PALS 2006 drugs

Question 1

Adenosine

Answer 1

SVT 0.1 mg/kg rapid IV push, 2nd dose 0.2 mg/kg rapid IV push, max 12 mg

Question 2

Albumin

Answer 2

Shock, trauma, burns: 0.5-1 g/kg (10-20 mL/kg of 5%) IV/IO rapid infusion

Question 3

Albuterol

Answer 3

Asthma, anaphylaxis, hyperkalemia: MDI 4-8 puffs INH q20 min PRN with spacer
Neb: 2.5 mg/dose (wt 20 kg) inh q20min PRN
Continuous: 0.5 mg/kg per hour INH (max 20 mg/hr)

Question 4

Amiodarone

Answer 4

SVT, VT
5 mg/kg IV/IO load over 20-60 min (max 300 mg), repeat to daily max 15 mg/kg (or 2.2 g)
PEA
5 mg/kg IV/IO bolus, repeat to daily max 15 mg/kg

Question 5

Atropine sulfate

Answer 5

Bradycardia (symptomatic)
0.02 mg/kg IV/IO (min dose 0.1 mg, max single peds dose 0.5 mg) max total dose child 1 mg, adolescent 2 mg
Toxins/Overdose
0.02-0.05 mg/kg (<12 yrs) or 0.05 mg/kg IV/IO q20 min until effect

Question 6

Calcium chloride 10%

Answer 6

Hypocalcemia, hyperkalemia, hypermagnesemia,CCB OD

20 mg/kg IV/IO slow push

Question 7

Dexamethasone

Answer 7

Croup

0.6 mg/kg PO/IM/IV (max 16 mg)

Question 8

Dextrose

Answer 8

Hypoglycemia

0.5-1g/kg IV/IO (D25W 2-4 mL/kg, D10 5-10 mL/kg)

Question 9

Diphenhydramine

Answer 9

Anaphylactic shock

1-2 mg/kg IV/IO/IM q4-6H (max 50 mg)

Question 10

Dobutamine

Answer 10

CHF, cardiogenic shock

2-20 mcg/kg/min IV/IO infusion

Question 11

Dopamine

Answer 11

Cardiogenic, distributive shock

2-20 mcg/kg/min IV/IO

Question 12

Epinephrine

Answer 12

Pulseless arrest, bradycardia

0. 01 mg/kg (0.1 mL/kg 1:10,000) IV/IO q3-5 min
1. 1 mg/kg (0.1 mL/kg 1:1000) ETT q3-5 min

Hypotensive shock
0.1-1 mcg/kg/min IV/IO

Anaphylaxis/Asthma
0.01 mg/kg IM q15m PRN

Croup
0.25-0.5 mL racemic (2.25%)

Question 13

Lasix

Answer 13

Pulmonary edema, fluid overload

1 mg/kg IV/IM (usual max 20 mg)

Question 14

Hydrocortisone

Answer 14

Adrenal insufficiency

2 mg/kg IV bolus (max 100 mg)

Question 15

Inamrinone

Answer 15

Myocardial dysfunction and increased SVR/PVF

Loading: 0.750-1 mg/kg IV/IO slow bolus then 5-10 mcg/kg/min IV/IO infusion

Question 16

Ipratropium bromide

Answer 16

Asthma

250-500 mcg inh q20 min PRN

Question 17

Lidocaine

Answer 17

VF/pulseless VT, wide complex tachy (with pulses)
1 mg/kg IV/IO bolus
20-50 mcg/kg/min IV/IO infusion maintenance (repeat bolus if started >15 mins after bolus)

Question 18

Magnesium sulfate

Answer 18

Asthma, torsades, hypomag

25-50 mg/kg IV/IO bolus over 15-20 min (max 2g)

Question 19

Methylprednisone

Answer 19

Asthma, anaphylactic shock

Load 2 mg/kg IV/IO/IM (max 80 mg), then 0.5 mg/kg q6h

Question 20

Milrinone

Answer 20

Myocardial dysfunction and increased SVR/PVR

50-75 mcg/kg IV/IO over 10-60 min followed by 0.5-0.75 mcg/kg/min IV/IO infusion

Question 21

Naloxone

Answer 21

Opioid reversal
OD: 0.1 mg/kg IV/IO/IM/SQ q2min PRN
slow: 1-5 mcg/kg titrated to effect

Question 22

Nitroglycerin

Answer 22

CHF, cardiogenic shock
0.25-0.5 mcg/kg/min infusion, may increase by 0.5-1 mcg/kg/min q3 min PRN to 1-5 mcg/kg/min (max 10 mcg/kg/min)
Adolescents: 10-20 mcg/min, increase by 5-10 mcg/min to max 200 mcg/min

Question 23

Norepinephrine

Answer 23

Hypotensive shock

0.1-2 mcg/kg/min

Question 24

Procainamide

Answer 24

SVT, aflutter, VT (with pulses)

15 mg/kg IV/IO load over 30-60 min

Question 25

Sodium Bicarbonate

Answer 25

Metabolic acidosis, hyerkalemia
1 mEq/kg IV/IO slow bolus
Sodium channel blocker overdose (TCAs)
1-2 mEq/kg bolus until serum pH >7.45 followed by infusion of 150 mEq/L to maintain alkalosis

Question 26

Sodium Nitroprusside

Answer 26

Cardiogenic shock, severe hypertension

1-8 mcg/kg/min (wt 40 kg)

Question 27

Terbutaline

Answer 27

Asthma, hyperkalemia

0.1-10 mcg/kg/min, consider 10 mcg/kg load