Acetaminophen 10-15mkdose (max: 6mg/kg/24H)

Acetazolamide 25mg/kg/24H Cefaclor 20-40 mkday

(500/5, 125mg, 250mg)
Cefazolin 50-100mkday
Acetylcysteine 2-5ml TID, QID (infant)
6-10ml TID, QID (child) Cefixime 10-12 mkd: PNA
10ml TID, QID (adult) 15-20 mkd: TY x 10-14days

Acyclovir >6yo: 800mg 4X/D Cefadroxil 25-50 mkday

(Varicella) <2yo: 200 mg QID or
(HZV) 20 mkdose QID Cefalexin 30-50 mkd
Max: 800 mg/day
Cefepime 30mkdose Q12 (<14 days old)
Albendazole >2yo: 400 mg SD 50 mkdose Q8: meningitic, sev sep
<2yo: 200 mg SD
Prep: 200mg/5mL Cefoxitin 50-100 mkday

Aldactone 2-3 mkday (OD, BID, TID) Cefuroxime 75-100mkday

Prep: 25, 50, 100mg/tab 20-40 mkday PO

Ambroxol 1.2-1.6 mkdose Cefotaxime 50 mkdose

10yo: 1 tab TID
5-10yo: tsp BID, TID Ceftriaxone 75-100 mkday
2-5yo: tsp TID (max: 3 gms/day)
13-24mos: 1.25 ml BID
7-12mos: 1 ml BID Ceftazidime 30 mkdose Q12/Q8
<6 mos: 0.5 ml BID
Cephalothin 50-100 mkday
Amikacin 15 mkd
NB: 29 wks 15mkdose 48H Cetirizine 0.25 mkday OD/BID
30-33wks 14mkdose 48H Prep: oral soln 1mg/ml
34-37wks 12mkdose 36H Drops 10mg/ml
>38wks 12mkdose 24H
50mg/ml amp Charcoal 1-2g/kg Q2-6H
5-10 x wt of ingested poison
Aminophylline 3-5mkdose
Dilute to equal amount amount with IVF Chloramphenicol IV: 50-100 mkd
Refer for tachycardia, hypo/hypertension, sz, vomiting PO: 30-50 mkd

Ampicillin-Sulbactam at least 100mkday ( Ampi) Chlorphenamine 0.35mg/kg/24H

(fp) (adult: 750mg IV q6-8H) Maleate
PO: 20-40 mkday
1.5 g(1g); 750 vial (500); 375 vial(250); Cimetidine 5 mkdose Q6-8H
250mg/5ml
Ciprofloxacin 20-40 mkday
Amphotericin B 0.3-0.7 mkd
NB: ID: 0.25-0.5 mg/K IV Clarithromycin 15 mkday
Infusion over 2-6H
MD: 0.5-1 mg/K IV q24-48H Clindamycin 10-20 mkday (mild)
Ampho B 50mg dilute w/ 10 ml 20-40 mkday (severe)
Dilute to make a conc of 5mg/ml
Ex: D1 = 0.25ml/kg = (wt x 0.25) = 0.52 0.52/5= 0.1 ml Clonazepam 0.01-0.03mg/kg/24H in
D2= 0.5 ml/kg = 1/0.5mg 2-3 divided doses
Ampho B 0.21 ml + 10.5 ml D5W
Reconstituted soln should be wrapped in aluminum foil Cloxacillin 50-100 mkday
to protect from life & store at ref
Infusion line wrapped in aluminum foil Digoxin Neonate: 10-30 mcg (LD)
Watch out for apnea, brady, cyanosis 5-10 mcg (MD)
Be given in AM preferably 1mo-2yo: 30 mcg (LD)
10-15 mcg (MD)
Ampicillin 100-150 mkd Child>10yo: 10 mcg (LD)
MD: 200-400 mkd 2-5 mcg/k/d (MD)
NB: 50 mkdose
Doxycycline 2-4 mkd
<29wks 0-28 Q12H
>28 Q8H
Dimetapp 0.1 mg/k/dose (drops)
30-36wks 0-14 Q12H
1-6 mos: 0.5 ml TID
>14 Q8H
2-24 mos: 1 ml TID
37-44wks 0-7 Q12H 2-4yo: tsp TID syrup
>7 Q8H 4-12yo: 5 ml TID
45wks ALL Q6H
Diazepam 0.2 mkdose
Amoxicillin 30-50 mkday/ 50-75 mkday HD
Erdosteine 15 mkday (BID)
Ansimar 10 mkdose BID
(6-9 mkdose BID) Erythromycin 30-50 mkday
Antamin 0.3 mkdose Ethambutol 15 mkd
ASA 75-100 mkd Fluconazole 4-6 mkday OD
Kawasaki: 80-100 x 2 wks or after 3-4 days afebrile
3-5 mg/kg/day OD 6-8 wks after Furosemide 0.5-1.0 mkdose (max: 4 mkdose)
Atenolol 0.8-1.5 mkday (max: 2mg/kg) FeSO4 4-6 mkday (Tx)
1-3 mkday (MD)
Augmentin PO: 20-40mkday (based on amox) Gentamycin 5-8 mkday
IV: 30 mkdose
Prep: 156/312 TID (125/250) Hydrocortisone 4-6 mkdose
228.5/457 BID (200/400)
375/625 (250/500) Hydralazine IV: 0.15 mkdose
PO: 0.75 mkd
Aztreonam 309 mkdose Q8H
Hydrasec 1.5mkdose (TID)
Ultramox 20-40 mkday TID based on amox
40-50 mkday IV Q8 based on amox Hydroxyzine 1mkday
Bambuterol 0.25-0.27 mkdose OD INH 5-10 mkday
Prep: Oral soln 1mg/ml
10mg/tab Lanoxin 0.003 mkdose
Bisacodyl <2yo: 5 mg Mannitol 2.5-5cc/K/dose
>2yo: 10mg
Prep: 5-10 mg/tab supp Mebendazole 500 SD
100 mkd x 3days (BID)
Bromhexine 0.5-0.85 mkday in 3 doses
Meclizine 12.5-50 mkd
Buscopan 0.15 mkd
Meropenem 20 mkdose Q12
Carbocisteine Inf: 10-20 mkday 40 mkdose Q8: meningitic dose
Child: 30-50 mkday
Meperidine 0.5 mkdose
Captopril Prem: 0.01mg/kg/dose Q8-12H
Neonate: 0.05-0.10 mkdose Q12-24 Metoclopromide PO: 1 mkd
Child: 0.3-0.5 mkdose IV: 0.5 mkday Q8
Metronidazole 30-50 mkday (TID)

Mefenamic Acid 6.5 mkdose EMERGENCY DRUGS

Prep: 50 mg/ml NaHCO3 1-2meqs/kg/dose
Atropine 0.04ml SQ
Motilium 0.2-0.4mkdose Q6H 0.01-0.02 mkdose IV
Not to exceed 1 mkday
Epinephrine 0.01 mkdose (1:1000)
Nystatin 1.2 M units/day 0.1mkdose (1:10000)
400,000 units/day max: 3 ml Q5-10 mins

Nalbuphine 0.1-0.2 mkdose Naloxone 0.1 mkdose

Nifedipine 0.25mkdose Mannitol 0.5-g/k/dose

1g = 5cc
Oxacillin 150-200mkd IV
Albumin 0.5-1 g/K
Paracetamol 5-25mkdose Prep: 25g/100cc
12.5/50cc
Piperazine 75mkday x 3 days Dilute in 50cc D5W and run x 20-25 ugtts/min

PipTazo 150-200 mkday Ca Gluconate 100-300 mkday (oral)

Based on piperacillin 1cc/kg (LD-IV)
1cc/kg/day (MD-IV)
Prednisone 1-2 mkd (preferably BID)
Epinephrine Drip (mg)/100cc x X/1cc x 100
Phenobarbital 5mkd (MD) cc/Hr= wt. X 0.3 -1 x 60
40
Phenytoin neonate: 15-20mg/k/day (LD) Prep: 1 amp in 25cc D5W
Child: 5mg/k/day Q12-24H (MD)
Acetazolamide 30 mkday q8H
PZA 15-30 mkd Prep: 250mg/tab

Pen G 50-100,000 U/k/day NaHCO3 8-10 mkday q8H

Prep: 325mg/tab
Rifampicin 10 mkday

Ranitidine 1-2 mkdose Caloric Equivalent

D50 - 2 cal
Sucralfate 1g/dose D10 - 0.4 cal
D5 - 0.2 cal
Salbutamol 0.15mkdose PO D 7.5- 0.3 cal
D 12.5 - 0.6 cal
Streptomycin 20-40mkd Amino Acid - 0.2
Intralipid - 1.1cal
Sumapen 50-100 mkday QID Vamin - 0.67
Corn Oil - 8.4
Tetracycline 25-50 mkd Karo - 4
MCT - 7.6
Theophylline 20mkd Amonisteril - 4
Olive Oil - 9
Terbutaline 0.075 mkdose
Milk Formula/Oz
Timentin 80mg/kg Q6-8H BM- 20/Oz PreNan - 24
80 mkdose Q12H (term.NB) NAN 22 Enfalac - 24

Tobramycin <7 days: 5 mkd Q12H Daily Fluid Req't

<5yo: 7.5 mkd Q8H BW D0-D2 D3-D4 D14-D30
5-10yo: 6 mkd Q8H 750g-1kg 110 140 150

Valproic acid 15 mkday 1k-1.25k 100 130 140

Vancomycin 10-12 mkdose 1.25k-1.5k 90 120 130

Severe: 15 mkdose Q8H
>1.5k 80 110 130
Zafirlukast 40mg/day PO Q12H *add 25% if w/ Photo
Prep: 20mg/tab
Na K
ANTISPASMODICS NB - 134- 146 <2mos 3.0 - 7.0
Dicycloverine 0.15mkday Infant - 139- 146 2- 12 m 3.5 - 6.0
Bentyl: 10mg/tab, 20mg/ml Child - 138 - 145
Relestal: 10mg/5ml, 5 mg/ml Thereafter - 136 146

Hyoscine Butyl Bromide 10mg/tab, 5mg/ml TPN

(Buscopan) Vamin : 100 x wt x dose
Preparation(%)
Diphenhydramine PO: 3-5 mkday
(Benadryl) IV: 1 mkdose Ca Gluc: 2cc/kg/day
Prep: Syrup 12.5mg/5ml
Cap: 25mg/cap BNC: 0.5-1cc/day
Inj: 50 mg/ml
IVF: accdg to TFI
ANTIFUNGAL
Mycostatin Tab: 1-2 tabs TID
Susp: Inf - 2ml QID Cholesterol
Child 2-4ml QID
Oral susp: 2 ml QID to be swabbed Age mg/dl mmol/L
on lips and buccal mucosa 1-3yr 45-182 1.15 - 4.70
4-6yr 109-189 2.80 - 4.80
Fluconazole 4-6 mkday OD/Q12H 6-9yr 5-75 - 95 5-75 - 95
(Diflucan) Prep: 50 mg/tab, 1 tab divided into M 126-172 - 191 3.26- 4.45 - 4.94
4 pptabs F 122- 173 - 204 3.16- 4.47 - 5.41
1 pptab OD with milk
10-14yr
AGE DRUGS M 130-179 - 204 3.36-4.63 - 5.28
Infloran Berna dissolve contents in 1 cap in 15 ml F 124-174 - 217 3.21-4.50 - 5.61
Of diluted formula TID
15-19yr
Furazolidone 4-7 mkday M 114-167 - 198 2.95-4.32 - 5.12
(Furoxone) Prep: 50mg/ml, 16.7mg/5ml F 125-175 - 212 3.23-4.53 - 5.45

Ercefuryl 40-60/60-100 mkd OD

Prep: 220mg/5ml Albumin
Prem: 1 day - 1.8 -3.0 g/dl 18-30g/L
Etofamide 20-40mkday
(Kitnos) Prep: 100mg/5ml Fullterm: <6days 2.5 - 3.4g/dl 25-34g/L

Secnedazole 30mkday <5 yr 3.9 - 5.0g/dl 39 - 50g/L

AMOEBIASIS 5-19yr 4.0 - 5.3g/dl 40 - 53g/L

Metronidazole 30-50 mkday
Prep: 125mg/5ml

Diloxanide 20 mkday
Prep: 125mg/5ml
Protein 3. Vomiting
Premature 4.3 -7.6g/dl 43-76g/L 4. Massive steroid administration
5. NaHCO3 administration
Newborn 4.6 -7.4 g/dl 46 - 74g/L
Respiratory Acidosis:
1-7 yr 6.1 -7.9 g/dl 46-74g/L 1. Hypoventilation
a) inadequate resp effort
8-12yr 6.4 - 8.1 g/dl 64 - 81g/L
b) CNS problem
c) Neuromuscular disease
13 -19yr 6.6 -8.2 - 66 g/dl 82 g/L
d) Mechanical ventilator setting
e) upper airway not patent
Extubation f) decreased lung tissue
g) decreased lung compliance
1. Dexa 0.5mkd IVTT Q12H x2 doses prior to extubation 2. Abnormal ventilation perfusion ratio
2. Salbuamol 0.5cc + NSS 0.5cc Q8H a) obstruction of small airway
3. Epinephrine 0.2mkd Q4H x 2 doses b) atelectasis
4. Dexamethasone Q12H x 2doses after extubation c) pneumonia
5. Chest physiothearpy d) pulmonary edema
6. Keep on right side position
7. NPO x 2h 3. Increased extrapulmonary shunt
PAI with 4.7cc NSS + 0.3cc Epinephrine QH x3 doses then maintain on PAI with 2cc a) pulmonary vasoconstriction
NSS Q6H. b) RDS, severe infection
c) Pulmonary hypoplasia
d) Cyanotic heart disease
Materials for Surfactant instillation:
- Gloves #3
Respiratory Alkalosis
- ET size (same brand as inserted)
1. with hypoxamia
- OGT F8
a) acute pulmonary disease:
- Syringe 10cc (2)
pneumonia and atelectasis, RDS, acute asthma
- Ruler
b) Acute myocardial disease:
- Beradine
MI, pulmonary edema, heart failure, CP bypass
- Cotton balls
- Ambubag
2. Without hypoxemia
a) anxiety, neurosis, psychosis
Post Surfactant
b) pain
c) CNS disease
- Maintain on NPO d) Anemia
- CXR-APL e) Carbon monoxide poisoning
- VBG/ABG 1 hr after
- B1B2, BUN, Crea, with S. Na, K, Ca
- Wean FiO2 by 5% every 1-2 hrs pulse ox guided for O2 Sat >95% until 40 - 50%
- No suctioning at least 1 hour aftre instillation unless with bradycardia, cyanosis,
hypotension, or obstruction
- Watch out for pneumothorax
- Standby butterfly G23, 10cc syringe, 3-way stopcock, betadine, cotton applicator,
gloves

PNUEMONIA IN CHILDREN
0-3 mos C. trachomatis
S. aureus, Gr neg

4-11 mos S. penumonia

H. influenzae

12-59 mos S. pneumonia

H. influenza

60 mos & over M. pneumonia

S. pneumonia

WEANING
Improvement in CXR
1. ABG with PO2 > 50 mmHg
2. Blood pH > 7.3
3. PCO2 < 55 mmHg
4. Hg 12-15 gm/Hct 36-45

GUIDELINES
1. DEC. FiO2 by 3-5% every time PO2 . 70
2. With FiO2 = 40%, dec. Pressure by increments of 2 cm H2O if 2-4H until 2-3
cm is reached
3. Transfer patient to O2 hood with FiO2 of 15-50%
CPAP
Requirement : adequate spon. Respiration
Components : O2 pressure
Indications:
1. HMD
2. Inhalation/chemical pneumonitis
3. Severe pneumonia
4. Meconium aspiration
5. Pulmo edema with or without assoc. CHF
6. Fluid overload

7. General atelectasis
8. Infants with apnea of prematurity
9. Infants with ARDS
10. PaO2 < 50-60 mmHg,
11. Breathing 60-70 with recurrent apnea

VENTILATOR PLANS
HMD PEEP = 4-6 cm H20
PIP = 18-30 cm H20

PFC PEEP= 2 cm H20

ROMS - resp opposite; metabolic same

Metabolic Acidosis:
1. RTA
2. DKA; Starvation
3. Lactic acidosis

Metabolic Alkalosis:
1. Hypokalemia
2. Hypochloremia
 PH<7.35 PH7.35- PH7.40- PH>7.45
7.45 7.45

PCO2 Part comp Comp met Comp resp Resp alk

<35 met acid acid alk

PCO2 Met acid Normal Normal Met alka

35-45

PCO2 Resp acid Comp resp Comp met Part comp

>45 acid alka met alka

IVF COMPOSITION

Na Cl K Ca Lactate
acetate
0.9NSS 154 154
0.3NaCl 51 51
LR 130 109 4 1.5 28lact
NR 140 98 5 1.5 27acet
23gluc
NM 40 40 13 1.5 16lact
Imb 25 22 20 1.5 23acet