Más contenido relacionado Pediatric dosage2. Common Dose
一般劑量
• > 20kg :錠劑磨粉
–
–
–
–
40Kg : 1 # po qid
30Kg : 1 # po tid
20Kg : 1/2# po qid
10Kg : 1/4# po qid
若可吞 , 不用磨
• < 20kg :糖漿
–
–
–
一般咳嗽 ˙ 流鼻水糖漿多為 BW/4 c.c.
退燒 ˙ 抗生素糖漿多為 BW/2 c.c.
例外: 止瀉藥水 ˙ 氣管擴張劑糖漿 ˙ 紅黴素類糖漿
3. Antipyretics 退燒藥
• Scanol (500mg/1#) :
– 10 ~ 15mg/kg/dose q4h ~ q6h (50 mg/kg/day)
• Antiphen (Acetaminophen syrup) :
– BW/2 ㏄ q4h prn if BT ≥ 38.5℃(120mg/kg/dose)
38.5℃
• Sconin(Ibuprofen syrup) : NSAIDs
– ≥ 38.5℃ : BW/4 cc q6h ; 39.5℃ : BW/2 cc
q6h
• Diclofen (supp)( 12.5mg ) :
– < 6kg
1/3# supp q6h prn if BT ≥ 39.5℃
– 6 ~ 10kg 1/2# supp q6h prn if BT ≥ 39.5℃
– > 10kg
1# supp q6h prn if BT ≥ 39.5 ℃
4. Antitussives and expectorants
止咳化痰藥
• Medicon-A ( 20mg/cap ): Common dose
• Medicon syrup (Dextromethorphan)
(2.5mg/ml) :
– BW/4 cc po qid ,1-2mg/kg/day q6-8h
• Mucosolven (Ambroxol liq.)(3mg/ml) ( 化痰 ):
– BW/4 cc qid ;<2 y/o:2.5~5 cc bid; 2~5y/o:2.5~5 cc tid
; 5~10y/o 5~10cc tid
• Unitussin (Glyceryl guaiacolate)(20mg/ml)( 化痰
> 止咳 ):
– BW/4 cc qid ; 2~6y/o:2.5~5 cc qid ; 6~12y/o 5~10cc
qid
5. Antihistamines & Decongestants
流鼻水 , 鼻塞‚抗過敏藥
• Cyproh syrup (Cyproheptadine 0.4 mg/ml) :
— BW/4 cc po qid
• Cyproh tablet ( 嗜睡 , 增加食慾 ) : Common
dose
• Demin (Chlorpheniramine 0.5mg/ml ) :
— BW/4 cc po qid
• CTM tablet ( 嗜睡 , 使痰更濃 ) : Common dose
• Venalin (Diphenhydramine 30mg/amp): 10-50mg
IV or IM q2-3h, max 400mg/day (1mg/kg/dose)
– Urticaria, angioedema or EPS 時可用
6. Antihistamines & Decongestants
流鼻水 , 鼻塞‚抗過敏藥
• Clarityne(10mg/tab) :
– < 30kg 1/2# po qd ;> 30kg 1# po qd
• Clarityne syrup (Loratadine 1mg/ml 60ml )
– < 30kg 5ml po qd ;> 30kg 10ml po qd
• Allegra (60mg tab) : 1# bid ->1# qd
7. Bronchodilator 氣管擴張劑
• Bricanyl (Terbutaline 2ml/5mg ) :
– <20Kg:½ # in N/S 3ml for neubrilization q6h;
>20Kg:1 # in N/S 3ml for neubrilization q6h
• Ventolin (Salbutamol neubule 2.5ml/5mg) :
– The same with Bricanyl;
– Tab(2mg): 0.1 mg/kg/dose up to 2 mg PO tid
• Berotec(Fenoterol HBr) syrup(0.5mg/ml) :
– BW/4~BW/5 cc tid ;<1 y/o:2.5 cc bid; 1~6y/o:2.5~5
cc tid ; 6~14y/o 5cc tid
• Meptin(Procaterol) syrup(mg/ml) :
– <6 y/o:BW/4~BW/5 cc q12h; >6y/o:5 cc po q12h
8. Bronchodilator 氣管擴張劑
• Xidanef (Ketotifen)100 ml syrup:
– 2.5-5ml bid
• Atrovent (Ipratropium UDV 0.5mg/2ml):
– 1 vial q6h prn
• Epinephrine(1:1000) :
0.01ml/kg/dose(Max 0.5ml) q15minSC
9. Xanthines 茶鹼類
• Aminophylline
• S.E : nausea, vomiting, insomnia, tachycardia
• Loading dose : 5(2~6)mg/kg/dose iv drip for 20
~ 30 min;Maintain : 1mg/ kg/hr
•
Infants=> 0.2~0.9mg/kg/hr,
1-9y/o=>1~1.2mg/kg/hr;
•
9-16y/o=>0.8~1mg/kg/hr;
•
youngsmoker:0.8~1mg/kg/hr,
•
nonsmoker:0.5~0.7mg/kg/hr
• Apnea of prematurity : 4~6mg/kg iv 30 min ,then
maintaince : 1.5~3 mg/kg/dose iv q8-12h
11. Steriods 類固醇
• Decadron : 0.1 mg/kg/dose im q8h.
• Rinderon (4mg/ml): 0.1 mg/kg/dose im,iv q8h
• Prednisolone(5mg/tab):1~2mg/kg/day po
qd~qid ; max:4#~8#(20~40) mg/day for 3~5 day.
• 40kg 給 Pulmicort (steroid ,200mcg/dose) :
– 1~2 puff bid for 3 month for prevent asthma( 可有效
預防氣喘再發 )
12. Urticaria 蕁麻疹
• Benadryl (Diphenhydramine):1mg/kg IM
• Decardon (Dexamethasone):
– 0.1mg/kg/dose IM
• Periactin tab :普通劑量 po qid.
• Prednisolone(5mg/tab.) :1~2 mg/kg/day
13. Antidiarrheals, digestives and
antiflatulents 止瀉、消化、消氣劑
• Kaopectin :
– < 6 mons : 3 ㏄ po qid (嚴重再給)
– 6 mons ~ 6 Y/O : 5 ㏄ po qid
– > 6 Y/O : 10 ㏄ po qid.
• Biofermin tab :普通劑量 ×2 po qid.
• Simethicone tab :普通劑量 po qid.
• Bismuth: 普通劑量 po qid.
14. Antiemetics 止吐劑
•
•
•
•
Motilium(10 mg/tab) :普通劑量 po qid.
Prepulsid : 0.1~0.2mg/kg/dose po qid
Novamine or Priperam may cause EPS
EPS :
Akineton=Biperidine(1#=2mg;5mg/1cc/am
p)
– Adult : 2mg per 30 min.max 4 vial(20mg)
15. Laxatives 輕瀉劑
• Glycerine ball enema : 0.5~1# qd
• MgO tab :普通劑量 po qid.
• Ducolax (Bisacodyl 5mg tab) :
6~12 yo 1# po st.
• Cascara (Cascara sagrada) : 1~2# po qhs
16. Anticonvulsants 抗痙攣劑
• Valium(Diazepam)(10mg/2 ㏄ /amp):
– <5y/o: 0.2 ~ 0.5mg/kg/dose iv slowly q15min × 3
( max 5mg)
– >5y/o: the same as above except (max 10 mg)
– adolescents: 5-10 mg/dose; max: 30mg.
• Neuropam(Lorazepan)(2mg/ml/amp) ; 中效 (1015 hrs) :
– 0.03-0.1mg/kg/dose q15 ~ 20min × 2 dose max:
4mg/dose
17. Anticonvulsants 抗痙攣劑
• Dilantin(phenytoin) (250mg/5cc/amp) :
– Loading 10 ~ 20mg/kg iv with rate <
1mg/kg/min,max50mg/min ,Maintain 5mg/kg/day iv
q12h, ( 不可加於 Glucose solution)
• Luminal(Phennobarbital) (100mg/cc/amp;32mg/1#)
– Loading 20mg/kg iv with rate < 30mg/min ;
Maintain 5-10mg/kg/day to achieve serum level 40
ug/ml
• Chloral hydrate enema(10% 30ml) :
– Neonates: 25-50 mg/kg/dose,
– Children: 25-100mg/kg/dose → 1/2~3/4 BW cc enema
18. Antibiotics 抗生素
• Penicillin :Bctereimia:2.5-5 ;Meningitis 7.5-10 ;
infection 10-25( 單位:萬 u/kg/dose q4-6h)
• Ampicillin : IV 100mg/kg/day, q6h.
• Amoxicillin Cap(500mg) : (Ac. tonsillitis, AOM)
• Hiconcil Cap(250mg)=> 50 mg/kg/day q8h.
• Amoxicillin syrup => BW/2 po q8h.
• Augmentin (amoxicillin + clavulanic acid,
375mg/1#,600mg/vial) : BW/2 po q8h.
19. Antibiotics 抗生素 -
Cephalosporins 頭芽孢 素
• Cephazolin(Veterin) : IV 100mg/kg/day, q6h.
• Keflex(250mg/1#,Cephalexin 1',Ceflexin 500mg/1#):2550 mg/kg/day poq6h for G(+).
• Keflor (2’ Cefaclor,250 mg/1#,125mg/5cc/60cc/susp) 50
mg/kg/day q8h.; BW/2 q8h.(AOM)
• Zinacef (2’ Cefuroxime, 250mg,750mg):
•
<2y/o:125mg/dose po bid; >2mg:250mg/dose po bid
• Zinnat (2’ Cefuroxime, 25mg/ml)
•
AOM : <2 y/o 5ml q12h ; >2 y/o 10ml q12h
•
Common infection: 5ml q12h
• Rocephin,Syntrix(3’Ceftriaxone 500mg/5cc/vial):
50-100mg/kg/day iv q12h-qd; Meningitis:100mg/kg/day
q12h (max:4g/day)
• Prostaphlin (Oxacillin) :
– IV 100mg/kg/day, q6h. (Cellulitis)
20. Antibiotics 抗生素 Macrolides
• Erythromycin(Mycoplasma,Chlamydia,Legionella)
• Erythrocin syrup (40mg/cc) : BW/4 cc po q6h Ilosone
(250/1#):30-50 mg/kg/day q6h.(20kg 1# qid, 40kg 2#
qid)
• Zithromax(Azithromycin,250mg/1#,200mg/5cc/susp)
•
child :1# qd * 3day (>40kg:2#)
• Zithromax syrup : BW/4 cc po qd * 3 days
• Klaricid(Clarithromycin ,250/tab):
Adult 1~2# po bid;
Child:7.5mg/kg bid
21. Antibiotics 抗生素 -UTI
• Nitrofurantoin(Ninru,100mg/1#) :
– 5 ~ 7mg/kg/day, po qid (UTI),Adult::1#po qid.
– Prophylactic dose: 1/3~1/4 therapeutic dose
• Azactam(Aztreonam 1 g/inj):90-120mg/kg/day iv
q6-8h for G(--) and Pseudomonas
• Mycostatin( 50 萬 u/1#):for Candida(Oral
thrush):
–
–
Infant: 2/5# (20 萬 u)/dose q6h
Child: 1# (40-60u)/dose q6h
• Baktar(TMP-80 + SMX-400):6-12 mg/kg/day po
q12h (Contraindication < 2 months,G6PD deficiency)
22. Cardiologic disease
• PGE1 ( PDA ) :IV 0.05-0.1μg/kg/min
• Supraventricular tachycardia
– Adenosine:0.1mg/kg rapid IV push give double or
triple the dose in 2-3 min (6mg max)
• Digoxin(not for WPW):loading 30-40μg/kg
– Give 1/2 dose, then 1/4 dose q6-8h for 2 more doses
• Verapamil(Isoptin 5mg/2ml/amp, 1# 80mg):
– >1y/o; 0.075-0.15 mg/kg,slow IV, repeat twice q15m
23. Fulid supplement
• 0 ~ 10Kg (4 MD/kg) : 100ml/kg/day
• 10 ~ 20kg(2 MD/kg) : 1000 ㏄+ ( BW - 10 ) ×50
㏄ /day
•Example 1: (1 MD/kg) : 1500 ㏄+ ( BW - 20 ) ×20
> 20kg
㏄ /day
BW=25 kg,Keep IV route with 0.33%G/S ______MD/min
•Ans: (10 ×4) + (10 ×2) + (5 ×1) = 65 MD/min
•Example 2:
BW=30 kg,Keep IV route with 0.33%G/S ______MD/min
______c.c. qd
•Ans: (10 ×4) + (10 ×2) + (10 ×1) = 70 MD/min
(10 ×100) + (10 ×50) + (10 ×20) = 1700 c.c./day
24. Management of Dehydration
Access fluid deficit:
• < 5%(mild): Consolable, Dry tongue, Mild loss
of skin turgor
• 5% -10%(moderate): Irritable, Reduced urine
output, Deep set eyes, Tachypnea, Marked loss
of skin turgor
• > 10%(severe): Lethargy or Coma, Sunken
anterior frontanelle and eyes, Cold extremities,
Weak or impalpable pulse, Hypotension
25. Management of Dehydration
•
Rehydration: First 8 hr
Later 16 hr
Deficit
1/2
1/2
Maintenance
1/3
2/3
• e.g.: 10kg, 10% loss, ≧3 days
• Deficit : 10% x 10 (kg) x 0.6(deficit% from ECF ) X 1000
= 600 ml
• Maintenance: 10 x 100 = 1000 ml
First 8 hr
later 16 hr
Deficit
300ml
300ml
Maintenance
333ml
660ml
27. Electrolyte supplement
• Na : 3 ~ 4 mEq/kg/day
– 3%NaCl 1ml = 0.5 mEq
– 0.9% NaCl 500ml = 77mEq
• K : 2 ~ 3 mEq/kg/day
– 15%KCl 1ml = 2 mEq
• Ca : 200~1000 mg/kg/day q8h-qd
– 10% Ca gluconate(100mg/1ml,1Amp = 10ml)
• NaHCO3 : 1 mEq/kg ( if PH < 7.2 )
– 17 mEq/20cc/amp
28. Correct Metabolic Acidosis
Tachypnea (BE=PCO2 – 1.5 x [HCO3] + 8 ± 2 )
BE
HCO3
Mild
<10
>17
Observation
Moderate 10-20 17-8
Slow correction
Severe
>20
<8
Rapid supply IVD 10’,
taper the speed if PH > 7
7% NaHCO3 ( 17 mEq/20ml ) supply half in 2-8 hours:
2-4 mEq/kg/dose
BE x 0.3 x BW
( 15-HCO3 ) x 0.6 x BW
30. 其他特殊用藥
• Lasix(40mg/1#,20mg/2cc/inj):1-2mg/kg/dose q6-12h
• Mannitol(60mg/20%/300cc):0.5-1.0g/kg/dose iv for
30min
• Insulin:
• DKA:0.05-0.1u/kg/hr iv drip ,
•
maintain : 0.5-1u/kg/day/SC
• Glucose intolerance in prematurity: 0.01-0.1u/kg/hr.
•
•
•
•
Difflam® Anti-Inflammatory Spray (得伏寧 消炎噴液劑)
¨ 成份 :每 mL 含 Benzydamine Hydrochloride 15 mg
¨ 作用: Benzydamine 為一抗炎止痛劑,可舒解口腔及咽喉疼痛。
¨ 用法:直接噴 5-10 次於疼痛和發炎部位,再輕輕吞 下,視需要,可每
1.5-3 小時重覆一次。
31. CPR 用藥
• E-T tube size :
– Newborn : 2.5 ~ 4 Fr ; > 2 Y/O = 4 + (age / 4) Fr
– Depth:lip-tip length (about = 3 * E-T tube size)
– Depth: 1/ 2/ 3/ 4 kg = > 7 / 8 / 9/ 10 cm
• Epinephrine ( 1 : 1000 ) : ( 1mg = 1ml )
– 0.01 ml/kg/dose iv; or 0.1 ml/kg/dose via ET tube
• Dopamine : ( 6×BW ) kg in N/S final V =
100ml 1MD/min = 1ug/kg/min
• N.E.(Levophed):1mg/ml; 0.05-0.1ug/kg/min drip.
• Nitroprusside(Nipride): 0.5-1.0 ug/kg/min drip.
32. CPR 用藥
• Atropine : 0.02mg/kg (1ml = 0.1mg ) q5m, total max
dose: child=1mg, adolescent: 2mg;minimal dose=0.1mg
• NaHCO3 : 1 meq/kg ( if PH < 7.2 )
• Lidocaine(10mg/ml): 1mg/kg loading, 20-50ung/kg/min,
(60xBW)mg of lidocaine dilute with N/S to 100ml, then
1MD/min10ug/kg/min
•
Adenosine: for PSVT
– Neonates and child: 0.05mg/kg iv push, increase bolus doses by
0.05mg/kg q2min, max dose:0.25mg/kg or 12mg
– Adult: 6mg12 mg 12 mg