Table Of Contents
- Age specific drug dosing:
- Warnings:
- Cautions:
- Contraindications:
Clarks Rule
- Pediatric Dose = child weight(kg)/adult weight of 70kg x adult dose
- Pediatric Dose = child weight(pounds)/adult weight of 150lbs x adult dose
Young’s Rule
Pediatric Dose by Surface Area
- Formula: SA of child (m2) / 1.7 x adult dose
- The reasoning for using Surface Area to calculate Pediatric Dose:
Factors influencing absorption
Pediatric Absorption
- Influencing factors are poorly developed/defined in infancy.
- Enteral absorption is not predictable (generally slower than adults).
Topical Absorption
- Much greater in children than adults, especially high in neonates.
- Only the pharmacokinetic parameter will INCREASE in children.
Pediatric Distribution
- Increased total body water (extracellular water) in infants and children results in lower peak levels of water-soluble drugs.
- Body fat will increase with age.
Pediatric Metabolism
- Neonatal hepatic function is underdeveloped.
- Results in prolonged half-lives of drugs being oxidized (lidocaine, during undergoing glucuronidation-phase II reactions).
Pediatric Excretion
- Underdeveloped renal function.
- Water-soluble drugs (penicillin, cephalosporins) show prolonged half-life. GFR, renal plasma flow, and tubular function reach adult values 9-12 months of age.
Side effects
Medication | Side Effects |
Acetaminophen | Hepatic dysfunction |
Alcohol | Aggressive Behavior Hypertension |
Aminoglycosides | Hearing loss |
Anticholinergics | Xerostomia (dry mouth) |
Chloramphenicol | Gray-Baby Syndrome |
Corticosteroids | Acne Adrenal insufficiency Growth suppression |
Insulin | Hypoglycemia |
Sulfonamide | Kernicterus |
Tetracyclines | Permanent discoloration of teeth |
Medications
Adenosine
Albuterol
- Dose:
- Common dose for pediatrics < 20 kg:
- Common dose for pediatrics > 20 kg:
- Can be repeated:
Amiodarone
- Indication:
Atropine
- Dose:
- Common max dose:
- Indications:
Benadryl
Dexamethasone (Decadron)
- Dose range:
- Common dose:
Dextrose
- Dose:
- Hypoglycemia:
Dilaudid
EPI (1:10,000)
- Common dose:
- Dose Max:
Etomidate
- Dose:
- Max dose:
- Min age:
Glucagon
Hydroxocobalamin
Ipratropium (Atrovent)
- Dose range:
- Common Dose:
Ketamine
- Dose range:
- Common Dose:
Morphine
Narcan
- Dose:
- Contra-indications:
Rocuronium
- Long term paralytic.
- Dose:
- Common Dose Range:
- Contraindications:
Solumedrol
Succinylcholine
- Who gets it:
- Dose:
- Too big for broslow tape:
- Considerations for succinylcholine:
Versed
- Dose range:
- Common dose for seizures:
- Common dose for RSI for 10 years and younger:
- Versed considerations:
Zofran
Expectorants
Guaifenesin
- Indications:
- MOA:
- Implications: