common pediatric meds

7/29/2019 Common Pediatric Meds

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Common Pediatric Medications

Medication Dosage Side Effects ReasonsAcetaminophen Child:PO 1015 mg/kg q46h PR 25 y,

120 mg q46h (max: 720 mg/day); 612

y, 325 mg q46h (max: 2.6 g/day)

Hepatotoxicity, hepatic

coma.

Fever. Pain.

Ampicillin Child (under 40 kg):PO/IV 2550

mg/kg/day divided q68h

Hypersensitivity (pruritus,

hemolytic anemia,interstitial nephritis,

anaphylactoid rxn)

Systemic infections: GU,

respiratory, GI tracts, skin

Amoxicillin Child/Infant (at least 3 mo):PO 2550

mg/kg/day (max: 6080 mg/kg/day)

divided q8h or 200400 mg q12h

Hypersensitivity (rash,

anaphylaxis)

Infections (ear, nose, throat,

GU tract, skin, soft tissue

caused by susceptible

bacteria).

Albuterol Child:PO 26 y, 0.10.2 mg/kg t.i.d.

(max: 4 mg/dose); 612 y, 2 mg 34

times/day Inhaled 412 y, 12

inhalations q46h

Tremor, restlessness,

convulsion, hallucinations.

HTN, hypotension,

bradycardia.Blurred vision

Bronchospasm

Atrovent Child (312 y):Inhalation 12 inhalationst.i.d. (max: 6/day) Nebulizer 125250

mcg t.i.d.

Blurred vision, acute eyepain. Cough, hoarseness,

epistaxis Urinary

retention.

Maintenance therapy- COPD:chronic bronchitis and

emphysema.

Azithromycin Child (6 mo or older):PO 10 mg/kg on

day 1, then 5 mg/kg for 4 more days

(max: 250 mg/day)

Hepatotoxicity Bacterial infections:

Pneumonia, lower respiratory

tract , pharyngitis/tonsillitis,

gonorrhea,skin

Baclofen Child:PO 27 y, 1015 mg/day divided

q8h, may increase by 515 mg/day

q3days (max: 40 mg/day); 8y or older,

1015 mg/day divided q8h, may increaseby 515 mg/day q3days (max: 60

mg/day)

Transient drowsiness,

Hypotension, Tinnitus;

blurred vision, mydriasis,

nystagmus, urinaryfrequency.

MUSCLE spasm.

Benadryl Child:PO 26 y, 6.25 mg q46h (max: 300

mg/24 h); 612 y, 12.525 mg q46h

(max: 300 mg/24 h) IV/IM 5 mg/kg/day

divided into 4 doses (max: 300 mg/day)

tachycardia,

cardiovascular collapse,

anaphylactic shock, mild

hypotension or HTN.

Allergy symptoms,

antiparkinsonism, motion

Sickness, nighttime Sedation

Benadryl Child:PO 26 y, 6.25 mg q46h (max: 25

mg/24 h); 612 y, 12.5 mg q46h (max:

50 mg/24 h)

tachycardia,

cardiovascular collapse,

anaphylactic shock, HTN.

Nonproductive Cough

Cefepime Child: IV 50 mg/kg q8h until resolution of

neutropenia Child:IV 50 mg/kg q12h for

710 days

elevated liver function

tests (ALT, AST),

Eosinophilia.

Febrile Neutropenia,

UTI/Pneumonia

Cefotaxime Child:IV/IM 1 wk or younger, 50 mg/kg

q12h; 14 wk, 50 g/kg/q8h; 1 mo12 y,

50200 mg/kg/day divided q48h (max:

12 g/24 h)

Pseudomembranous

colitis, increases in serum

AST, ALT, LDH, bilirubin,

alkaline phosphatase conc

Infections: lower respiratory

tract, skin, bones & joints, CN

(meningitis & ventriculitis),

gynecologic & GU tract

Cefuroxime Moderate to Severe InfectionsChild (3

mo12 y):PO 1015 mg/kg (125250 mg)

q12h IV/IM 50100 mg/kg/day divided

q8h (max: 6 g/day) Bacterial Meningitis

Adult:IV/IM 1.53 g q8h

serum creatinine & BUN,

creatinine clearance,

superinfections, +

Coombs' test.

Infections caused by

susceptible organisms in lowe

respiratory tract, urinary tract

skin


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Ceftriaxone Mod.- Severe InfectionsChild:IV/IM 50

75 mg/kg/day in 2 divided doses 414

days (max: 2 g/day) Bacterial Otitis

Media

Child:IM 50 mg/kg (max: 1 g) Meningitis

Adult:IV/IM 2 g q12h

Child:IV/IM 100 mg/kg/day in 2 divided

doses (max: 4 g/day)

Pruritus, fever, chills,

pseudomembranous

colitis

Infections caused by

susceptible organisms in lowe

respiratory tract, skin, urinary

tract, bones and joints.

Cipro Bacterial conjuctivitis 1-2 drops every 2

hours for 2 days then every 4 hours for 5

days. Complicated pyelonephritis: 10 to

20 mg/kg orally every 12 hours for 10 to

21 days, MAX 750 mg/dose. UTI: 10 to 20

mg/kg MAX 750 mg/dose orally evry 12

hours for 10 to 21 days

Seizures, acute kidney

failure, prolonged QT

interval, Torsades de

pointes.

Bacterial conjunctivitis,

complicated UTI,

pyelonephritis and anthrax.

Clindamycin Child:PO 1030 mg/kg/day q68h IM/IV

2040 mg/kg/day in divided doses

Cardiac arrest,

agranulocytosis,sensitizati

on, generalized myalgia.

Serious infections when less

toxic alternatives are

inappropriate

Decadron Allergies, Inflammation, Neoplasias

Child:PO/IV/IM 0.080.3 mg/kg/daydivided q612h Cerebral Edema

Child:PO/IV/IM 12 mg/kg loading dose,

then 11.5 mg/kg/day divided q46h 5

days (max: 16 mg/day)

CHF, HTN, edema, bowel

perforation, vertebralcompression fracture,

petechiae, ecchymoses

Allergies, Inflammation,

Neoplasias, Cerebral Edema

Dilaudid Moderate to Severe Pain

Child:PO 0.030.08 mg/kg q46h (max: 5

mg/dose) IV 0.015 mg/kg q46h prn

Antitussive

Child (612 y):PO 0.5 mg q34h prn

Respiratory depression. Moderate to severe pain.

Persistent nonproductive

cough.

Fentanyl Premedication

Child:PO Suck on lozenge until sedated,wt. 1025 kg, 200 mcg lozenge; wt. 25

35 kg, 300 mcg lozenge; wt. 3540 kg,

400 mcg lozenge

General Anesthesia

Child:IV 23 mcg/kg as needed

Postoperative Pain

Child:IM 1.73.3 mcg/kg q12h prn

Circulatory depression,

cardiac arrest, respiratorydepression or arrest.

Analgesic during operative

and perioperative periods.

Fluconazole Oropharyngeal Candidiasis

Child:PO/IV 36 mg/kg/day 14 days

Esophageal Candidiasis

Child/Infant:PO/IV 36 mg/kg/day 21

days Systemic Candidemia

Child/Infant/Nenonate (>14 days):PO/IV

6 mg/kg q12h 28 days

Cryptococcal Meningitis

Child/Infant/Neonate (> 14 days):PO/IV

12 mg/kg day 1, then 612 mg/kg/day

1012 wk

Headache, abdominal

pain, diarrhea, increase in

AST in pts with

cryptococcal meningitis

and AIDS

Cryptococcal meningitis and

oropharyngeal and systemic

candidiasis

Fleets enema

(Sodium

phosphates)

Constipation

Rectal: Children:

2-4 yrs: of one 2.25 ounce pediatric

Edema, hypotension,

hypocalcemia, abdominal

pain, mucosal bleeding,

Short-term tx of constipation;

evacuation of colon for rectal

& bowel exams


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enema single dose

5-11 yrs: 2.25 ounce pediatric enema

single dose

12 yrs: 4.5 ounce enema single dose

acute renal failure

Fosphenytoin Status epilepticus

Infants/ children:

4-8 PE/kg/day IM/IV divided qd-tid; Start:

15-20 mg PE/kg IV x1; Max: 3 mgPE/kg/min up to 150 mg PE/min IV

Seizure disorder, short-term tx

Infants/ children:

IM/IV 4-6 mg PE/kg/day divided qd-tid;

Start: IM/IV 10-20 mg PE/kg x1; Max: 3

mg PE/kg/min up to 150 mg PE/min IV

Pruritis, tachycardia, brain

edema, nystagmus,

dizziness, muscle

weakness, cardiac arrest

Generalized convulsive status

epilepticus;

prevention/management of

seizures

Gentamicin Mod. - Severe Infection

Child:IV/IM 67.5 mg/kg/day in 3

divided doses Intrathecal Older than 3

mo, 12 mg preservative free daily

Prophylaxis of Bacterial Endocarditis

(Wt.


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divided doses 2 wk, then increase to 0.3

mg/kg/day in divided doses 2 wk (max:

5 mg/kg/day or 250 mg/day)Bipolar

Disorder, Pts ReceivingCarbamazepine

Adult/Adolescent (>16 y):PO Start w/ 50

mg daily for 2 wk, then 50 mg bid. for 2

wk, then 100 bid for 1 wk, then 150 mg

bid. for 1 wk, then 200 mg bid.

Levetiracetam Adult/Adolescent (older than 16 y):PO

500 mg b.i.d., may increase by 500 mg

b.i.d. q2wk (max: 3000 mg/day) IV 500

mg b.i.d., may increase q2wk (max: 3000

mg/day)

Child (415 y):PO 10 mg/kg b.i.d.; may

increase by 20 mg/kg q2wk up to 60

mg/kg/day Tonic

Clonic Seizures

Adult/Adolescent (older than 16 y):

PO/IV 500 mg bid., increase by 1000 mg

q2wk to dose of 3000 mg/dayChild (older than 6 y):PO 10 mg/kg bid.,

increase by 20 mg/kg q2wk to dose of 60

mg/kg/day in 2 doses Myoclonic Seizures

Adult/Adolescent/Child (at least 12 y):PO

500 mg b.i.d., increase by 1000 mg/day

q2wk to recommended dose of 3000

mg/day in divided doses

Somnolence, Asthenia,

headache, infection,

suicidal ideation

Partial onset, myoclonic, tonic

clonic seizures.

Morphine

Sulfate

Child:IV 0.050.1 mg/kg q4h or 0.025

2.6 mg/kg/h by continuous infusion (max:

10 mg/dose) IM/Subcutaneous 0.10.2

mg/kg q4h (max: 15 mg/dose) PO 0.2

0.5mg/kg q46h; 0.30.6 mg/kg sustained

release q12h

Cardiac arrest, severe

respiratory depression or

arrest; pulmonary edema.

Skeletal muscle flaccidity;hypothermia

Severe acute and chronic pain

Phenobarbitol Anticonvulsant

Child:PO/IV 48 mg/kg/day in divided

doses Status Epilepticus

Child:IV 1020 mg/kg in single or divided

doses, then 5 mg/kg/dose q1530min

(total max: 40 mg/kg)

Sedative/Hypnotic

Child:PO 2 mg/kg/day in 3 divided doses

IV/IM 35 mg/kg

Respiratory depression,

Folic acid deficiency,

paradoxic excitement and

exacerbation of

hyperkinetic behavior,

Somnolence, insomnia.

Long-term management of

tonic-clonic (grand mal)

seizures & partial seizures,

preop. & postop. sedation &

to treat pylorospasm in infant

Topamax Partial-Onset Seizures

Child (216 y):PO Initiate w/ 13 mg/kg

at bedtime 1 wk, then increase by 13

mg/kg/day in 2 divided doses q12wk to

a target range of 59 mg/kg/day

Generalized Tonic-Clonic

Child:PO Initiate w/ 13 mg/kg at

bedtime; titrate to 6 mg/kg/day by the

end of 8 wk

Hyperthermia, Fatigue,

speech problems, wt. loss,

dizziness, ataxia,

psychomotor slowing,

confusion, nystagmus,

paresthesia, memory

difficulty

partial-onset seizures in adult

and children age 216 y;

generalized tonic-clonic

seizures

common pediatric meds

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