Common drugs dosage in pediatric
Steroids
1 vial contain 100mg diluted in 2 cc N/S)
dose: 5-10 mg/kg/day dived 12 hours
Hydrocortisone vial
Roughly for each 5 kg give 1cc
(1cc contain 50mg), Do not give in CHD
(0.3 - 0.6 mg/kg/day) once repeated as need
Decadron amp. (Dexamethasone): (1 amp
divided every 12 hours
contain 8mg/2cc)
roughly, give 0.5 cc for each 10kg (safe in
CHD)
Antibiotics
Amikacin amp. 15 mg/kg/day divided every 12 hours
Ampicillin vial 50 - 200mg / kg / day divided every 6 hours
50 - 100mg / kg divided every 8 hours
Amoxicillin vial
(Otitis media, pneumonia 80 -90 mg/kg/day)
4 mg/kg/day single dose per day or 2 to 2.5
Gentamicin amp (Garamycin)
mg/kg/dose every 8 hours
Ampicillin 100 mg/kg/dose intravenously (IV)
every eight hours
In neonate sepsis antibiotic used is
Gentamicin 4 mg/kg/dose IV every 24 hours
Flagyl bottle: (1.5 cc / kg / dose) x 3
Normal dose: 50 to 75 mg/kg/dose every 24
hours; maximum dose: 1,000 mg/dose
Ceftriaxone vial:
Meningeal dose :100 mg/kg/day divided every
12 to 24 hours; maximum daily dose: 4,000 mg/day
Cefotaxime (Claforan) vial 100 - 200 mg/kg/ day divided 8 hours
(For pseudomonas especially)
90 to 150 mg/kg/day divided every 8 hours.
Ceftazidime vial
For cystic fibrosis: IV: 200 to 400 mg/kg/day
divided every 6 to 8 hours; maximum: 12 g/day
IV: 45 to 60 mg/kg/day divided every 6 to 8
Vancomycin vial
hours
10 mg/kg/dose every 8 to 12 hours; maximum
Ciprofloxacin bottle (Ciprodar)
dose: 400 mg/dose.
Meropenem vial 20 mg/kg/dose every 8 hours
Zovirax (acyclovir) (vial 250 mg per vial) 10 mg/kg/dose every 8 hrs.
Anti- epileptic
(1 amp. Contain 10mg/1ml)
Diazepam ampoule 0.1 - 0.3 mg / kg / dose) not recommended
under 6 months
loading dose: 15-20mg/kg
Luminal amp. (phenobarbital):
maintenance: 3-5 mg/kg divided 12 hourly
(given after 8-12 hours of bolus dose)
Phenytoin amp: loading dose: 15-20mg/kg
(Do not mix with dextrose – G/W or other maintenance: (4-5 mg/kg) divided every 12
drugs) hours (given after 8-12 hours of bolus dose)
Printed by: Dr. Ferand Waleed / Emergency medicine resident
others
Zofran amp (ondansetron) 0.2mg/kg/dose
(1 amp contain 8mg /4ml) (1cc=2mg) Or roughly give 1cc for each 10kg
Zantac amp 2-4mg / kg/ dose x 3
loading dose 5mg/kg
Aminophylline amp
maintenance 2-3 mg given after 8 -12 hrs
Ventolin nebulizer 0.5 cc in 2.5 cc N/S
Lasix amp 1-2mg/kg
Paracetamol bottle 1 - 1.5 cc/ kg/dose (15 mg/kg) per dose 3-4
doses per day
resuscitation
0.01 mg /kg
maximum dose: 1 mg/dose;
Adrenaline amp
note: dilute 1 cc of 1:1000 adrenaline in 10 cc
syringe and after dilution give 1cc/ for 10 kg
The dose may be repeated up to 4 times in 24
Allermin amp (1-amp contain10mg/1ml)
hours if required (0.25mg/kg) (1/4cc every 10
(In anaphylaxis IM or IV)
kg)
Atropine 0.02 mg/kg/dose; minimum dose: 0.1
reserve use for those patients unresponsive to mg/dose, maximum dose: 0.5 mg/dose.
improved oxygenation and epinephrine (PALS) may repeat once in 5 minutes
hypoglycemia Loading dose: 2 mL/kg of dextrose 10%
Maintenance of hypoglycemia 5 to 6 mg/kg/minute (typically, dextrose 10%
glucose infusion rate (GIR) at maintenance rate).
GIR = (dextrose percentage × rate of infusion
[mL/hr]) ÷ (6 × weight [kg])
Blood products
whole blood 20cc/kg
packed RBC 10cc/kg
cryoprecipitate: 1 pint each 5kg
platelets 10-15cc/kg
Fluid therapy
Shoot maintenance: (⅕ G/S)
20cc/kg Give N/S give during 30 mins First 10kg = 100cc per kg
(repeated as required) maximum 500cc Second 10kg =1000 cc + 50 cc per kg
Third 10kg = 1500 cc + 20 cc per kg
Neonate fluid management
1st day: Term neonate: 60cc/kg/24 hrs. G/W 10%
Preterm 70cc/kg/24 hrs. G/W 10%
2nd day: 70cc/kg/24hr G/W 10%
3rd day: 80-90cc/kg/24hours ⅕ G/S
4th day and above: 100cc/kg/24hours ⅕ G/S
Printed by: Dr. Ferand Waleed / Emergency medicine resident
Syrups
Kg * X
Ingredient Dose (mg/kg/day) Number of doses Mg/5ml X اﻟﺟرﻋﺔ
ﺑﺎل ﻣﻠﻲ
Penicillin
125 1.6
Amoxicillin syrup 20-40mg 3 times
250 0.8
Dose in cc = (weight of patient * X ) / NO. of doses
156 1.6
312 0.8
Augmentin
457 0.54
(Amoxicillin + 25-50mg 3 times
200 0.42
clavulanic acid )
400 0.625
600 1.25
cephalosporins
1st generation
Cefadroxil 25-50 1 or 2 times 125 2
Cephalexin 125 2
20-50 3 times
(cefex) 250 1
2nd generation
Cefuroxime 125 0.6
10-15 2 times
(cefutil) 250 0.3
125 1.6
Cefaclor syrup 20-40 3 times 250 0.8
375 0.533
3rd generation
Cefixime syrup
8 once 100 0.4
Suprax - winex
Cefdinir
14 1 or 2 times 125 0.56
Sefarin -omnicef
Macrolides
Azithromycin syrup 10 mg/kg/day once 200mg/5ml 0.25
Clarithromycin 125 0.6
15 mg/kg/day twice
syrup 250 0.3
125 2
Erythromycin syrup 50 mg/kg/day twice 200 1.25
400 0.625
Trimethoprim +
20 2 times 200/40 0.5
sulfamethoxazole
125 1.2
metronidazole 30 4 times
100 0.75
Antipyretic
Ibuprofen syrup 20 3 times 100 1.5
Every 4 – 6 hrs.
125mg/5ml 2
Paracetamol 50 mg/kg/day do not exceed 5
250mg/5ml 1
doses
Printed by: Dr. Ferand Waleed / Emergency medicine resident
Management of gastroenteritis and dehydration in pediatric
First of make sure that the patient is not severely dehydrated
According to American Academy of Pediatrics, the only patient who needs admission are those with
sever dehydration
• Admit patient with any number of episodes of bloody diarrhea – even if one time ( may be
HUS)
Moderate and mild cases can be discharged home with instruction of
1- For vomiting give: ondansetron syrup 0.15mg/kg/dose PO
If patient is not responding oral ondansetron admit the patient and give him the ondansetron iv
and wait for two hours, and reassess, if vomiting stopped or continues and start feeding and
fluid intake, if everything goes well, discharge home with the syrup form
2- ORS (Oral rehydration solution)
ﻣﺣﻠول اﻻرواء اﻟﻔﻣوي
ﯾوﺟد ﻧوﻋﯾن ﺑﺎودر وﺷراب ﺟﺎھز ﯾﺷﺑﮫ اﻟﻌﺻﯾر
اﻟﻛﻣﯾﺔ اﻟﻠﻲ ﯾﺄﺧذھﺎ اﻟﻣرﯾض ھﻲ
50 – 100 ml/kg of ORS (average 30ml/kg/hr.)
ﺳﻲ ﺳﻲ ﺑﺎﻟﺳﺎﻋﺔ اﻟوﺣدة300 ﻛﯾﻠو ﻻزم ﯾﺄﺧذ10 ﯾﻌﻧﻲ اﻟﻠﻲ وزﻧﮫ
3- Zinc syrup 1 x 1 20mg ( أﯾﺎم )و ان ﺗﺳﺣﻧت ﺣﺎﻟت اﻟﻣرﯾض10 ﻟﻣده
If infant <6 month give zinc 10 mg 1 x 1
4- Probiotic sachet
ﻣﻼﺣظﺔ ﯾوﺟد دواء ﺑﺎﺳم ﺗﺟﺎريbiolact sachet (sachet contain both zinc and probiotic)
Biolact sachet 6month – 2years (one sachet) more than 2 years two sachet per day
5- Hidrasec powder sachet
Used for diarrhea – dose not stop intestine motility, instead decrease secretion of villi
Safe to be used in pediatric age group
For infant less than 9 kg give 10 mg sachet 1 x 3
For infant More than 9 kg give 30mg sachet 1 x 3
Duration of this treatment: 3 days and stop or until 2 normal stools recorded
6- Smecta (Diosmectite – natural aluminomagesuim silicate)
Works by reducing inflammation and inhibit mucolysis, and adsorbs bacteria and bacteria
enterotoxin’s
Dose infant below 1 year 1 sachet every 12 hrs. (2 sachet per day)
Dose infant from 1 year – 12 years 1 sachet every 8 hrs. (3 sachet per day)
Printed by: Dr. Ferand Waleed / Emergency medicine resident
