Antibiotics
|
DRUG NAME |
DOSE |
FREQUENCY |
MAX DOSE |
COMMENTS |
|
Acyclovir |
20 mg/kg/dose 10-15 mg/kg/dose |
Q 8 hrs |
20 mg/kg/dose for 3 mos-12yr 10-15mg/kg/dose for >12 yr |
|
|
Ampicillin |
100-400 mg/kg/day |
÷ Q 6 hr |
2 gm/dose |
|
|
Amp/Sulbactam (Unasyn) |
100-300 mg/kg/day |
÷ Q 6 hr |
2 gm/dose Amp |
Express as Ampicillin component |
|
Abelcet |
5 mg/kg/day |
Daily |
Liposomal ampho B |
|
|
Caspofungin |
50-70 mg/m2 |
|||
|
Cefazolin |
20-25 mg/kg/dose |
Q 8 hr |
1 gm/dose |
|
|
Cefepime |
50 mg/kg/dose |
Q 8 hr Q 12 meningitis/CF |
2 gm/dose |
|
|
Ceftriaxone |
50-100 mg/kg/day |
Daily or ÷ Q 12 hr |
2 gm/dose |
100 mg/kg/d ÷ Q 12 hr for meningitis |
|
Clindamycin |
10 mg/kg/dose |
Q 8 hr or Q 6 hr |
900 mg Q 8 |
|
|
Fluconazole |
6-12 mg/kg/day 3-6 mg/kg/day |
Daily |
High dose for disseminated infections (12mg/kg/d) |
|
|
Gentamicin |
2.5 mg/kg/dose |
Q 8 hr or Q 12 hr Or based on troughs |
Q 8 hr for normal kidneys, Q 12 if < 1 mos Dose per trough for renal failure |
|
|
Meropenem |
20 mg/kg/dose |
Q 8 hr |
1 gm/dose |
Adjust for renal failure |
|
Metronidazole |
30 mg/kg/day |
÷ Q 6 hr |
PO is best route if able |
|
|
Nafcillin |
50-200 mg/kg/day |
÷ Q 6 hr |
2 gm/dose |
Better if used centrally |
|
Pip-Tazobactam (Zosyn) |
50-75 mg/kg/dose |
Q 6 hr |
4 gm Piperacillin |
Express as Piperacillin component |
|
Vancomycin |
15 mg/kg/dose |
Q 6, 8 ,12 hrs or by troughs |
1 gm/dose |
Q 8 hr normal kidneys, Q 6 hr meningitis, Q 12 hr if < 1 month, Per trough for renal failure |
Common medications
Rapid sequence intubation (RSI)
| Cardiac Patients | |
| Atropine | 0.02 mg/kg/dose (1 cc, infants) |
| Fentanyl | 2.5-5 mcg/kg/dose (May cause chest wall rigidity) |
| Rocuronium | 1 mg/kg/dose |
| High ICPs | |
| Lidocaine | 1 mg/kg/dose |
| Etomidate | 0.1-0.3 mg/kg |
| Rocuronium | 1 mg/kg/dose |
| Asthma | |
| Ketamine | 1-2 mg/kg/dose (Bronchodilator, raises SVR) |
| Atropine | 0.02mg/kg/dose |
| Rocuronium | 1 mg/kg/dose |
| Respiratory Failure (Not Asthma) | |
| Propofol | 1-2 mg/kg/dose |
| Atropine | 0.02 mg/kg/dose |
| Rocuronium | 1 mg/kg/dose |
| Sepsis | |
| Ketamine | 1-2 mg/kg/dose (raises SVR) |
| Rocuronium | 1 mg/kg/dose |
| **Avoid Etomidate (cortisol suppression) and Propofol (hypotension) | |
Above are general guidelines for RSI. Decision should be made based on provider preference.
Sedatives and paralytics
| Ativan | 0.05-0.1 mg/kg/dose, max 2-4 mg |
| Dexmedetomidine | 0.5 mcg/kg bolus over 10 min, then 0.25-1 mcg/kg/hr |
| Fentanyl | 1-2 mcg/kg/dose |
| Methadone | 0.05 -0.2 mg/kg/day PO Q12hr, dose based on prior narcotics |
| Propofol | 0.5-1 mg/kg/dose boluses, 25-100 mcg/kg/min for most infusions |
| Rocuronium | 1 mg/kg/dose (max blockade <5 mins) |
| Vecuronium | 0.1 mg/kg/dose |
| Versed | 0.05-0.1 mg/kg/dose, max 2-4 mg |
GI medications
| Famotidine | 0.5mg/kg/dose IV/PO BID, max 20 mg BID |
| Omeprazole | 1-3 mg/kg/day PO divided BID or daily |
| Pantoprazole | 1-3 mg/kg/day IV divided BID |
| Reglan | 0.1 mg/kg/dose IV |
| Ursodiol | 10-15 mg/kg/day PO |
Fluids and electrolytes
| 5 % Albumin | 5-10 cc/kg IV (hypotension, volume replacement) |
| 25% Albumin | 1 g/kg IV over 60 min (for hypoalbuminemia) |
| NaHCO3 | 1-2 meq/kg IV over 20-30 min (central line) |
| Chlorothiazide | 5-10 mg/kg/dose PO/IV Q 12 hr |
| D10W & D 25W | 2 cc/kg IV push |
| Diamox | 5 mg/kg/dose IV Q 12 hr |
| Furosemide |
1 mg/kg/dose IV Q 6 to Q 12 hrs |
| Metolozone | 0.2-0.4 mg/kg/day |
| NS Bolus | 10-20 cc/kg over 30-60 min |
| Spironolactone | 1 mg/kg/dose PO Q 12 hr |
| THAM | 3 cc/kg IV (equivalent to 1 meq/kg Bicarb) |
Cardiac medications
| Ca Chloride | 20 mg/kg IV (must be central line, for iCa <4) |
| Captopril | 0.25-1 mg/kg/dose Q 8 hr (test dose 0.1mg/kg) |
| Digoxin | 5 mcg/kg/dose PO Q 12 hr |
| Enalapril | 0.1-0.4 mg/kg/day divided BID (start w/ low dose) |
| Epinephrine | 0.1 cc/kg of 1:10,000 IV |
| KCl | 0.5-1 meq/kg/dose, max 20 meq |
| Mg Sulfate | 25 mg/kg/dose IV Q 6 hr X 3 dose (for Mg < 2) |
Heme/Onc medications
| Aspirin | 5 mg/kg/day (anti-plt effect for shunts) |
| Enoxaparin | 1.5 mg/kg/dose BID for clot tx, daily for prophylaxis |
| Factor VIIa | 90 mcg/kg/dose, may repeat Q 2-3 hrs X 3 doses prn |
| FFP | 10cc/kg IV over 1 hr |
| IVIG | 1 g/kg IV over 3-4 hrs |
| pRBCs | 10-15 cc/kg IV over 2-3 hr (unless Hgb < 5-6) |
| Vit K | 1 mg IM infants, Adults 10 mg IM |
Neurologic medications
| Dilantin | 15-20 mg/kg IV load, then 3-6 mg/kg/day PO/IV divided BID or TID |
| Keppra | 10 mg/kg/dose PO/IV BID, adolescent 500 mg BID |
| Mannitol | 0.5-1 g/kg/dose IV |
| 3% NaCl | 3 cc/kg/dose IV over 30 min for high ICPs |
| Phenobarbital | 15-20 mg/kg IV load, then 4-6 mg/kg/day PO/IV divided Q 12 |