Acetaminophen Infants & child: 10 -15 mkdose q4-6H 15mkday OD

analgesic, >12y.o.:325-650mg q4-6h Amikacin given only once patient has voided
antipyretic MAX: 5 doses/24hr
Ad rxn: fetal hepatic necrosis
(Tx: acetylcysteine)
(100/ml drp, 120/5,250/5, 325mg,supp:125, Aminophylline ?3-5mkdose IV load: 6-8mk
250) (20min)
1-9yo: PO-27mkDay q4-6h IV:1-1.2mkhr
Acetazolamide Neonates: 25mg/kg/24H BID, TID, or QID 4- 9-12yo:PO-20mkDay q6h IV:0.9mkhr
hydroceph, 7D 12-16yo:PO-16mkDay q6h IV:0.7mkhr
edema, epilepsy Children w/ edema: diuresis: 5mg/k/24h 6mo-1yr: 0.6-0.7mkhr
Ad rxn: metab acidosis, hypoCl, hypoK, 6wks-6mos: 0.5mkhr
drowsiness, anorexia, muscle weakness Neonate: IV: 0.2mkhr
Prep: IV:500/5ml,PO:125mg, 250mg Neonatal Apnea:
LD- 5-6mkdose MD- 1-2mkdose q6-
Acetylcysteine 2-5ml TID, QID (infant) 8h
mucolytic 6-10ml TID, QID (child) Dilute to equal amt with IVF
Ad rxn: bronchospasm(give dilator 10-15min Refer: Inc HR, sZ, Hypo/hypertension,
b4) vomiting, arrhythmia, feeding intolerance
(100/5ml syr, 100mg,200mg sachet, 600mg Amiodarone Vent arrhythmia/ PSVT
tab) Antiarrythmic PO: <1yo: 600-800m/BSA/Day BID (X4-14D)
B10 ml TID, QID Class III >1yo: 10-15/20mkD BID x 10 D 5-
Acyclovir >6yo- 800mg 4x/D 10mkD
(Varicella, HZV) 2-6yo: 400mg QID Cut all doses in half after 1-4wks of Tx or
>2yo- 200mg QID or 20mkdose QID x5D control
Max: 800mg/day (200mg, 400mg, IV: LD 5mkd x1hr  cont 5-15ug/k/min
800mg/tab) Contra: markd sinus brady, 2nd & 3rd AVblock
Herpex: 200mg/5mL susp Prep: 200mg/tab, 150mg/3mL amp
VT/VF: 5mkdose rapid IV for pulselessness
Adenosine Neonate & child: 0.05mkdose push then inc Perfusing arrhythmias: same dose 20-60min
Paroxysmal SVT bolus doses by 0.05mkdose q2min
antiarrythmic Max: 0.25mk or 12mg
Prep:3mg/ml (2ml) Ampicillin- At least 100mkday (based on Ampi)
Sulbactam 100-150(200child)mkD Q6h (mild/mod infxn)
Albendazole >2y.o 400mg or 10mL susp SD Aminopenicillin 200-300(400child)mkD q6h
1-2y.o.: 200mg/tab or 5mL SD (GBS, Listeria, E coli) (meningitic/severe)
< 2y.o 200 SD Adjust dose in renal
Adult: 750max q6-8h IV PO: 20-40mkday
failure
Prep: 400mg/tab, 4%susp 10mL Prep: 750(500), 1.5g(1g), 375(250),
250/5susp, 375mg, 750mg/tab
Albumin Neonate:0.5- 1g/kg/dose MAX: 1g/k/24hr
colloid Infants & child: 0.5-1g/k/dose Max: 6g Amphotericin B 0.3 - 0.7mkd
Ad rxn: urticaria, fever, circ overload, edema X saline NB: Initial:0.25-0.5mgK IV Infusion:2-6H
Prep: 25%/50cc,100cc, 12.5/50cc solnprecipitate MD:0.5-1mg/kg IvQ24-48H
Aldactone 2-3 mkday (od,bid,tid) Ampho B 50 mg dilute with 10ml dilute to
Monitor: CBC, Crea,
Spironolactone Prep:25mg, 50, 100/tab make a conc of 5mg/ml
U/O, BUN, Crea, Elec
Ad rxn: hyperK, agranulocytosis, headache Test dose...
eg 2.1kg
AlOH,MgOH see Day 1:0.25/kg
Maalox =(wt x0.25)=0.52mg
Ambroxol 1.2 - 1.6 mkdose TID (0.52/ 5)= 0.1ml
Sinecod EXP (Novartis Approximates): 0.1 ml + 5.2 ml D5water to run for 6h
>12yo: 10ml BID 30mg/5ml syr Day2: 0.5ml/kg= 1/05mg
7-12yo: 5ml BID to TID 15mg/5ml syr Ampho B 0.21ml + 10.5 ml D5W
3-6yo: 2.5ml TID 15mg/5ml syr Reconstituted solution =wrapped in
1-2yo: 2.5ml BID 15mg/5ml syr aluminum foil to protect from life n store at
13-14mos infant: 1.25ml BID to TID drops ref
7-12mos: 1ml BID or 12mkday Infusion line wrapped in aluminum foil
3-6mos: 0.5ml BID or 6mkday Watch out for apnea, bradycardia, cyanosis
Tab: 30mg/tab, Be given in AM preferably
Syr: 15mg/5ml, 30mg/5ml Ampicillin 100-150(200)mkD q6h MAX: 500mg
Drops 6mg/ml GBS, Listeria, E coli q6h
Amikacin 15mkDay q8h MAX: 1.5g/24hr Adjust in RF MeninG: 200-400 mkd MAX: 12g/24hr
NB:< 29 0-7 18 mkd 48H NewBorn: 50mkdose q12, 100mkday q6H
8-28 15 mkd 36H Postnatal Age Interval
>28 15 mkd 24H <29 0-28 12
30-33 0-7 18 mkd 36H >28 8
>7 15 mkd 24H 30-36 0-14 12
>34 ALL 15 mkd 24H >14 8
Prep: 100mg/2mL, 250mg/2mL, 37-44 0-7 12
500mg/2mL >7 8
 >45 All 6 Bromhexine 0.5-0.85 mkday in 3 doses
Prep: 250mg, 500mg vial. 250mg, 500mg/cap Budesonide 1-8 yo= 0.5mg/24 hr OD, BID
125/5mL, 250/5mL, 100/ml drops Adrenal corticosteroid Max dose 4 doses/ 24 hrs
Anti-infl ammatory
Amoxicillin 30-50mkDay/ 50-75mkDay H.D
Prep: 250, 500mg/cap, 125/5ml, 250/5mL
susp, 100/ml drops Buscopan 0.1-0.2mkdose MAX: 0.8mkD
0.15 mkD QID, 0.01mkdose
Ansimar 10 mkdose BID (6-9) Prep: 10mg/tab, 2mg/ml syr, 20mg/amp
Prep: 100mg/5mL
Carbamazepine 10-20mkday, then 1.5-3 mkday
Antamin 0.3 mkdose 200-400MG/Tab, 100/5mL susp
Amoxicillin- 20-40mkday PO TID based:Amox Carbocisteine Inf: 10-20 mkday TID
Sulbactam 40-50 mkday IV q8 based:Amox Child: 30-50 mkday q8-12H
(Ultramox) 2-6yo: 375 IV Q6/Q8 Solmux Approximates:
6-12yo: 750IV Q6/Q8 >12yo :1 cap TID
Prep: 250/250/5mL, 750(500+250), 8-12yo : 15ml ped 100mg/5ml susp TID
1.5(1g+500) 4-7yo : 10ml ped 100mg/5ml susp TID
2-3yo : 5ml ped 100mg/5ml susp TID
Co-Amoxiclav Oral:20-40mkDay (based:Amox) TID 1-2yo : 1.5ml drops TID
Adjust in RF 25-45mkDay BID Drops: 40mg/ml (Solmux)
IV:30-50 mkdose q8h Ped Susp: 100mg/5ml, 200mg/5ml
Prep: 156/312 (125/250) TID Forte Susp: 500mg/5ml
228.5/457 (200/400) BID Cap: 500mg
375/625 (250/500) Captopril Premature:0.01m/kdose q8-12H
Neonate:0.05-0.10mkdose q12-24H
Ascorbic Acid Scurvy: 100-300mkDay Children:0.3– 0.5mkdose
Urinary acidification: 500mg q6hrs Max:6m/k/24H
Cefaclor 20 - 40 mkday TID (MAX 1gm/day)
ASA 75 - 100 mkd Prep: 80,100,300mg/tab (2nd gen) Durration:7,10,14days
Ad Rxn: Kawasaki: 80-100 q6h (x2wks) during febrile Prep: 125mg/5mL, 250mg/5mL
myelosuppression, Drops: 50mg/mL
phase or until after 3-4days afebrile then dec
hepatotoxicity
to 3-5m/k/day OD 6-8wks after or ESR & plt Tabs:500mg
normal Cefixime Pneumonia:10-12 mkday BID x7days
Rheumatic Fever: 60-100mkday q6hr (2nd gen) Typhoid: 15-20mkday BID x10-14days
Contra: <16y w/ chickenpox or flu like Sx(Reye synd) Prep: 20mg/mL drops; 100mg/5mL susp;
100-200mg/cap
Atenolol 0.8 – 1.5mkday (max: 2mg/kg) Cefalexin 30 - 50 mkday TID to QID (q6H)
HPN, arrythmia Contra: pulmo edema, cardio shock (1st gen) Prep: 125mg/5ml; 250mg/5mL, 250-
Ad rxn: brady, hypotension, 2nd/3rd AV block, 500mg/cap
wheezing, headache, constipation Cefazolin 100mkday q6h IVTT
(1st gen) 500mg vial, 1g vial
Atropine sulfate Sinus brady: 0.02mkdose (min 0.1mg, MAX: Cefepime 30mkdose q12 ( < 14days old))
Dose <0.1 paradoxical 0.5mg) q 5min (4th gen) 50mkdose q8 (meningitic, severe sepsis)
brady Antidote to organophosphate: 0.02-0.05mkd 100-150mkday q8h MAX: 6 grams OD
q10-20min then q1-4hr for 24hrs Cefoxitin 20-40mkdose IV q6-8H, up to 200mkday,
(2nd gen) max 12g/day for severe infections
Azithromycin 10-50 mkdose OD x3days
OM: 10mkD x3d MAX:500mkday Cefoperazone 100-150 mkday q8/12h
CAP(>6m): 10mkDx1 day 5mkD x4days MAX: 12grams OD
ATP (>2y): 12mkD x5days MAX: 500mkday Prep: 1.5g/vial(1gr); 2g/vial(1gr)
Adolescents: 500mg x1day 250mg x4 Cefuroxime 75- 100 mkday(IV)q8 MAX 750mg IV q8
days or 500mg OD x 3days (2nd gen) 20-40mkday (PO)BID
Prep: 500mg, 2g/tab, 100/5, 200/5mL susp, Prep:125mg/5ml, 250mg/5ml;
500IV 250mg,500mg/cap;
Aztreonam 30mkdose q8h, inc by probenecid and furo 750mg/vial
monobactam Prep: 500vial Cefpodoxime 8-10 mkday BID Po

Bambuterol 0.25-0.27mkdose OD Cefotaxime 50 -100 mkday q6-12H, usu q8h

Bambec Oral sol:1mg/ml, tab 10mg (3rd gen) Up to 150 or 200mkday for life-threatening
inf.
Benadryl 0.5-1 mkdose(IV) q6h-8h Premature infant: MAX 50mkday
3 - 5 mkday(PO) q6h Prep: 500mg, 1 gram/ vial
Prep: 25mg.50mg/cap; 12.5/5mL, 50mg/mL
Ceftriaxone 75- 100 mkday IV OD (MAX: 3g/day)
(3rd gen) 50 to 75mkday for mild to moderate infection
Bisacodyl <2yo– 5mg 100mkday for severe infection (max
>2yo– 10mg; (5-10mg/tab supp.) 4gm/day)
Prep: 5mg/tab; 10mg supp, 10mg/30mL Order: ___mg IV OD via soluset to run for
enema 30mins
 Prep: 500mg, 1gm/vial 0.2-0.4 mkday (MD)
Dicycloverine 1 mkdose q6h PO Prep: 10/5ml syr
Ceftazidime 30mkdose q12(<7days old) (relestal/bentyl) 6-12y: 5ml 5mg/ml drops
(3rd gen) 50mkdose q8 (>7 days old) 2-5y: 2.5-5ml
Prep: 250, 500, 1g, 2g/vial 6mos-2 yrs: 0.5-1ml
Carbamazepine 10-20 mkday 1.5-3 mkday Digoxin Neonate: 10-30mcg (LD)
Prep: 20mg/mL , 100mg/5mL, 200/400 tab Prep: 0.25mg/tab 5-10mcg (MD)
0.05mg/ml syr 1mos-2yr: 30mcg (LD)
Cetirizine 0.25mkday OD/BID 0.25/2ml amp 10-15mcg (MD)
5mg/5ml solution for 2yo and up Child >10yo: 10mcg (LD)
Oral solution (1mg/ml) 2-5 mcg/k/day (MD)
Drops 10mg/ml; 2.5mg/ml for 1 to 2yo Diphenhydramine IM, IV, PO:5 mkday q6H as needed
Usual Doses: (max: 300 mg/24 hr).(Nelson Ref)
10mg/ml drops 1-2yo 5 drops BID 1mkdose IV q6H
5mg/5ml soln 2-6yo 5ml OD Syr: 12.5mg/5ml
>6yo 10ml OD or 5ml BID Cap:25mg, 50mg
Charcoal 1 – 2 g/kg q2-6H Ampule: 50mg/ml
5 – 10 x wt of ingested poison Doxycycline 2 - 4 mkd
Chloramphenicol IV: 50-100mkday q6h (>75 mkday:Typhoid) 100mg/cap
PO: 30-50mkday Dimetapp 0.1 mg /k/dose(drops)
PreMature/NB: 25 mkday (bromphenamine + 1 - 6 mos -0.5ml TID
Prep: 125/5ml; 250-500/cap; 1g/vial pseudoephedrine) 2 - 24 mos 1ml TID
syrup: 2 - 4yo 3/4 tsp TID prep:
Chlorphenamine 0.35mg/kg/24H 2m/5/5ml
Maleate 2mg/5ml; 4mg/tab; 10mg/ml amp 4 - 12 yo 5ml TID
Diazepam 0.2- 0.5 mkdose
Cimetidine PO, IV, IM:20– 40 mg/kg/24 hr q6H (Nelson) Rectal: 0.5 (2-5y) 0.3(>6y)
Syr 100mg/5ml Prep: 2mg, 5mg,10mg/tab, 10mg/2ml amp
Amp: 150mg/ml
Ciprofloxacin 20-40 mkday BID PO Domperidone 0.3mkdose q8H
(Ciprobay) Typhiod relapse: 10-20mkday (Motilium) 1mh/ml susp; 10mg tab
NOT for <18yo Max: 500mg q12h Dyspepsia: 2.5ml/10kg body wt TID
Prep: 250mg, 500mg/tab (Motilium)
Nausea/vomiting: 5ml/10kg body wt TID-QID
10mkdose IV q8H max 1200mkday Epinephrine 0.01-0.03mkdose (1:10,000) (0.1-0.3ml/k)
Prep:100mg/50ml, 200mg/100ml, Q3-5min
400mg/200ml IV infusions Erceflora (B. Clausii)
Clarithromycin 15mkday BID or 7.5mkdose BID (Bacillus clausii) >1mo= 1-2 vials/day (BID)
125mg/5ml; 250mg/5ml 2-11yo 1-2 vials/day
Clindamycin PO: 10-20mkday mild q6-8h Ercefuryl <6mos: 1 tsp BID
IV: 20-40mkday severe q6-8h (nifuroxazide) >6mos: 1 tsp TID
Prep: 75mg/5ml syr; 150-300m/cap; 150/ml Adult: 1 cap QID
IV Prep: 200/cap; 220/5ml susp
Clonazepam 0.01– 0.03m/k/24h in 2-3 divided doses Erdostein 1mkday(BID)
Prep: 2mg/tab 2-6y:(10-20) 2.5ml
7-12y(21-30) 5ml
Cloxacillin 25-50 mkday q6h >12y (>30)
Prep: 125-250mg/5ml syr; 250-500mg/cap
Erythromycin 30 - 50 mkday q6-8h
CoTrimoxazole 4mkdose BID PO based on trimethoprim Prep: 200/5ml
(Trimethoprim + IV: 8-10mkday q8-12H (Max 960mg/day) 400mg/5ml susp
Sulfamethoxazole) Prep: 200mgSMZ/40mgTM/5ml syr; Drops: 100mg/2.5ml
400/80/5ml adult syr Tab: 250mg, 500mg

Co-Amoxiclav PO:40mkday BID to TID (based on Amox) Esomeprazole <10y : 10mg PO BID Prep:10mg/sachet
156.25mg (125mg Amox;31.25)/5ml (nexium) 10-12y: 20mg PO BID 20-40mg/tab
228.5mg (200mg Amox; 28.5)/5ml 12-17y: 20-40mg OD
312.5mg (250mg Amox;62.5)/5ml GERD 20 mg once daily for 4 wk-8 wks
457mg (400mg Amox;57)/5ml Dissolve 1 sachet in 15ml NC water
625mg tab BID to TID
Ethambutol 15 mkday
IV:30-50mkdose q8H
Famotidine PO= 1-1.2mkday q8-12: 20-40mg/tab
Desloratadine >12yo 10ml OD IV = 0.5mkday q8h: 25mg/2ml amp
(Aerius) 6-11y: 5ml OD Prep: 2.5mg/5ml <3mos: IV= 0.25-0.5mkday OD
1-5 y: 2.5ml OD 5mg/tab
6-11mos: 2ml OD Fluconazole 4-6mkday OD
(Diflucan) Prep: 50mg, 150mg, 200mgcap ; 2mg/ml x
Dexamethasone 0.5-1 mkday (LD) 100ml vial
 100mg/cap
Furosemide IV= 0.5-1.0 mkdose q8h (max:40mkday) 30 mos-9 yrs: 1 sachet/dose
PO=1-2mkdose q8h >9yrs: 2 sachets/dose
Prep: 20-40mg/tab, 20mg/2ml amp Hydroxyzine diHCl PO=
(Iterax) 12mos-6yo : 1-2.5mkday TID ( for pruritus)
>6yo : 1-2 mkday TID
Pre-op: 1mkdose 1 hour prior to surgery
IM=0.5-1mkdose q4-6H
PO/IM (Nelson’s): 0.6 mg/kg/dose q 6 hr.
Syr: 2mg/ml syr
Tab: 10mg, 25mg

IVIg Prep: 2.5g/50cc vial

10g/200cc vial
RD: 2g/kg/dose, infuse x12hrs
FeSO4 Test dose: 0.01-0.02 cc/kg/min
4 - 6 mkday (Therapeutic) Incremin: 30mg/5ml infuse for 30 mins
1-3 mkday (Prophylactic) Ferlin drops: 25mcg/ml
Preterm: 2-4mkday Ferlin syrup: 150mg/5ml Ibuprofen 5-10mkdose q6-8hr
Iberet: 26.25mg/5ml, 105mg/tab JRA: 30-50mkday q6h
Closure of PDA: <32wks=0.5-1.5kg
10mkdose x15mkdose (24 & 48hr) in
Supplemental Therapeutic
15min
(Prophylactic Dose
Age Prep: 100mg/5ml susp
Dose)
Group 200mg/5ml susp
Cap: 200mg (capsule or softgel)
Inosiplex 250mg/5ml
(Immunosin) <6mos 1ml 2-6yo 3ml
Orally, once Orally, 3 times
6-12mos 1.5m 6-12yo 5ml q3-4H
daily a day
Methisoprinol 250mg/5ml, 500mg tab
(Isoprinosine) <1yo (<9kg) ¼ tsp
1-3yo (9-14kg) ½ tsp
3-7yo (14-21kg) ¾ tsp
 Oral Drops
>7yo (>21kg) 1 tsp TID
   4-<6 months 0.5 mL 0.5 mL
   6-12 months 0.75-1 mL 0.75-1 mL Ketoconazole 200mg tab
   1-2 years 1 mL 1 mL Fungal infections 50 to 100mg OD
eg tinea corporis,
tinea pedis 2% Cream (eg Nizoral by Zuellig) 5g, 10g
(athlete’s foot) tube
 Syrup tinea cruris Apply to affected area OD x 2-6weeks
   2-6 years 2.5 mL (½ tsp) 2.5 mL (½ tsp)
   7-12 years 2.5 mL (½ tsp) 5 mL (1 tsp) L- Carnitine 50-100 mkday q8-12h Max:300
Prep: 330mg/tab; 1gram/10ml

Lactulose Inf: 5ml/day

Gentamycin 5 - 8 mkday q8h 1-6y: 5-10ml/day
7-14y: 10ml/day
Guaifenesin 100mg/5ml syr Prep: 3.3 g/5ml
(Benadryl 2-6yo 5ml TID Lanoxin 0.003 mkdose BID
Expectorant) 6-12yo 10ml TID Prep: 0.25mg/tab; 0.05mg/ml elixir;
Not for <2yo 0.25mg/2ml amp
Hemostan 10mg/kg/dose
Prep: 250-500mg/cap Lanzoprazole 15mg/FDT tab OD
Hydrocortisone 4-6 mkdose q6H IV (Prevacid) <10kg: 7.5 mg PO OD
10mkdose as loading dose, then 5mkdose NOT for <1yo 11-30k: 15mg PO QD-BID
q6 >30kg: 30 mg PO QD-BID
Prep: 100mg/2ml amp; 250mg/2ml amp; Prep: 15-30mg/FDT; 15-30mg/cap
500mg/4ml amp 15mg tab + 5ml water in syringe PO
Levocetiriine 6-12mos: 1.25mg (5drops) OD
Note: High dose steroid given beyond 48- (xyzal) 1-6 yrs: 2.5mg/day (10drops) BID
72H may cause hypernatremia 6-12yrs: 5mg (20 drops) OD or 1 tab
Hydralazine 0.15mkdose(IV) (0.1 to 0.2mkdose q4-6h) Prep: 5mg/ml drops; 5mg/tab
(antihypertensive) 0.75mkd(PO)
max: 0.5mkdose, 3.5mkday Levothyroxine <6mos =25-50mcg (8-10mcd/k/dose) QD
Prep: 20mg/ml ampule 6-12mos = 50-75mcg (6-8)
Given w/ food 1-5 y= 75-100mcg (5-6)
Racecadotril 1.5mkdose(TID) Prep:10mg/sch 6-12y = 100-150mcg (4-5)
(Hidrasec) 1 mo-9 mos: 1 sachet/dose Prep:100mcg/tab
30mg/scht >12y = 150-200mcg (2-3)
9 mos-30 mos: 2 sachets/dose
 50mcg/tab mg/kg, then either same dose q 1– 2 hr or
Loratadine 1-2y = 2.5ml continuous infusion of 1– 2 g/kg/min.
2-12y(<30kg) = 5ml OD HS
2-12y(>30k) = 10ml Motilium/ vometa 0.15-0.4mkdose q6h
Prep: 5mg/5ml syr (Domperidone) 2.5ml/10kg TID
not to exceed 1mkday
Maalox 2-4tsp/ tabs QID prep: 1mg/ml syr; 10mg/tab
(AlOH,MgOH) 1hr after meals and HS
2-4 chewable tabs N- Acetylcysteine 100mg bid-qid
(Para antidote) Neb: inf: 1-2ml of 20% soln + equal H20/NSS
Mannitol 2.5-5cc/K/dose Caution in 2-4ml of 10% TID-QID
Max: 100mg q6h asthmatic; Child: 3-5ml of 20%; 6-10ml of 10% soln
Not for <2yo Adolescent: 5-10ml of 10% or 20%
Mebendazole 500 SD = 50mg/ml (10ml single dose) Prep: 100mg/5ml syr, 100mg/ml inh;
100mg or 5ml BID x 3days 100-200mg/sachet; 600mg/eff tab in 75cc
5ml BID x3 days 20mg/ml (30ml); h20
Prep: 100-500mg/tab
Sample: Fluimucil 200mg sachet in 4
Meclizine 12.5 - 50 mkd tablespoons water BID
Prep: 12.5 – 25mg/tab Mometasone AR: 2-11y: 50mcg(1 spray) QD
(nasonex) >12y: 100mcg(2 sprays) QD
Meropenem 20mkdose q8 OR 60-120mkday q8h
40mkdose q8 meningitic Montelukast 6mo-2y= 4mg/sachet OD in milk w/in 15 min
Cr cl <10 = ½ dose q24h 2-5 = 4mg/tab OD
10-25 = ½ dose q12h 6-14= 5mg/tab
26-50 = q12h >15 = 10mg/tab
Nalbuphine 0.1 - 0.2 mkdose
Meperidine 0.5 mkdose Prep: 10mg/ml amp
Metoclopromide IV:0.1– 0.2 mkdose q 6– 8 hr PRN (Nelson’s)
0.1-0.2mkdose QID – dysmotility/ GERD Nystatin 1ml QID as oral solution 400,000 U/day
Prep: 10mg/tab; 5mg/5ml syr; 10mg/2ml IV 1.2 M units/day

Metoprolol 1-2mkday BID Nicardipine 5mg/hr by 2.5mg/hr max: 15mg/hr

Max: 6mkday Q5-15min
Prep: 25-50-100mg/tab
Nifedipine 0.25 mkdose
Metronidazole 30-50 mkday PO(TID) Prep: 5,10,20,30,60mg/tab
125mg/5ml syr, 500mg tab
7.5mg/kg by slow IV infusion (30-60min) q6- Nitrofurantoin 5-7mkday q6h
8H UTI: 1-2mkdose qHS
10mkdose IV q8H slow IV infusion
7.5 mkdose IV q6H slow IV infusion Ondansetron 5mg/m2 BSA as single IV dose over 15mins
500/100ml IV infusion. prior to chemotherapy
2mg/ml ampule
Diloxanide 20mkday TID 4mg PO 12hours after chemotherapy
Prep: 500mg/tab; 125mg/5ml susp 4mg, 8mg FC tab
4-11y: 4mg TID
Mefenamic Acid 6.5 mkdose q6-8H (MAX 25mkday) 11-18y: 8mg TID
Prep: 50mg/5ml, 125mg/5ml
Cap: 250mg, 500mg Omeprazole 1mkday OD-BID (0.5-1.5)
<20kg: 10mg PO OD
Midazolam IV: 6mo-5y: 0.05-0.1mkdose max: 0.6mkd >20kg: 20mg PO OD
6-12yr: 0.025-0.05mkdose max: 10mg
>12: 0.5-2 mkdose Oxacillin 150-200mkday IV q6h
Ave:0.2mkdose (eg before lumbar puncture) Prep: 250-500mg/vial

PO: >6mos: 0.25-0.5mkdose max:20mg Paracetamol 10-15mkdose q4H for fever, q4-6H for pain
6mo-5yr: 1mkdose Drops: 100mg/ml
Nelson’s: Syr: 120mg/5ml
Neonates: IV: Continuous infusion 0.15– 0.5 250mg/5ml
g/kg/min for sedation; IV bolus 0.05– 0.15 Tablet: 250mg, 325mg, 500mg
mg/kg q 2– 4 hr. Ampule IV:150mg/ml, 300mg/ml
Max for IV: 300mg/dose (adult dose)
Infants and children: Prefer Ibuprofen if with G6PD
Status epilepticus: IV:loading dose of 0.15 Phenobarbital MD: 5 mkday
mg/kg followed by continuous infusion of LD: 15-20 mkdose +5mkday Max: 30
1 g/kg/min. 15mg/tab (gr ¼) 30mg/tab (gr1/2)
60 mg/tab(gr 1) 90 mg/tab (gr1 ½)
Sedation: IV:loading dose of 0.05– 0.2
Piperazine 75mkday x3days (Solmux Broncho) Susp: 2mg/500mg/5ml
Piperacillin- <6mos: 150-200MKday (piperacillin) q6-q8h Cap: 2mg/500mg
Tazobactam >6mos: 300-400mkday q6-8h Simethicone <2y= 0.5ml TID-QID
100-300mkday q4-6hrs max: 24g OD (Restime) >2y= 1ml TID
>40= 4.5g q8h Prep: 40mg/ml
<40= 112.5mkdose q8h
Sucralfate 40-80mkday q6h
Prednisone 1 - 2 mkday (preferably BID) Prep: 1g/tab
Prep: 5,10,20mg/tab;
10mg/5ml; 15mg/5ml sus Theophylline 20 mkd

Phenytoin LD: 15– 20m/k/day MAX: 1500mg/24hr Terbutaline 1.5mg/5ml syr

MD: 5m/k/day q12-24H (Bricanyl) 0.075 mkdose TID
Prep: 30-100mg/cap; 30mg/5ml;
125mg/5ml 2.5mg tab
0.075 mkdose TID
Pen G 50,000 U q6-8h (<28 DOL) 20kg ¼ to ½ tab TID
100,000-400,000 U/kday q6h (>28 DOL) 20 to 30kg ½ to 1 tab TID
If >30kg 1 to 2 tabs TID
Procaterol <5y= 0.25ml/kg BID/ TID
(Meptin) >6y= 5ml OD HS/BID Nebule 5mg/2ml
Prep: 100mcg/ml inh; 5mcg/ml syr; <20kg ½ nebule q6-8H
25-50mcg/tab >20kg 1 nebule q6-8H
Tetracycline 25-50mkday q6h
Pyrantel pamoate 11mkday
125mg/5ml Timentin 80mg/k Q6-8H
Racecadotril 1.5mg/kg/dose TID (min age: 1month) 80mkdose q12H (termNB)
(Hidrasec) 10mg, 30mg sachet for oral liquid Tobramycin <7days 5 mkdq12
<5y 7.5 mkdq8
Weight Hidrasec # sachet 5 -10y 6 mkd q8
8kg 10mg 1 Tranexamic Acid IV:10 mg/kg immediately before surgery,
10kg 10mg 1 then 25 mg/kg/dose PO tid– qid for 2– 8 days
15kg 10mg 2 Prep: 250mg, 500mg cap
20kg 30mg 1 IV: 250mg/2.5ml amp; 500mg/5ml amp
25kg 30mg 1 Valproic Acid 15 mkday
>27kg 30mg 2 Vancomycin 10 - 12 mkdose q8h (severe:15mkdose q8)
40-60mkday q6h
Ex: 1 sachet in 100cc water and take TID until Zafirlukast 40mg/day PO q12H (20mg/tab)
with two normal/formed stools or maximum (Accolate)
of 7 days. Zertin/Erdostein 7.5 mkdose q12
*The granules should be added to food or Zinc sulfate syrup Drops: 27.5mg/15ml
mixed with water in a glass or baby bottle. Syr: 55mg/5ml
Diarrhea: <6mos 2.5ml syr or 1ml drops OD
Adult: 100mg/cap 1 cap TID >6mos 5ml syr or 2ml drops OD
As supplement:
Ranitidine 1mkdose IV q8-12H (MAX 50mg/dose)
1-3yrs 1.25ml syr or 0.5ml drops OD
Ampule: 25mg/ml; 50mg/5ml amp
4-8yo 2.5ml syr OD
2mkdose PO
9-13yo 5ml syr OD
Nelson’s: 1-5mkday
Tab: 75mg, 150mg, 300mg Zinc + Ascorbic 6mos-2yo 0.6ml drops OD
Acid (Pedzinc Plus 3-12yo 2.5ml syr OD
Salbutamol 0.15mkdose TID
C) >12yo 5ml syr OD
2mg/5ml syr
Approximate dosages:
2-6yo 2.5-5ml TID Antikoch’s Treatment
7-12yo 5ml TID
>12yo 5-10ml TID Kidz Kit3 INH 200mg/5ml (5mkdose OD)
Nelson’s PO: RIF 200mg/5ml (10mkdose OD)
<6yo 0.1 – 0.2mkdose TID PZA 500mg/5ml (15mkdose OD) for 2 mos
6-12yo 2mkdose TID Kidz Kit3 Forte INH 200mg/5ml
>12yo 2-4mkdose TID RIF 200mg/5ml
Salbutamol + 50mg/1mg/5ml PZA 500mg/5ml
Guaifenesin 2-6yo 5ml TID Ethambutol
(Asfrenon) 7-12yo 10ml TID Myrin P
>12yo 10-20ml TID Streptomycin
Salbutamol + 5-10ml syr TID
Guaifenesin + 1 tab TID Vitamins and Supplements Summary
Bromhexine
(PECOF)
Salbutamol + 7-12 yo 2.5 – 5ml TID
Carbocisteine >12yo 1-2capsules TID
 Ascorbic Acid (Vit C) 100mg/ml drops of diluted formula TID
<3mos 0.3ml OD Furazolidone (Furoxone) Prep: 50mg/ml, 16.7,g/5 ml
3-12mos 0.6ml OD RD= 4-7 mkday
1-2yo 1.2ml OD Ercefuryl (40-60/ 60-100)
OD(60-100mkd)
100mg/5ml syrup Prep.: 220 mg/5 ml
2-6yo 5ml (1 tsp) OD Etofamide (kitnos) Prep. 100 mg/5ml
7-12yo 5-10ml OD RD= 20-40 mkday
Metronidazole Prep 125mg/5ml
100mg chewable tablet (eg Ceelin) RD= 30-50mkday
2-6yo 1 tab OD Diloxanide Furamide Prep 125mg/5ml
7-12yo 1 tab OD RD= 20 mkday
Ascorbic acid + Zinc 40mg Vit C/5mg Zinc/ml drops Secnedazole Prep:
(Ceelin Plus) 6-11mos 0.5 to 1ml OD RD= 30 mkday
1-2yo 1ml OD

ANTISPASMODICS
100mg Vit C/10mg Zinc/5ml syrup
Dicycloverine - 0.15mkday
1-3yo 2.5ml (1/2 tsp) OD
Bentyl 10 mg/tab, 20mg/ml
4-8yo 5ml OD
Relestal 10mg/5ml, 5 mg/ml
9-13yo 5-10ml OD
Hyoscine Butyl Bromide 10mg/tab, 5 mg/ml
Appebon 500 Syrup 2-6yo 5-10ml OD
(Buscopan)
Buclizine + Vit B1 B6 7-14yo 10-20ml OD
Diphenhydramine (BENDARYL) Syrup: 12.5 mg/5ml
B12 Iron L-lysine
Cap - 25 mg
Appebon 500 Tablet FOR ADULTS
Inj - 50 mg/ml
Buclizine + Vit B1 B6 2tabs OB or 1 tab BID
3-5 mkday po
B12 Vit C
1 mkdose IV
Appebon with Iron 5ml OD
ANTIFUNGAL
Syrup
Mycostatin Tab: 1-2 tabs TID
Vit B1 B6 B12
Susp: infant 2ml QID
Iron(10mg elemental)
Children- 4-6 ml QID
L-lysine
Oral Susp : 2 ml QID
Appebon Kid Syrup 2-12yo 5ml OD
to be swabbed on lips and
Vit B1 B6 B12 Iron L-
buccal mucosa
lysine
Difflucan (Fluconazole) 4-6 mkday
Nutrilin MTV Drops
50 mg/tab 1 tab divided into
0-6mos 0.5ml OD
4pptabs 1pptab OD with milk
7mos – 2yo 1ml OD
PO/IV=3-6mkday OD/q12H
Syrup
Bronchodilators
2-6yo 5ml OD
Aminophylline RD= 3-5 mkdose
7-12yo 5-10ml OD
dilute with equal amt of IVF
Propan with Iron 1 capsule OD to BID
refer for vomiting,
(Buclizine, B
hypotension, H/A, Sz,
vitamins,Iron)
tachycardia
Propan Syrup 2-6yo 5ml OD
Theophylline syrup 80mg/15ml
(Buclizine, B 7-12yo 10-15ml OD
(Nuellin) Tab= 50 mg, 125 mg
vitamins,++)
RD= 4 mkdose
Propan TLC Drops
Budesonide
Multivitamins <6mos 0.3ml OD Adrenal corticosteroid
6mos-2yo 0.6ml OD Anti-inflammatory
Syrup
1-3yo 2.5 to 5ml OD
4-12yo 5ml OD
Zinc sulfate syrup Drops: 27.5mg/15ml Nelson: 0.5-1mkday
Syr: 55mg/5ml
Diarrhea: <6mos 2.5ml syr or 1ml drops OD Emergency Drugs
>6mos 5ml syr or 2ml drops OD NaHCO3 1-2 meq/kg/dose
As supplement: Atropine 0.04 mk SQ
1-3yrs 1.25ml syr or 0.5ml drops OD 0.02 mkdose IV
4-8yo 2.5ml syr Epinephrine 0.01 mkdose (1:1000)
9-13yo 5ml syr 0.1 mkdose (1:10000)
Zinc + Ascorbic Acid 6mos-2yo 0.6ml drops OD max. 3 ml q5-10 mins
(Pedzinc Plus C) 3-12yo 2.5ml syr OD
>12yo 5ml syr OD DRIP:
0.6 x wt(kg) x ug/k/min = __mg in 100mL of
mL/Hr D5W/NS

= 1mL/Hr will deliver 0.1 ug/k/min

AGE Drugs Naloxone 0.1 mkdose
Infloran Berna dissolve contents of 1 cap in 15 ml Mannitol 0.5-2 gkdose
1g= 5cc
Albumin 0.5-1 g/K Acetazola- 250mg/tab
Prep: 25g/100cc mide 30 mkday q8H
12.5/50cc NaHCO3 325mg/tab
Dilute in 50cc D5W x20-25 ugtts/min 8-10 mkday q8H
Dobutamine Prep: 250mg/20cc Furosemide Drip:
12.5 mg/cc Prep: 10 mg/mL ampule
cc/Hr = wt x ugm x 60 Dose:
500 Infant/Child: 0.05m/k/hr (titrate to clinical effect)
= 2 CC+ 48 cc D5W Adult: 0.1 m/k/hr (max: 0.4 m/k/hr

DRIP: Wt(kg) x DD x 24h = __mg in 24 mL of NS to make 1

2.5 – 15 ug/kg/min (max: 40ug/kg/min) cc/hr = 0.1 mg/kg/hr
Peak effect: 10-20 min OR
Preparation: Wt(kg) x DD x 24 x 5 = __mg in 120mL of NS to make 5
12.5mg/mL x 20mL/_ = 250mg/mL mL/hr = 0.1mg/kg/hr
Premix: IV infusions = 6 x Desired dose(ug/k/min) x wt(kg) = mg drug
1000ug/mL x 250mL = 250mg/250mL Desired rate(mL/Hr) 100mL fld
2000ug/mL in 250mL = 500ug/250mL

= 6 x wt(kg) = __mg in 100mL

* 250mg in D5W 250cc (1mg/mL) Medication Usual Dilution in IV Infusion Rate
Ugtts/min = wt(kg) x DD Dose 100mL D5W
16.6 Dopamine 2-20 6mg/kg 1 mL/Hr=1ug/kg/min
= wt(kg) x DD x 0.06 Dobutamine 2.5-15 6mg/kg 1mL/Hr=1ug/kg/min
* 500mg in D5W 250cc (2mg/mL) Epinephrine 0.1-1 0.6mg/kg 1mL/Hr=0.1ug/kg/min
Ugtts/min = wt(kg) x DD
Lidocaine 20-50 0.6mg/kg 1mL/Hr=1ug/kg/min
33.2
Prostaglandin 0.05- 0.3mg/kg 1mL/Hr=0.05ug/kg/min
= wt(kg) x DD x 0.03
E 0.1 For Patency of PDA:
-IV: begin infusion at 0.05
-0.1ug/kg/min, when
desired effect is
PH<7.35 PH7.35- PH7.40- PH>7.45
achieved, dec to 0.05-
7.45 7.45
0.025-0.01ug/kg/min
PCO2 <35 Part comp Comp Comp Resp alk
-if unresponsive, inc to
met acid met acid resp alk
0.4ug/kg/min
PCO2 Met acid Normal Normal Met alka -Ampule: 500ug/mL
Eg. 2.6kg
35-45
2.6kg x 0.05ug/kg/min x60
PCO2 >45 Resp acid Comp Comp Part comp 500ug/mL
resp acid met alka met alka =0.02
Terbutaline 0.1-0.4 0.6mg/kg 1mL/Hr=0.1ug/kg/min
Dopamine Prep: 40, 80, 160 mg/ml
Cc/hr = wt x ugm x60
(200/250) 400 or 800 (400/250)
(1:100) (1:50)
DRIP:
Premix: 200mg/250mL; 400mg/250mL
Prep: 40mg/mL x 5mL/amp = 200mg/mL

= 6 x wt(kg) = __mg in 100mL

Ph PCO2 HCO3 BE
(1mL/Hr = 1 ug/kg/min)
*200mg in D5W 250cc Met Acid
Ugtts/mins = wt(kg) x desired dose(DD) Uncompensatd  N   (-)
13.3 Partly comp     (-)
= wt(kg) x DD x 0.075 Complt comp N    (-)
*400mg in D5W 250cc Met Alka
Ugtts/mins = wt(kg) x DD Uncompnsatd  N   (+)
26.6
Partly Comp    (+)
= wt(kg) x DD x 0.0375
Complt Comp N    (+)
Dopamine/Dobutamine
Resp Acid
Wt x desired x 60 x24
Concentration Uncompnstd   N N
Ca 100-300 mkday (oral) Partly Comp    
Gluconate 1cc/kg (LD-IV) Complt Comp N   
1 cc/kg/day (MD-IV) Resp Alka
Epinephrine (mg)/100cc x X/1cc x 100 Uncomp   N N
Drip Partly comp    
cc/Hr= wt. X 0.3 -1 x 60 Complt Comp N   
40
Prep: 1 amp in 25cc D5W Caloric Equivalent:
D50 2
D10 0.4 PPN
D5 0.2 Vamin : 100 x wt x dose
D7.5 0.3 Preparation(%)
D12.5 0.6
Ca Gluc: 2cc/kg/day
Amino acid 0.2
BNC: 0.5-1cc/day
Intralipid 1.1 IVF: accdg to TFI
Vamin 0.67
Corn oil 8.4 Cholesterol
Karo, Aminosteril 4 Total mg/dl = mmol/L
MCT 7.6 1-3yr : 45-182 = 1.15 - 4.70
Olive Oil 9 4-6yr 109-189 = 2.80 - 4.80
Breastmilk 20 /oz 6-9yr 5-75-95 5 -75- 95
PreNan 24 M 126-172-191 = 3.26- 4.45-4.94
NAN 22 F 122- 173- 204= 3.16- 4.47-5.41
Enfalac 24 10-14yr
Pediasure 225kcal/225mL M 130-179-204 = 3.36-4.63-5.28
F 124-174-217 = 3.21-4.50- 5.61
Na 15-19yr
NB - 134- 146 M 114-167-198 = 2.95-4.32-5.12
Infant - 139- 146 F 125-175-212 = 3.23-4.53-5.45
Child - 138 - 145
Albumin
Thereafter - 136 - 146
Prem 1 day - 1.8 -3.0 g/dl -- 18-30g/L
Fullterm <6days 2.5 - 3.4g/dl -- 25-34g/L
K
<5 yr 3.9 - 5.0g/dl -- 39 - 50g/L
<2mos 3.0 - 7.0
5-19yr 4.0 - 5.3g/dl --- 40 - 53g/L
2- 12 m 3.5 - 6.0
>12m 3.5 - 5.0
Protein
Prem 4.3 -- 7.6g/dl --- 43-76g/L
Ca
Newborn: 4.6 -- 7.4 g/dl --- 46 - 74g/L
Cordblood - 2.25 - 2.88
1--7 yr 6.1 -- 7.9 g/dl -- 46-74g/L
NB - 2.3 - 2.65
8-12yr 6.4 -- 8.1 g/dl -- 64 - 81g/L
24-48H - 1.75 - 3.0
13 -19yr 6.6 -- 8.2 -- 66 - 82 g/L
4-7d - 2.25 - 2.73
Child - 2.2 - 2.7 Corrected Reticulocyte: observed retic x observed hct
Thereaftr - 2.1 - 2.55 Normal hct for age

Dextrosity:
D5 = 50 glucose D10 = 100 glucose D12.5 = 125 glucose
Crea Mg/dl (x88.4) umol/L Limits of Dextrosity: Peripheral Line: D12
Cordbld 0.6 -1.2 === 53 -106 Central Line: D20
NB 0.3 -1.0 === 27-88
Infant 0.2 - 0.4 === 18 -35 Total Fluid Intake (TFI): Term: 60-80; Preterm: 80-100
Child 0.3 - 0.7 === 27 -62 TFI: Rate (cc) x 24 hr
Adolescent 0.5-1.0 === 44 -88 Wt(kg)
Adult M: 0.6-1.2 == 53-106 Computation:
F: 0.5 - 1.1== 44-97 Wt(kg) x TFI = ___ divide 3 (soluset: 100cc)

IVF Na Cl K Ca Lactatea To
Composition cetate adjust
0.9NSS 154 154 dextrosity
0.3NaCl 51 51 10: eg.
LR 130 109 4 1.5 28lact TFI: 90
NR 140 98 5 1.5 27acet D5IMB 80
23gluc x 0.05 = 4
NM 40 40 13 1.5 16lact D50W 10
Imb 25 22 20 1.5 23acet x 0.50 = 5
90
9
BUN Mg/dL (x0.357) mmol/L Check: 9 / 90 x 100 = 10 = Dextrosity: 10
Cordbld 21-40 ***** 7.5 - 14.3 Then, 90 x 3 (q8h cycle) = 11.25cc/hr
Prem 3 - 25 ***** 1.1 - 9 24h
NB 3 -12 ***** 1.1 - 4.3 “chart”: 90cc x 11cc/hr q8h
Inf/Child 5 -18 ***** 1.8 - 6.4
Thereafter 7-18 ***** 2.5 - 6.4 Then, compute for:

Daily Fluid Requirement

Weight (kg) D0-2 D3-4 D14-30
750g – 1kg 110 140 150
1 - 1.25 100 130 140
1.25 – 1.5 90 120 130
>1.5 80 110 130
Add 25% if with PHOTOTHERAPY
 0-3 mos C. trachomatis, S. aureus, Gr neg
4-11 mos S. Penumonia, H. influenzae
GIR: Rate(cc) x dextrosity x0.167 12-59 mosS. Pneumonia, H. influenza
Wt >60 mos M. Pneumonia, S. pneumonia
OR
Dextrosity x IVF rate x10 CPAP
Wt(kg) x 60 Requirement : adequate spon. Respiration
Components : O2 pressure
Indications:
0. HMD
1. Inhalation/chemical pneumonitis
2. Severe pneumonia
Normal Values:
3. Meconium aspiration
NB/Infants: 6-8 mg/kg/min
4. Pulmo edema with or without assoc. CHF
Children: 4-6 mg/kg/min
5. Fluid overload
If hypoglycemic, may increase GIR to 15 mg/kg/min
6. General atelectasis
7. Infants with apnea of prematurity
8. Infants with ARDS
Blood glucose monitoring:
9. PaO2 < 50-60 mmHg, breathing
- Monitor CBG q6-8h
 60-70 with recurrent apnea
- if CBG≤40mg/dL, give d10W 2cc/k/dose as slow IV push, get
CBG q15 mins, then q1Hr until stable
- if feeding, no need to monitor
- if CBG is persistently LOW, check IV line
- may need to increase dextrosity

WEANING
1. Improvement in CXR
2. ABG with PO2 > 50 mmHg
3. Blood pH > 7.3
4. PCO2 < 55 mmHg
5. Hg 12-15 gm/Hct 36-45

GUIDELINES
1. DEC. FiO2 by 3-5% every time PO2 . 70
2. With FiO2 = 40%, dec. Pressure by increments of 2 cm H2O if 2-4H until
Peak Flow:
2-3 cm is reached
Ht in cm - 100 x5 +175(M)
3. Transfer patient to O2 hood with FiO2 of 15-50%
170(F)
Extubation
Albumin: wt (g/Kg) x quantity of Stock(50cc or 100cc)
1. Dexa 0.5mkd IVTT Q12H x2 doses prior to extubation
%
2. Salbuamol 0.5cc + NSS 0.5cc Q8H
IVF: cc/h x 24h x Dextrosity x 3.4 3. Epinephrine 0.2mkd Q4H x 2 doses
100 4. Dexamethasone Q12H x 2doses after extubation
5. Chest physiothearpy
Aminosteril: wt x g/k x 100 6. Keep on right side position
% 7. NPO x 2h
Cal: cc/day x % X 4  PAI with 4.7cc NSS + 0.3cc Epinephrine QH x3 doses then maintain on
100 PAI with 2cc NSS Q6H.

Materials for Surfactant instillation:

- Gloves #3 - OGT F8 VENTILATOR PLANS
- Syringe 10cc (2) - Ruler HMD PEEP = 4-6 cm H20 PFC PEEP= 2 cm H20
- Betadine - Cotton balls PIP = 18-30 cm H20
- ET size (same brand as inserted) - Ambubag
Oxygenation Status
Post Surfactant At room air, sea level:
- Maintain on NPO PaO2 80 -100 Normal or acceptable
- CXR-APL <80 mild hypoxemia
- VBG/ABG 1 hr after <60 moderate hypoxemia
- B1B2, BUN, Crea, with S. Na, K, Ca <40 severe hypoxemia
- Wean FiO2 by 5% every 1-2 hrs pulse ox guided for O2 Sat >95% until On oxygen support:
40 - 50% PaO2 80 - 100 corrected hypoxemia
- No suctioning at least 1 hour aftre instillation unless with bradycardia, >N overcorrected hypoxemia
cyanosis, hypotension, or obstruction <N uncorrected hypoxemia
- Watch out for pneumothorax
- Standby butterfly G23, 10cc syringe, 3-way stopcock, betadine, cotton ROMS - resp opposite; metabolic same
applicator, gloves Metabolic Acidosis:
1. RTA
PNUEMONIA IN CHILDREN 2. DKA; Starvation
3. Lactic acidosis
 Diet: Low Salt diet
Metabolic Alkalosis: Labs: CBC,plt Na, K
1. Hypokalemia BUN, Crea C3
2. Hypochloremia ASOT
3. Vomiting IVF: D5.03 NaCl (no KCl first)
4. Massive steroid administration Furosemide (1-2mkdose, max:4mkdose);Hold:BP<80sys
5. NaHCO3 administration Pen G/ Ampicillin-Sulbactam
Limit Oral intake to TFR
Respiratory Acidosis: Watch out for HPN
1. Hypoventilation Weigh Patient daily pre-breakfast/post-voiding
a. inadequate resp effort
CNS problem TFR: BSA x Insensible water loss + UO
Neuromuscular disease UO- if with Furosemide divide by 2
Mechanical ventilator setting TUNE/MENDOZA PROTOCOL
b. upper airway not patent WK Methylpred Dose PRED
c. decreased lung tissue 1-2 30mg/kg 6 none
d. decreased lung compliance 2x/wk
2. Abnormal ventilation perfusion ratio 3-10 30mg/kg 8 2mg/kg/48h
a. obstruction of small airway wkly
b. atelectasis 11-18 30mg/kg 4 W/ or w/o
c. pneumonia q2wks tapering
d. pulmonary edema 19-50 30mg/kg 8 Slow
3. Increased extrapulmonary shunt q4wks tapering
a. pulmonary vasoconstriction 51-82 30mg/kg 4 Slow
* RDS, severe infection q8wks tapering
b. Pulmonary hypoplasia
c. Cyanotic heart disease Elises Protocol:
12 months - Monthly--- 3 consecutive days
Respiratory Alkalosis 6 months - 1 dose/ monthly --- cont prednisone 2 mg/kg
1. with hypoxamia q other tapering
a. acute pulmonary disease -
- pneumonia and atelectasis, RDS, acute asthma Alkylating Agents
b. Acute myocardial disease  Cyclophosphamide - 2.5mg/kg/day X 8wks
- MI, pulmonary edema, heart failure, CP bypass - (Nelson) 3mg/kg/24h x 12wks
2. Without hypoxemia - (Total 140mg/kg)
a. anxiety, neurosis, psychosis
- 500mg/m2 (BSA) 750mg 1g
b. pain
 Cyclosporine - 5mg/kg/day
c. CNS disease
- immunosuppressive, altered perselectivity
d. Anemia
- steroid- sparing drug
e. Carbon monoxide poisoning
- high relapse rate when D/C
NEPHROTIC SYNDROME
TREATMENT: 1st Episode  Chlorambucin - 0.2mg/kg/day x 8-12 wks
4weeks: 60mg/m2/day divided doses (max 80md/day) - hematologic malignancy
4weeks: 40mg/ m2 / alt days single am dose (max 60mg)
8days: 20mg/ m2 / alt days single am dose (max 20mg)  Nitrogen Mustard - 1958
8 days: 10 mg/ m2 / alt days single am dose (max 10mg)  LTVamisole - 2.5mg/kg/alternate days
- maintain in remission in about 50% of losses of
MCNS: relapse treatment (Eddy) steroid - dependent NS
Until urine remission: 60mg/ m2 /day in divided doses RENAL BIOPSY
8 days: 60mg/ m2 alt days single am dose
8 days: 40mg/ m2 alt days single am dose
8 days: 30mg/ m2 alt days single am dose
8 days: 20mg/ m2 alt days single am dose
8 days: 10mg/ m2 alt days single am dose
Remission - absence of proteinuria 5 consecutive days LUPUS NEPHRITIS IN CHILDHOOD
Difficult patients: Classification
1. Steroid resistent I - normal
2. Steroid dependent - 2 relapses/ 14 days after II - pure Mesangiopathy (mesangial 19-27%
discontinuation od decrease in dose III - Segmental & Proliferaive GN (Focal Segmental
3. Steroid toxic - 18 - 24%)
4. Steroid Dependent/ Frequent relapsers - 2 relapses in 6 mos. IV - Diffuse Proliferative Lupus Nephritis (39-44%)
V - Diffuse Membranous GN - (8-22%)
Dr. James Woo VI - Advanced Sclerosing GN
BSA: wt X 4 +9 TFR: BSAx 500(<20k)/400 (>20k) + U.O
100 Seroassay-
1. ANA - unusual in children
Dr Alcala/Caso BSA- Wt in Kg x Ht in CM - ANA titer does not correlate with disease severity
3600
2. Antibodies to ds DNA & Smith (Sm) Antigen more specific level may
Post Streptococcal Acute Glomerulonephritis present in 70% of 25%
Anti ds DNA + Anti-Sm Ab + Serum C3 - Sick Infant
Age Photo Exchange
Renal Disease Activity <24H 10-14 20
C3 >24h 15 20

C3a, C5a C5b-a Healthy

Age Photo ET if Photo fails DVET
25-48 >15 >20 >25
Leukocytes membrane attack
49-72 >18 >25 >30
>72 >20 >25 >30
Hyperkalemia
Serum K >5.5meq
ECG
1. Sodium Bicarbonate - shifts K into cells
- 1 meq/kg IV over 10 - 30 min
- onset 15-30 min
AVR AVL
2. Calcium Carbonate - (10%) - stabilizes membrane potential
- 0.5 -1ml/kg over 5-15 min
(+)I
- onset immediate
3. Glucose and Insulin - stimulates cellular uptake of K
- glucose 0.5 mg/kg witn insulin 0.1mg/kg over 30
(+)150 (+30)
min
(+120) (+)60
- onset: 30 - 120 min
III (+90) II
4. B - Agonist (Albuterol/Salbutamol) - stimulates cellular
AVF
uptake of K

QT -
HYPOKALEMIA - 0.5-1 meq/kg/dose X 1h
PR
- continuous correction: 0.2-0.3 meq/kg/hr
QT
- fast correction K (symptomatic)
Rate
0.5meq/kg/hr (child) x10 meq KCl in 166 ml fluid x 1-2hr[s
Axis
max 40meq KCL/500cc PNSS x 1-2 hrs
- ICU - 10meq/10cc (1:1) central line
- Oral: 10% oral KCl soln has 1.34meq/ml AGE Preterm Newborn Infant 1 year
Wt (kg) 1.5 3 5 10
FT Consider Photo # * ETT size 2.5-3.0, 3.0-3.5, 3.5-4.0, 4.0-4.5,
Photo uncuff uncuff uncuff uncuff
≤24H Suction catheter 5 6 8 8
25-48H ≥12 ≥15 ≥20 ≥25 Chest tube 8-10 10-12 10-12 16-20
NGT/Foley 5 5-8 5-8 8
49-72H ≥15 ≥18 ≥25 ≥30 Laryngoscope 0 1 1 1-2
Mask NB NB NB- Infant
>72H ≥17 ≥20 ≥25 ≥30 infant
# DVET if photo fails
* DVET and intensive photo AGE 3 yr 6 yr 10 yr Adolescent
Wt (kg) 15 20 30 50
Photo for 1500g 1500- >2000 ETT size 4.5-5.0, 5.0-5.5, 6.0- >6.5, cuffed
Preterms 2000 uncuff uncuff 6.5,
<24H >4 >4 >5 cuffed
24-48H >5 >7 >8 Suction catheter 8-10 10 10 10
49-72H >7 >9 >12 Chest tube 16-20 20-28 28-32 32-40
≥72H >8 >10 >14 NGT/Foley 8-10 10-12 12-14 14-18
Laryngoscope 2 2 2-3 3
DVET for 1500g 1500- >2000g Mask Child Child Adult Adult
Preterms 2000g
<24H >10-15 >15 >16-18
24-48H >10-15 >15 >16-18
49-72H >10-15 >16 >17-19
>72H >15 >17 >18-20

Polin
Wt (PT) Photo DVET
<1.25 5-7 10-13
1.25-1.49 7-10 13-16
1.5-1.99 10-12 16-18
2.0-2.5 12-14 18-20
 pH: N= 4.5-6.5
Acidic Alkalotic
Resp/ Metab acidosis Resp/ Metab acidosis
UTI by E. coli UTI w/ urea-splitting org
HypoKalemia Renal tubular acidosis
Starvation Vegetarian diet
Technical Updates of the Guidelines on Integrated High protein diet Prolonged urine storage
Management of Childhood Illnesses (IMCI) PROTEIN:
T race = <0.2 g/L protein 1+ = 0.3
Acute Oral amoxicillin should be used in
2+ = 1 3+ = 3 4+ = >20
Respiratory 25mg/kg/dose twice daily for the
Infections treatment of non-severe pneumonia
Oral amoxicillin should be given for
three days for non-severe pneumonia
in children 2-59 months of age
Where referral is difficult and injection is
not available, oral amoxicillin in
45mg/kg/dose twice daily should be
given to children with severe
pneumonia for 5 days
Injectable Ampicillin plus injectable
gentamicin is a better choice than
injectable chloramphenicol for very
severe pneumonia in children 2-59
months of age. A pre-referral dose of
7.5mg/kg intramuscular injection
gentamicin and 50 mg/kg injection
Ampicillin can be used
Children with wheeze and fast breathing
and/or lower chest indrawing should be
given a trial of rapid-acting inhaled
bronchodilator (up to 3 cycles) before
they are classified as pneumonia &
prescribed antibiotics. 0.5ml Salbutamol
diluted in 2 mL of sterile water per dose
nebulization should be used.
Diarrheal Ciprofloxacin is the most appropriate
Disease drug in place of nalidixic acid which
leads to rapid development of
resistance

RTD: “Clinical Practice Guidelines in Pediatric Pulmonary

Tuberculosis” - Dr. A. Jiao
Latent TB
- infection with MTB, (+)Mantoux test, no clinical s/sx or CXR of TB
- implies devt of antibody of TB, exposure to TB
- carries high risk of progressing to TB disease
- carries high risk of progressing to TB disease

Bedside NEPHROLOGY
Urinalysis
- examined within 30 min
- can be preserved for up to 6 hours in 4⁰C
Interpretation of Urinalysis:
COLOR:
Yellow – Normal Dark red – Hemoglobin/Myoglobin
Tea-colored – Blood Black – Hemolysis
Greenish – Bile Milky – Fat/Chyle
Brown – Nitrofurantoin Red – Rifampicin
CLARITY:
Clear – Normal Cloudy – Infection, casts, protein