Ped medhandbook

pediatric drugs

1. ats
Pediatric
Medication

Handbook

3. Atropine

Calcium

Epinephrine

0.02 m se 0.04 mg/kg IM/ET
Min: 0.1 mg
Max 1 mg IV

le 20 mg/kg = 0.2 mL/kg of 10% solution
ate 60 - 100 mg/kg = 0.6 - 1 mL/kg of
/ push
Max: 1000 mg/dose of Ca Chloride or 3,000 mg

Ca Gluconate

0.01 mg/kg IV/1O (0.1 mL/kg 1:10,000)
Max: 1 mg/dose (10 mL 1:10,000)

High dose = 0.1 mg/kg (0.1 mL/kg 1:1,000)
Max ET: 2.5 mg/d

0.51 unit/kg bolus IV/ in epinephrine-refrac
c arrest (not routinely recommended)
40 kg) 40 units

ules/kg;

Dopamineand 2 min

butami

4. Load: 300 - 500 meg/k Methadone Initial: 0.1 mg/kg/dose IV/PO every 6 hrs. If
infusion: 50 - 250 mcg/kg/min transitioning to methadone to wean off other

opioids, larger doses may be needed - discuss
—————— with pharma
Milrinone May load with 25 - 50 megkg over 30-60 min (check Available oral
with attending), infusion: 0.25 -1 meg/kg/min

Norepinephrine 0.052 meg/kg/min

Fentanyl Initial: 1 - 2 meg/kg/hr

Nitro 0.25 - 10 mog/kg/min; Adult (>40 kg) initial

infusion dose: 10 mcg/min (Note that dose is er
notweight based in adults). Commonly used in Initial 03 - 0.5 mokkg/hr
iaximum dose of 200 meg/min Max: 2 mo/kg/he

ANTIARRHYTHMICS PARALYTICS

Rocuronium 0.5 - 1 mg/kg/dose IV; lasts 15-45 min; fastest

onset of nondepolarizing agents

Amiodarone Load: 5 mg/kg IV over 25 min, may repeat x 2, infusion
5-15 mog/kg/min

INTUBATED PATIENT SEDATION/PAIN PROTOCOL EE

Dexmedetomidine Initial: 0.2 - 0.7 meg/kg/hr

Max: 1.5 mog/kg/hr

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Acetaminophen 0.5 - 1 mg/kg/dose codeine component PO every
odeine tablet 4 hrs PRN
**Because of variability in metabolism, use
codeine containing products cautiously in children

(Dilaudid?)

<3 years of age**
Available forms at CHKD: Tylenol No. 3: Acetamino-
phen 300 mg and codeine phosphate 30 mg
enol No 2: Acetaminophen 300 mg and cod
phosphate 15 mg

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Hydromorphone 0.015 mg

every 4 hrs PRN or
0.03-0.08 mg/kg/dose PO every 4 hrs PRN
‘Adult dose: 0.2 - 0.6 mg IV every 4 hrs PRN or
1-2 mg PO every 4 hrs PRN
alable PO form at CHKD: 4 mg tablet

(See separate order form for PCA dosing)

Morphine

0.05- 0.1 mg/kg/d
PRN (caution in renal falure patients)
Immediate release preparation: 0.2-0.5 me
PO every 4 hrs or ev

Available forms at CHKD: 10 mg/5 mL oral si
Immediate release tablets: 15, 30 mg

Extended release tablets: 15, 30, 60 mg

10 mg/kg/dose PO every 6 hrs PRN
Max: 800 mg/dose **Not for routine antipyretic.
use in patients <6 months of age**

Ibuprofen

Nalbuphine
(Nubain®)

vllble oral solution at CHKD: 100 mg/5 mL

‘Analgesia: 0.1 0.15 mg/kg/dose IM/IV/SQ every

6 hrs PRN
Max: 20 mg/dose

Pruritus: 0.02 — 0.05 mg/kg/dose IV/IM/SQ every 3
to4 hrs PRN
Max: 5 mg/dose

6. Oxycodone Immedliate release preparation: 0.05 - 0.15 mi
dose PO every 4 hrs or every 6 hrs PRN
Extend se in adults; start with 10 mg every
12 hrs
Initial adult dose (>50 kg) 5 mg/dose every 4 or
ery S hrs PRN

Available forms at CHKD: Immediate release capsule

in 5 mg and Extended release tablet in 10 mc

Tramadol 1-2 mgkg/dose PO every 4 to 6 hrs prn
(Ultram®) Adult dose: 50-100 mg PO every 4 to 6 hrs pm
(maximum dos

Hydromorphone _0.1- 0.2m

SEDATIVES

Clonidine 1.5 - 5 meg/kg/dose PO every 8 hrs in addition to
opioid and/or benzodiazepine
Available solution: 100 meg/mL. Tablets: 0.1 mg

Patches: 0.1, 0.2, 0

Diazepam 0.12 - 08 mg/kg/day PO div every 6 hrs; long half-

(Valium*) life with chronic dosing; may dose BID or TID.
0.04 - 0.3 mg/kg/dose IV every 2106 hrs
CHKO - oral soln: 1 mg/mL; tablets 2 mg, 5 mg

Ketamine

Midazolam 0.1 mglkg/dose IV every 1 hr PRN
(Versed®) Max: 5 mg/dose
05 mg/kg/dose PO
20 mg/dose
0.2 -0.3 mg/kg/dose INTRANASAL
Max: 10 mg/dose

ANTIMICROBIALS

Acyclovir (Neonates and infants) 20 mg/kg/dose IV every 8 hrs

(Adolescents) 10 mg/k ery 8 hours
(VZV) 500 mg ry 8 hrs

(HSV) 250 mg/m’/dose IV every 8 hrs
Oral dosing: 750 mg/mé/dose PO every 12 hrs
Suspension: 200 mg/5 mL; capsule: 200 mg;
tablet: 200 mg, 400 mg

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Amoxicillin
Clavulanic Acid
ugmentin®)

Adthromycin

Cefdinir
(Omnicef?)

Cefoxitin

Ceftazidime”

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15-20 mg/kg/dose (amoxiclin component) PO BID
Mutti drug resistant OM: 40 - 45 mg/kg/dose
lin component) PO BID
(Max: 875 mg/dose)
vailable oral solution concentrations: 125 mg/5
mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5 mL.
600 mg/5 mL. Tablet: 250 mg, 500 mg, 875 mg

10 mg/kg IV/PO on Day 1
5 mg/kg IV/PC 4 hrs on Day 2 -

< 6 mos: 10 mg/kg IV/PO on Day 1 - 5

Adult dose: 500 mg on Day 1, then 250 mg on Day
2-5. Available oral solution concentration: 200
mg/5 mL. Tablet: 250 mg, 500 mg, 600 mg

> 6 mos: 14 mg/kg/day once daily or divided BID
> 12 yo= adults: 600 mg PO once daily

Dosage forms: capsule 300 mg, 125 mg/ml,
250 mg/SmL.

30 mg/kg/dose IV every 8 hrs

‘Adult dose: 1 gm IV every 8 hrs

Serious infection/peritonitis: 30 mg/kg/dose IV
6 his

Adult dose: 2 gm IV every 6 hrs

Restricted to 1D/HemOnc/CF
50 mg/kg/dose IV every 8 hrs
Adult dose: 2 gm IV even

jefuroxime

Doxyeycline

Metronidazole
(Flagyl?)

50 mg/kg/dose
Adult dí

2.1 mg/kg/dose IV/PO every 12 hrs
Adult dose: 100 mg IV/PO every 12 hrs

Use with caution in children < 8 years of age
Available oral solution concentration: 25 mg/5 mL.

NICU or preterm infants see page 37

Term infants < 1 mo: 2.5 mg/kg/dose IV eve

> 1 mo:5 - 7.5 mg/kg/day IV every 24 hrs

Max: 500 mg/day (except cystic fibrosis patients)
ynergy dosing: 1 mg/kg/dose IN

CF: 10 mg/kg/dose IV every 24 hrs

MED Service to follow and order levels

7.5 mg/kg
Adult dose: 500 mg/dose every 6 hrs.
(50 mg/mL compounded suspension a

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Outpatients:
FA II O O Ceftriaxone 250 mg IM once + Doxycycline 100 mg PO every
Piperacill e 12 hrs for 14 days + Metronidazole 500 mg PO
Tazobactam dose IV every 8 every 12 hrs for 14 da
(Zosyn®)

Trimethoprim’ 3-6 mg TMP/kg/dose PO every 12 hrs for mild/
Sulfamethoxa- moderate infections
zole (TMP/SMX) Adult dose: TMP 160 mg/ SMX 800 mg PO every
(BactinvSeptra*) 12 hrs
rimoxazole) evere infections: 5 mg TMP/kg/dose IV every Calcium
Gluconat Max: 4 gm/dose - may be
is: 2.5 mg TMP/kg/dose PO
page 31)
**Notfor routine use in patients < 2 months of

Potassium 0.5 - 1 mEg/kg/dose IV over 1 hour (with cardiac
zole 200 mg/trimethoprim 40 mg/5 mL Chlorid monitoring)

vailable oral solution concentration: sulfamethoxa-

Tablet sizes: single-strength: TMP 80 mg/SMX 400 CHA
mg, double-strength: TMP 160 mg/ SMX 800 mg Usual starting oral replacement dose: 1 mEq/kg/
dose PO one to four times a day (1 - 4 meykg/day)

AAA € A Potassium usually given as chloride salt but can
Vancomycin 15 mg/kg/dose IV every 8 hrs use acetate salt depending on goal.
leningitis/Ventriculi eve
6 hrs
‘Adult dose: 1000 mg IV every 12 hrs

MED Service to follow and order levels
jodium chloride Infuse 4 - 6 ml/kg over 15 ~ 30 min

a (Hypertonic mEg/kg of Na) to rapidly treat symptomatic
513 mEq hyponatremia in the ICU or ED setting only!

9. Electrolyte
Sodium (Na)

Potassium (K)

Calcium (Ca)

‘Magnesium
(Mg)

Phosphate
(P04)

Bicarbonate
(HC03)

Starting IV Dose
Range (mEg/kg/day)

1-2

1-2

05

0.25-05

05-15
mmol/kg/day

1-3

mEq = mg
lence

1 mEq = 58 mg
(NaCl)

1 mEq = 75 mg (KCl)

1 mEq = 20 mg
(elemental Ca)

100 mg Ca Carbonate
= 40 mg elemental Ca
=2mEq

1 mEg=12 mg
(elemental Mg)

1 mmol = 31 mg
(elemental PO4)

1 mEq = 84 mg
{NaHCOS)

Bioavailability

100%

100%

25-35%
(up to 60%
in infants)

Up to 30%

1-20%

100%

Commonly Used Oral Product(s)

NaCl tabs: *1 gm (-17 meq Na)
(NaC! injection for oral use: *2.5 mEq/m))

KCL solns: *20 mEq/15 ml & 40 mEq/15 ml
KCL ER tabs: 8, 10, 15, 20 mEq

KCL ER caps: 8 mEq,*10 mEq

KCL powder (per packet): 20 mEq, 25 mEq

Calcium Carbonate Chewtabs: 400 mg, 420 mg,
500 mg [10 mEq], 600 mg, 650 mg, 750 mg, 850 mg, 1000 mg,

1250 mg, 1500 mg

Calcium Carbonate Softchew(Rolaids®): 1177 mg [471 mg]

Calcium Carbonate tab: 364 mg, *1250 mg [25 mEq], 1500 mg

Calcium Carbonate susp: *250 mg/ml [100 mg/ml; 5 mEq/ml]

Calcium glubionate syrup: "360 mg/ml [23 mg/m; 1.15 mEq/mt]
Calcium gluconate tab: "500 mg [45 mg], 650 mg [58.5 mg], 975 mg [87.75 mg]

Mg Oxide tabs: *400 mg [20 mEq], 500 mg

Mg Oxide caps: 140 mg, 600 mg

Mg Gluconate tabs: *500 mg [2.4 mEq]

Mg Gluconate soin: *200 mg/ml [0.96 mEq/mt]

*Phos-Na K powder: 250 mg phos [8 mmol] & 7.1 mEq K/Na each per packet
* Phos Neutral or Phospha 250 Neutral tabs: 250 mg phos [8 mmol] &
13 mEq Na & 1.1 mEq K per tab

“Fleet Phospho-soda: 128.5 mg phos [4.1 mmol] & 1.9 mEq Na per mL.
Na Bicarb tabs: 325 mg [3.8 mEq] & “650 mg [7.6 mEq]

(Na Bicarb injection for oral use: *1 mEq/ml)

10. Ethosuximide
(Zarontin®)

Loraze
(Ativan?)

Oxcarbazepine
(Trleptal®)

Phenytoin
(Fosphenytoin PE)

Initial: 15 mg/kg/day PO divided e
ax: 250 mg/dose)

0.1 mg/kg/dose IV (for seizures > 5 mins)
Max: 4 mg/dose; Repeat as needed every 10 - 15
min

4-5 mg/kg/dose PO every 12 hours (inital starting
dose); lower doses may be

combination with other anticon

Adult dose 600 mg PO twice a da

Available oral solution: 300 mg/5 mL

Loading dose: 20 mg/kg/dose IV
Maintenance: 5 - 10 mg/kg/day divided every
hrs IV/PO

Fosphenytoin is not available orally

(trough 10-20 meg/mL, Free phenytoin trough
1-2 mog/mL)

Available oral phenytoin suspension: 125 mg
mL. Chewable tablet: 50 mg; extended release
capsule: 100 mg

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Captopril

Digoxin

Labetalol

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Neonates: 0.05 - 0.1 mg/kg/dos
hou

Infants & Children: 0.2 - 0.5 mg/kg/dose PO every
6 - 12 hrs; First Dose: 0.1 mg/kg — monitor for
hypotension

Adults: 6.25 — 25 mg/dose PO BID-TID

Max: 6 mg/kg/day

Tablets: 12.5 mg, 25 mg, 50 mg

ries base
age. Please refer to Lexicomp for dosing informa-
tion.

Maintenance: 5-10 meg/kg/day PO/IV divided BID
Solution: 50 meg/mL Tablet: 125, 250 meg

Prednisone/
Pred

Ipratroprium
(Atrovent®)

ry 12 hrs PRN
hypertensive urgency
Max: 20 mg/dose IV

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PO: 0.5- 1 mg/kg/day y 6-12 hrs
Max: 8 mg/kg/day

WV: 0.01 -0.1 mg/kg/dose
Max: Infants - 1 mg/dose
Children- 3 mg/do:
Solution: 4 mg/mL. & 8 mg/mL. Immediate release
tablet: 10, 20, 40, 60 & 80 mg

6-12hrs

0.6 mg/kg/dose 1
hours apart (Max: 16 m

1-2 mg/kg/day PO divided every 12 = 24 hrs
(Maximum for asthma: 60 mg/day

Tablets: 1, 2.5, 5, 10, & 20 mg

Available solution: 15 mg/5 mL

0.5 mg INH every 6 - Bhrs x 24hrs (0.5 mg INH
every 20 min X 3 doses in ED)

12. Terbutaline 10 meg/kg slow IV bolus (10 min); then 0.2

meg/kg/min; may titrate by 0.1 meg/k
every 30 min to 2 mag/kg/min

GI/METABOLIC

Erythromycin /kg/day PO divided every 6-8 hrs

ACUTE ALLERGIC REACTIONS (for Gl motility) ethylsuccinate: 200 mg/5 mL or 400 mg/5 mL;
estolate: 250 mg/5 mL.

DIURETICS

Famotidine 0.5 mg/kg/dose IV every 12 hrs
N (Pepcid®) Adult dose: 20 mg/dose IV BID
Chlorothiazide mo: 10 - 20 mg/kg/dose PO every 12 h Solution: 10 mg/mL Tablet: 20 m

(Diurit®) > 6 mo: 10 mg/kg/dose PO every 12 hrs Ranitidine as oral agent at CHKD)
spension: 250 mg/5 mL.

For constipation, 1 -3 mUkg/day divided every

Furosemide 20 mg) 8-12 hrs,

(Lasix) (PO bioavailability -60% of 1 Max 60 mL/day
Continuous infusion: 0.05-0.4 mg Solution: 10,
to effect

= Omeprazole Restricted to kids < 10kg at CHKD
Spironolactone (Prilosec?) 05- 1 mg/kg/dose PO, daily or every 12 hrs
(Aldactone‘ Pre-term infants: 0.7 mg

Solution: 2 mg/mL

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Polyethylene glycol
ith electrolytes
(Miralax®)

Ranitidine
(Zantac®)

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1 gm/kg/day PO, m
(CHKO standardized doses
17am)

ay PO divided every 8-12 hrs
‘Adult dose: 150 mg BID
Solution: 25 mg/mL. Syrup: 15 mg/mL.
Tablet: 150 mg

Hydrocortisone

dosing,
Adult stress dose: 100 mg

Prednisone/
Prednisolone

kg/day PO divided every 12-2.
Usual adult max 60 mg/day
Tablets: 1, 2.5, 5, 10, 20 mg
Available solution: 15 mg/5 mL.

Ursodiol
(Actigall®)

30 mg/kg/day PO divided every 8-12 hrs
‘Adult dose: 300 mg PO BID
Solution: 60 mg/mL Capsule: 300 mg

vated Charcoal

Flumazenil Benzodiazepine reversal (contraindicated with
history of seizu
0.01 mg/kg/dose IV; lasts less < 1 hr
Max: 0.2 mg/dose, may repeat e
to 1 mg PRN

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14. Insulin, Regular +
glucose

insulin; infuse over 30 - 60 min

spiratory depression: 0.001 - 0.01 mg

Max: 2 mg/dose

Hyperkalemia: 0.5 gm/kg glucose + 0.1 unitkg

dose IV (1-10 mog/kg/dose), may repeat ev
2-3 min PRN

Max: 0.4 mg/dose. Titration of small (1-2 meg/
kg) doses limits risk of acute pain/stress

Rapid, full reversal of narcotic overdose: 0.1
mg/kg/dose IV, may repeat every 2-3 min PRN

MISCELLANEOUS MEDICATIONS

Aspirin

0.05 - 0.15 mg/kg/day IV/IM/PO divided 46 - 8 hr

Haloperidol

page 34

Iron

6 mg/kg/day PO elemental iron divided
Supplementation

THAM

0.9 mmol THAM; requires renal function

dose PO/PR q24h (CHKD standardized
20.25, 40.5, 81 mg)

(see algorithm for acute behavior management

dose IV (-1 mmolkg/dose) 3 mL =

BLOOD PRODUCTS **Blood Bank phone number: [phone]**

FFP 10 mL/kg (do not infuse rapid

1 PediFFP unit = 50 mL. decrease ionized calcium concentra-

tion)

Patients less than 2yo: 10 mU/ kg
<10 kg one-half pheresis unit body weight
0 kg one pheresis unit Patients greater than 2 yo: 1 unit /
One pheresis unit = ight (1 random donor
6-10 single donor units ke by -50,000/
mm‘)

Weight (pounds) BSA (m?)

15. Anti-infectives

Liposomal 3 mg/kg/dose IV q24h (empiric therapy)

‘Amphotericin B 5 mg/kg/dose IV q24h (documented infection)

(Ambisome®) round to nearest 50 mg vial size

‘Trimethoprim’ PCP prophylaxis -->Refer to page 3

Meropenem 20 mg/kg/dose IV q8h (adult 1 g IV qh; se

Merrem®) infection: 2 g IV q8h)

Oxacilin si

Vancomycin 15 mg/kg/dose IV a8h (pt >45 kg: 1 gm IV q12h)

Sulfamethoxa- Infections ~>Refer to page 12
zole (TMP/

SMX) (Bactrim

Septra®)

otrimoxazole)

lose IV geh (adult dose: 2 gm/dose)

50 mg/kg/dose IV q24h (adult dose: 2 gm/do

Fluconazole 5 mg/kg/dose (max: 200 mg/dose) PO/IV qday

(Oiflucan®) forprophy /dose IV/PO aday for

systemic candidiasis

MED Service to follow and order levels

Oral antibiotics

Cefuroxime 15 mg/kg/dose PO q12h (adult dose: 250-500 mg

(Ceftin*) PO q12h)
Suspension: 125 mg/5 mL, 250 mg/5 mL; Oral

tablet: 250 mg, 500 mg

Cefixime 8 mg/kg/dose PO daily or 4 mg/kg/dose PO q12h
(Suprax®) (max: 400 mg/day)
Suspension: 100 mg/5 mL, 200 mg/5 mL; Oral
tablet: 400 mg

16. (max: 10 mg/dose)
Di sis: 8 mg IV/PO qi2h x2 da

10 qt2hx 2 days in combination v
scheduled SHT-3 antagonist (eg, ondansetron) in
adult-size patie

5 mg/m?/dose PO q4h or g6h pro
(dose in 2.5 mg increments)

0.02-0.04 mg/kg/dose IV qôh prn for nausea/vom-

iting (max: 2 mg/dose)

jocusate

Kg/dose PO BID (max: 400 m
round to nearest 50-mg cap size or

<6yo: 2-4 mL/kg; 6-12 yo: 100-150 ml;
150-300 mL PO 96h until stooling

nna/Docusate <6yo:0.5 tab PO BID; 6-12 yo: 1 tab PO BID;

(Peri-Colace®) 2yo: 2 tabs PO BID

Famotidine
(Pepcid®)

/dose IV daily or BID;
(Nexium) 10-20kg: 10 mg PO/IV daily or BID
>20-30 kg: 20 mg PO/IV daily or BID;
0 kg: 40 mg PO/IV daily or BID

0.1-0.15 mg/kg/dose IV q8h pra

(max: 10 mg/dose; 40 mg

Pain Management

‘Acetaminopt 0.51 mg/kg/dose codeine or 0.2-0.4 m

Codeine dose PO q4h or gh prn/scheduled
Oral liquid: 12 mg codeine/120 mg acetamino-

phen

Oral tablet: 30 mg codeine/300 mg acetamino-
phen (Tylenol No. 3 tab) 15 mg codeine/300
mg acetaminophen (Tylenol No. 2 tab)

17. Hydrocodone 0.2 mg/kg/dose hydrocodone PO q4h pra x 10-15 mL
‘Acetaminophen (max: 10 mg/dose)
(Lortab®) Oral elixir: 2.5 mg hydrocodone/167 mg

acetaminophen per 5 mL
Oral tablet: 5 mg hydrocodone/500 mg
acetaminophen (Lortab 5/500)

Electrolyte Supplements
Ibuprofen 10 mg/kg/dose PO q6h scheduled/prn me Supe

(Motrin®/Advil®) (max: 800 mg/dose; 3200 mg/day)

Morphine 0.05-0.1 mg/kg/dose IV q2h or q4h pra
(adult: 2.5-10 mg/dose)

MS Contin 24-h PCA total morphine x3 divided in 2-3 doses
Controlled Release — scheduled (dose in 15-mg increment

Bactrim® Dosing Chart for PCP Prophylaxis

ss | ps

Naloxone Pruritus from PCA: 0.25-2 meg/kg/hr IV as Tabs | Tabs

(Narcan®) continuous infusion

Miscellaneous

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INFANT FORMULAS

EntamilLipil | Simiac A Similac Isomil | Enfamil Pregestimi Almentum Nutramigen Neocate

wron |Eary Advance | ProSobee

CLE EZ Di Le | 0 | 0 ARE | 7]

PEDIATRIC/ADOLESCENT FORMULAS

Jeviy Nutren 15 | PetiasurePeptide | Peptamendr | Elecareur Vivonex RTE | Carnation
1cal ren 20) Inst. Breakta
(12ca)

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Pharmacologic Management of Anxiety and/or Violent/Aggressive Behavior of Pediatric Patients

Agitated or Hostile Behavior

1

Behavioral
Interventions

Poor
Response

Di

loue
rate

Repeat
(3

caution

2 Antihistamine

phenhydramine
(Benadry!)
ro | m | Ww

ELE

Dem Suspected

Poor

[Responde

Benzodiazepine

Lorazepam
(Ativan)
fe [ro I m I m

Basen [Rp Tate] sen
fu Zaire
103 ma

Use Monitored Be

IV Ree Associate dh Respkatoy
Depression

PIV Route near es Rk of OT Prolngaton Use Monitored Bed

Neuroleptic
rom

Haloperidol Olanzapine
(Haldol) of (Zyprexa)

002510075 mg/hgrdese dese | FÉ Mylo: Sal dose
For > 12 yl: 10 mg dese
vo | m | mw" Rowe vo m

nin

dom |g Emin

Repet | 82 Ba

mps dose ax ECTS

1>02m9/4g
or 1 < 12yl0a Toul Dees > Sma

> 101mg int hour . or

Use Monitored Bea 889% | 1> t2yiee To Doses >1Omg

Poor
Response

5

Combination of
Benzodiazepine AND Neuroleptic

0.05 mg / kg m3 0.05 mg I kg
Lorazepam Haloperidol
IM IM

(Can Administ Lorazepam & Halapeidlin Same Synge)
2mg! dose 5 mg! dose

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Antibiotics/Antivirals/Antitungals/Immune Globulin

Amikacin IV: Infuse over 30 mins. (Base di

0-4 weeks, <12009m:

Postnatal age < 7 days: 1200-2000qm: ko/dose q12hr
>2000 gm: g/dose q12hr

Postnatal age > 7 days: 1200-20009m: 7.5 mg/kg/dose q12hr

>2000gm: 10mgkg/dose q8hr

Amphotericin B (over 4 hr per NICU protocol) 1 mg/kg IV g24hr

Extend interval to q48hr with renal dysfunction. Needs a separate line/
port if infusing w/ TPN & fats. With 1 line: Run TPN over 20hrs, check

while off TPN during Ampho infusion.

Cefazolin (Ancef®) IV, IM
Postnatal age: < 7days OR < 2000gm 20 mg/kg/dose q12hr
>7 days & > 2000gm 20 mg/kg/dose q8hr

xitin (Mefoxin®)IV. IM &

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indamyoin IV, IM- Infuse IV o
All neonates < 1200gm:
Postnatal age: < 7 days & < 2000gm
<7days&>2000gm 5 mg/
>7 days &<12009m 5 mg/k
> 7 days & 1200-20009m 5 mg/kg/dose q8hr
> 7 days £ > 2000gm 5 mg/kg/dose qGhr
>30 days & >2.5kg 10 mg/kg/dose IV qBhr

Fluconazole IV/ PO—Infuse IV over 60 mi
<29 weeks Postmenstrual Age: 0-14 da /dose q72h
4 days: kg/dose q48hr
30-36 weeks Postmenstrual Age: 0-14 day q48hr
>14 de g/dose q24hr

37-44 weeks Postmenstrual Age:

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Hepatitis B Vaccine and Hep B Immune Globulin IM
Hepatitis B Vaccine: 0.5 ml IM x 1
Hepatitis B Immune Globulin: (HB1G) 0.5 ml IM x 1 _
+ HbsAg-positive mother: Give Hep B vaccine and HBIG w/in 12hr of Rifampin IV or PO= Infuse IV over 30 mins.
birth 10 mg/kg/dose IV/PO q12hr
+ Preterm infant < 2kg & HbsAg-unknown mother: Give Hep B Synergy for MRSA in combination w/other ABX:
vaccine. Give HBIG if mom tests positive or if results are unknown IV/PO q12hr
within 12hrs of birth AER ...........
+ Infant > 2kg & HbsAg-unknown mother: Give Hep B vaccine and
obtain HbsAg on mother. Give HBIG within 7 days of birth, ony if
mother tests positive

Meropenem (Merrem®) IV=Infuse over 30 mins. m
<7 days OR<2000gm: 20 mg/kg/dose IV q12hr Vancomye IV = Infuse over 60 mins.
Postnatal age
All neonates < 1200gm: 15 mg/kg/dose q24hr
<7 days 8 >1200gm: 15 mg/kg/dose qi 2hr
> 7 days & 1200 -2000gm: 15 mg/kg/dose q12hr
>7 days & > 2000qm: 15 mg/kg/dose qBhr

Nystatin — PO={100,000 units/ml} suspension
Preterm Infant:0.5 mito each side of mouth q6hr
Term Infant: 1 mi to each side of mouth q6hr
Cream/Ointment: apply to area topically BID - QID

Penicillin & IV, IM— Infuse IV over 30 mins
Postnatal age: < 7 days OR < 1200gm 50,000 units/kg/dose q12hr

<7 days &>2000gm 50,000 units/kg/dose qBhr

> 7 days &1200-20009m 5 dose gBhr

> 7 days & > 2000gm ‚50,000 units/kg/dose q6hr iday IV/PO q24hr
GBS Meningitis: — 100,000 units/kg/dose qôhr

22. <q Previous spread

Cardiac

Bosentan PO only (for PAH); limited peds data. Avoid if
(Tracleer) impaired liver function and monitor LFT during

Initial dose: 1-2 mg/kg/dose PO BID
Titrate to maintenance dose of 2-4 mg/kg/dose

Dopamine Standardized Drip Concentration
0

Hydralazine IV or PO (specify BP parameters)
(PO is approximately 2 times the IV dose)

IV: 0.25 - 0.5 mg/kg/dose q6-Bhr prn (max. 2 mg/
kg/dose)

0.25 - 1 mg/kg/dose q6-8hr pr

Ibuprofen IV for PDA closure
(NeoProfen®) PDA Tx: Load 10 mg/kg x 1 dose then 5 mg/kg/

dose 024h x 2 doses starting 24hr after load
(max. 2 courses)

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opranolol IVorPO (per Cardiology

(Inderal) IV: 0.01 mg/kg/dose IV Q6hr or O8hr
PO: 0.25 mg/kg/dose PO QGhr or Qähr

Gastrointestinal

Famotidine CHKD'S only IV H, Blocker
(Pepcid®) <1 month of age: 05 mg)
BID

Use Total Daily dose in TPN
Dosing Adjustment in Renal Impairment:
/kg/dose q24hr
CrCl <10 mi/min/me: 0.5 mg/kg/dose q48hr

someprazole CHKD's only IV proton pump inhibitor
(Nexium?) jay. May increase to BID if needed.
15009, incr. sepsis risk)

Omeprazole CHKD'S PO proton pump inhibitor for patients
(Prilosec) < 10kg

for < 10kg: 0.5 - 1 mg/kg/dose PO daily.

May increase to BID if needed

(not recommended in <1500g, incr. sepsi

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Respiratory

Ursodiol
(Actigall

PO only
10-15 m

PO only

dose q12hr 1 mg

Bumetanide IV or PO: 0.05 mg/kg/dose 08-012 hr, tirate
ess (Bumex®) based on diuresis

Calcium Ca Gluconate (IV): 100 - 200 mi
Supplementation over hour

a NEE) Curosurf® Via ETT only (divided into 2 aliquots) Max.
Granulocyte lony Neutropenia/Sepsis: 10 mg/kg IV q24hr until (Poractant Alfa) total dose 5 ml/kg. Load: 2.5 ml/k
Stimulating Factor >1000 (order 1 dose at a time) Subsequent doses: 1.25 mlkg/dose q12hr —
(GCSF)/filgrastim up to 2 additional dos

Furosemide
(Lasix®)

Insulin Standard Drip Conc. Continuous IV infusion:
(Regular only) 0.01 to 0.1 units/kg/hr; titrated to blood —
glucose Racemic Epinephrine
~ (HHN)

% solution diluted in 3mi

Magnesium nesium Sulfate (IV):
Supplementation Mag. Gluconate (PO): 185-370 mg/kg/day
PO g6hr

24. Diazepam
(Valium?)

Midazolam

Pancuronium
avulon®)

or PO “reserved for older/TERM infants due
to decreased metabolism*; very long half-life with
chronic dosing and often only need to dose
three times per day.
Consult your NICU Pharmacist for dosing.

05 to 0.1 mg/kg/d
ff

IV or PO Standard Drip Concentration
continuous IV infusion: 0.05 to 0.2 mg/kg/h

bolus: 0. kg/dose IV q2hr- q4hr
PR

IV only; prolonged duration with poor renal
function

0.1 mg/kg/dose IV Q1hr PRN movement

NO analgesic effect-use with sedation/analgesia
For multiple doses/day, also order Lacri-lube OU
PRN

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