Working doses in paediatrics- Dr. Tarek Rahman
Download as PDF: working drug dose in paediatrics (1)
| DRUGS | DOSE | INTERVAL |
| Inj Ampicillin(Pen-A:250mg/2.5cc,500mg/5cc) | 50mg/kg/dose, =0.5cc/kg/dose=50unit/kg/dose | PNA0-7days:12hrly >7 days:8hrly |
| In meningitis:75-150mg/kg/dose | ||
| Inj Gentamicin(Genacin,gentin:20,80mg/2cc) | 5mg/kg/dose, =0.5cc/kg/dose=50unit/kg/dose | >1000gm:once daily<1000gm:36hrlyCheck trough level with fourth dose(Roberton) |
| Inj Ceftazidime/Cefotaxime(250mg/2.5cc,500mg/5cc) | 50mg/kg/dose =0.5cc/kg/dose =50unit/kg/dose | 0-7days:12hrly >7days:8hrly |
| In meningitis:100mg/kg/dose =1cc/kg/dose | ||
| Inj Amikacin (Kacin,Amikin:100,250,500mg/2cc) | 7.5mg/kg/dose =0.15cc/kg/dose(calculated by 100mg/2cc)=15unit/kg/dose | 12hrly |
| OR15 mg/kg/dose=0.30cc/kg/dose= 30unit/kg/dose | Once daily(Source: Roberton)Check trough level with fourth dose(Source:Roberton) | |
| Inj Meropenem( Ropenen, I-penem,Spebac:500mg/10cc) |
20mg/kg/dose=0.4cc/kg/dose=40unit/kg/dose | 0-14days:12hrly >14days:8hrly (source:NEOFAX 2010) Infuse over 30 minutes |
| In meningitis:40mg/kg/dose =0.8cc/kg/dose =80unit/kg/dose | ||
| Inj Imipenem/cilastatin(500mg/100cc) | 20mg/kg/dose=4cc/kg/dose | 12hrly Infuse over 30 minutes |
| (In meningitis:Dose&Frequency same) | ||
| Inj Vancomycin(500mg/10cc) | 10mg/kg/dose=0.2cc/kg/dose=20unit/kg/dose | 0-14days:12hrly >14days:8hrly (source:NEOFAX 2010)Always infuse over 1 hr
Check trough level with fourth dose(Source:Roberton) |
| In meningitis:15mg/kg/dose =0.3cc/kg/dose =30unit/kg/dose |
| Inj Netilmicin(200,50mg/2cc) | 2.5mg/kg/dose=0.025cc/kg/dose(calculated by 200mg/2cc) =2.5unit/kg/dose | 0-7days:12hrly >7days:8hrly (source:Gomella) |
| OR5mg/kg/dose=0.05cc/kg/dose= 5unit/kg/dose
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Once daily Check trough level with fourth dose(source:Roberton)
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| Inj Ciprofloxacin(Neofloxacin:200mg/100cc) | 7.5mg/kg/dose=3.75cc/kg/dose | 12hrlyInfuse over 30 minutes |
| Inj Clarithromicin(Klaricid:500mg/10cc) | 7.5mg/kg/dose= 0.15cc/kg/dose | 12hrlyAlways infuse over 1 hr |
| Inj Colistin(1million=10,00000unit/10cc) | 25,000unit/kg/dose=0.25cc/kg/dose=25unit/kg/dose(by 100 unit insulin syringe) | 8hrly Infuse over 30 minutes |
| Inj Cefepime(Tetracef,ceftipime:500mg/10cc) | 50mg/kg/dose=1cc/kg/dose | 12hrlyInfuse over 30 minutes |
| In meningitis:Dose& Frequency same | ||
| Inj Piperacillin-Tazobactam (Zosyn:4.5gm/20cc diluent)Piperacillin:4gmTazobactam:0.5gm | 80mg/kg/dose(piperacilin component) =0.4cc/kg/dose=40unit/kg/dose | 12hrlyRange:50-100mg/kg/dose (piperacillin component) Infuse over 30 minutes |
| Inj Linezolid(Arlin:600mg/300ml) | 10mg/kg/dose | 12 hrlyInfuse over 30 minutes |
| DRUGS | DOSE | INTERVAL | ||
| Inj Metronidazole(Filmet,Mez:500mg/100cc) | 7.5mg/kg/dose=1.5cc/kg/dose | |||
| GESTATION | PNA | INTERVAL | ||
| ≤29wks | 0-28days>28 | 48 hrs24 | ||
| 30-36 | 0-14>14 | 2412 | ||
| ≥37 | 0-7>7 | 2412 | ||
| Inj Acyclovir(Xovir,Zovirax:500mg/10cc) | 20mg/kg/dose=0.4cc/kg/dose=40unit/kg/dose | 8hrlyAlways infuse over 1 hr | ||
| Inj Flucloxacillin Fluclox,Phylopen:250mg/2.5cc,500mg/5cc | 50 mg/kg/dose=0.5cc/kg/dose=50unit/kg/dose | 12 hrly | ||
| In Osteomyelitis: 100mg/kg/dose =1cc/kg/dose | 6hrly over 4-6 wks)(Source: Roberton) | |||
| DRUGS | DOSES | INTERVAL |
| Inj Phytomenadion(Inj Konakion:2mg/0.2cc) | Prophylaxis: At birth: 2mg=0.2cc=20units,PO stat or 1mg=0.1cc=10units,IV statOn D4 :doOn D28 :do | RESCUE:Treatment should be continued three consecutive days±FFP/PLT |
| Infant of diabetic MOMASYMPTOMATIC HYPOGLYCEMIAJJCBG <2mmol/l on at least 2 consecutive sample but no clinical signsA)If baby is on feeding Continue supervised BF
Increase feed volume and frequency Monitor prefeed CBG at least 2 hrly If not corrected Open IV channel with 10% dextrose@GIR 6-8mg/kg/min B)If baby is on IV fluid Increase conc or infusion rate (5-7.5%,7.5-10%,10-12.5%) |
SYMPTOMATIC HYPOGLYCEMIA JJCBG <1mmol/l and/Clinical signs –Repeat CBG(always imperative) –Blood sample should be sent in lab for accurate BG level BUT sould not wait for result.
–Bolus 10% IV glucose(2ml/kg)………AIIMS –Immediately after bolus,a glucose infusion rate 6 mg/kg/min –Hrly blood glucose monitoring untill ≥2mmol/l –Investigate possible causes(eg. Sepsis) –Subsequent hypoglycemic episodes may be treated by increasing the GIR by 2 mg/kg/min till a maximum of 12 mg/kg/min –If two or more consecutive values are normal(>50 mg/dl) after 24hrs of parenteral therapy,the infusion can be tapered off at the rate off 2mg/kg/min every 6 hrs with glucose monitoring |
Glucose monitoring in IDMAt birth2 hrly×3 D:16 hrly×312hrly×2 D:2
24hrly×1 D:3- subsequent When should screening be stopped? At the ends of 72 hrs in at risk babies After stopping of the IV fluid ,baby is on full feed and has two consecutive values >50 mg/dl Indications IV fluid: Symptomatic hypoglycemia CBG <1.7 mmol/l Hypoglycemia persisting despite feeding Unable/Contra-indications to feeding |
| DRUGS | DOSE | INTERVAL | ||||
| Infant of HBsAg positive MOM
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AT BIRTHInj Immunoglobulin(Hepabig):0.5cc( 100 unit) IM in RT anteriolateral thigh Inj Antigen(Engerix):0.5cc(10 unit) ) IM in LT anteriolateral thigh
–Repeat at 1M, 6M or –Vaccination should be submerged in EPI schedule(6,10,14 wks) |
AT 9-18 month: HBsAg and Anti-HBs should be donev If HBsAg(+): Child Should be re-evaluatedv If Anti-HBs(+): Child is immune to HBSv If both HBsAg and Anti-HBs(–): Repeat complete hepatitis B vaccine series (source: Nelson) | ||||
| INTERVAL | ||||||
| Tab.Digoxin(Lenoxin:1 tab=0.25mg) Syp.Digoxin(syp centoxin=0.25mg/ml)
Inj.Digoxin (Dixin:1 amp=0.25mg/2ml)
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Preterm | TERM | ||||
| IV(µg/kg/day) | Oral | IV | Oral | |||
| Total digitalizing dose(TDD) | 15-25 | 20-30 | 0-30 | 25-35 | ||
| Maintenance dose | 4-6 | 5-7.5 | 5-8 | 6-10 | ||
TDD is to be divided 1/2, 1/4 and 1/4every 8 hrs Oral dose is 25% higher than iv doseIndications:
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| Frusemide+Spironolactone(Frulac/Lasilactone:1 tab=20/50mg) | Frusemide= 1mg/kg/doseSpironolactone=1-2mg/kg/dose | 12 hrly or once dailySource:Roberton | ||||
| Captopril(Acetor,Cardopril:1 tab=25mg) | 0.01-0.05mg/kg/dose | 8-12 hrly | ||||
| DRUGS | DOSE | INTERVAL | |
| Inj Phenobarbitone(Barbit:200mg/cc) | Loading =20mg/kg/dose =0.1cc/kg/dose =10unit/kg/dose | ||
| Maintenance=2.5mg/kg/dose =1.5unit/kg/doseN.B:10mg/kg/dose=5unit/kg/dose | 12hrly | ||
| Inj Fosphenytoin(Fosphen:150mg/2cc) | Loading =30mg/kg/dose =0.4cc/kg/dose =40unit/kg/dose | ||
| Maintenance=3.75mg/kg/dose =5unit/kg///doseN.B:15mg/kg/dose=20unit/kg/dose | 12hrly | ||
| Inj Ranitidine(Ranison,Neotack:50mg/2cc) | 1mg/kg/dose=4unit/kg/dose | 12hrly Source:Gomella p-779 | |
| Inj Frusemide(Lasix:20mg/2cc) | 1mg/kg/dose =10unit/kg/dose | ||
