 ugtts/min 3rd hr: VS q30

3. 2ml x wt x 1 hr 2 x 9.8kgs =19-20ugtts/min 4th hr: VS q30mins to 1hr
4. Remaining ml x 8hrs 392 – (4ml+ 9.5ml + Remaining 8hrs: VS q1
19.5ml)= 359 divide 8hrs
44-45ugtt/mim
 KAWASAKI DISEASE

KAWASAKI DISEASE/ MUCOCUTANEOUS LYMPH NODE SYNDROME

1. fever at least 5 days – usually high spiking, remittent
2. 4/5 signs:
a. Bilateral bulbar conjunctival injection: generally non-purulent
b. mucosal changes: injected pharynx, dry/fissured lips, strawberry
tongue
c. peripheral extremity changes: edema, erythema of hands and feet,
periungal desquamation
d. rash: primary truncal, non-vesicular, periungal and perianal area
e. CLADS: >/ 1.5cms unilateral
Complications: Myocarditis Sx: Tachycardia
Pericardial Effusion
Aneurysm- develops on 2nd to 3rd week of Illness
Acute Coronary Thrombosis
Treatment: IVIG 2gms/kg/day
High dose Aspirin in 1st 10days of Illness 80-100mkd q6
until 14days
Then 3-5mkd OD until 6-8wks
For Acute Coronary Thrombosis: Tissue Plasminogen
Activator: 7mkd (max 75mg/day)
Labs: N WBC, ↑ESR CRP
HEMATOLOGY
 BLOOD TRANSFUSION

BLOOD TRANSFUSION ORDER

pRBC: 4hrs 1. Prepare and Transfuse __
Formula: (desired Hct- Pxt unit __ properly typed and
value) x wt cross matched
2. Secure consent for
Desired: 0.35
transfusion
FFP: 2hrs 3. Shift present IVF to PNSS
Formula: 10-15cc/kg and put on KVO while on
Cryoprecipitate: Fast Drip going BT
1u/6kgs 4. Run each unit of blood for
Platelet conc: Fast Drip __hrs
1u/10kgs 5. Watch out for transfusion
reaction such as fever,
tachycardia, tachypnea,
pruritus
6. Watch out for signs of
Congestion like DOB
7. VS q 30 for the 1st hour then
q1
8. Diphehydramine at bedside
(1mkdose)
9. Refer accordingly
Dose of Factor VIII (units)= u/dl % desired rise in plasma FVIII
x BW in kgs x 0.5
Dose of Factor IX (units)= u/dl % desired rise in plasma
When bleeding occurs: 35-40% hemostatic level
For life threatening/major bleeds: 100%
 DEGREE OF DEHYDRATION

Degree of MILD MODERATE SEVERE

Dehydration (3-5%) (6-10%) (9-15%)
(%)
Level of Alert Lethargic Obtunded
Consciousness
Capillary refill Normal 2-4 seconds >4 seconds,
cool limbs
Mucous Normal Dry Parched,
Membranes cracked
Tears Slightly Decreased Absent
increased
Heart Rate Normal Increased Very increased
Respiratory Normal Increased Kussmaul
Rate/Pattern
Blood Pressure Normal Normal but Decreased
orthostatic
Pulse Normal Thready Faint or
impalpable
Skin Turgor Normal Slow Tenting
Fontanel Normal Depressed Sunken
Eyes Normal Sunken Very sunken
Fluid Deficit
• Weight < 10 kg 50 100 150
• Weight 10 kg 30 60 90
NEONATOLOGY
MANROE CHART
BHUTANI CHART
APGAR SCORING SYSTEM
NEW BALLARD SCORING SYSTEM
NEW BALLARD SCORING SYSTEM
ET TUBE SIZE
NEWBORN RESUSCITATION
 JAUNDICE

PHYSIOLOGIC JAUNDICE PATHOLOGIC JAUNDICE

Appears on second to third DOL (term) May appear in first 24 hours of life

Disappears by fifth DOL (term)—7th Variable

Peaks at second to third DOL Variable

Peak bilirubin <13 mg/dL (term) Unlimited

Rate of bilirubin rise <5 mg/dL/d Usually >5 mg/dL/d

BREASTFEEDING JAUNDICE BREASTMILK JAUNDICE

Occurs in the first days of life Occurs in week 2 of life

cause: lack of calories cause: glucoronidase in breast milk

tx; rehydration. lactation consultation tx: phototherapy

gone by 2–3 months

NEWBORN REFLEXES
FENTON CHART FOR BOYS
FENTON CHART FOR GIRLS
ANTHROPOMETRIC MEASUREMENTS
ANTHROPOMETRIC MEASUREMENTS
ANTHROPOMETRIC MEASUREMENTS
VITAL SIGNS
LABORATORY VALUES
NUTRITION
NUTRITION
IMMUNIZATION
IMMUNIZATION
IMMUNIZATION
IMMUNIZATION
IMMUNIZATION
IMMUNIZATION
IMMUNIZATION
IMMUNIZATION
ACUTE CARE
PEDIATRIC ACUTE CARE
PEDIATRIC GCS
PEDIATRIC ACUTE CARE
PEDIATRIC ACUTE CARE
PEDIATRIC ACUTE CARE
PEDIATRIC ACUTE CARE
SKIN LESIONS
SKIN LESIONS
EXANTHEMS
DRUG FORMULARY
 DRUG FORMULARY

ACETAMINOPHEN (PARACETAMOL) Tempra/Biogesic/Calpol

o 100mg/ml drops [15/30ml bottle]
TD: 10-15 mkdose Q4-6 o 120mg/5ml [30/60/120ml bottle]
Neonates: 10-15 mkdose Q6-8 o 250mg/5ml [30/60/120ml bottle]

Opigesic
o 125mg & 250 mg supp

Rexidol
o 600 mg/tab

Aeknil
o 300mg/2 ml amp [2ml amp]

ACETYLCYSTEINE
Granules: 100mg BID-QID
Inh: 1 amp OD-BID for ≥5-10 days
Inj (IM): ½ amp OD-BID
Inj (IV): 1-1½ amp BID-TID. It is
recommended to dilute IV inj w/ 0.9% NaCl
soln or a 5% glucose soln.
Fluimucil
o 600mg/tab (effervescent)
o 100mg & 200mg sachet (granules for
oral solution)
o 100mg/5ml syr [150ml bottle]
o 100mg/ml (inh) [3ml amp]
o 100mg/ml (inj) [3ml amp]

ACYCLOVIR Herpex
o 200,400,800mg tab
Varicella (≥2 yr): o 200mg/5ml [50ml bottle]
IV: 30 mkday ÷ Q8 × 7–10 d
PO: 80 mkday ÷ QID × 5 d Zovirax
o 200,400,800mg tab
Zoster: o 250mg/vial
IV: 30 mkday ÷ Q8 × 7–10 d
PO (12 yr): 4000 mday ÷ Q5 × 5-7 Hapivir
o 400 mg/5 mL
 DRUG FORMULARY

ALBUTEROL Ventolin
(SALBUTAMOL) o 2.5mg/2.5mL neb
o 2mg/5mL syr [60ml bottle]
Nebulization: o 2mg tab
<1 yr: 0.05–0.15 mkdose Q4–6
1–5 yr: 1.25–2.5 mdose Q4–6 Asmalin
5–12 yr: 2.5 mdose Q4–6 o 1mg/mL pulmoneb
>12 yr: 2.5–5 mdose Q4–8 o 2mg/5ml syr [60ml bottle]

Oral:
2–6 yr: 0.3 mkday ÷ TID
6–12 yr: 6 mday÷ TID
>12 yr 2–4 mdose TID–QID
ALUMINUM HYDROXIDE + Maalox
MAGNESIUM HYDROXIDE o Chewtab: Al(OH)3 200 mg, Mg(OH)2
200 mg
TD: 300–900 mg PO 1–3 hr PC and HS o Per 5mL susp Al(OH)3 225 mg,
Mg(OH)2 200 mg [60/180/355ml bottle]

AMBROXOL Ambrolex
o 7.5mg/ml drops [15ml bottle]
TD: 1.2-1.6 mkdose TID o 15mg/5ml syr [60/120ml bottle]
o 30mg/5ml syr [60ml bottle]
<2 yr: 5-10 drops
2-5 yr: 10-20 drops Mucosolvan
<2 yr: 2.5 ml o 6mg/ml drops [15ml bottle]
2-5 yr: 2.5 ml o 15mg/5ml syr [60/125ml bottle]
6-11 yr: 5 ml o 30mg/5ml syr [60/125ml bottle]
AMIKACIN Amikacide
o 50,125,250mg/ml [2ml amp]
TD: 15–22.5 mkday ÷ Q8 IV/IM Amicyn
o 100,250mg/ml [2ml amp]
Amikin
o 100,250,500mg/ml [2ml amp]
 DRUG FORMULARY
AMINOPHYLLINE
Neonatal apnea:
LD: 5–6 mg/kg IV
MD: 1–2 mkdose Q6–8 IV
Neonate: 0.2 mkhr
6 wk–6 mo: 0.5 mkhr
6 mo–1 yr: 0.6–0.7 mkhr
1–9 yr: 1–1.2 mkhr
9–12 yr and smoker: 0.9 mkhr
>12 yr nonsmoker: 0.7 mkhr
AMOXICILLIN
Neonate: 20–30 mkday ÷ Q12 PO
Child: 25–50 mkday ÷ Q8–12 PO
High dose: 80–90 mkday ÷ BID PO
AMOXICILLIN–CLAVULANIC ACID
1–<3 mo:
30 mkday ÷ Q12 PO
≥3 mo:
TID: 20–40 mkday ÷ Q8 PO
BID: 25–45 mkday ÷ Q12 PO
Amilin
o 25 mg/ml [10ml amp]
Asthma exacerbation
IV LD: 6 mg/kg IV over 20 min (each 1.2
mg/kg dose raises the serum theophylline
concentration 2 mg/L)
IV MD: Continuous IV drip or total daily doses
IV ÷ Q4–6 hr
Pediamox
o 100mg/ml drops [10ml bottle]
o 250mg/5ml [60/105ml bottle]
Himox
o 100mg/ml drops [10ml bottle]
o 125mg/5ml [60/105ml bottle]
o 250mg/5ml [60ml bottle]
Amoclav
228.5mg/5ml susp (200mg *amox) [70ml bot]
457mg/5ml susp (400mg) [35/70ml bottle]
Pediaclav
312.5mg/5ml susp (250mg) [60ml bottle]
Augmentin
156.25/5ml susp (125mg) [60ml bottle]
228.5mg/5ml susp (200mg) [70ml bottle]
312.5mg/5ml susp (250mg) [60ml bottle]
457mg/5ml susp (400mg) [35/70ml bottle]
375 mg/tab (250mg)
 DRUG FORMULARY

AMPICILLIN Ampicin
o 250,500 mg vial
PO: 50–100 mkday ÷ Q6 hr o 500 mg cap

IM/IV: 100–200 mkday ÷ Q6 Excillin

o 250,500 mg, 1g vial
Severe infections: 200–400 mkday ÷ Q4–6
IM/IV

AMPICILLIN-SULBACTAM Unasyn
o 250 mg/5ml susp [60ml bottle]
<30 kg: 25-50 mkday ÷ Q12 PO o 375,750 mg, 1.5g vial
>30 kg: 375-750 mg BI
IM/IV Ampimax
≥ 1 mo: 100–150 mkday ÷ Q6 o 750mg, 1g vial
Meningitic: 200–300 mkday ÷ Q6
Child: 100–200 mkday ÷ Q6
Meningitic: 200–400 mkday ÷ Q4–6

ASCORBIC ACID C-4-Kids

o 100mg/ml drops [15ml bottle]
TD: 100–300 mg/24 hr ÷ OD-BID o 100mg/5ml syr [120ml bottle]

Ceelin
o 100mg/ml drops [15/30/45ml bottle]
o 100mg/5ml syr [60/120/250/500ml]
o 100mg/chew tab

AZITHROMYCIN Zenith (azithromycin monohydrate)

AOM, CAP, & sinusitis* (≥6 mo) PO-OD:
5 days: 10 mg/kg D1, then 5 mg/kg
3 days: 10 mkday*
1 day: 30 mkday
ATP (2–15 yr): 12 mkday x 5 days
o 200mg/5ml susp [20ml bottle]
Zithromax (azithromycin dihydrate)
o 200mg/5ml susp [15/22.5ml bottle]
o 250 & 500mg/tab
o 500mg/vial
 DRUG FORMULARY

ASPIRIN Aspilets
o 80mg/tab
Analgesic/antipyretic: o 80mg/EC tab
10–15 mkdose PO/PR Q4–6
Max. dose: 4 g/24 hr Bayprin
o 100mg/EC tab
Anti-inflammatory:
60–100 mkday PO ÷ Q6–8 Cor-30
o 30mg/tab
Kawasaki disease:
80–100 mkday PO ÷ QID then
3–5 mkday hr PO QAM. Continue for 8 wk or
until Plt Ct and ESR are normal
BAMBUTEROL Bambec
o 1mg/ml/sol’n
2-5 yr: 10 mg (10 mL) OD o 10mg/tab
6-12 yr: Initially 10 mg, may be increased to
20 mg after 1-2 wk.

BISACODYL Dulcolax
o 5mg/ped supp
Oral: 0.3 mg/kg/dose or 5–10 mg, 6 hr prior o 10mg/adult sup
to effect o 5mg/tab

Suppository (as a single dose):

<2 yr: 5 mg 2–11 yr: 5–10 mg
>11 y: 10 mg

Enema (>12 yr): 30 mL

CALCIUM CARBONATE Tums
Hypocalcemia: o 500mg chew tabs
112.5-162.5 mkday ÷ QID
Antacid (PO):
2–5 yr: 400 mg
>6–11 yr: 800 mg
>11 yr: 1000–3000 mg
 DRUG FORMULARY

CALCIUM GLUCONATE Calcinate

o 100 mg/mL [10ml bottle]
Hypocalcemia (Infant):
IV: 200–500 mkday ÷ Q6
PO: 400–800 mkday ÷ Q6
Child: 200–500 mkday IV/0PO ÷ Q6

Cardiac arrest: Tetany: 100–200 mkdose IV over 5–10

TD: 100 mg/kg/dose IV Q10 min min, repeat 6 hr later if needed

CARBOCISTEINE Loviscol Infant drops 50 mg/ml [15ml bot]

o 13-24 mo:1.2 ml Q6

Loviscol Ped syr 100 mg/5 ml [60/120ml]

o 8-12 yr: 10-15ml Q8
o 4-7 yr: 7.5-10ml Q8
o 1-3 yr: 5-7.5ml Q8

Robikids 250 mg/5 ml susp [15/60/120]

o 6-12 yr: 5 ml Q8
o 2-5 yr: 2.5 ml Q8

CARBAMAZEPINE Tegretol
o 100mg/5ml susp [100ml bottle]
<6 yr o 200mg tab
LD: 10-20 mkday P.O. BID-TID or QID o 200mg SR tab
(susp) o 400mg LA tab
Increment: Q5-7days.
Max: of 35 mkday
>12 yr
6-12 yr Initial: 200 mg PO BID
LD: 10 mkday P.O. BID Increment: 200 mday Q 1wk (÷BID–QID)
Increment: 100 mday (TID-QID) Q 1 wk until desired response is obtained
MD: 20-30 mkday BID-QID MD: 800–1200 mday PO ÷ BID–QID
Max: 1000 mday
 DRUG FORMULARY

CEFACLOR Ceclor
o 50mg/ml drops [20ml bottle]
TD: 20–40 mkday PO ÷ Q8 o 125mg/5ml susp [60ml bottle]
o 250mg/5ml susp [60ml bottle]
Otitis media: 40 mkday Q12

Pharyngitis: 20 mkday Q12

CEFADROXIL Drozid
o 125mg/5ml syr [60ml bottle]
TD: 30 mg/kg/24 hr PO ÷ Q12 hr
Cefadrox-500
o 500mg/cap

CEFAZOLIN Stancef
o 500mg & 1g vial
TD: 50-100mkday Q8 IV
CEFALEXIN Cefalin
o 100mg/ml drops [10ml bottle]
TD: 25–100 mkday PO ÷ Q6 hr. o 125mg/5ml susp [60ml bottle]
o 250mg/5ml susp [60ml bottle]
Otitis media: 75–100 mkday PO ÷ Q6
Ceporex
Strep Pharyngitis and skin infections: 25–50 o 100mg/ml drops [10ml bottle]
mkday PO ÷ Q6–12 o 125mg/5ml susp [70ml bottle]
o 250mg/5ml susp [30/70ml bottle]
o 250 & 500mg cap

CEFEPIME Axera
o 500mg, 1g & 2 g vial
TD: 100mkd Q12 IV
Cepimax
Meningitis: 150mkd Q8 IV o 500mg, 1g & 2 g vial
Cystic Fibrosis: 150mkd Q8 IV
 DRUG FORMULARY

CEFIXIME Tergecef
o 20mg/ml drops [10ml bottle]
TD: 8mkday Q12-24⁰ o 100mg/5ml susp [30/60ml bottle]
o 100 & 200 mg cap
UTI: 16mkday Q12 (Di) then 8 mkd x 13
days Ultraxime
o 20mg/ml drops [10ml bottle]
o 100mg/5ml susp [30/60ml bottle]

CEFOPERAZONE Available as combination with sulbactam

TD: 100-150mkday Q8-12 Sulperazone

o 1g cefoperazone /500mg
sulbactam.vial

CEFOTAXIME Cladex
o 1g vial
< 12 yr or < 50 kg: 100-200mkday Q6-8
Meningitis: 200mkday Q6 Claforan
>12 yr or ≥50 kg: 1–2 g/dose Q6–8 IV/IM o 500mg vial

CEFOTETAN No brand
o 20mg/ml amp
TD: 40–80 mkday ÷ Q12 IV/IM o 40mg/ml amp
o 1g, 2g, 10g vial

CEFOXITIN Monowel/Panafox
o 1g vial
Mild/moderate infections: 80–100 mkday ÷
Q6–8 IM/IV

Severe infections: 100–160 mkday ÷ Q4–6

IM/IV
 DRUG FORMULARY

CEFPODOXIME Trizef
o 50mg/5ml susp [60ml bottle]
Otitis media: 10 mkday PO ÷ Q12–24 × 5 o 100mg FC tab
days
Cefadox
Pharyngitis/tonsillitis: 10 mkday PO ÷ Q12 o 200mg tab
hr × 5–10 days

CEFTAZIDIME Fortum
o 250 & 500mg vial
TD: 100–150 mkday ÷ Q8 IV/IM o 1 & 2 g vial
CF/Meningitis: 150 mkday ÷ Q8 IV/IM Zeptrigen
o 500mg & 1g vial

CEFTRIAXONE Forgram
o 500mg & 1g vial
Infant/child: 50-75 mkd Q12
Megion
Typhoid meningitis: 75-100mkd Q12 o 1g vial

CEFUROXIME Zinnat
o 125mg/5ml susp [50/70ml bottle]
IM/IV: o 250mg/5ml susp [50ml bottle]
Neonate: 50–100 mkday ÷ Q12 o 250 & 500mg tab
>3 mo-child: 75–150 mkday ÷ Q8
Zegen
PO (3 mo–12 yr): o 750mg & 1.5g vial
Pharyngitis and tonsillitis: o 250 & 500mg tab
Oral suspension: 20 mkday ÷ Q12
Tabs: 125 mg PO Q12 Zinacef
o 250 & 750mg vial
Otitis media, impetigo, and sinusitis: o 1.5g vial
Oral suspension: 30 mkday ÷ Q12 o 250 & 500mg tab
Tabs: 250 mg Q12 hr
 DRUG FORMULARY

CETIRIZINE Alllerkid
o 2.5mg/ml drops [10ml bottle]
6mo-< 2yr: 2.5mg OD o 5mg/5ml syrup [30/60ml bottle]
2-5 yr: 2.5-5mg OD
≥6 yr: 5-10mg OD Alnix
o 10mg/tab

Virlix
o 10mg/ml drops [10ml bottle]
o 1mg/ml sol’n [30ml bottle]
o 10mg tab

CHLORAMPHENICOL Pediachlor
o 125 mg/5 mL susp [60ml bottle]
Neonate
LD: 20mg/kg
MD (12 hrs after LD): 25-50mkday

Infant: 50-75mkday IV Q6
Meningitis: 75-100 mkd Q6

CHLORPHENIRAMINE MALEATE Antamin

o 2mg/5ml syrup [60ml bottle]
Child < 12 yr: 0.35 mkday PO ÷ Q4–6 o 4mg tab
2–5 yr: 1 mdose PO Q4–6
6–11 yr: 2 mdose PO Q4–6
≥12 yr: 4 mg/dose PO Q4–6

CIMETIDINE Cimulcer
o 100mg/ml amp
Neonate: 5–20 mkday PO ÷ Q6–12
Infant: 10–20 mkday PO ÷ Q6–12 Tagamet
Child: 20–40 mkday PO ÷ Q6 o 200 & 400mg tab
 DRUG FORMULARY

CIPROFLOXACIN Ciprobay
o 250 & 500mg tab
PO: 20–30 mkday ÷ Q12; max 1.5 g/d o 500mg & 1g XR tab
IV: 20–30 mkday ÷ Q12; max 800 mg/d o 100mg/50ml vial
o 200mg/100ml vial
Comp. UTI or pyeloneph (×10–21 d): o 400mg/200ml vial
PO: 20–40 mkday ÷ Q12; max 1.5 g/d
IV: 18–30 mkday ÷ Q8; max 1.2 g/d
CLARITHROMYCIN Klaz
o 125mg/5ml susp [35/70ml bottle]
TD: 15 mkday PO ÷ Q12
o 250mg/5ml susp [35/70ml bottle]
o 250 & 500mg tab
o 500mg/mod rel tab (Klaz OD)

Klaricid
o 250 & 500mg tab
o 500mg/mod rel tab (Klaricid OD)

CLINDAMYCIN Dalacin C
o 75 mg/5 ml sol’n [60ml bottle]
Neonate: 5mkdose Q8-12 hr o 150mg/ml [4 ml amp]
PO: 10–30 mkday ÷ Q6–8; max 1.8 g/d o 150 & 300mg cap
IM/IV: 25–40 mkday ÷ Q6–8
CLONAZEPAM Rivotril
o 2mg tab
10 yr or <30 kg
Initial: 0.01–0.03 mkday ÷ Q8 PO. Clonotril-0.5
Max Di: 0.05 mkday o 500 mcg tab
Increment: 0.25–0.5 mday Q3 days, up to
max MD of 0.1–0.2 mkday ÷ Q8

≥ 10 yr or ≥ 30 kg
Initial: 1.5 mday PO ÷ TID
Increment: 0.5–1 mday Q3 days; max. dose
20 mday
 DRUG FORMULARY

CLOXACILLIN Cloxid, Encloxil, Medaclox,

o 125mg/5ml [60ml bottle]
PO: 50-100 mkd Q6
IV: 100 mkd Q6 Pannox
o 250mg/5ml [60ml bottle]

COTRIMOXAZOLE (SMZ-TM) Bactrim

Minor/moderate infections (PO or IV)
Child: 8–12 mkday ÷ BID
Severe infections (PO or IV)
Child: 20 mkday ÷ Q6–8
o 200mg/40mg/5ml [50ml bottle]
Septrin
o 200mg/40mg/5ml [30/70ml bottle]
Trim-S
o 200mg/40mg/5ml [60ml bottle]
Trim-S Forte
o 400mg/80mg/5ml [60ml bottle]
Trizole
o 400mg/80mg/5ml [30/60ml bottle]

DESLORATIDINE Aerius
o 2.5mg/5ml syr [60ml bottle]
6-11 mo: 1mg or 2ml o 5mg/tab
1-5 yr: 1.25mg 2.5ml
6-11 yr: 2.5mg or 5ml

DEXAMETHASONE Decilone
o 500mcg & 4mg tab
Airway edema: 0.5–2 mkday IV/IM ÷ Q6 (24 o 5mg/ml amp [1ml amp]
hr before extubation & for 4–6 doses after
extubation) Oradexon
Croup: 0.6 mkdose PO/IV/IM × 1 o 500mcg tab

Anti-inflammatory: 0.08–0.3 mkday PO, IV, Drenex

IM ÷ Q6–12 o 750mcg & 3mg tab

Brain tumor: Dexamet

LD: 1-2mkdose IV/IM o 5mg/ml amp [1ml amp]
MD: 1-1.5mkday Q4-6
 DRUG FORMULARY

DESONIDE Desowen cream/lotion

o .05% [15g cream/tube, 60ml lotion]
2-3x daily
DIAZEPAM Trankil
o 5mg/ml amp [2ml amp]
Sedative/muscle relaxant:
IM or IV: 0.04–0.2 mkdose Q2–4; max. dose Valium
0.6 mg/kg within an 8-hr period o 5 & 10mg tab
PO: 0.12–0.8 mkday ÷ Q6–8 o 10mg/2ml amp [2ml amp]
Status epilepticus:
Neonate: 0.3–0.75 mkdose IV Q15–30 min
× 2–3 doses; max. dose: 2 mg.
> 1 mo: 0.2–0.5 mg/kg/dose IV Q15–30 min; Rectal dose: 0.5 mkdose, followed by 0.25
max. dose <5 yr, 5 mg; ≥5 yr, 10 mg. mkdose in 10 min PRN
May repeat dosing in 2–4 hr as needed.

DICYCLOVERINE Relestal
o 5mg/ml drops [15ml bottle]
6 mo-2 yr: 0.5 – 1ml o 10mg/5ml syr [60ml bottle]
2-5 yr: 2.5 – 5ml
6-12 yr: 5ml

DIPHENHYDRAMINE Benadryl AH
o 12.5mg/5ml syr [ml bottle]
Severe allergic reaction and dystonic o 25 & 50mg cap
reactions (PO/IM/IV):
Child: 1–2 mkdose Q6 Hyphen
usual dose: 5 mkday ÷ Q6 o 50mg/ml amp
Max. dose: 50 mdose & 300 mday

Sleep aid (PO/IM/IV):

2–11 yr: 1 mkdose 30 min before bedtime.
 DRUG FORMULARY

DIVALPROEX SODIUM Depakote

o 125mg sprinkle cap
Di: 10–15 mkday ÷ OD–TID
Increment: 5–10 mkday at weekly intervals Depakote ER XR
to max. dose of 60 mkday o 250& 500mg tab
MD: 30–60 mkday ÷ BID–TID.

DILOXANIDE FUROATE Diloxan

o 500mg/tab
TD: 20m kday ÷ Q8 hr x 7-10 days

DOMPERIDONE Motilium
o 1mg/ml drops [100ml bottle]
Susp: 2.5 mL/10 kg TID o 10mg tab

Drops: 2.5-5 mg/10 kg or 0.3-0.6 mL/5 kg Vometa

o 5mg/ml drops [10ml bottle]
FT: 0.2-0.4 mkdose Q4-8 hr o 5mg/5ml susp [60ml bottle]

Vometa FT
o 10mg fast melt tab

DOXYCYCLINE Doxin
o 100mg cap
Di ≤45 kg: 2.2 mkdose BID PO/IV
MD ≤45 kg: 2.2–4.4 mkday OD–BID PO/IV Vibramycin
o 100mg cap
Di >45 kg: 100 mdose BID PO/IV
MD >45 kg: 100–200 mday ÷ OD–BID
PO/IV

Malaria prophylaxis (start 1–2 days before

exposure, and continue for 4 wk after
leaving
endemic area):
>8 yr: 2 mkday PO once daily
 DRUG FORMULARY

EPINEPHRINE Adrenin
o 1mg/ml amp

Asystole and bradycardia: Neonate Bronchodilator: 1:1000 (aqueous):

0.01–0.03 mg/kg of 1:10,000 solution (0.1– Infant and child: 0.01 mL/kg/dose SC
0.3 mL/kg) IV/ET (max. sdose 0.5 mL); repeat Q15 min × 3–
Q3–5 min PRN 4 doses or Q4 PRN

Infant and child: Nebulization (alternative to racemic

Di: 0.01 mg/kg of 1:10,000 solution (0.1 epinephrine): 0.5 mL/kg of 1:1000 solution
mL/kg) IO/IV; max. dose 1 mg (10 mL). diluted in 3 mL NS.
Subsequent doses Q3–5 min PRN
ERTAPENEM Invanz
o 1g/vial
TD: 15 mg/kg/dose IV/IM Q12 hr

ERYTHROMYCIN Pharex Erythromycin (ethysuccinate)

ETHYLSUCCINATE/ESTOLATE o 200mg/5ml susp [60ml bottle]

TD: 30–50 mg/kg/24 hr ÷ Q6–8 hr Ilosone (estolate)

o 100mg/ml drops [10ml bottle]
o 125mg/5ml susp [60ml bottle]
o 250mg/5ml susp (Ilosone DS) [60ml]

ERDOSTEINE Ectrin
o 175mg/5ml susp [60ml bottle]
TD: 10 mkday BID o 300mg cap

Ectrin: Zertin
>30 kg: 10 mL BID o 175mg/5mL susp [60/100ml bottle]
20-30 kg: 5 mL TID o 300mg cap
15-19 kg: 5 mL BID
Zertin:
>12 yr (>30 kg): 7.5 mL BID
7-12 yr (21-30 kg): 5 mL BID
2-6 yr (10-20 kg): 2.5 mL BID
 DRUG FORMULARY

ESOMEPRAZOLE Nexium
o 10mg granules for oral susp
GERD (use for up to 8 weeks) PO: o 20 & 40mg tab
1–11 yr: 10mg OD o 40 mg vial
≥12 yr: 20–40mg OD

GERD w/ erosive esophagitis (IV):

Infant: 0.5-1 mkdose OD
<55 kg: 10mg OD
≥55 kg: 20-40mg OD

FAMOTIDINE H2Bloc
o 20mg tab
≥3 mo–1 yr: 0.5 mkdose PO Q12 hr
o 20mg vial
Child (1–12 yr):
IV Initial: 0.6–0.8 mkday ÷ Q8–12
PO: Initial: 1–1.2 mkday ÷ Q8–12
Peptic ulcer: 0.5 mkday PO QHS or ÷ Q12
GERD: 1–2 mkday PO ÷ Q12

FUROSEMIDE Lasix
o 20mg/2ml amp
IM, IV: o 40mg tab
Neonate: 0.5–1 mkdose Q8–24; max. dose
2 mg/kg/dose
Infant & child: 1–2 mkdose Q6–12

PO:
Infant and child: 2 mkdose; may increase by
1–2 mkdose Q6–8 after prev dose. Max.
dose: 6 mkdose.

FURAZOLIDONE Diapectolin
o 50mg/5ml susp
1-3 yr: 5-7.5ml TID-QID
≥4 yr: 7.5-15ml TID-QID
 DRUG FORMULARY

GENTAMICIN Servigenta
o 80mg/2ml amp
TD: 7.5 mg/kg/24 hr ÷ Q8 hr
Neonates: 4mkdose Q24 Mycin
o 40mg/ml amp (2ml amp)

GLYCERIN Pedia Supp

o 1.955g supp
Neonate: 0.5 mLkdose PR as an enema OD
PRN Adult Supp
< 6 yr: 2–5 mL PR as an enema or 1 infant o 2.5g supp
supp PR OD PRN
>6 yr: 5–15 mL PR as an enema or 1 adult
supp PR OD PRN

HYDROCORTISONE Solu-Cortef
o 100mg vial
Status asthmaticus: o 250mg vial
Child: o 500mg vial
LD (optional): 4–8 mkdose IV; max. dose of
250 mg
MD: 8 mkday ÷ Q6IV

Anti-inflammatory:
Child:
PO: 2.5–10 mkday ÷ Q6–8
IM/IV: 1–5 mkday ÷ Q12–24
Adolescent PO/IM/IV: 15–240 mdose Q12
.

HYDROXYZINE Iterax
o 2mg/ml syr [100ml bottle]
TD: 2 mkday PO ÷ Q6–8 PRN o 10 & 25mg tab
 DRUG FORMULARY

HYOSCINE-N-BUTYLBROMIDE Buscopan
o 10mg tab
TD: 0.3-0.6mg/kg/day wt SIVP o 20mg amp
<6 yr: ¼ amp TID SC/IM/IV
>6 yr: 1-2 tabs 3-5x/day or 1-2 amps
SC/IM/IV

IBUPROFEN Dolan FP
o 100mg/2.5ml drops [15ml bottle]
TD: 5–10 mg/kg/dose Q6–8 hr PO o 100mg/5ml susp [60ml bottle]
o 200mg/5ml Forte susp [60ml bottle]

Advil, Brufen
o 100mg/5ml susp [60ml bottle]

IPRATROPIUM BROMIDE Atrovent

o 0.5mg/2ml vial
Infant: 125–250 mcg/dose Q8
≤ 12 yr: 250 mcg/dose Q6–8
.
IRON (FeSO4 - 20% elemental Fe)

Child: 3–6 mg elemental Fe/kg/24 hr ÷ OD–

TID PO
LACTULOSE Duphalac
o 3.3g/5ml syr [45/120ml bottle]
TD: 1–3 mL/kg/24 hr PO ÷ BID.
Movelax
3.3g/5ml syr [30/120ml bottle]
LANSOPRAZOLE Prevacid FDT
o 15 & 30mg FDT tab
≤30 kg: 15 mg PO OD
>30 kg: 30 mg PO OD–BID Prevacid IV
o 30mg vial
 DRUG FORMULARY

LEVOFLOXACIN Levox
o 250mg/50ml [50ml bottle]
<5 yr: 10 mkdose IV/PO Q12 o 500mg/100ml [100ml bottle]
≥5 yr: 10 mkdose IV/PO Q24 o 500 & 750mg tab

LEVODROPOPIZINE Levopront
o 30mg/5ml syr [60/120ml bottle]
>2 yr: 1 mg/kg
>12 yr: 10 mL
10-20 kg: 3 mL
20-30 kg:5 mL

LORATADINE Allerta
o 5mg/5ml syr [30/60ml bottle]
2–5 yr: 5 mg PO once daily
≥6 yr: 10 mg PO once daily Claritin
. o 5mg/5ml syr [30ml bottle]
o 10mg tab

MEBENDAZOLE Antiox
o 20mg/ml susp [30ml bottle]
Pinworms: 100 mg PO × 1 o 50mg/ml susp [10ml bottle]
Hook, round, & whipworm: 100 mg PO BID o 500mg tab
× 3 days or 500 mg PO × 1.
Capillariasis: 200 mg PO BID × 20 days
Visceral larva migrans: 100–200 mg PO BID
× 5 days
Trichinellosis: 200–400 mg PO TID × 3
days, then 400–500 mg PO TID × 10 Days

MEFENAMIC ACID Ponstan

o 50mg/5ml susp [60ml bottle]
TD: 19.5-25 mkday ÷ TID o 500mg tab
o 250 & 500mg SF cap
 DRUG FORMULARY

METHYLPREDNISOLONE Medrol
o 4 & 16mg tab
Anti-inflammatory: 0.5–1.7 mkday ÷ Q6–12
PO/IM/IV Solu-Medrol
o 125mg/2ml vial
Asthma exacerbation (3-10 days) o 40mg/ml vial
≤2 yr: 1–2 mkday ÷ Q12–24 o 500mg/8ml vial
>12 yr: 40–60 mday ÷ Q12–24

METOCLOPRAMIDE Plasil
o 5mg/5ml syr
GERD: 0.1–0.2 mg/kg/dose up to QID o 10mg tab
IV/IM/PO o 10mg/2ml amp

Antiemetic: 1–2 mkdose Q2–6 IV/IM/PO

(Premedicate with diphenhydramine to
reduce EPS.)

METRONIDAZOLE Flagyl
o 125mg/5ml
Amebiasis: 35–50 mkday PO ÷ TID × 10 o 500mg tab
days. o 500mg/100ml infusion vial

MIDAZOLAM Dormicum
o 15mg tab
Refrac. status epilepticus ≥2 mo LD: 0.15 o 5mg/ml amp
mg/kg IV × 1 then o 5mg/5ml amp
Cont. inf: 1 mcg/kg/ min; titrate dose upward o 15mg/3ml amp
Q5 min to effect

MONTELUKAST Kastair
o 10mg tab
6 mo–5 yr: 4 mg PO QHS Singulair
6–14 yr: 5 mg PO QHS o 4mg granules for oral sol’n
≥15 yr: 10 mg PO QHS o 4 & 5mg chew tab
o 10 mg tab
 DRUG FORMULARY

NIFUROXAZIDE Ercefuryl
o 218mg/5ml susp
> 2 yr: 660mg/d ÷ TID x 7 d o 200mg cap
> 6 yr: 3-4 cap/day x 7 d

NITROFURANTOIN Macrodantin
o 50 & 100mg cap
> 1 mo: 5–7 mkday ÷ Q6 PO
≥12 yr: 50-100 mdose Q6 PO

OMEPRAZOLE Losec
o 10 & 20mg cap
TD: 1 mkday PO ÷ OD–BID or o 40mg amp & vial
5–<10 kg: 5 mg PO OD
10–<20 kg: 10 mg PO OD Omepron
≥20 kg: 20 mg PO OD o 20 & 40mg cap
o 40mg vial

OXACILLIN Cilvex, Oxal, Oxapen, Panadox

o 500mg vial
TD: 100–200 mkday ÷ Q4–6

OXYMETAZOLINE Drixine Ped nasal drops

o 0.025 % nasal drops [10ml bottle]
2-5 yr: 2-3 drops per nostril bid
>5 yr: 2-3 spray per nostril bid Drixine nasal spray
o 0.05 % nasal spray [15ml bottle]

PANTOPRAZOLE Pantoloc
o 20 & 40mg tab
GERD (limited data): o 40mg vial
<5 yr: 1.2 mkday PO OD
≥5 yr: 20 or 40 mg PO OD
 DRUG FORMULARY

PENICILLIN G – Na+ or K+ salt

IM/IV: 100,000–400,000 ukday ÷ Q4–6 (use
higher dose & Q4 interval for meningitis &
severe infections)
o 1,000,000 u/50ml premixed injectable
o 2,000,000 u/50ml premixed injectable
o 3,000,000 u/50ml premixed injectable
Penicilin K
o 5,000,000u/vial
o 20,000,000u/vial

Penicilin Na
o 5,000,000u/vial

PENICILLIN G —BENZATHINE Benzapen

o 1,200,00 u / vial
Group A strep: 600,000 udose IM

Rheumatic fever: 600,000 udose IM Q3–4

wk

PENICILLIN V
o 125mg/5m
Child: 25–50 mkday ÷ Q6–8 PO o 250mg/5mll
Adol: 125–500 mg/dose PO Q6–8 o 250, 500mg tab

PHENOBARBITAL
LD: 15–20 mkdose IV (max. loading dose:
1000 mg). May give additional 5-mg/kg
doses Q15–30 min to a max. total of 40
mg/kg.
Hyperbilirubinemia (<12 yr):
3–8 mkday PO ÷ BID–TID
Luminal
o 130mg/ml amp
MD:: Monitor levels.
Neonate: 3–5 mkday PO/IV ÷ OD–BID
Infant: 5–6 mkday PO/IV ÷ OD–BID
1–5 yr: 6–8 mkday PO/IV ÷ OD–BID
6–12 yr: 4–6 mkday PO/IV ÷ OD–BID
>12 yr: 1–3 mkday PO/IV ÷ OD–BID
 DRUG FORMULARY

PHENYLEPHRINE HCL

Oral decongestant (see remarks):

4–<6 yr (2.5 mg/mL): 1 mL (2.5 mg) PO Q4
hr; max 6ml/day
(2.5 mg/5 mL): 5 mL (2.5 mg) PO Q4 hr,
max: 30ml/day
≥6–<12 yr (2.5 mg/5 mL): 10 mL (5 mg) PO
Q4 hr up to 60 ml/day

PHENYTOIN Dilantin
o 30mg/5ml susp [120ml bottle]
LD (all ages): 15–20 mg/kg IV o 125mg/5ml susp [120ml bottle]
Max. dose: 1500 mg/24 hr o 100mg cap
o 50mg/ml [2ml amp]
MD: (12 hr after LD):
Neonate: 5 mkday PO/IV ÷ Q12. Usual
range is 4–8 mkday PO/IV ÷ Q8–12
Infant/child: 5 mkday ÷ BID–TID PO/IV.

Usual dose ranges are (doses divided

BID–TID):
6 mo–3 yr: 8–10 mg/kg/24 hr
4–6 yr: 7.5–9 mg/kg/24 hr
7–9 yr: 7–8 mg/kg/24 hr
10–16 yr: 6–7 mg/kg/24 hr

PIPERACILLI-TAZOBACTAM Piptaz
o 2g/250mg vial
2–9 mo: 240 mkday ÷ Q8 o 4g/500mg vial
>9 mo: 300 mkday ÷ Q8
 DRUG FORMULARY

PREDNISONE Prolix
o 10mg/5ml susp [60ml bottle]
Antiinflammatory: 0.5–2 mkday PO ÷ OD– o 20mg tab
BID
Unicort
Acute asthma: 2 mkday PO ÷ OD–BID × 5– o 10mg/5ml susp
7 days

PROCATEROL Meptin
o 5mcg/ml syr [60ml bottle]
≤5 yr: 0.25ml/kg BID-TID o 25 & 50mcg tab
>6 yr: 5ml or 25mcg tab OD-BID
Mepti Swinghaler
o 10mcg/puff inhaler [200 puff]

PROMETHAZINE Promet
o 25mg/ml amp [1ml amp]
Nausea & vomiting PO/IM/IV/PR
≥2 yr: 0.25–1 mkdose Q4–6 PRN; max.
dose: 25 mg/dose

Motion sickness:
≥2 yr: 0.5 mkdose Q12 PO/PR PRN; max.
dose: 25 mg/dose

PYRANTEL PAMOATE Combantrin

o 125mg, 250mg tab
TD: 11mkdose/day x 3days o 125mg/5ml [10ml bottle]

Quantrel
(oxantel 20mg + pyrantel embonate
20mg)
o 100mg/100mg/5ml [10ml bottle]
 DRUG FORMULARY

RACECADOTRIL Hidrasec
o 10mg granules for oral susp
TD: 1.5 mkd TID o 30mg granules for ora susp
o 100mg cap
<9kg: 10mg TID (10mg/sachet)
9-12kg: 20mg TID (2 sachet)
12-27kg: 30 mg TID (30mg/sachet)
>27: 60mg TID (2 sachet)

RANITIDINE Zantac
o 75,150,&300mg tab
GERD/erosive esophagitis: o 25mg/ml amp
IV/IM: 2–4 mkday ÷ Q6–8; max. dose: 200
mg/24 hr Duodenal/gastric ulcer
PO: 5–10 mkday ÷ Q8–12 hr. max dose: IV/IM: 2–4 mkday ÷ Q6–8; max. dose:
600mg/day 200 mg/24 hr
Tx: 4–8 mkday ÷ Q12 PO; max. dose: 300
mg/day
MD: 2–4 mkday ÷ Q12 PO; max. dose:
150 mg/day

SALMETEROL

Persistent asthma:
≥4 yr: 1 inhalation (50 mcg) Q12

SIMETICONE Restime
o 40mg/ml drops [10ml bottle]
<2 yr: 20 mg PO QID PRN; max. dose: 240 o 40mg chew tab
mg/24 hr
2–12 yr: 40 mg PO QID PRN Disflatyl
>12 yr: 40–250 mg PO QPC & QHS o 40mg chew tab
 DRUG FORMULARY

TERBUTALINE Bricanyl
o 1.5mg/5ml syr [60/120ml bottle]
Oral: o 2.5mg tab
≤12 yr: 0.05 mkdose Q8 hr; max. dose: 0.15 o 5mg/2ml neb
mkdose or 5mg/day o 500mcg/ml amp [1ml amp]
>12 yr: 2.5–5 mg/dose PO Q6–8

Nebulization:
<2 yr: 0.5 mg in 2.5 mL NS Q4–6
2–9 yr: 1 mg in 2.5 mL NS Q4–6
>9 yr: 1.5–2.5mg in 2.5mL NS Q4–6

TETRACYCLINE

≥8 yr: 25–50 mkday PO ÷ Q6

TICARCILLIN AND CLAVULANATE Triclav

o 1.5g/100mg/vial
Mild/mod infections: 200 mkday IV ÷ Q6 o 3g/200mg/vial
Severe infections: 300 mkday IV ÷ Q4–6
TRANEXAMIC ACID Hemostan
o 250mg/2.5ml amp
TD: 15-25 mkday ÷ BID-QID o 500mg/5ml amp
o 250 & 500mg cap

VALPROIC ACID Depakene

o 250mg/5ml syr [120ml bottle]
Di: 10–15 mkday PO ÷ OD–TID
Inc: 5–10 mkday per wk to max. dose of 60
mkday
MD: 30–60 mg/kg/24 hr ÷ BID–TID

VANCOMYCIN Vancocin CP
o 500mg vial
TD: 15-25 mkday ÷ BID-QID
 DRUG FORMULARY

ANTI-TB DRUGS
ISONIAZID o 200mg/5ml

10-15 mkdose PO OD

RIFAMPICIN o 200mg/5ml

10-20 mkdose PO OD

PYRAZINAMIDE o 500mg/5ml

30-40 mkdose PO OD

ETHAMBUTOL

20-25 mkdose PO OD

STREPTOMYCIN o 1g/vial

20-40 mkdose IM OD
 DRUG FORMULARY

DIETARY SUPPLEMENTS//VITAMINS & MINERALS

APPEBON KID SYRUP o 2-12 yr: 5 mL OD

60, 120, 250ml bottle

NUTRILIN DROPS o 7 mo-2 yr: 1 mL OD

o 0-6 mo: 0.5 mL OD
15, 30ml bottle

NUTRILIN SYRUP o 7-12 yr: 5-10 mL OD

o 2-6 yr: 5 mL. OD
120, 250ml bottle

TIKI TIKI PLUS DROPS o 7 mo-1 yr: 0.5-0.75 mL OD

o 1-2 yr: 0.75 mL OD
15, 30ml bottle

TIKI TIKI STAR SYRUP o 4-12 yr: 5 mL OD

o 1-3 yr: 2.5-5 mL OD
60, 120ml bottle

IMMUNOSIN SYR 250 MG/5 ML TD: 500-100 mkday ÷ Q4-6

IMMUNOSIN TAB 500 MG o 7-12 yr: 5 mL
(IMMUNOPLEX) o 3-6 yr: 3 mL
o 1-2 yr: 2 mL
60ml bottle o 7-12 mo: 1.5 mL
o birth -6 mo: 1 mL
 DRUG FORMULARY

PROBIOTICS
ERCEFLORA
(Bacillus clausii)

2-11 years: 1-2 vials of 2 billion/5 mL Administration at regular intervals (3-4

susp. hrs), diluting the content of the vial in
>1 month: 1-2 vials of 2 billion/5 mL susp sweetened water, milk, tea or orange
juice.
Prep: 2 billion/5 mL vials
PROTEXIN RESTORE
(Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus,
Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis,
Lactobacillus bulgaricus, fructooligosaccharide (FOS))

Recommended Dose: 1 sachet daily for 5-7 days or as needed.

Prep: sachet

PROTEXIN VITALITY
(Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus,
Lactobacillus acidophilus, Bifidobacterium breve, Bifidobacterium infantis,
Lactobacillus bulgaricus, vit C, fructooligosaccharide (FOS))

Recommended Dose: 1-2 tab daily for ≥4 yr

Prep: chewable tab

NORMAGUT
(Saccharomyces boulardii))

Recommended Dose: 1 cap OD to BID, mixed with a glass of water or juice

Prep250mg capsule
 DRUG FORMULARY
ORAL REHYDRATION SOLUTIONS
PEDIALYTE MILD 30
(Na 30 meq, K 20 meq, Mg 4 meq, Ca 4 meq, Cl 30 meq, lactate 28 meq. Ener: 20 kCal/100 mL)
Dose: Total daily intake should be
adjusted based on individual needs.
Administration: May be taken with or
without food.
Prep: 500 mL oral sol’n
(apple/grapes/strawberry)
PEDIALYTE-45/PEDIALYTE-75/PEDIALYTE-90
(Per L Pedialyte-45 Cl 35 mEq, citrate 30 mEq, dextrose 25 g, K 20 mEq, Na 45 mEq. Per L
Pedialyte-75 Cl 65 mEq, citrate 30 mEq, dextrose 25 g, K 20 mEq, Na 75 mEq. Per L Pedialyte-
90 Cl 80 mEq, citrate 30 mEq, dextrose 25 g, K 20 mEq, Na 90 mEq)

Dose: Total daily intake should be

adjusted based on individual needs. Administration: May be taken with or
without food.
Prep: 500 mL oral sol’n
GLUCOST R
(Per L Pedialyte-45 Cl 35 mEq, citrate 30 mEq, dextrose 25 g, K 20 mEq, Na 45 mEq. Per L
Pedialyte-75 Cl 65 mEq, citrate 30 mEq, dextrose 25 g, K 20 mEq, Na 75 mEq. Per L Pedialyte-
90 Cl 80 mEq, citrate 30 mEq, dextrose 25 g, K 20 mEq, Na 90 mEq)

Mild dehydration
Deficit Therapy (to be given within 4-6
Childn 30 mL/kg
hrs): Dissolve 2 sachets in 200 mL of
Infant ≤2 yr 50 mL/kg
water. Can increased according to needs
Moderate dehydration
eg, 10 sachets in 1 L of water.
Childn 60 mL/kg
Infant 100 mL/kg
Maintenance Therapy (to be given
Maintenance therapy
within the next 24 hrs): Dissolve 1
Childn 60 mL/kg/day
sachet in 100 mL of water. Can increased
Infant 100 mL/kg/day
according to needs eg, 10 sachets in 1 L
Prep: sachet
of water
 DRUG FORMULARY
ORAL REHYDRATION SOLUTIONS
HYDRITE
(Per tab NaCl 350 mg, Na bicarbonate 250 mg, KCl 150 mg, anhydrous glucose 2 mg. Per
sachet NaCl 520 mg, trisodium citrate dihydrate 580 mg, KCl 300 mg, anhydrous glucose 2.7 g)

Administration: Direction: Dissolve 2 tabs or 1 sachet in every glass (200 mL) of

drinking water. Give as much fluid as the child wants until diarrhea or vomiting stops

PREVENTION OF DEHYDRATION

TREATMENT OF DEHYDRATION
 DRUG FORMULARY

COUGH AND COLD PREPARATIONS

ALNIX PLUS SYRUP
(Per 5 mL syr Cetirizine diHCl 5 mg, 6-12 yr: 5 mL BID
phenylephrine HCl 5 mg) 2-5 yr: 2.5 m BID

COLVAN DROPS & SYRUP

(Per mL Colvan drops
Phenylpropanolamine HCl 6.25 mg,
chlorphenamine maleate 0.25 mg Per 5
mL Colvan syr Phenylpropanolamine HCl
12.5 mg, chlorphenamine maleate 0.5 mg)
Drops 1-2 yr: 1 mL Q6
DISUDRIN DROPS & SYRUP 7-12 mo: 0.75 mL Q6
(Per mL drops Phenylephrine HCl 2.5 mg, 4-6 mo: 0.5 mL Q6
chlorphenamine maleate 0.5 mg 1-3 mo: 0.25 mL Q6
Per 5 mL syr Phenylephrine HCl 5 mg,
chlorphenamine maleate 1 mg) Syrup >12 yr: 10 mL Q6
7-12 yr: 5mL Q6
NASATAPP DROPS & SYRUP 2-6 yr: 2.5 mL Q6
(Per mL drops Phenylpropanolamine HCl
6.25 mg, brompheniramine maleate 2 mg
Per 5 mL syr Phenylpropanolamine HCl
12.5 mg, brompheniramine maleate 4 mg)

DIMETAPP
(Per 5 mL syrup: Brompheniramine 2-6 yr: 2.5 mL Q4-6
maleate 2 mg, phenylephrine HCl 5 mg) 6-12 yrs: 5 mL Q4-6
12 yrs: 10 mL Q4-6
 DRUG FORMULARY

COUGH AND COLD PREPARATIONS

AMBROLEX DROPS 7.5 MG/ML o 2-5 yr:10-20 drops TID
(ambroxol) o <2 yr: 5-10 drops TID

AMBROLEX PED SYR 15 MG/5 ML o 6-11 yr: 5 mL TID

(ambroxol) o 2-5 yr: 2.5 mL TID
o <2 yr: 2.5 mL TID

ASMALIN BRONCHO SYRUP o >12 yr: 10-20 mL Q8-12

(Per 5 mL syr Guaifenesin 50 mg, o 7-12 yr: 10 mL Q8-12
salbutamol 1 mg) o 2-6 yr: 5-10 mL Q8-12

LOVISCOL INFANT DROPS 50 MG/ML o 13-24 mo:1.2 mL Q6

(carbocisteine)

LOVISCOL PED SYR 100 MG/5 ML o 8-12 yr: 10-15ml Q8

(carbocisteine) o 4-7 yr: 7.5-10ml Q8
o 1-3 yr: 5-7.5ml Q8

MUCOSOLVAN DROPS 6MG/ML o 13-24 mo: 1.25 mL BID

(ambroxol) o 7-12 mo: 1 mL BID
o <6 mo: 0.5 mL BID

MUCOSOLVAN PED SYR 15 MG/5 ML o 5-10 yr: 5 mL BID-TID

(ambroxol) o 2-5 yr: 2.5 mL TID
o <2 yr: 2.5mL BID

ROBIKIDS 250 MG/5 ML SUSP o 6-12 yr: 5 mL Q8

(carbocisteine) o 2-5 yr: 2.5 mL Q8
 DRUG FORMULARY
COUGH AND COLD PREPARATIONS
SOLMUX BRONCHO
(Salbutamol 2 mg, carbocisteine 500 mg)
VENTOLIN EXPECTORANT SYR
(Per 5 mL syr Guaifenesin 50 mg,
salbutamol sulfate 1 mg)
COMBIVENT / DUAVENT
(Ipratropium Br 500 mcg, salbutamol 2.5
mg)
SERETIDE
(100 Diskus Salmeterol xinafoate 50 mcg,
fluticasone propionate 100 mcg. 250
Diskus Salmeterol xinafoate 50 mcg,
fluticasone propionate 250 mcg. 500
Diskus Salmeterol xinafoate 50 mcg,
fluticasone propionate 500 mcg. 25/50
MDI Salmeterol xinafoate 25 mcg,
fluticasone propionate 50 mcg. 25/125
MDI Salmeterol xinafoate 25 mcg,
fluticasone propionate 125 mcg. 25/250
MDI Salmeterol xinafoate 25 mcg,
fluticasone propionate 250 mcg)
o 7-12 yr: 2.5-5mL TID-QID
o >12 yr: 10-20 mL BID-TID
o 7-12 yr: 10 mL BID-TID
o 2-6 yr: 5-10 mL BID-TID
o >12 yr: 1-2 neb Q6-8
o 2-12 yr: 3 drops/kg/dose Q6-8
o Diskus ≥12 yr :1 inhalation of
Seretide 100 or 250 or 500 BID
o Diskus ≥4 yr: 1 inhalation of
Seretide 100 BID
o
o MDI ≥12 yr: 2 inhalations of
Seretide 25/50 or 25/125 or
o MDI ≥4 yr: 2 inhalations of Seretide
25/50 BID
NUTRITION
 NUTRITION
FORMULA MILK
NESTLE (1:1) MEAD JOHNSON (1:1)
o AL 110 Lactose Free o Alacta 0-6mos
o Alfare o Alactamil 6mo-1y/o
o NAN H.W. 1,2 o Enfalac A+ 0->1yr
o NAN 1,2,3 o Enfalac iron fortified 0->1y/o
o NESTOGEN 1,2,3 o Enfalac LF 0- >1y/o
o NAN/NESTOGEN 3-10-24mos o Enfalac Premature
o PRENAN o Enfapro A+ infants
o Enfapro LF
o BEAR BRAND 1+ o Enfapro with DHA
o NIDO Jr 1-3y/o o Enfagrow AT >1y/o
o NIDO 3+ 3-5y/o o Enfagrow LF
o NIDO 5+ >5y/o o Enfakid AT 3y/o & above

PACIFIC HEALTHCARE (1:1) ABBOTT (1:2)

o Frisolac 0-6mos
o Frisomel 6mos-1yr
o Frisogrow 1-3yr
o Frisokid 4-7yr
o Isomil B-6mos
o Isomil 2 6mos onward
o Similac advance 0-6mos
o Similac neosure 0-12mos (wt gain)
o Grow >1y/o
o Gain + Advance >1y/o
o Gain school Adv>3y/o

UNILAB NUTRITIONALS (1:2) WYETH (1:2)

o Hinulac >6mos o Bonna: 0-6mos
o Hinulac Excel 6-12 mos o Bonnamil .6mos
o Mylac o Promil >6mos
o Mylac excel 0-12 mos o Promil Gold>6mos
o S26-B-6mos
FONTERRA o S26 Gold B-6mos
o S26 LF B-6mos
o Anchor 1-3y/o
o Progress Gold>1y/o
o Anchor 3+: 3-7yrs
o Promil Kid 1-3y/o
o Promil preschool>3y
 NUTRITION
AAP Recommendations on Breastfeeding Management for Term Infants
1. Exclusive breastfeeding for about 6 months
o Breastfeeding preferred; alternatively expressed mother’s milk, or donor breast milk
o To continue for at least the first year and beyond as long as mutually desired by
mother and child
o Complementary foods rich in iron and other micronutrientsshould be introduced at
about 6 mo of age
2. Peripartum policies and practices that optimize breastfeeding initiation and maintenance
should be compatible with the AAP and Academy of Breastfeeding Medicine Model
Hospital Policy and include the following:
o Direct skin-to-skin contact with mothers immediately after delivery until the first
feeding is accomplished and encouraged throughout the postpartum period
o Delay in routine procedures (weighing, measuring, bathing,blood tests, vaccines,
and eye prophylaxis) until after the first feeding is completed
o Delay in administration of intramuscular vitamin K until after the first feeding is
completed but within 6 hr of birth
o Ensure 8-12 feedings at the breast every 24 hr
o Ensure formal evaluation and documentation of breastfeeding by trained caregivers
(including position, latch, milk transfer, examination) at least once for each nursing
shift
o Give no supplements (water, glucose water, commercial infant formula, or other
fluids) to breastfeeding newborn infants unless medically indicated using standard
evidence-based guidelines for the management of hyperbilirubinemia and
hypoglycemia
o Avoid routine pacifier use in the postpartum period
o Begin daily oral vitamin D drops (400 IU) at hospital discharge
3. All breastfeeding infants should be seen by a pediatrician within 48 to 72 hr after
discharge from the hospital
o Evaluate hydration (elimination patterns)
o Evaluate body weight gain (body weight loss no more than 7% from birth and no
further weight loss by day 5: assess feeding and consider more frequent follow-up)
o Discuss maternal/infant issues
o Observe feeding
4. Mother and infant should sleep in proximity to each other to facilitate breastfeeding
5. Pacifier should be offered, while placing infant in back-to-sleep position, no earlier than
3 to 4 weeks of age and after breastfeeding has been established
 NUTRITION
ABSOLUTE AND RELATIVE CONTRAINDICATIONS TO BREASTFEEDING
HIV and HTLV In the United States, breastfeeding is contraindicated
infection In other settings, health risks of not breastfeeding must be
weighed against the risk of transmitting virus to the infant
Tuberculosis Breastfeeding is contraindicated until completion of
infection approximately 2 wk of appropriate maternal therapy

Varicella-zoster Infant should not have direct contact to active lesions

infection Infant should receive immune globulin

Herpes simplex Breastfeeding is contraindicated with active herpetic lesions

infection of the breast

CMV May be found in milk of mothers who are CMV seropositive

infection Transmission through human milk causing symptomatic
illness in term infants is uncommon
Hepatitis B Infants routinely receive hepatitis B immune globulin and
infection hepatitis B vaccine if mother is HbsAg positive
No delay in initiation of breastfeeding is required
Hepatitis C Breast-feeding is not contraindicated
infection

Alcohol intake Limit maternal alcohol intake to <0.5 g/kg/day (for a woman
of average weight, this is the equivalent of 2 cans of beer, 2
glasses of wine, or 2 oz of liquor)
Cigarette smoking Discourage cigarette smoking, but smoking is not a
contraindication to breastfeeding

Chemotherapy, Breastfeeding is generally contraindicated

radiopharmaceuticals
 NUTRITION

PATTERNS OF MILK SUPPLY

DAY OF LIFE MILK SUPPLY

Some milk (~5 mL) may be expressed
Day 1

Lactogenesis, milk production increases

Days 2-4

Milk present, fullness, leaking felt

Day 5

Breasts should feel ―empty‖ after feeding

Day 6 onward

AMOUNT PER FEEDING

WEIGHT AMOUNT

3-5kgs 2oz

4.5-5.5 4oz

6.5kgs 6oz

7.5kgs 6oz
 NUTRITION

FEEDING ALGORITHM FOR TERM INFANTS

 NUTRITION

IMPORTANT PRINCIPLES FOR WEANING

Begin at 6 months of age

At the proper age, encourage a cup rather than a bottle

Introduce 1 food at a time

Energy density should exceed that of breast milk

Iron-containing foods (meat, iron-supplemented cereals) are required

Zinc intake should be encouraged with foods such as meat, dairy, wheat, and rice

Phytate intake should be low to enhance mineral absorption

Breast milk should continue to 12 mo, formula or cow milk is then substituted

Give no more than 24 oz/day of cow milk

Fluids other than breast milk, formula, and water should be discouraged

Give no more than 4-6 oz/day of fruit juices; no sugar sweetened beverages

Adapted from American Academy of Pediatrics: Pediatric nutrition handbook, ed 6,

Elk Grove Village, IL, 2008, American Academy of Pediatrics.
 NUTRITION

CLASSIFICATION OF UNDERNUTRITION
CLASSIFICATION INDEX GRADING
90-75% of median weight-for-age Grade 1 (mild)
Gomez 75-60% Grade 2 (mod)
(underweight)
<60% Grade 3 (severe)

90-80% of median weight-for-height Mild

Waterlow
<70% Severe
(wasting)

95-90% of median height-for-age Mild

Waterlow 90-85% Moderate

(stunting) <85% Severe

<−2 to >−3 SD weight-for-height Moderate

WHO
<−3 Severe
(wasting)

<−2 to >−3 SD height-for-age Moderate

WHO
<−3 Severe
(stunting)

WHO 115-125 mm mid-upper arm Moderate

(wasting) circumference
for age group
<115 mm Severe
6-59 mo
 NUTRITION

EQUATIONS TO ESTIMATE ENERGY REQUIREMENT

INFANTS AND YOUNG CHILDREN: EER (KCAL/DAY) = TEE + ED

o 0-3 mo EER = (89 × weight [kg] − 100) + 175
o 4-6 mo EER = (89 × weight [kg] − 100) + 56
o 7-12 mo EER = (89 × weight [kg] − 100) + 22
o 13-36 mo EER = (89 × weight [kg] − 100) + 20

CHILDREN AND ADOLESCENTS 3-18 YR: EER (KCAL/DAY) = TEE + ED

Boys
o 3-8 yr EER = 88.5 − (61.9 × age [yr] + PA × [(26.7 × weight [kg] + (903 × height [m])] +
20
o 9-18 yr EER = 88.5 − (61.9 × age [yr] + PA × [(26.7 × weight [kg] + (903 × height [m])]
+ 25

Girls
o 3-8 yr EER = 135.3 − (30.8 × age [yr] + PA [(10 × weight [kg] + (934 × height [m])] +
20
o 9-18 yr EER = 135.3 − (30.8 × age [yr] + PA [(10 × weight [kg] + (934 × height [m])] +
25
ED, energy deposition;EER, estimated energy requirement;TEE, total energy expenditure
PA indicates the physical activity coefficient:
For boys:
PA = 1.00 (sedentary, estimated physical activity level 1.0-1.4)
PA = 1.13 (low active, estimated physical activity level 1.4-1.6)
PA = 1.26 (active, estimated physical activity level 1.6-1.9)
PA = 1.42 (very active, estimated physical activity level 1.9-2.5)
For girls:
PA = 1.00 (sedentary, estimated physical activity level 1.0-1.4)
PA = 1.16 (low active, estimated physical activity level 1.4-1.6)
PA = 1.31 (active, estimated physical activity level 1.6-1.9)
PA = 1.56 (very active, estimated physical activity level 1.9-2.5).

Adapted from Kleinman RE, editor: Pediatric nutrition handbook, ed 6, Elk Grove Village,
IL, 2009, American Academy of Pediatrics
FLUIDS AND
ELECTROLYTES
 FLUIDS & ELECTROLYTES

LUDAN’S METHOD
Hydration Phase
Weight Mild Moderate Severe
< 10 kg, <2y/o 50cc/kg 100cc/kg 150cc/kg
>10 kg, >2y/o 30cc/kg 60cc/kg 90cc/kg
D5 0.3% in 6-8 hrs 1st hr: ¼ PLRS 1st hr: 1/3 PLRS

5-7 hr: ¾ D5LRS 5-7 hr: 2/3 D50.3%

Maintenance Phase
Weight FR
0-10 kg 100cckd
If Patient has Respiratory Problem: use
11-20 kg 75cckd
lower TFR
21-30 kg 60cckd
>30 kg 50cckd

HOLLIDAY-SEGAR METHOD
(MAINTENANCE BASED ON CALORIC EXPENDITURE)
Body Weight mL/kg/day mL/kg/hr
1st 10 kg 100 ≈4
2nd 10 kg 50 ≈2
Each additional kg 20 ≈1
divide in 24hrs= ugtts/min
To calculate needed electrolytes:
Na+ 3 mEq/100 mL H20
K+ 2 mEq/100 mL H20
Cl2- mEq/100 mL H20
 FLUIDS & ELECTROLYTES

BODY SURFACE AREA

HYDRATION PHASE FOR 6-8 HRS

SA 5%- usually used, SA 10% SA 15%

ugtts/min= [(wt in kgs/ 0.95)-wt in kgs] x 2000 / 6-8 hrs

3

MAINTENANCE BASED ON BSA

wt in kgs x 4 + 9 Ht (cm) x Wt (kg)

100 3600

TFR = BSA x 1500 mL/m2/24 hr

ugtts/min= (wt in kgs x 4 + 9) x 15
24

SURFACE AREA MAINTENANCE IF WITH FEVER

1. SA x 1500= A
2. x 10cc/kg/1°C rise in temp [Febrile T – Normal T (37.5°C)] = B
3. (A+B) / 24 hrs= ugtts/min
 FLUIDS & ELECTROLYTES

IVF Glu Na Cl K Ca HCO3 Mg HPO4

D5W 50
D10W 100
D20W 200
D50-50 500

0.45 NaCl 77 77

3% NaCl 513 513

PNSS 154 154

D50.3
50 51 51
NaCl
D50.45 50 77 77

D50.9 50 154 154

D5LRS 50 130 109 4 3 28

PLRS 130 109 4 3 28

D5IMB 50 25 22 20 23 3 3

D5NM 50 40 40 13 3

D5NR 50 140 98 5 3

D5NMK 50 40 57 30 3