Pedia Notes-print2.docx

FLUIDS and ELECTROLYTES: >5y;>30 kg- D5LR >3y;>15kg-D5NM

>15kg- D5LRS <15kg-D5 0.3 NaCl, D5IMB *to hydrate: wt x deficit / 8hrs not to hydrate: wt x deficit/8hrs DEFICIT MILD MOD SEV

<10kg 50 100 150

>10kg 30 60 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

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 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.

NEWBORN 0-1day old- 80cc/kg/hr 290 3100 4110 5120 6130 7140 8150 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

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.

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 t.y.

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.

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

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.

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.

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.

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

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:

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 sidedrip Refer prn

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

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

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 f w/ flatulence- AlMG + dimeticone (maalox plus)

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/day Vit 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

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

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

ANTIHISTAMINE

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 HYDROXYZINE HCL ( Iterax)

Q8H RD: 0.2mkdose Amp: 10mg/ml vial: 10mg/ml syrup: 2mg/5ml tab: 4 mg *20kg-1/2 amp IM

DIPHENHYDRAMINE HCL RD: 3-5mkdose PO 1mkdose IV syr: 12.5mg/5ml Cap: 25mg, 50mg 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

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

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

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

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

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

susp: 115mg/ml; cap: 300 mg

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 COMBIVENTHYDROCORTISONE 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) 175mg/5ml-10mkday BID; 300mg/cap BID

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

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

CEPHALOSPORINSl 1st Gen: CEFALEXIN-Q6H RD: 30-50 mkday po 50-100mkday IV

CEFAMANDOL RD: 50-100mkday CEFOXITIN RD: 50-100mkday IV CEFPROZIL RD: 20-40mkday drops: 100mg/ml powder: 125mg/5ml Susp: 125mg/ml 250mg/5ml 250mg/5ml tab: 250mg; 500mg Cap: 250mg; 500mg CEFOTIAM CEFAZOLIN RD: 50-100mkday RD: 50-100mkday IV tab: 200mg x 3 doses vial: 0.5g; 1 gm vial: 250mg CEFIXIME-Q12H Inj: 500mg; 1 g RD: 3-6mkday po 2nd gen: 15mkday CEFACLOR-Q8H drops: 20mg/ml RD: 20-40mkday SUSP: 100MG/5ML drops: 50mg/ml Cap: 100mg; 200mg susp: 125mg/5ml CEFDINIR 250mg/5ml RD: 9-18mkday Tab: 315mg; 750mg (BID)Cap: 100mg Cap: 500mg 3rd GEN CEFUROXIME-Q6-8H CEFOPERAZONE RD: 20-40mkday po RD: 100-150mkday IV 50-100mkday IV Vial: 1.5g susp: 125mg/5ml 250mg/5ml tab: 250mg; 500mg inj: 250mg; 750mg; 1.5 g 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)

Dobu- premix 0.06-1000=250/250in D5W 0.03-2000

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

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

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

ANTICONVULSANTS/SEDATIVES

MACROLIDES ERYTHROMYCIN-Q8H RD: 35-50mkday granules: 200mg/5ml 400mg/5ml drops: 100mg/ 2.5ml tab: 250mg; 500mg CLARITHROMYCIN-Q12H RD: 7.5 mkdose

COTRIMOXAZOLE-BID RD: 5-8mkday 8-UTI; !0-BPN susp: 200mg/40mg/5ml(40mg/5ml) (wt/2) 400mg/80mg/5ml(80mg/5ml) (wt/4) tab: 400mg/80mg 800mg/100mg

15mkday 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

DRIP FORMULA 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

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) Dobu- premix wt x RD x60 0.06-1000=250/250in D5W 2000 0.03-2000 OR wt x dose x 0.06/0.03 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

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

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

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

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

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

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 NAHCO3 1 ml/kg/H x 15 min BE x wt. x 0.3 or 1 meq/kg 1.5 ml/kg/H x 15 min can be given IV push or drip 2 ml/kg/H x 15 min 50mcg/kg 2.5 ml/kg/H x 15 min Na >1-2 neq/kg 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 (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 Correction of hyponatremia 2.5mg/Hmeqs Q 5-15 min (max dose:15mg/h) decrease by 1ml=2.5 NaCl 3mg/H as needed to maintain desired response 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

HYPONATREMIA D-A x wt x 0.6 + (2-3) maintenance

1st shift: D5w-6.6 D5IMB-50 NaCL-2.5? Hypokalemia D-A x wt x 0.3 + (wt x 2) ?

HYPOCALCEMIA K/K(?)- 0.1 to 0.3meqs/k/H N K of body=50meqs K/R-meqs KCL/# hrs/wt

wt x 0.2 x 8 x 3 x 2 x wt SK- <3-5%-.05 <2.5-10%-0.10

wt x RD x 100/6%/24 OR wt. x RD /o.694 * start 1 g x 48H then resume at 2g(?)

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 0.20.3mg/kg/H for elderly patients, pregnant patients and those in CHF,liver disease or cor pulmonale watch out for hypoglycemia and tachycardia

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

Consider photo

photo

Exchange transfusion if Extensive photo

FiO2- 100% target FiO2 x TFR (S) 79

Exchange transfusion if INtensive photo


>/=12 (170)

>/=15 (260)

>/=20 (340)

CORRECTED WBC: e.g RBC=7500=75000/500-15 for evry RBC=1 WBC WBC=37-15=22 corrected RBC

wt x 0.05 x 50 + wt x (2 /maintenance)

ABG-no correction if <10 B.D *O Age

ABG-no correction if <10 B.D

>/=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


-

D/C home


49-7//2

D/Cphoto


>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

Tx/rec

OPD

PHOTO

INTENSIVE PHOTO

PHOTO/ exc trans