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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
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)
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
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
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
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
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
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)
Appears on second to third DOL (term) May appear in first 24 hours of life
Opigesic
o 125mg & 250 mg supp
Rexidol
o 600 mg/tab
Aeknil
o 300mg/2 ml amp [2ml amp]
ACETYLCYSTEINE Fluimucil
o 600mg/tab (effervescent)
Granules: 100mg BID-QID o 100mg & 200mg sachet (granules for
Inh: 1 amp OD-BID for ≥5-10 days oral solution)
Inj (IM): ½ amp OD-BID o 100mg/5ml syr [150ml bottle]
Inj (IV): 1-1½ amp BID-TID. It is o 100mg/ml (inh) [3ml amp]
recommended to dilute IV inj w/ 0.9% NaCl o 100mg/ml (inj) [3ml amp]
soln or a 5% glucose soln.
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 Amilin
o 25 mg/ml [10ml amp]
Neonatal apnea:
LD: 5–6 mg/kg IV
MD: 1–2 mkdose Q6–8 IV
AMOXICILLIN Pediamox
o 100mg/ml drops [10ml bottle]
Neonate: 20–30 mkday ÷ Q12 PO o 250mg/5ml [60/105ml bottle]
AMPICILLIN Ampicin
o 250,500 mg vial
PO: 50–100 mkday ÷ Q6 hr o 500 mg cap
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
Ceelin
o 100mg/ml drops [15/30/45ml bottle]
o 100mg/5ml syr [60/120/250/500ml]
o 100mg/chew tab
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
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
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]
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
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
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
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
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
DOMPERIDONE Motilium
o 1mg/ml drops [100ml bottle]
Susp: 2.5 mL/10 kg TID o 10mg tab
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
EPINEPHRINE Adrenin
o 1mg/ml amp
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
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)
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]
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
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
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
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
Penicilin Na
o 5,000,000u/vial
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 Luminal
o 130mg/ml amp
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 MD:: Monitor levels.
mg/kg. 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
Hyperbilirubinemia (<12 yr): 6–12 yr: 4–6 mkday PO/IV ÷ OD–BID
3–8 mkday PO ÷ BID–TID >12 yr: 1–3 mkday PO/IV ÷ OD–BID
DRUG FORMULARY
PHENYLEPHRINE HCL
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.
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
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
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
PROBIOTICS
ERCEFLORA
(Bacillus clausii)
PROTEXIN VITALITY
(Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus,
Lactobacillus acidophilus, Bifidobacterium breve, Bifidobacterium infantis,
Lactobacillus bulgaricus, vit C, fructooligosaccharide (FOS))
NORMAGUT
(Saccharomyces boulardii))
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)
PREVENTION OF DEHYDRATION
TREATMENT OF DEHYDRATION
DRUG FORMULARY
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
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
WEIGHT AMOUNT
3-5kgs 2oz
4.5-5.5 4oz
6.5kgs 6oz
7.5kgs 6oz
NUTRITION
Zinc intake should be encouraged with foods such as meat, dairy, wheat, and rice
Breast milk should continue to 12 mo, formula or cow milk is then substituted
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
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)
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
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
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
D5W 50
D10W 100
D20W 200
D50-50 500
0.45 NaCl 77 77
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