Pediatric Medications Flashcards
Pediatric maintenance fluids
use D5NS. Use NS if glucose contraindicated
a. ≤10 kg body weight: 4 x (wt in kg) = mL/hr
b. 11–20kgbodyweight:2x(wtinkg–10)+40=2x(Wtinkg)+20=mL/hr
c. >20kgbodyweight:(wtinkg–20)+60= Wtinkg+40=mL/h
Pediatric maintenance fluid for head injury
3/4 calculated volume NS
Push dose Epi
0.1 mL/kg (1 mcg/kg) every 3 – 5 min PRN to maintain SBP >70 + (2x age in years). Max 20 mcg per dose.
Hypovolemic shock fluid resuscitation
20ml/kg
Cardiogenic shock fluid bolus
5 – 10 mL/kg NS bolus. May repeat PRN if no pulmonary edema is present (maximum is 60mL/kg total).
Pediatric Norepi dose
0.05-2mcg/kg/min not to exceed 45 mcg/min
Septic Shock Fluid
20mL/kg LR bolus. Repeat PRN. More than 100mL/kg may be required.
Epi infusion
0.05 – 0.3 mcg/kg/min titrated to a maximum 1 mcg/kg/min.
Neurogenic shock fluid
(40-60 mL/kg in pediatric
patients),
Phenylephrine
0.25 – 5 mcg/kg/min
Maximum rate 200 mcg/min, although some providers may exceed this rate.
Dilaudid
<6 months: 5 mcg/kg
>6 months: 15mcg/kg
Fentanyl Push dose
1-2 mcg/kg
Fentanyl infusion
0.5 mcg/kg/hr after initial IV bolus
After 5 – 10 minutes, if pain control is inadequate,
bolus 0.5 mcg/kg and increase infusion by 0.5 mcg/kg/hr. Repeat bolus and infusion titration q 5 – 10 min PRN to a max of 3 mcg/kg/hr.
Morphine
0.1 – 0.2 mg/kg IV/IM.
Ketamine for pain adjunct
0.2 mg/kg slow IV push
Ativan for sedation
0.05 – 0.1 mg/kg IV or IM.
Versed for sedation
0.05 – 0.1 mg/kg IV or IM.
0.3 mg/kg IN (max dose 10 mg), half of dose in each nostril
Versed infusion
50 mcg/kg/hr after initial IV bolus.
If sedation inadequate after 5 – 10 minutes, bolus 50
mcg/kg and increase infusion by 10 mcg/kg/hr. Repeat bolus and increase infusion q 5 – 10 min PRN, not to exceed an infusion rate of 100 mcg/kg/hr.
Ketamine for sedation
Loading dose 1 mg/kg slow IV push (if induction dose
not given). Repeat 0.5 mg/kg q 15 minutes.
Ketamine infusion
0.5 mg/kg/hr
If sedation inadequate after 10 minutes, bolus 0.5 mg/kg and increase infusion by 0.5 mg/kg/hr. Repeat bolus and increase infusion q 10 minutes PRN to a max rate of 4 mg/kg/hr.
Pediatric propofol
Bolus with 0.5 mg/kg (max 20 mg), and increase
drip rate by 10 mcg/kg/min q 5 min, not to exceed 75
mcg/kg/min.
Ativan for anxiety
0.02mg/kg IV, not to exceed 1mg. May repeat q 30 – 45 min PRN.
Narcan
0.02 mg/kg IV/IM/IN
1. May repeat q3–5min (not to exceed 0.4mg in a single
dose).
Zofran
0.1mg/kg IV or IM for pediatric patients >1 month old (max 4 mg/dose)
Phenergen
> 2 years old: 0.5 mg/kg (25mg max) deep IM or IV
Ativan for nausea
0.05 mg/kg IV or IM.
Benadryl for nausea
1mg/kg IV (max 25mg)
Duoneb for asthma
0.5 mg ipratropium/2.5 mg albuterol (3mL = 1 unit) via nebulizer q 10min PRN
x 3 doses total.
Solu-Medrol
2mg/kg IV (Max 60mg).
Mag Sulfate for asthma
50 mg/kg IV over 20 – 30 min once. Maximum dose 2
grams.
Racemic epi for croup
0.5 mL of 2.25% solution diluted in 2.5mL NS.
May repeat q20–30min PRN.
Fentanyl for pretreatment of RSI
2 – 3 mcg/kg slow IV push over 30-60
seconds.
Ketamine induction dose
2mg/kg
Versed induction dose
0.1 mg/kg IV.
Etomidate
0.3 mg/kg IVP. May repeat x 2.
Succinylcholine
1.5 mg/kg IV (maximum of 200mg)
Only for 10 years and older
Rocuronium
1mg/kg IV
1.8mg/kg IM
Atropine if needing during RSI
0.02 mg/kg IV.
Pediatric epi dose Cardiac arrest
Epinephrine dosing should be calculated in mL/kg.
a. IV/IO: Epinephrine (1:10,000) 0.1 mL/kg
b. Per ET Tube: Epinephrine (1:1000) 0.1mL/kg.
c. Mayrepeatq3–5min.
Epi infusion ROSC
0.1 – 1.0 mcg/kg/min IV, titrated PRN.
No maximum epinephrine dose listed per ACLS and PALS, but consider adding Norepinephrine if hypotension persists beyond 30 mcg/min in adults and 1 mcg/kg/min in pediatric patients.
Versed for sedation ROSC
0.025 mg/kg. If BP stable, repeat q 5 minutes to a max of 0.1 mg/kg q 15 minutes (not to exceed 5 mg/dose)
Lasix for pulmonary edema
1 – 2 mg/kg IVP up to 20 mg or amount equal to patient’s usual oral dose, whichever is higher.
Benadryl for allergic reactions
1mg/kg max 50
Epi for anaphylaxis
0.01 mg/kg (0.01 mL/kg) IM (thigh), (maximum
0.5 mg per dose.) May repeat q 10 minutes PRN x 3.
1:1000 concentration
