drug dosages
DESCRIPTION
DrugsTRANSCRIPT
BETA-LACTAMS
Penicillin 50-100 mkD q6
Pen G Crystalline 100,000-200,000 ukD q12 50,000-100,000 ukD q8/q12 (< 7days) 75,000-150,000 ukD q6-q12 (>7days)
Benzathine Penicillin1.2 m.u., 2.4 m.u/vial
500,000 u/K single dose (early syphilis) 50,000 u/K max dose 2.4 M u/dose (syphilis)
SumapenPhenoxymethyl penicillin125/5 – 200,000 u/5mL250/5 – 400,000 u/5mL
50 mkD q6
AmpicillinD: 125mg/1.25mLS: 125mg/5mL, 250mg/5mLC: 250mg, 500mgV: 125mg, 250mg, 500mg, 1gm
50-100 mkD q6/q8 (neonates) 100-200 mkD q4/q6 100-150 mkD q8-q12 (meningitis neonates) 200-400 mkD q4/q6 (meningitis)
Ampicillin-SulbactamSultamicillin (Unasyn)S: 250mg/5mLC: 375mg, 750mgV: 750mg, 1.5gm
100-200 mkD q8 IV 1.5-12gm/day IV 50mkD q12 (<30kg) 2.25gm (single dose, gonorrhea)
AmoxicillinD: 100mg/mLS: 125mg/5mL, 250mg/5mLC: 250mg, 500mgV: 1gm
30-50 mkD q8
Amoxicillin-ClavulanicAcid (Co-Amoxiclav)S: 156.25/5 (125), 228.5/5(200), 312.5/5 (250), 457/5(400)T: 375mg, 625mgV: 600mg (500), 1.2gm (1000)
30-50mkD q8 po 50-100mkD q8 IV
Amoxicillin-sulbactam(Ultramox)S: 250mg/5mLT: 500mgV: 500/250mg, 1000/500
30-50mkD q8 po 50-100mkD q8 IV
Piperacillin-TazobactamV: 4gm/500mg, 2gm/250mg
200-300 mkD q6 150-300 mkD q8 (<6months)
AztreonamV: 1gm
50 mkD q6-q8 (children) 30 mkD q6-q8 (1wk-2y/o)
MeropenemV: 500mg, 1gm
20 mkD q12 (septic) 40 mkD q12 (meningitic)
ImipenemV: 500mg
15 mkD (max 2gm/D) 50 mkD or 1-2 gm q6-q8 (max 4gm/D; adult)
CEPHALOSPORINS
FIRST GENERATION
CefalexinD: 100mg/mLS: 125mg/5mL, 250mg/5mLC: 250mg, 500mg, 1gm
25-50 mkD q6 (max 4gm/D)
CefazolinV: 500mg, 1gm
20-50mkD q6-q8 100mkD (severe infection)
SECOND GENERATION
CefaclorD: 50mg/mLS: 125mg/5mL, 250mg/5mLC: 250mg, 500mg
20-40 mKD q8
CefuroximeS: 125mg/5mL, 250mg/5mLT: 250mg, 500mgV: 750gm, 1.5gm
20-40 mkD q12 50-100 mkD q8 IV
CefoxitinV: 500mg, 1gm
80-160 mkD q4-q6 (max 12gm/D) 20-40 mkD (infants)
THIRD GENERATION
CeftazidimeV: 250mg, 500mg, 1gm, 2 gm
100-150 mkD q8 IV
CeftriaxoneV: 250mg, 500mg, 1gm, 2gm
50-100 mkD OD IV
CefotaximeV: 250mg, 500mg, 1gm
100-200 mkD q4-q6
CefiximeD: 20mg/mLS:100mg/5mLC: 100mg, 200mg
3-8 mkD q12
FOURTH GENERATION
CefepimeV: 500mg, 1gm, 2gm
50mkD q8-12 x 10 days 500mg-1gm q12 (>12 y/o)
TETRACYCLINE
TetracyclineC: 250mg, 500mg
25-50 mkD
DoxycyclineC: 100mg
4.4 mkD 2.2 mkD
FLUOROQUINOLONES
CiprofloxacinT: 250mg, 500mgV: 2mg/mL infusion
7.5-15 mkD
LevofloxacinT: 250mg, 500mgV: 5mg/mL infusion
8mkD q12 (250mg max)
MACROLIDES
ErythromycinD: 100mg/2.5mLS: 200mg/5mL, 400mg/5mL,
30-50 mkD q8-q12 (max 1gm)
ClarithromycinS: 125mg/5mL, 250mg/5mLT: 250mg, 500mgV: 50mg/mL
15 mkD q12 (max 1gm/D)
AzithromycinS: 200mg/5mLC: 250mg, 500mgV: 500mg
10 mkD x 3 days 10 mkD 1st day, 2 mkD 2nd -5th day
ANTIFUNGALS
FluconazoleT: 50mg, 100mg, 150mg, 200mgV: 2mg/mL
12 mkD LD 6 mkD MD
KetoconazoleT: 200mg
5 mkD OD (<15kg) 100 mkD OD (>20kg) 200 mkD OD (>30kg)
GriseofulvinT: 125mg, 500mg
10 mkD
Amphotericin BV: 5mg/mL, 50mg/10mL
MD: 0.5-1 mkD OD
ANTIPARASITIC
Pyrantel PamoateS: 125mg/5mLT: 125mg
11 mkD x 3 doses OD
MebendazoleS: 20mg/mL, 50mg/mLT: 100mg, 500mg
200 - 500 mkD OD single dose
ANTITUBERCULOSIS
Rifampicin (R)D: 100mg/5mLS: 200mg/5mLC: 150mg, 300mg, 450mg
10-20 mkD OD AC
Isoniazid (H)S: 200mg/5mLC: 75mg, 100mg, 200mg, 300mg, 400mg
10-20 mkD OD AC
Pyrazinamide (Z)S: 250mg/5mLC: 400mg, 500mg
15-30 mkD OD PC
Ethambutol (E)C: 275mg, 400mg, 800mg
15 mkD OD 5-25mKD (<2 months)
Streptomycin (S)V: 1gm
10 mkD OD Q 48 or EOD
AMINOGLYCOSIDES
AmikacinV: 50mg/mL, 125mg/mL, 250mg/mL
15 mkD (LD) 10 mkD q12 (MD)
GentamycinV: 40mg/mL, 80mg/2mL
5-8 mkD q8-q12
NeltilmicinV: 50mg/mL, 75mg/mL
6-8 mkD OD
OTHER ANTIBACTERIALS/ANTIBIOTICS
ChloramphenicolS: 125mg/5mLC: 250mg, 500mgV: 1gm
50-100 mkD q6-q8 PO 50 mkD q6 IV 25 mkD q6 (neonates)
Co-trimoxazoleS: 40mg/5mL (200), 80mg/5mL(400), 160mg/5mL (800)T: 400mg/80mg, 800mg/160mg
5-8 mkD q12
ClindamycinS: 75mg/5mL granulesC: 150mg, 300mgV: 150mg/mL SIVP in 30mins
NB: 5mkD q8-12 po Infant/child:o15-25mkD q6 IVo20-30 mkD q6 PO
VancomycinV: 500mg
<1200g (0-4wks): 15mkdose OD >1200g (0-1wk): 20mkdose OD (1-4wks): 30mkdose OD Infant/child:o20mkdose q8 POo60mkD q8 1-3 hr infusion
MetronidazoleS: 125mg/5mLT: 500mgV: 5mg/mL
30-50 mkD q8-q12 PO 15 mkD LD, 7.5 mkD q8
ANTIVIRALS
AcyclovirS: 200mg/5mLT: 200mg, 400mg, 800mgV: 250mg
10-20 mkD q6 200mg 5x daily (adult, children, > 2 y/o) ½ adult dose (children < 2 y/o)
AmantadineT: 100mg, 250mgV: 500mg
5-9 mkD q12 (<8y/o) 100-200mg (>8 y/o; not >200mg/D)
Methisoprinosol (Isoprinosine)S: 250mg/5mLT: 500mg
50 mkD q6-q8
ANALGESIC AND ANTIPYRETICS
ParacetamolD: 100mg/mLS: 120mg/5mL, 250mg/5mLT: 80mg, 500mgV: 150mg/mL, 300mg/2mLSupp: 125mg, 250mg
10-15 mkd q4
IbuprofenD: 100mg/2.5mLS: 100mg/5mL, 200mg/5mLC: 200mg, 800mg
6-8 mkd q6
Mefenamic AcidS: 50mg/5mL
6.5 mkd q6
C: 250mg, 500mgAspirinT: 80mg, 100mg, 325mg
60-80 mkD RHD: 100mkD (1st 2wks), 75 mkD (4wks) Anti-inflammatory: 60-90 mkD Kawasaki: 80-100mkD q6
IndomethacinC: 100mg
1-2 mkD x 3 (PDA)
NaproxenT: 275mg, 550mg
5-7 mkD q8-q12 (>2y/o)
NalbuphineV: 10mg/mL
0.1-0.2 mkd IM, IV
MidazolamT: 15mgV: 1mg/mL, 5mg/mL
0.2 mkd
Meperidine 6 mkD/ 0.5-1 mkD
MorphineT: 10mg, 30mg, 60mg, 100mgV: 10mg/mL
0.1-0.2 mkd q6 (max 15mg)
NEPHRO / RENAL MEDICATIONS
Prednisone Nephrotic: >40mg/day Hypoalbuminemia: <2.5mg/dL 60mkD x 4-6 weeks then 40mkD (am) x 2-3
months Alternate day doseCyclophosphamide 2-3 mkD single dose 8-12 weeks
COUGH AND COLDS MEDICATIONS
Chlorpheniramine maleateS: 2mg/5mLT: 4mgV: 10mg/mL
0.2-0.3 mkD >12 y/o: 5mL TID or 1 tab TID
Ambroxol Age Dose
30mg/tab >10y/o 5-10 y/o
1 tab TID½ tab TID
Syrup (15mg/5mL) >10y/o 6-10 y/o 2-5 y/o
10mL TID5mL BID-TID2.5mL BID
Infant drops (6mg/mL 1-2 y/o 7-12 mos <6 mos
1.25mL BID1mL BID0.5mL BID
Carbocisteine Age Dose
Syrup (100mg/5mL) 2-3 y/o 4-7 y/o 8-12 y/o
5mL TID10mL TID15mL TID
Syrup (250mg/5mL) 2-3 y/o 4-7 y/o 8-12 y/o
2.5mL TID5mL TID7.5 mL TID
Drops (50mg/mL) <2 mos 3-6 mos 7-12 mos 13-24 mos
0.3mL TID0.6mL TID0.9mL TID1.2mL TID
ErdosteineS: 175mg/5mLC: 300mg
>30kg 20-30kg 15-19kg
10mL BID5mL TID5mL BID
Procaterol (Meptin)S: 5mcg/mLT: 25mcg, 50mcg
< 5y/o >6y/o Adult
0.25mKD BID-TID5mL or 25mcg/tab OD-BID20mL or 50mcg/tab OD-BID
Salbutamol + Guaifenesin
>12 y/o 6-12 y/o 2-6 y/o
10mL TID, 1 cap BID-TID 1tsp TID½-1tsp TID
Acetylcysteine (Fluimucil)Sachet: 100mg, 200mgS: 100mg/5mLT (effervescent): 600mg
Children Adult
100mg BID-QID200mg BID-TID, 600mgOD
GuaifenesinS: 100mg/5mLC: 200mg
6-12 y/o Adult:
5mL TID-QID5-10mL TID-QID1-2cap TID-QID
Phenylpropanolamine Age Dose
Drops (6.25mg/mL) 1-2 y/o 7-12 mos 4-6 mos 1-3 mos
1mL QID0.75mL QID0.5mL QID0.25 mL QID
Syrup (12.5mg/5mL) 2-6 y/o 7-12 y/o
2.5mL QID5mL QID
NEUROLEPTICS & ANTI-CONVULSANTS
DiazepamT: 5mg, 10mg/tabV: 5mg/mL, 10mg/mL
0.2-0.3 mkD Max dose: <5y/o: 5mg; >5y/o: 10mg Drip: 50mg (10cc) + 250cc 0.9 NSS to run at
1cc/kg/hr
Carbamazepine(Tegretol)
<4 y/o: 20-60mg/day inc by 20-60mg OD 4y/o: 100mg/day inc by 100mg weekly 10-20 mk MD
Mannitol 20% 2.5-5 cc/kg q6-q8
Phenobarbital20mg/5mL; grain 1=60mgT: 15mg, 30mg, 60mg, 90mgV: 130mg/mL
LD: 10-20 mkd MD: 5 mkD q12 Max: 1-2gms (300mg)
Phenytoin (Dilantin)S: 30mg/5mL, 125mg/5mLV: 50mg/mL
10-20 mkd LD 5 mkD q12 MD Max: 1 gm
Valproic AcidS: 250mg/5mLV: 100mg/mL
15mkD (LD) OD/BID 20mKD q8 (MD)
STEROIDS
BetamethasoneT: 500mcgV: 1mL, 2mL
0.0178-0.25 mkD q6-q8 Max: 9mg/D
DexamethasoneT: 500mcg, 750mcg, 4mg (forte tab)V: 2mg/mL, 4mg/mL, 5mg/mL
0.5-1mkD for ICP 1 mkD q4-q6 for cerebral edema 0.2-0.5 mkd for bacterial meningitis 5mg – 10mg IV q6 (adult dose)
HydrocortisoneT: 20mgV: 100mg, 200mg, 250mg, 400mg, 500mg
10-15 mkD LD, 4-6 mkD q6-q8 MD (asthma) 3-4 mkD (Dengue)
PrednisoneS: 10mg/5mLT: 5mg, 20mg
1-2 mkD q12 BSA x 60 mkD (Nephrotic)
ANTI-HISTAMINES
Promethazine HCl (Phenergan)V: 25mg/mL
1mg/kg IM
FexofenadineT: 120mg, 180mg
120mg OD
Chlorphenamine maleateS: 2mg/5mLT: 4mgV: 10mg/mL
<1y/o: 2.5mL TID 1-3y/o: 2.5-5mL TID >6y/o: 5mL TID 7-12y/o: ½ tab TID Adult: 1 tab TID or 2 tsp TID IV/IM: 1mL OD
ANTI-HISTAMINES
CetirizineD: 2.5mg/mL, 10mg/mLS: 1mg/mL, 5mg/5mLT: 10mg
6mons-1y/o 1mL OD
1-2 y/o 2.5 mg BID (5 drops BID) 1mL OD or BID
2-5 y/o ¼ tab BID or ½ tab OD 5mL OD or 2.5mL BID
6-12 y/o ½ tab BID 10mL OD or 5mL BID
12 y/o > 1 tab OD
DiphenhydramineS: 12.5mg/5mLC: 25mg, 50mgV: 50mg/mL
1-2 mg/kg IV (max 100mg/dose) 3-5 mkD POo2-6 y/o: 2.5 mL q6/q8o6-12 y/o: 5mL q6/q8
Hydroxyzine HClS: 2mg/mLT: 10mg, 25mg
1-2 mkD q12 PO Adult: 25mg BID -QID
LoratadineS: 1mg/mL, 5mg/5mLT: 10mg
1-2 y/o: 2.5mL OD 2-12 y/o:o<30kg: 5mLo>30kg: 10mL
>12y/o: 1 tab OD
RESPIRATORY MEDICATIONS & BRONCHODILATORS
Aminophylline5mg/mL
3-5 mkD (0.6-0.9mk/hr) LD: 3-6mg/kg x 20-30mins MD: 2mkd q8 MD:o1-9y/o: 0.8 1-1.2hro9-12 y/o: 0.7 0.9hro2-16 y/o: 0.5 q6-8
Example: 20kg = (wt x dose) / preparation (20 x 5) / 5 = 20cc SIVP as LD (20 x 2) / 2 = 8cc SIVP q8 as MD
Hydrocortisone (Solu-Cortef)V: 100mg, 200mg, 250mg
10mkd LD, 4-9mkd MD 10-20 mkD LD 5-6 mkD q8 MD (asthma) 3-5m mk/dose IV
SalbutamolS: 2mg/5mLT: 2mg
0.15-0.30 mkD q6
Terbutaline1.5mg/5mL syrup,5mg/2minebule
0.075 mkd q6 PO 0.01 mkd (max 0.5cc)
DIURETICSAldactone 2-3.5 mkD
FurosemideT: 20,40,60mgV: 20mg/mL
1 mkd q6-12 IV
Acetazolamide (Diamox)T: 250 mg
20 mkD 250 – 375 mg/day
ANTI-HYPERTENSIVES/CARDIAC MEDSCaptopril 0.5-1 mkD q8
Diazoxide 5mg rapid IV push
HydralazineT: 10mg, 25mg, 50mgV: 20mg
0.15-0.3 mkdose q4-6 IV 1-3mkD q4-6 po
NifedipineC: 5mg, 10mg
0.25 mkD q4-q6 PO
AmlodipineT: 5mg, 10mg
5mg/tab OD-BID
PropranololT: 5mg, 10mg
1-2 mkD q6-12
Digoxin 0.05 mg/kg IV/IM
Amiodarone 10mkd 30min-1hr LD
Ca GluconateV: 100mg/mL
25 mkd q8 Dilute 1 mL n 2 mL sterile water
Ca Chloride 0.33/kg (27mg ca/cc)
Ca Carbonate 30-50 mkd q8
Aspirin 65 mkD RHD:o1st 2 weeks: 100mkDo4 weeks: 75mkD
Anti-inflammatory: 60-90 mkD Kawasaki: 100 mkD,q6 (-) Fever: 8-10 mkDs
GASTRO MEDS AND ANTI-ULCERSAl Mg (OH)3 (Maalox) 2-4 tabs 20 mins pre meal and HS
Al Mg (OH)3 + dimethicone 2-4 tsp or tab QID
Bisacodyl (Dulcolax) 6-12 y/o: 5-10 mg
T: 5mgSupp: pedia 5mg, adult 10mg
>12 y/o: 10-15 mg
Hyoscine-N-butylbromide(Buscopan)T: 10mgV: 20mg
12 y/o: 1-2 tab 3-5x a day, max 100mg/day
Infants & young children: 0.3-0.6 mkD
CimetidineT: 200mg, 400mgV: 100mg/mL, 150mg/mL
5 mkD q6 LD, 5-10 mkD q6
RanitidineT: 75mg, 150mg, 300mgV: 25mg/mL
1 mkD q8 Adult: 150mg BID or 300mg OD
DicycloverineD: 5mg/mLS: 10mg/5mLT: 10mg
6 mons-2 y/o: 0.5-1mL QID 2-5 y.o: 2.5-5mL QID 6-12 y/o: 5 mL QID
DomperidoneD: 5mg/mLS: 1mg/mL 5mg/5mLT: 10mg
0.2mL kg/dose q8
Erceflora 1 vial BID x 5 days
Lactulose 2mL/kg/dose q6
OmeprazoleC: 20mg, 40mgV: 40mg
0.6-0.7 mkD OD
Nitrofuroxide(Ercefuryl)S: 218g/5mLC: 200mg
<6 mos: 1 tsp BID >6 mos: 1tsp TID
ProzincD: 0.5-1mL OD (1mL=10mg elemental Zn)S: 2.5-5mL OD (5mL= 20mg elemental Zn)
<6 mos: 10mg >6 mos: 20mg
Racecadotril (Hidrasec) <9kg: 10mg/sachet TID 9-13kg: 10mg/2sachet TID 13-27kg: 30mg/sachet TID >27kg: 30mg/2sachet TID Adults: 100mg/cap TID
MULTIVITAMINS<3 months 0.3mL OD
3-12 months 0.6mL OD1-2 y/o 1.2mL OD2-6 y/o 2.5mL OD
7-12 y/o 5mL OD>12 y/o 20mL or 1 tab OD
IDEAL BODY WEIGHT
Age Kilograms Pounds
At Birth3 kg (Filipinos)
3.35 kg (Caucasians)7
3 - 12 mo Age (mo) + 9 / 2Age (mo) + 10 (F)Age (mo) + 11 (C)
2 - 6 y.o. Age (y) x 2 + 8 Age (y) x 5 + 176 - 12 y.o. Age (y) x 7 – 5 / 2 Age (y) x 7 + 5
LENGTH / HEIGHTLength: recumbent (0-2yo) vs Height: standing (>2yo)
Age Centimeters InchesAt Birth 50 201 year 75 30
2 - 12 yrs Age x 6 + 77 Age x 2.5 + 30
Age Gain in 1st Year is ~ 25cm0 - 3 mo + 9 cm 3 cm/month3 - 6 mo + 8 cm 2.67 cm/month6 - 9 mo + 5 cm 1.6 cm/month
9 - 12 mo + 3 cm 1 cm/month
VITAL SIGNSAGE HR RR BP
Preterm 120-170 40-70 55-75/40-700-3 months 100-150 35-55 65-85 / 45-553-6 months 90-120 30-45 70-90 / 50-65
6mons -1 y/o 80-120 25-40 80-100 / 55-65
1-3 y/o 70-110 20-30 90-105 / 55-703-6 y/o 65-110 20-25 95-110 / 60-75
6-12 y/o 60-95 14-22 100-120 / 60-7512 y/o 55-85 12-18 100-135 / 65-85
HOLIDAY-SEGAR METHOD (MAINTENANCE)
WEIGHT TOTAL FLUID REQUIREMENT0 - 10 kg 100 mL / kg11- 20 kg 1000 + [ 50 for each kg in excess of 10 kg]> 20 kg 1500 + [ 20 for each kg in excess of 20 kg]
LUDAN’S METHOD (HYDRATION THERAPY)
MILD DEHYDRATION
MODERATE DEHYRATION
SEVERE DEHYDRATION
< 15 kg, < 2 y/o 50 cc/kg 100 cc/kg 150 cc/kg> 15 kg, > 2 y/o 30 cc/kg 60 cc/kg 90 cc/kg
D5 0.3% in6-8 hours
1st hr: ¼ Plain LRNext 5-7 hrs:¾ D5 0.3% in
5-7 hours
1st hr: ⅓ Plain LRNext 5-7 hrs:⅔ D5 0.3% in
5-7 hours
SEIZURE: HISTORY TAKING
Pre-ictalWas there any warning before the spell? If so, what was the warning?Did the child complain of abdominal discomfort, fear or any other unpleasant sensations before the spell?What was the child doing before the spell?Was the child asleep or awake prior to the event?Was the child sleep deprived prior to the spell?Were there any triggers for the spell?Was the child well before the spell or was there a fever or illness?
IctalWas the child responding during the spell or was consciousness impaired?Were there any repetitive behaviors during the episode, such as lip smacking, pulling at clothing, and constant rubbing of objects.Did any body movements occur?Was there any perioral cyanosis?What was the child’s skin colour during the event?Did the patient lose continence during the spell?How long did the spell last?How many episodes has the child experienced?How often do the spells occur?
Post-ictalHow did the patient feel after the spell?Did the child remember anything that occurred during the spell?Did the child seem confused and tired after the spell?How long did it take for the child to get back to baseline condition?Did the child suffer from a headache after the spell?
Other questions to ask:Has the child ever had any seizures before? Febrile seizures?Ask about past medical history, developmental history and current medications to rule out a symptomatic seizure.Is there any family history of seizures?
F.R.I.C.H.M.O.N.D.◦ Fluids◦ Respiration◦ Infection◦ Cardiac◦ Hematologic◦ Metabolic◦ Output & Input [cc/kg/h] N: 1-2◦ Neuro◦ Diet
SAMPLE ADMITTING ORDERS
(Please indicate date, time, and weight of the patient) Please admit to room of choice under the service of Dr. _______ Secure consent for admission and management TPR Q shift and record I&O Q shift and record Diet: IVF:
Diagnostics:
Therapeutics: Use CAPITAL LETTERS for the generic name of drugs
Dr. ______ informed of this admission Inform PROD once patient is admitted PJIIC/PSIIC to do complete database Monitor VS Q4 (including BP) WOF: _____ Refer accordingly
PEDIATRICS
PEDIATRICS