FLUIDS and ELECTROLYTES:
>5y;>30 kg- D5LR >15kg- D5LRS
>3y;>15kg-D5NM <15kg-D5 0.3 NaCl,
D5IMB
*to hydrate: wt x deficit / 8hrs
not to hydrate: wt x deficit/8hrs
DEFICIT
<10kg >10kg
MILD 50
30
MOD 100 60
SEV 150 90
MAINTENANCE (24H)
0-3 kg- 75cc/kg
3-10 kg- 100
10-20 kg - 75
20-30 kg - 60
30-40 kg - 50
>40 kg - 40
BPN:
Pls admit
TPR Q4H and record
Diet for age ( if not tachypneic)
Labs:
CBC,CXR,U/A,F/A
IVF:
D5 0.3NaCl 500cc x
MEDS:
Para p.o/IV (10mg/kg)
Ampi ( 50-100 Q8H)
S/O:
MIO Q shift and record
Monitor VS Q4H and record
TSB for fever
W/o for persistence of fever, episodes of
tachypnea and other untoward s/sx
Standby O2 at bedside
Refer prn
t.y.
NEWBORN
0-1day old- 80cc/kg/hr
2-
90
3-
100
4-
110
5-
120
6-
130
7-
140
8-
150
MILD DHN:
30-50 cc/kg/6H D50.3NaCL
MODERATE DHN:
60-90cc/kg/6H
¼ of computed deficit give D5LRx 2 hrs,
the ¾ to be given for the next 6 hrs
D50.3NaCl
SEVERE DHN:
>100cc/kg/6H
1/3 with D5LR x 2 H then 2/3 with
D5O.3NaCl x 6H
NEONATAL PNEUMONIA
Pls admit
TPR Q4H and record
breastfeeding w/( strict aspiration
precaution)
Labs:
CBC,CXR,U/A,F/A, Bld CS
IVF:
MEDS
Ceftazidime
Oxacillin
Amikacin
PAI w/ Salb
S/O:
MIO Q shift and record
Monitor VS Q4H and record
TSB for fever
W/o for persistence of fever, episodes of
tachypnea and other untoward s/sx
Standby O2 at bedside
Refer prn
AMOEBIASIS
Pls admit
TPR Q4H and record
NPO x 4 H (if w/ vomiting)
IVF:
D5LR 1L x ___cc/H
Labs:
CBC,APC; U/A; F/A; S.Na,K,Ca
Meds:
Metro ( 30-50 mkday p.o Q8H)
7.5mkdose iv
15mkdose-loading dose
Diloxanide ( 20-40mkday x 10 days Q8H)
S/O:
MIO Q shift and record
Monitor VS Q4H and record
Vomitus and stool ct sheet @ bedside
TSB for fever
W/o for persistence of fever and any
untoward s/sx
BRONCHIAL ASTHMA
Pls admit
TPR Q4H and record
Diet: NPO if RR>/= 50cpm
Labs:
CBC,APC;U/A; F/A; Chest X-ray PAL view
IVF:
D5 0.3NaCl 500cc
Meds:
para
hydrocortisone ( 5 mkdose Q4H)
S/O:
MIO Q shift and record
Monitor VS Q4H and record
TSB for fever
W/o for persistence of fever, episodes of
tachypnea and other untoward s/sx
Standby O2 at bedside
Refer prd
t.y.
AGE w/ mild DHN
Pls admit
TPR Q4H and record
NPO x 4 H (if w/ vomiting)
IVF:
D5 0.3 NaCl 500cc x ___cc/H + 2 meqs
Kcl/100cc IVF postvoiding
Labs:
CBC,APC; U/A; F/A; S.Na,K,Ca
Meds:
S/O:
FD 100cc PLR now
MIO Q shift and record
Monitor VS Q4H and record
Vomitus and stool ct sheet @ bedside
TSB for fever
W/o for persistence of fever and any
untoward s/sx
Replace GI losses vol/vol w/ PLR
Refer prn
t.y.
DHF III
Pls admit
TPR Q2H and record
DAT w/ no colored foods
IVF:
Labs:
CBC,APC; U/A; F/A; PT,APTT
DNS1Ag; BT w/ Rh typing
Meds:
para
Rani (0.8-1mkdose IV Q8-12H)
0.75-1.5mkdose p.o
S/O:
Fd 150 cc of present IVF
MIO Q 2H and record
Monitor VS QH and record
Request 500cc of FFp of px bldtype after
proper crosmatching
W/o for , narrow pulse pressure,
bleeding episodes and other untoward s/sx
Refer prn
t.y.
DENGUE FEVER
Pls admit
TPR Q4H and record
DAT w/ no colored foods
IVF:
D5LR 1L x ___cc/H
Labs:
CBC,APC; U/A; F/A; PT,APTT
BT w/ Rh typing
DNS1AG
Meds:
none temp
S/O:
MIO Q shift and record
Monitor VS Q4H and record
W/o for , narrow pulse pressure,
bleeding episodes and other untoward s/sx
Refer prn
ANALGESICS/ANTIPYRETIC
PARACETAMOL(Q4H) MEFENAMIC ACID (Q6-8H)
RD: 10-15mkdose po RD: 5-8mkdose 10mkdose IV susp: 50mg/5ml 15mkdose-BFC 125mg/5ml Drps: 100mg/ml Cap: 250mg/500 60mg/0.6mk Syrup: 120mg/5ml ASPIRIN (Q4-6H) 125mg/5ml RD: 10-15mg/kg/dose 350mg/5ml upto 60-80mg/kg/24H Tab: 325mg/tab anti-inflam:
250mg/tab 60-100mg/kg/24H po 500mg/tab Kawasaki: 80-100mkday Amp: 150mg/ml 300mg/ml NIMESULIDE ( BID) IBUPROFEN RD: 2.5-5mkdose RD: 5-10mg/kg/dose 100mg/tab po Q6-8H susp: 100mg/5ml forte: 200ng/5ml cap: 200mg
NEONATAL SEPSIS
Pls admit
TPR Q4H and record
Cont. breastfeeding
IVF:
D50.3 NaCL 500cc x ___cc/H
Labs:
CBC,APC; U/A; F/A; S.Na,K,Ca
Meds:
Ampi ( 50-100 Q8H)
Ceftazidime 95mgIVTT
S/O:
MIO Q shift and record
Daily cord care w/ NSS
W/o for persistence of fever, jaundice
and any untoward s/sx
Phototherapy
Refer prn
t.y.
SEIZURE DISORDER
Pls admit
TPRQ4H and record
NPO temp
Labs:
CBC,APC; U/A;F/A; hgt now then Q6H
while NPO
IVF:
D5 0.3NaCl 500cc + 2 meqs KCL/100cc
IVF postvoiding
Med:
none temp
S/O:
MIO q shift and record
monitor VS Q4H and NVS Q H and record Seizure precaution at bedside Standby O2, padded tongue depressor at bedside
Replace GI losses vol/vol w/ PLRS as sidedrep
Refer prn
BFC
Pls admit
TPRQ4H and record
NPO temp
Labs:
CBC,APC; U/A;F/A; hgt now then Q6H
while NPO
IVF:
D5 0.3NaCl 500cc + 2 meqs KCL/100cc
IVF postvoiding
Med:
Para; Ibup; diazepam ( 0.2 mkdose)
S/O:
MIO q shift and record
monitor VS Q4H and NVS Q H and record Seizure precaution at bedside Standby O2, padded tongue depressor at bedside
Replace GI losses vol/vol w/ PLRS as sidedrip Refer prn
RHEUMATIC FEVER
Pls admit
TPR Q4H and record
DAT
Labs:
CBC,APC ESR, CRP
IVF:
D5IMB 500cc x
Meds:
Pen G Q6H IVTT ANST ( 92,000)
s/o:
MIO Q4H and record
Monitor V/S Q 4H and record
Complete bedrest w/ no bathroom
privileges, cyanosis Refer for
persistence of chest pain
refer prn.
MTV: ASCORBIC ACID drops 100mg/ml: <3mos- 0.3ml/day 3-12mos- 0.6ml/day 1-2y.o-1.2 ml/day syrup: 100mg/ml 2-6y.o- 5ml/day 7-12y.o- 10ml/dayVit b complex + lysine + beclizine (Appebon Syrup) 2-6y.o- 1-2tsp OD 7-14y.o-2-4 tsp OD IRON 1mkday OD-prophylactic 3-6mkday BID-therapeutic ZINC 10mg-infants 20mg->2y.o VITAMIN A 6-11mos-100,000IU- 1 dose 12-71mos-200,000IU LP ORDERS flat on bed x 4H NPO x 4H
send the ff sp to lab as follows: TT#3-CSF cell ct, diff ct TT#2-CSF,sugar and protein TT#1-CSF, Gs/CS, AFB, KOH RBS now
monitor VS Q15mins until stable Refer px for any untoward s/sx S/P EXTUBATION ORDERS Nebulize w/ Racemic epi now extubate px now
neb w/ racemic epi Q15 mins x 3 doses suction secretions
neb w/ salb, 1 neb Q6H NPO x 6H
CXR, ABG 6H post extubation O2-6-10 lpm
WOF retractions,tachypnea, and other s/sx, Racemic Epi: PNSS-4.7 Epi: 0.3(?)ml/5ml
ANTI-EMETIC/ANTI-SPASMODIC
METOCLOPRAMIDE NIFUROXIDE (Ercefuryl) RD: 0.5mkdose po <6mos- 10ml O.2mkdose IV >6mos-5ml Amp: 10mg/2ml, Adult- 1 cap Q6H 5mg/2ml Susp: 220mg/5ml syr: 5mg/5ml Cap: 200mg tab: 10 mg
DICYCLOVERINE HCl HYOSCINE N-BUTYL (Q8H) BROMIDE(Q6-8H) RD: 2.5-5mg/kg/day RD: 0.15mkdose 6mos-2y.o- o.5-1ml Amp: 20mg/ml 2yo-5yo- 2.5-5ml tab: 10 mg drops: 5mg/ml, 15mg/ml syr: 2mg/ml, 10mg/ml tab: 10 mg DOMPERIDONE (motilium)-Q8H *15 RD: O.3mkdose
dyspepsia: Adult-1 tab/2tsp Q8H susp: 1mg/ml children; 2.5ml Q8H tab 10mg N/V: Adult-2tab/4tsp Q6-Q8H Children 5ml Q6-Q8H dyspepsia n/v 10kg 2.5ml 5ml 20kg 5ml 10ml 30kg 7.5ml 15ml Adult 1 tab 2 tabs *to take 15 mins before meals susp- 1mg/ml
ANTACIDS
RANITIDINE (Q8-12H) FAMOTIDINE
RD: 0.75mkdose p.o (Q12H/ IV-Q8H) 0.8-1 mkdose IV RD: O.2mkdose Amp: 25mg/ml amp: 25mg/2ml 50mg/5ml tab: 20mg/40 Tab: 150mg/300mg CIMETIDINE (Q4-6H) RD: 10-15mkday <1y.o: 20mkday 1-12y.o- 20-25mkday liquid: 100mg/5ml Amp:150mg/ml 100mg/ml tab: 200mg 400mg AlMg (Maalox)- Q6H 2-4tabs
*Take 30 minutes-1 hour after meal at bedtime susp: 180 ml; 355ml
Tab: Chewable
ANTI-DIARRHEALS
PAROROMYCIN (Humagel)
RD: 20-30 mkday 3-4 divided dose 150mg/cap, 150mg/5ml RACECADOTRIL (Hidrasec) 1 mos onwards RD: 1.5mg/kg/day Q8H BW hidrasec sachet <9kg 10mg 1 sachet 9-13kg 10mg 1 sachet 13-27 30mg 1 sachet >27kg 30mg 2 sachet Adult 100mg/cap Q 8H
ERCEFLORA- Bacillus clausii
>1mos- 1-2 vials/day 2-11y.o- 1-2 vials/day Adult- 2-3 vials/day NIFUROXAZIDE (Ercefuryl) <6mos- 1 tsp BID >6mos-1tsp TID AMEBICIDES METRONIDAZOLE- Q6H RD: 30-50 mkday po 7.5 mkdose IV 15 mkdose- loading dose vial-5mg/ml IV infusion: 500mg/100ml Susp: 125mg/5ml 200mg/5ml FURAZOLIDONE RD: 4-7 mkday Liquid: 16.7mg/5ml Susp:50mg/ml PARAMOMYCIN RD: 20-30 mkday susp: 150mg/15ml ETOFAMIDE ( kitnos) RD: 15-20mkday x 3 days Q 12H Susp: 100mg/5ml Tab: 200mg; 500mg ANTIHELMINTHICS MEBENDAZOLE
500mg/tab single dose
100mg/tab or 5 ml BID x 3 consecutive days 20mg/ml susp: 5 ml BID x 3 consecutive days 50mg/ml susp: 10ml SD
Enterobiasis ( 100mg or 5 mg SD rpt 2 or 4 wks) Susp: 20mg/ml, 50mg/ml
Tab: 100mg;500mg *deworm @ 2-4 years old
PYRANTEL PAMOATE RD: 10-20 mkdose Susp: 125mg/5ml tab: 125mg; 850 mg ALBENDAZOLE RD: 75 mkday susp: 200mg/5ml tab: 400mg QUINOLONES CIPROFLOXACIN-BID vial: 100mg/50ml 200mg/100ml 400mg/200ml tab: 250mg, 500mg ANTIHISTAMINE
HYDROXYZINE HCL ( Iterax) DESLORATADINE
Q12H x 5 days (Aerius) RD: 1mg/kg/day 6-11 mos- 2 ml OR wt /4 1-5yo- 2.5ml Syrup: 2mg/ml 6-11yo-5ml Tab: 10 mg; 25mg >/=12yo- 10ml amp:5mg/ml syr: 2.5ml/5ml CHLORPHENAMINE MALEATE tab: 5 mg Q8H RD: 0.2mkdose DIPHENHYDRAMINE HCL Amp: 10mg/ml RD: 3-5mkdose PO vial: 10mg/ml 1mkdose IV syrup: 2mg/5ml syr: 12.5mg/5ml tab: 4 mg Cap: 25mg, 50mg *20kg-1/2 amp IM IV/IM: 50mg/ml >20kg- 1 amp IM
CETIRIZINE diHCL- OD-BID RD: 0.25-0.27 mkdose drops: 10mg/ml 2.5mg/ml soln: 1mg/ml syr: 5mg/5ml tab: 10 mg BRONCHODILATORS SALBUTAMOL-TID RD: 0.13-0.15 mkdose Syr: 2mg/5ml 100mg/5ml amp: 1mg/ml tab: 2 mg TERBUTALINE- BID-TID 1-15yo-2.5ml <3yo- 0.075 mkdose syr: 1.5mg/5ml soln; 2.5mg/5ml amp: 0.5mg/ml tab: 2.5mg BAMBUTEROL 6-12yo- 5mkdose oral soln: 1mg/ml Tab: 10mg AMINOPHYLLINE/THEOPHYLINE 3-5mkdose 80mg/5ml; 125mg/tab,175mg/tab MUCOLYTIC CARBOCISTEINE- Q8H-Q12h RD: 30-50mkday drops: 50mg/5ml Syr: 100mg/5ml 250mg/5ml Susp: 250mg/5ml Cap: 500mg <3mos- 0.25ml 3-5mos- 0.5 6-8mos-0.75 9-12mos- 1 5y.o- 5 ml AMBROXOL-Q8H RD: 1.2-1.8mkday liq: 15mg/5ml ; 30mg/5ml Soln for inhalations: 15ml/2ml Amp: 15mg/2ml
Ped drops: 6mg/ml tab: 30mg; retard cap 75 ERDOSTEINE- Q12H RD: 10mkday 10-20kg, 2-6yo- 2.5ml 21-30kg, 7-12yo- 5ml >30kg, >12yo-5ml TID/ 7.5ml BID susp: 115mg/ml; cap: 300 mg AMINOGLYCOSIDES GENTAMYCIN- OD-BID 5-8mkday AMIKACIN OD-BID RD: 12-15mkday- 15mkdose OD VANCOMYCIN: RD: 15mkday ANTIHYPERTENSIVE FUROSEMIDE RD: 0.5-1mkdose Amp: 20mg/2ml Tab: 4omg HYDRALAZINE RD: 0.1-0.2mkdose Amp: 20mg/ml tab: 10mg; 15mg;50mg ASPIRIN 75-100mkday NIFEDIPINE-Q4-6H RD: 10mkdose max: 10mg/kg/24H SPIRONOLACTONE
1-3.3mkday QID p.o
ANTI-TB DRUGS I-10;R-15;S-20;E-25;P-30 ISONIAZID RD: 5-10 syr: 100mg/5ml 200mg/5ml tab: 100mg;200mg;300mg RIFAMPICIN RD: 10-15mkday drops: 100mg/ml Cap: 300; 450mg PYRAZINAMIDE RD: 15-30mkday susp: 250mg/5ml tab: 500mg ETHAMBUTOL: RD:15-25mkday Syr; 125mg/5ml tab: 400mg STREPTOMYCIN RD: 15-20mg/kg/day vial: 1gm STEROIDS PREDNISONE-BID AMINOPHYLLINE
RD: 1 mkday BID; 2mkday OD LD: 5-7mkdose susp: 10mg/5ml MD:3-5mkdose syr: 15mg/5ml; 20mg/5ml
Tab: 1mg, 5mg,10,20,30,50
DEXAMETHASONE
RD: 0.5-1mkdose
0.3mkdose initial, then 0.1 mkdose 1-2mg/kg Q6H x 4 doses
*xtubate on 3rd dose
COMBIVENT-HYDROCORTISONE 200ug Ipatropium
RD:5mkdose Q6-8H >2y.o-5-8drps LD: 10mkdose 2Y-3-3 drps MD: 5 ( max 100) >4y.o-20drps Vial inj: 100mg; 250mg; 500mg PROCATEROL (Meptin)-BID-TID RD: 0.25mkdose OR 0.25x wt. syr: 5 meq/ml
tab: 25meq, 50meq
ERDOSTEINE (Ectrin/Zertin)
Dobu- premix 0.06-1000=250/250in D5W 0.03-2000 ANTI-TB DRUGS I-10;R-15;S-20;E-25;P-30 ISONIAZID AMANTADINE HCL RD: 5-10 RD: 4.4-8.8mkday syr: 100mg/5ml syr: 50mg/5ml 200mg/5ml tab:100mg tab: 100mg;200mg;300mg RIFAMPICIN RIBAVIRIN RD: 10-15mkday RD: 10mkdose drops: 100mg/ml Syr; 50mg/5ml Cap: 300; 450mg Tab: 100mg PYRAZINAMIDE RD: 15-30mkday susp: 250mg/5ml tab: 500mg ETHAMBUTOL: RD:15-25mkday Syr; 125mg/5ml tab: 400mg STREPTOMYCIN RD: 15-20mg/kg/day vial: 1gm MACROLIDES ERYTHROMYCIN-Q8H COTRIMOXAZOLE-BID RD: 35-50mkday RD: 5-8mkday granules: 200mg/5ml 8-UTI; !0-BPN 400mg/5ml susp: 200mg/40mg/5ml- drops: 100mg/ 2.5ml (40mg/5ml) (wt/2) tab: 250mg; 500mg 400mg/80mg/5ml- CLARITHROMYCIN-Q12H (80mg/5ml) (wt/4) RD: 7.5 mkdose tab: 400mg/80mg 15mkday 800mg/100mg Susp: 125mg/5ml tab: 250; 500mg ROXITHROMYCIN-OD-BID Adult: 150mg/tab; 300mg/tab Q12H children: >40kg kiddie tab: 100mg AZITHROMYCIN-OD-BID RD: 15-20mkday susp: 200mg/5ml tab: 250mg; 500mg vial: 500mg CHLORAMPHENICOL-Q6H RD: 50-100mkday 75 mkday ( Enteric fever) FT infant>/= 2wk- 25-50mg/kg/day PT- 25mg/kg/day vial-1g susp: 125mg/5ml cap: 250mg; 500mg ANTIFUNGAL NYSTATIN-Q6H
adult and children: 4-6ml infant: 2ml tab: 500,000 U Susp: 100,000U/ml AMPHOTERICIN B RD: ).3-0.7mkday slow IV infusion *250mcg/kg/day-1 mg/kg/day Vial 50mg/5ml; 2mg/ml Cap: 50mg; 100mg; 200mg FLUCONAZOLE-OD RD: 3-6mkday vial 3 mg/ml Cap: 50, 150mg, 300mg GRISEOFULVIN Tab: 125mg/500mg KETOCONAZOLE x 5 days OD Adult 200mg/tab 5-12y 100mg/tab 1-4y 50mg/tab CEPHALOSPORINSl 1st Gen: CEFALEXIN-Q6H RD: 30-50 mkday po 50-100mkday IV drops: 100mg/ml Susp: 125mg/ml 250mg/5ml Cap: 250mg; 500mg CEFAZOLIN RD: 50-100mkday IV x 3 doses vial: 250mg Inj: 500mg; 1 g 2nd gen: CEFACLOR-Q8H RD: 20-40mkday drops: 50mg/ml susp: 125mg/5ml 250mg/5ml Tab: 315mg; 750mg (BID) Cap: 500mg CEFUROXIME-Q6-8H RD: 20-40mkday po 50-100mkday IV susp: 125mg/5ml 250mg/5ml tab: 250mg; 500mg inj: 250mg; 750mg; 1.5 g CEFAMANDOL RD: 50-100mkday CEFOXITIN RD: 50-100mkday IV CEFPROZIL RD: 20-40mkday powder: 125mg/5ml 250mg/5ml tab: 250mg; 500mg CEFOTIAM RD: 50-100mkday tab: 200mg vial: 0.5g; 1 gm CEFIXIME-Q12H RD: 3-6mkday po 15mkday drops: 20mg/ml SUSP: 100MG/5ML Cap: 100mg; 200mg CEFDINIR RD: 9-18mkday Cap: 100mg 3rd GEN CEFOPERAZONE RD: 100-150mkday IV Vial: 1.5g DOPAMINE DRIP (200mg/250ml-800conc) 0.0375/26.6 (400mg/250ml-1600conc)0.075/13.3 wt X RD X 60 ( 0.075) Shortcut: wt x RD 13.3 (800-conc) wt x RD 26.6 (1600-conc)
to Check: AD: dose given x Prep/60/wt OR wt x RD x 140D/ 1600/24 LEVOPHED 4mg/4ml; 2mg/ml e.g 2mg/ml 2/100 x 1000=20—concn (Wt x dose x 60) = ml concn To check: ml x conc/60/15=dose FUROSEMIDE DRIP 20mg/2ml **4ml +20cc PNSS to run @ 1cc/H (wt)15 x (Dose)0.1 x 24 36 x 2/20=3.6 3.6/4ml=.9 or 1 cc Prep: 10mg/ml amp ( 2 m) Dose:
-infant and child-0.05mg/kg/H (titratr to clinical effect) -adult 0.1mg/kg/H (max: 0.4mg/kg/H)
wt(kg) x dose x 24= mg in 24 ml of NS to make: 1 ml/H=0.1mg/kg/H wt(kg) x dose x 24 x 5= mg in 120 ml NS to make: 5 ml/H=0.1mg/kg/H *20mg furo + 20cc distilled water to make conc of 1 mg/ml infusion rate: 0.05 x wt e.g: 0.05 x mgx 1=4cc DOBUTAMINE DRIP 2.5-15 mcg/kg/min(max: 40mcg/kg/min) peak effect:10-20min prep: 12.5mg/ml x 20ml/vial=250mg/250ml (vial) Premix: 1000mcg/ml in 250ml=250mg/250ml(1mg/ml) 2000mcg/ml in 250 ml= 500mg/250ml (2mg/ml) wt x RD x60 2000 OR wt x RD x 1400/12500 OR 6 x wt in kg=___mg in 100ml(1mcg/kg/min) e.g: 250mg in D%W 250cc(1mg/ml) mcgtts/min=(wt x DD)/16.6 = wt x DD xO.O6 500mg in D5W 250cc(2mg/ml) ugtts/min=(wt xDD)/33.2 =wt x DD x 0.03
*to check: :7.5- Actual x 2000/60/wt actual x conc/60/wt C'EFTRIAXONE-BID RD: 50-100mkday Vial: 500mg; 1g; 250mg CEFTAZIDIME RD: 30-50mkday IV Vial: 250mg; 500mg; 1g; 2g CEFPODOXIME 3-10mkday susp: 50mg/5ml tab: 100mg 4th Gen CEFEPIME-OD-BID RD:50-100 Vial: 500mg; 1 gm; 2gm
DRIP FORMULA
6 x wt (kg)xmcg/kg/min= mgin100ml of
D5W/NS
Ml/H
isoproterenol/Epinephrine/Norepi:
.6 x wt (kg)= mgin100ml o
* 1 ml/H will deliver o.1 mcg/kg/min
Dopamine/dobutamine/amrinone/Nitropr
usside
6 x bodywt in kg= mg in 100ml
*. 1 ml/H will deliver 1 mcg/kg/min
dopa/dobu:
6 x body wt (kg) =# mg to add to diluents
to make 100ml volume
ANTICONVULSANTS/SEDATIVES
PHENOBARBITAL LD: 10mkday
MD; 5 mkday ( max 25 mkdose)
MIDAZOLAM RD:0.2mkdose tab: 15mg amp: 5mg/ml, 5/5,15/3 DIAZEPAM RD: O.2-O.8mkdose PHENYTOIN LD: 10mkdose MD: 5 mkday Susp: 30/5,125/5 Cap 30,100 Dobu- premix 0.06-1000=250/250in D5W 0.03-2000 wt x dose x 0.06/0.03
EPINEPHRINE DRIP wt x 0.6mg=mg added to 100mgD5W 1cc/H= 0.1 ug/kg/min 5cc/H-0.5cc/min 10cc/H-1mg/kg/min ml/H= wt x dose x 60 conc 0.1mkd/.1cc/kg/dose INSULIN DRIP 0.1- 1cc or ml/H wt x 0.1 x 24= # of ml/cc of insulin to be added to NSS to make 24 ml soln to run for 24H
MIDAZOLAM DRIP prep: 5mg/ml amp Dose: intermittent 0.05-0.15mg/kg/dose continuous 1-2mcg/kg/dose 6 x wt (kg) x mcg/kg/min= mg in 100ml of D5W/NS ml/H
max total dose: 10mg (intermittent)
Can cause respiratory dpression,hypotension,bradycardia
NICARDIPINE DRIP
prep: 2.5mg/ml= 25mg/10ml ampule Dose:
child 0.5-5mcg/kg/min (titrate to clinical effect) Adult: start with 5mg/H, increase dose as needed by 2.5mg/H Q 5-15 min (max dose:15mg/h) decrease by 3mg/H as needed to maintain desired response AMINOPHYLLINE DRIP
LD: 5mg/kg BW in 30cc D5W in a soluset (if px is not maintained on oral theophylline)
Or
25 mg/vial dilute 1 ml + 4ml NSS to make 5 mg/ml solution. Aspirate ___ml give per i.v. infusion for 30 min as LD ( 5mg/kg)
D5w 250 cc + Aminophylline 250mg/amp at __ugtts/min maint drip; 0.4-0.8 mg/kg/H
formula ugtts/min=dose x BW
Note: maintenance infusion ratemust be induced to 0.2-0.3mg/kg/H for elderly patients, pregnant patients and those in CHF,liver disease or cor pulmonale watch out for hypoglycemia and tachycardia
AMIODARONE DRIP prep:50mg/ml ampule Dose;infant and child
5mg/kg over 30 min followed by infusion starting at 5mcg/kg/min
Max dose: 10mcg/kg/min or 20 mg/kg/H must be diluted in D5W
Infusion concentration should not exceed 2 mg/ml wt (kg) x dose x 60 x 50= mg in 50ml of D5W 1000 to make: 1ml/H=1mcg/kg/min INSULIN DRIP prep:1U/ml ampule Dose:
infant and child 0.1Ukg/H (titrate to clinical effect) glucose drop=80-100mg/dl/H wt (kg) x dose x 24 = U in 24ml NS to make: 1ml/H=0.1 U/kg/H OR wt(kg) x dose x 24 x 5= U in 120ml of NS to make: 5ml/H=0.1U/kg/H NICARDIPINE DRIP prep: 2.5mg/ml= 25mg/10ml ampule Dose:
child 0.5-5mcg/kg/min (titrate to clinical effect) Adult: start with 5mg/H, increase dose as needed by 2.5mg/H Q 5-15 min (max dose:15mg/h) decrease by 3mg/H as needed to maintain desired response IVIG
dose: 2 g/kg in 12 H or 400mg/kg/dose x 5d 2.5g/vial,dilute w/ 50 ml diluents to make 50mg/ml,administer the ff: Test dose: 0.5 ml/kg/H x 15 min 1 ml/kg/H x 15 min 1.5 ml/kg/H x 15 min 2 ml/kg/H x 15 min 2.5 ml/kg/H x 15 min 3 ml/kg/H x 15 min 3.5 ml/kg/H x 15 min 4 ml/kg/H x 15 min
If tolerated infuse the rest at ___cc/H for 10H watch out for headache,flushing,hypotension,fever and chills AMINOSTERIL 0.5/kg- inc until 3g/kg wt x RD x 100/6%/24 OR wt. x RD /o.694
* start 1 g x 48H then resume at 2g(?)
DUET (double vol exchange transfusion) bld vol- 80cc/kg e.g wt- 3kg 3 x 80 x 74-60/74=3360/74 45cc to be exchanged 160-180cc/kg/FWB mothers bld type-wt 80 x 2 INDICATIONS: S-sepsis S-S.biliruubin >20mg/dl H-hypoxia and acidosis H-Hemolytic dose of NB A-ABO incomoatibility P-Prematurity COMPLICATIONS: V-Vascular embolism I-Infection C-Cardiac arrhythmia vol overdose CP arrest E-Electrolyte imbalance FiO2- 100% target FiO2 x TFR (S) 79 ABG-no correction if <10 B.D * O Correction of hyponatremia 1ml=2.5 meqs NaCl wt= 1.8kg S.Na=131.4 d- A x wt x 0.6 (140-131.4x1.8 x0.6=9.2meqs) + wt x 3=maintenance ( 1.8 x 3= 5.4) ½ -4.6 – 1.8-6.4 ¼-2.3- 1.8-4.1 ¼- 2.3-1.8-4.1 1st shift: D5w-6.6 D5IMB-50 NaCL-2.5? Hypokalemia D-A x wt x 0.3 + (wt x 2) ? wt x 0.2 x 8 x 3 x 2 x wt SK- <3-5%-.05 <2.5-10%-0.10 wt x 0.05 x 50 + wt x (2 /maintenance) Age Consider photo photo Exchange transfusion if Extensive photo Exchange transfusion if INtensive photo </=24d 25-48 >/=12 (170) >/=15 (260) >/=20 (340) >/=25 (430) 49-72 >/=15 (260) >/=18 (310) >/=25 (430) >/=30 (510) >72 >/=17 (290) >/=20 (340) >/=25 (430) >/= 30 (510)
RESPONSE TO PHOTO *check rebound B2 for 12-24H after disccharge
Bil Age Action
<18 - Wean to singl photo
</=18 - D/C home </=14 49-7//2 D/Cphoto </=15 >72’ D/C photo Age in hrs TSB (mg/dl) 24-48H <15 15-<20 20-<25 >/=25 49-72 <18 18-<24 25-<30 >/=30 >72 <20 20-<25 25-</=30 >/=30
Tx/rec OPD PHOTO INTENSIVE PHOTO
PHOTO/ exc trans
NAHCO3
BE x wt. x 0.3 or 1 meq/kg can be given IV push or drip 50mcg/kg Na >1-2 neq/kg HYPONATREMIA D-A x wt x 0.6 + (2-3) maintenance HYPOCALCEMIA K/K(?)- 0.1 to 0.3meqs/k/H N K of body=50meqs K/R-meqs KCL/# hrs/wt ABG-no correction if <10 B.D CORRECTED WBC: e.g RBC=7500=75000/500-15 for evry RBC=1 WBC WBC=37-15=22 corrected RBC
