Pediatirc Drug

PEDIATRIC
Drug and Dosages

A Quick Glance
ii
Pediatrics is an everchanging field, but as new research and clinical

experience broadens our knowledge, changes in treatment may
become necessary or appropriate. The publishers and participants
of this work have checked with sources believed to be reliable in
their efforts to provide information that is complete and generally in
accord with the standards at the time of publication. Care has been
taken to confirm the accuracy of the information presented and to
describe generally accepted practices. However, in view of the
possibility of human error or changes in medical sciences, neither
the publisher or any other party who has been involved in the
preparation of this work warrants that the information contained
herein is every respect complete. Readers are advised to check the
product information currently provided by the manufacturer of each
drug to be administered to verify the recommended dose, the method
and duration of administration, and the contraindications. Application
of this information in a particular situation remarks the professional
responsibility of the Pediatrician/Practitioner. This recommendation
is of particular importance in connection with new or infrequently
used drugs. It is the responsibility of the treating physician relying on
experience and knowledge of the patient, to determine dosages and
the best treatment for the patient.
Researched, Edited, Printed and Published by :

Indegene Lifesystems Pvt. Ltd.
#130, 1st Cross, 5th Block, Koramangala,
Bangalore - 560095
Tel : 080-5524314 / 5535761
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may be reproduced, stored in retrieval system, tapes, discs,
microfilm, etc., or transmitted in any form or by any means
electronic, mechanical, photocopying, recording, or
otherwise, without the written permission of Indegene
Lifesystems, Bangalore.
iii
Preface
This is a concise and “reader friendly” version of a pediatrician’s

compendium, designed for quick reference of current essential drugs
in pediatric practice. We hope the format makes it easier for
pediatricians and public health doctors working with children to find
information needed on all drugs used in India and around the world.
This book presents the usual recommended doses for the
medications in use but, we recommend its use in conjunction with
the clinical judgment of the prescribing physician tailored to each
individual diagnosis. It is our intent that the advice provided in this
book will make the treatment more specific and effective.
We hope that this book will be an useful tool in daily practice of the
busy pediatrician.
iv
Abbreviations
ABG arterial blood gases GI gastrointestinal

ac before meals GU genitourinary
ACE angiotensin-converting gyn gynecologic
enzyme h hour
ADHD attention deficit hyperactivity HF heart failure
disorder
Hgb hemoglobin
AIDS acquired immunodeficiency
syndrome HIV human immunodeficiency virus
ALL acute lymphocytic leukemia hs at bedtime
AML acute myelogenous leukemia HSV herpes simplex virus
amp ampule Hz0 water

ASAP as soon as possible IBS irritable bowel syndrome
ATC around-the-clock ID intradermal
bid twice a day IM intramuscular
BM bowel movement inj injection
BMT bone marrow transplantation INR international normalized ratio

BP blood pressure IU international unit
BPH benign prostatic hyperplasia IV intravenous
BSA body surface area K potassium
Ca calcium KCI potassium chloride
CA cancer L liter
CAD coronary artery disease liq liquid
caps capsule lop intraocular pressure
CF cystic fibrosis IPPB Intermittent positive-pressure

breathing
CMV cytomegalovirus
M molar
COPD chronic obstructive
pulmonary disease MAC Mycobacterium aviumcomplex
CrCl creatinine clearance MAO monoamine oxidase
CSF cerebrospinal fluid max maximum
CSS Controlled Substance mcg microgram

Schedule mEq milliequivalent
CVA cerebrovascular accident mg milligram
D5W dextrose 5% in water mgt management
dil diluted, dilution MI myocardial infarction
dl deciliter min minute
DM diabetes mellitus ml milliliter
DVT deep vein thrombosis mol molecular
ET endotracheal MS multiple sclerosis
GERD gastroesophageal reflux mz square meter
disease Na sodium
v
Abbreviations
NaCI sodium chloride RDA recommended daily allowance

ng nanogram RDS respiratory distress syndrome
NG nasogastric RF renal failure
NSAID nonsteroidal anti-inflammatory SC subcutaneous
drug sec second
NSS normal saline solution SIADH syndrome of inappropriate
OC oral contraceptive antidiuretic hormone
OCD obsessive-compulsive disorder SL sublingual
oint ointment sol solution
OM otitis media SSRI selective serotonin reuptake
ophth ophthalmic inhibitor
PAC premature atrial contraction ST sinus tachycardia
Paco2 partial pressure of CO2 suppl supplement
PAT paroxysmal atrial tachycardia susp suspension
PC after meals SVT supraventricular tachycardia
PE pulmonary embolism tab tablet
ped pediatric TB tuberculosis
PID pelvic inflammatory disease tbl tablespoon
pkg package TCA tricyclic antidepressant
pkt packet temp temperature
PO by mouth tid three times a day
PPB positive-pressure breathing tol tolerate, tolerated
PR by rectum tsp teaspoon
PRC pregnancy risk category U unit
prn as needed URI upper respiratory tract infection
PSVT paroxysmal supraventricular UTI urinary tract infection
tachycardia vag vaginal
PT prothrombin time VF ventricular fibrillation
PTT partial thromboplastin time VT ventricular tachycardia
PVC premature ventricular wk week
contraction wkly weekly
qd daily wt weight
qid four times a day yr year
RA rheumatoid arthritis
vi
Pregnancy Risk Category: PRC
Pregnancy risk categories parallel those assigned by the Food and Drug Administration to
reflect a drug’s potential to cause birth defects.
A: Adequate studies in pregnant women have failed to show a risk to the fetus.
B: Animal studies haven’t shown a risk to the fetus, but controlled studies haven’t been
conducted in pregnant women; or animal studies have shown an adverse effect on
the fetus, but adequate studies in pregnant women haven’t shown a fetal risk.
C: Animal studies have shown an adverse effect on the fetus, but adequate studies
haven’t been conducted in humans. The benefits may be acceptable despite the
risks.
D: The drug may pose risks to the human fetus, but potential benefits may be acceptable
despite the risks.
X: Studies in animals and humans show fetal abnormalities, or reports of adverse

reactions indicate evidence of fetal risk.
vii
Contents
Preface .............................................................................................................................iii
Abbreviations ................................................................................................................... iv
Pregnancy Risk Category: PRC ...................................................................................... vi
Pediatrics Drug Facts .......................................................................................................1
Appendix 1: Vaccines Considered Essential in Childhood ..........................................103
Appendix 2: Newer Vaccines in Childhood ..................................................................104
Appendix 3: Laboratory References ...........................................................................105
Appendix 4: Urinalysis .................................................................................................107
Appendix 5: Inhalational Drug References ..................................................................108
Appendix 6: Management of Fever in Infants and Young Children ..............................109
Appendix 7: Management of Severe Asthma Exacerbation in a Child ........................110
Appendix 8: Evaluation and Treatment of Diarrhea .....................................................111

Assessment of dehydration in a patient with diarrhea ......................................... 111
Composition and concentration of WHO/UNICEF

recommended oral dehydration salts (ORS) ............................................... 111
Guidelines for replacement of fluid and electrolytes

in children with ‘No dehydration’ (Plan A)* ................................................. 111
Deficit fluid therapy for ‘Severe dehydration’

(Plan C) (100 ml/kg body weight) ............................................................ 112
Antimicrobials used to treat specific causes of

diarrhea in children ................................................................................ 112
Index .............................................................................................................................113
PEDIATRiC DRUG 1
Acetaminophen PRC: B
Classes
A
Para-aminophenol derivative; nonnarcotic analgesic, antipyretic
Indications
Pain, fever
Dosages
Pain, fever—Child < 3 month: 40 mg PO q 4-6 h.
Child 4-11 month: 80 mg PO q 4-6 h.
Child 12-23 month: 120 mg PO q 4-6 h.
Child 2-3 yr: 160 mg PO, PR q 4-6.
Child 4-5 yr: 240 mg PO, PR q 4-6 h.
Child 11 yr: 480 mg PO, PR q 4-6 h.
Child > 11 yr, adult: 325-650 mg PO, PR q 4-6 h. Max 4 gram qd. For long-term, max
2.6 gram qd.
Adenosine PRC: C
Classes
Nucleoside; anti-arrhythmic
Indications
PSVT
Dosages
PSVT—Neonate, infant, child: 0.05 mg/kg IV; increase by 0.05 mg/kg IV q 2 min to max
0.25 mg/kg. Max 12 mg/dose.
Adult: 6 mg IV over 1-2 sec. If PSVT persists for 1-2 min, 12 mg by rapid IV push.
Repeat prn. Max 12 mg/dose.
Albuterol Sulfate PRC: C

Classes
Adrenergic; bronchodilator
Indications
Bronchospasm
Prevention of exercise-induced bronchospasm
Dosages
Bronchospasm—Child 2-5 yr: 0.1 mg/kg PO tid, max 2 mg (syrup or immed-rel tab) tid.
Or in child > 2 yr, 0.1-0.15 mg/kg (max 2.5 mg) tid-qid by nebulizer.
Child 6-11 yr: 2 mg PO (syrup or immed-rel tab) tid-qid or 4 mg (sustained-release tab)
PO q 12 h. Or in child ≥ 4 yr, 1-2 inhalant, inhalation q 4-6 h with spacer; or 200 mcg q 4-6 h
with Rotahaler.
Children ≥ 12 yr, adult: Tab 2-4 mg (immed-rel) PO tid or qid; max 8 mg qid. Or 4 mg
(sustained-release) PO q 12 h. Increase to 8 mg q 12 h prn. Max 16 mg q 12 h. Syrup: 2-
4 mg (1-2 tsp) PO tid-qid. Aerosol inhalant, inhalation: 1-2 inhalant, inhalation q 4-6 h.
2 PEDIATRiC DRUG
Solution for inhalant, inhalation: 2.5 mg tid-qid by nebulizer. Caps for inhalant, inhalation: 200
A mcg q 4-6 h with Rotahaler.
Prevention of exercise-induced bronchospasm—Child ≥ 4 yr, adult: 2 inhalant, inhalation
15 min before exercise.
Allopurinol; Allopurinol Sodium PRC: C

Classes
Xanthine oxidase inhibitor; antigout
Indications
Hyperuricemia secondary to malignancies
Prevention of uric acid nephropathy during CA chemotherapy
Dosages
Hyperuricemia secondary to malignancies—Child < 6 yr: 50 mg PO tid.
Child 6-10 yr: 100 mg PO tid.
Prevention of uric acid nephropathy during CA chemotherapy—Child: 200 mg/m2 IV qd or
in equally divided infusion q 6, 8 or 12 h starting 1-2 day before chemotherapy.
Adult: 600-800 mg PO qd × 2-3 day starting 1-2 day before chemotherapy. Or 200-400
mg/m2 IV qd or in equally divided infusion q 6, 8, or 12 h starting 1-2 day before chemotherapy.
Max 600 mg/day.
Alprostadil PRC: NR
Classes
Prostaglandin derivative; ductus arteriosus patency adjunct
Indications
Maintenance patency of ductus arteriosus until surgery
Dosages
Maintenance patency of ductus arteriosus until surgery—Infant: 0.05 to 0.1 mcg/kg/min
IV via pump. Max 0.4 mcg/kg/min. Maintenance doses vary. Rate of 0.002-0.005 mcg/kg/
min may be effective.
Amantadine Hydrochloride PRC: C

Classes
Synthetic cyclic primary amine; antiviral, antiparkinsonian
Indications
Influenza type A virus; respiratory tract illnesses in debilitated pts
Drug-induced extrapyramidal reactions
Dosages
Influenza type A virus; respiratory tract illnesses in debilitated pts— Child 1-9 yr: 4.4-8.8
mg/kg PO qd, divided bid-tid. Max 150 mg/day.
Child 9-12 yr: 100 mg PO bid.
Adolescent, adult: 200 mg PO qd or divided bid.
Drug-induced extrapyramidal reactions—Adult: 100-300 mg/day PO in divided doses.
PEDIATRiC DRUG 3
Amikacin Sulfate PRC: D

Classes: A
Aminoglycoside; antibiotic
Indications
Serious infection
Dosages
Serious infection—Neonate 0-4 wk and < 1,200g: 7.5 mg/kg IM, IV q 18 h.
Neonate < 1 wk and < 1,200-2,000 gram: 7.5 mg/kg IM, IV q 12 h.
Neonate < 1 wk and > 2,000 gram: 7.5-10 mg/kg IM, IV q 12 h.
Neonate > 1 wk and < 1,200-2,000 gram: 7.5-10 mg/kg IM, IV q 8-12 h.
Neonate > 1 wk and > 2,000 gram: 10 mg/kg IM, IV q 8 h.
Infant, child, adult: 15 mg/kg/day divided q 8-12 h IM, IV in 100-200 ml D5W over 30-60
min. Max 1.5 gram/day.
Adult: 4-20 mg intrathecally or intraventricularly × 1 with IM or IV administration.
Aminophylline PRC: C
Classes
Xanthine derivative; bronchodilator
Indications
Bronchospasm
Chronic bronchial asthma
Apnea of prematurity
Bronchospasm from CF
Dosages
Bronchospasm—Pts not on theophylline: Loading dose 6 mg/kg IV, then maintenance
infusion.
Child 6 month-9 yr: 1.2 mg/kg/h IV × 12 h, then 1 mg/kg/h IV; or 4 mg/kg PO q 4 h × 3
doses, then 4 mg/kg q 6 h.
Child 9-16 yr: 1 mg/kg/h IV × 12 h, then 0.8 mg/kg/h IV; or 3 mg/kg PO q 4 h × 3 doses,
then 3 mg/kg q 6 h.
Adult (nonsmoker): 0.7 mg/kg/h IV × 12 h, then 0.5 mg/kg/h IV; or 3 mg/kg PO q 6 h × 2
doses, then 3 mg/kg q 8 h.
Otherwise-healthy adult smoker: 1 mg/kg/h IV × 12 h, then 0.8 mg/kg/h IV; or 3 mg/kg/
PO q 4 h × 3 doses, then 3 mg/kg/ q 6 h.
Pts on theophylline: Infusion of 0.63 mg/kg will increase plasma drug level by µgram/ml.
If no signs of toxicity, 3.1 mg/kg, then maintenance infusion.
Chronic bronchial asthma—Child: 16 mg/kg PO qd divided tid-qid.
Adult: 400 mg PO qd divided tid-qid.
Apnea of prematurity—Neonate: 4-5 mg/kg/ IV or PO, then 1.5-2.5 mg/kg IV or PO q 12 h,
starting 12 h after loading dose.Apnea of prematurity-Neonate: 4-5 mg/kg IV or PO, then
1.5-2.5 mg/kg IV or PO q 12 h, starting 12 h after loading dose.
Bronchospasm from CF—Infant: 10-12 mg/kg IV qd.
4 PEDIATRiC DRUG
Amoxicillin/Clavulanate Potassium PRC: B

A Classes
Aminopenicillin, beta-lactamase inhibitor; antibiotic
Indications
Lower respiratory infection, OM, sinusitis, skin and skin structure infection, UTI
Dosages
Lower respiratory infection, OM, sinusitis, skin and skin structure infection, UTI—Neonate,
infant < 3 month: 30 mg/kg PO of 125 mg/5 ml susp qd divided q 12 h.
Infant, child ≥ 3 month and < 40 kg: 45 mg/kg PO of 200 mg/5 ml or 400 mg/5 ml susp,
or 200-400 mg chewable tab qd divided q 12 h; or 40 mg/kg of 125 mg/5 ml or 250 mg/5 ml
susp or 125-250 mg chewable tab qd divided q 8 h. For less severe infection, 25 mg/kg PO
of 200 mg/5 ml or 400 mg/5 ml susp, or 200-400 mg chewable tab qd divided q 12 h; or 20
mg/kg PO of 125 mg/5 ml or 250 mg/5 ml susp, or 125-250 mg chewable tab qd divided q
8 h.
Child > 40 kg, adult: 250 mg PO q 8 h or 500 PO q 12 h. For severe infection, 500 mg q
8 h or 875 mg q 12 h.
Amoxicillin Trihydrate PRC: C

Classes
Aminopenicillin; antibiotic
Indications
Systemic infection, respiratory infection, uncomplicated UTI
Uncomplicated gonorrhea
Endocarditis prophylaxis for dental procedures
Dosages
Systemic infection, respiratory infection, uncomplicated UTI—Neonate, infant < 3 month:
30 mg/kg/day PO divided q 12 h.
Infant, child > 3 month: 20-40 mg/kg PO qd divided q 8 h.
Ped drops: Child < 6 kg, 0.75 ml q 8 h; 6-7 kg, 1 ml q 8 h; 7-8 kg, 1.25 ml q 8 h. Child with
respiratory infection and < 6 kg, 1.25 ml q 8 h; 6-7 kg, 1.75 ml q 8 h; 7-8 kg, 2.25 ml q 8 h.
Adult: 250 mg PO q 8 h. In adult, child > 20 kg with severe infection, 500 mg q 8 h may be
needed.
Uncomplicated gonorrhea—Child > 2 yr: 50 mg/kg in 1 dose with 25 mg/kg probenecid.
Adult: 3 gram PO in 1 dose.
Endocarditis prophylaxis for dental procedures—Child: 50 mg/kg PO 1 h before procedure.
Adult: 2 gram PO 1 h before procedure.
Amphotericin B PRC: B
Classes
Polyene macrolide; antifungal
Indications
Fungal infection, endocarditis; septicemia
Sporotrichosis
Aspergillosis
PEDIATRiC DRUG 5
Dosages
Fungal infection, endocarditis; septicemia—Child, adult: Test dose of 1 mg in 20 ml D5W A
IV over 20-30 min. If tol, 0.25-0.30 mg/kg/day IV. Increase by 5-10 mg/day untill dose is 1
mg/kg/day or 1.5 mg/kg every other day.
Sporotrichosis—Adult: 0.4-0.5 mg/kg/day IV × 2-3 month. Max 2.5 gram over 9 month.
Aspergillosis—Adult: 0.5-0.6 mg/kg/day IV. Max 1.5 mg/kg/day. Total IV dose 1.5-4 gram
over 11 month.
Amphotericin B Cholesteryl Sulfate Complex PRC: B

Classes
Polyene macrolide; antifungal
Indications
Invasive aspergillosis in pts intolerant of amphotericin B deoxycholate
Dosages
Invasive aspergillosis in pts intolerant of amphotericin B deoxycholate—Child, adult: 3-4
mg/kg/day IV at 1 mg/kg/h; increase to 6 mg/kg/day if no improvement or infection
progresses.
Ampicillin, Ampicillin Sodium, Ampicillin Trihydrate PRC: B

Classes
Aminopenicillin; antibiotic
Indications
Systemic infection, UTI
Meningitis
Prophylaxis for bacterial endocarditis before dental or minor respiratory procedures
Dosages
Systemic infection, UTI—Neonate ≤ 1 wk and < 2 kg: 25 mg/kg IM or IV q 12 h.
Neonate ≤ 1 wk and > 2 kg: 25 mg/kg IM or IV q 8 h.
Neonate > 1 wk and ≤ 2 kg: 25 mg/kg IM or IV q 8 h.
Neonate > 1 week and > 2 kg: 25 mg/kg IM or IV q 6 h.
Child: 50-100 mg/kg PO, IV, or IM qd, in divided doses q 6 h for mild to moderate infection;
or 200-400 mg/kg IM or IV qd, in divided doses q 4-6 h for severe infection.
Adult: 250-500 mg PO q 6 h.
Meningitis—Neonate ≤ 1 wk and ≤ 2 kg: 50-75 mg/kg IV q 12 h.
Neonate ≤ 1 wk and > 2 kg: 50-75 mg/kg IV q 8 h.
Neonate > 1 wk and ≤ 2 kg: 50 mg/kg IV q 8 h.
Neonate > 1 wk and > 2 kg: 50 mg/kg IV q 6 h.
Infant, child 2 month-12 yr: Up to 400 mg/kg IV qd × 3 day, then up to 300 mg/kg IM
divided q 4 h.
Adult: 8-14 gram IV divided q 3-4 h × 3 day; then IM if desired.
Uncomplicated gonorrhea—Child < 40 kg: 50 mg/kg/day IV or IM in divided doses q 6-8 h.
Child > 40 kg, adult: 500 mg IV or IM q 6 h.
Adult: 3.5 gram PO with 1 gram probenecid in 1 dose.
6 PEDIATRiC DRUG
Prophylaxis for bacterial endocarditis before dental or minor respiratory procedures—
A Child: 30 mg/kg IV or IM within 30 min of procedure.
Adult: 2 gram IV or IM within 30 min of procedure.
Ampicillin Sodium/Sulbactam Sodium PRC: B

Classes
Aminopenicillin/beta-lactamase inhibitor combination; antibiotic
Indications
Skin-structure, intra-abdominal, gyn infection
Dosages
Skin-structure, intra-abdominal, gyn infection—Infant, child ≥ 1 month: 100-150 mg/kg/
day IV divided q 6 h for mild to moderate infection; 200-300 mg/kg/day IV divided q 6 h for
severe infection.
Child ≥ 1 yr for skin-structure infection: 30 mg/kg/day IV divided q 6 h for max of 14
day.
Child ≥ 40 kg, adult: 1.5-3 gram IM or IV q 6 h. Max 4 gram/day sulbactam.
Ascorbic Acid (Vitamin C) PRC: A

Classes
Water-soluble vitamin; vitamin
Indications
Scurvy
Prevention of ascorbic acid deficiency in pts with poor nutrition or increased requirements
Dosages
Scurvy—Infant: 50-100 mg PO, IM, IV, or SC qd.
Child: 100-300 mg PO, SC, IM, or IV qd, then at least 35 mg/day for maintenance.
Adult: 300 mg-1 gram, PO, SC, IM, or IV qd or bid, then at least 50 mg/day for maintenance.
Prevention of ascorbic acid deficiency in pts with poor nutrition or increased requirements—
Neonate, infant, child > 2 wk: At least 20-50 mg PO, SC, IM, or IV qd.
Adult: 75-150 mg PO, SC, IM or IV qd.
Pregnant, breast-feeding women: At least 60-80 mg PO, SC, IM, or IV qd.
Aspirin PRC: D
Classes
Salicylate; nonnarcotic analgesic, antipyretic, anti-inflammatory, antiplatelet drug
Indications
Arthritis
Mild pain, fever
Juvenile rheumatoid arthritis
Rheumatic fever
Dosages
Arthritis—Child: 80-130 mg/kg PO qd in divided doses.
Adult: 3.6-5.4 gram PO qd in divided doses.
PEDIATRiC DRUG 7
Mild pain, fever—Child 2-11 yr: 1.5 gram/m2 PO or PR qd or 65 mg/kg PO or PR qd divided

q 4-6 h prn. Max 5 doses/day. Max rectal dose, 2.5 gram/m2/day. A
Child ≥ 11 yr, adult: 325-650 mg PO or PR q 4 h prn. Max 4 gram/day.
Juvenile rheumatoid arthritis—Child ≤ 25 kg: 60-130 mg/kg/day PO in divided doses.
Child > 25 kg: 2.4-3.6 gram qd in divided doses. Increase by 10 mg/kg/day q 7 day prn.
Maintenance dose 80-100 mg/kg/day.
Rheumatic fever—Child: 90-130 mg/kg PO qd divided q 4-6 h.
Adult: 4.9-7.8 gram PO qd divided q 4 to 6 h × 1-2 wk; then decrease to 60-70 mg/kg/day
× 1-6 wk; then gradually withdraw over 1-2 wk.
Atropine Sulfate PRC: C

Classes
Anticholinergic, belladonna alkaloid; antiarrhythmic, vagolytic
Indications
Symptomatic bradycardia, bradyarrhythmia
Preoperative to diminish secretions and block cardiac vagal reflexes
Antidote for anticholinesterase insecticide poisoning
Acute iritis, uveitis
Cycloplegic refraction
Dosages
Symptomatic bradycardia, bradyarrhythmia—Child: 0.02 mg/kg IV; max 1 mg or 0.3
mg/m2: repeat q 5 min.
Adult: 0.5-1 mg IV push; repeat q 3-5 min; max 2 mg.
Preoperative to diminish secretions and block cardiac vagal reflexes—Child < 20 kg: 0.1
mg IM for 3 kg; 0.2 mg IM for 4-9 kg; 0.3 mg IM for 10-20 kg 30-60 min before anesthesia.
Child > 20 kg, adult: 0.4 mg IM or SC 30-60 min before anesthesia.
Antidote for anticholinesterase insecticide poisoning—Child: 0.05 mg/kg IM or IV q 10-30
min until symptoms disappear.
Adult: 1-2 mg IM or IV. Additional 2 mg q 5-60 min until symptoms disappear.
Acute iritis, uveitis—Child, Adult: 1-2 drops (0.5 or 1% solution) in eye qid (child: use
0.5% solution) or small amount oint in conjuntival sac tid.
Cycloplegic refraction—Child: 1-2 drops (0.5% solution) in each eye bid × 1-3 day before
eye examination and 1 h before examination.
Adult: 1-2 drops (1% solution) 1 h before refraction.
Azelastine Hydrochloride, Ophthalmic Solution PRC: C

Classes
H1-receptor antagonist; ophth, nasal antihistamine
Indications
Eye itching from allergic conjunctivitis
Allergic rhinitis
Dosages
Eye itching from allergic conjunctivitis—Child ≥ 3 yr, adult: 1 drops in affected eye bid.
Allergic rhinitis—Child ≥ 12 yr, adult: 2 sprays in each nostril bid.
8 PEDIATRiC DRUG
Aztreonam PRC: B
Classes
B Monobactam; antibiotic
Indications
UTI, septicemia, respiratory tract, intra-abdominal, gyn, skin infection; adjunct treatment in
PID; gonorrhea
Dosages
UTI, septicemia, respiratory tract, intra-abdominal, gyn, skin infection; adjunct treatment in
PID; gonorrhea—Neonate < 1 wk and < 2 kg: 30 mg/kg IV q 12 h.
Neonate < 1 wk and > 2kg: 30 mg/kg IV q 8 h.
Neonate 1-4 wk and < 2 kg: 30 mg/kg IV q 8 h.
Neonate 1-4 wk and > 2 kg: 30 mg/kg IV q 6 h.
Child ≥ 9 month with normal renal function: 30 mg/kg IV q 8 h for mild-moderate
infection; 30 mg/kg IV q 6-8 h for moderate-severe infection. Max 120 mg/kg/day. Pts with
CF: 50 mg/kg q 6-8 h.
Adult: 500 mg-2 gram IV or IM q 8-12 h. For severe systemic or life-threatening infection,
2 gram q 6-8 h. Max 8 gram/day. For gonorrhea, 1 gram IM in 1 dose.
Bacitracin (Systemic) PRC: C

Classes
Polypeptide antibiotic; antibiotic
Indications
Pneumonia, empyema from staphylococci
Dosages
Pneumonia, empyema from staphylococci—Child < 2.5 kg: 900 U/kg IM qd in 2-3 divided
doses.
Child > 2.5 kg: 1,000 U/kg IM qd in 2-3 divided doses.
Beclomethasone Dipropionate (Oral Inhalant) PRC: C

Classes
Glucocorticoid; anti-inflammatory, antasthmatic
Indications
Asthma
Dosages
Asthma—Child 6-12 yr: 1-2 inhalant, inhalation reg strength tid-qid. Max 10 inhalant,
inhalation qd. 2 inhalant, inhalation double strength bid. Max 5 inhalant, inhalation/day.
Child > 12 yr, adult: 2 inhalant, inhalation reg strength tid-qid or 4 inhalant, inhalation bid;
max 20 inhalant, inhalation qd. 2 inhalant, inhalation double strength bid; for pts with severe
asthma, start with 6-8 inhalant, inhalation/day and adjust down. Max 10 inhalant,
inhalation/day.
Beclomethasone Dipropionate Monohydrate (Nasal) PRC: C

Classes
Glucocorticoid, anti-inflammatory; antasthmatic
PEDIATRiC DRUG 9
Indications
Rhinitis, prevention of nasal polyps after surgery removal
Dosages B
Rhinitis, prevention of nasal polyps after surgery removal—Child 6-12 yr: 1 spray (inhalant,
inhalation) in each nostril tid.
Child > 12 yr, adult: 1 spray (inhalant, inhalation) in each nostril bid-qid.
Child 6-12 yr: 1 spray (spray) in each nostril bid. If no response or severe symptoms,
increase to 2 sprays/nostril bid.
Child > 12 yr, adult: 1-2 sprays (spray) in each nostril bid.
Betamethasone (Systemic), Betamethasone Sodium Phosphate,

PRC: C
Betamethasone Sodium Phosphate and Betamethasone Acetate
Classes
Glucocorticoid; anti-inflammatory
Indications
Adrenocortical insufficiency
Severe inflammation, immunosuppression
Dosages
Adrenocortical insufficiency—Child: 17.5 mcg/kg PO qd or 500 mcg/m2 PO qd in 3-4
divided doses; or 17.5 mcg/kg/day or 500 mcg/m2/day IM in 3 divided doses q 3 day.
Adult: 0.6-7.2 mg PO qd, or up to 9 mg IM or IV qd.
Severe inflammation, immunosuppression—Adult: 0.6-7.2 mg PO qd.
Adult: 0.5-9 mg (Na phosphate) IM, IV or into joint or soft tissue qd.
Adult: 0.5-2 ml (Na phosphate and acetate) into joint or soft tissue q 1-2 wk prm.
Betamethasone Dipropionate, Betamethasone Dipropionate,

PRC: C
(Augmented), Betamethasone Valerate
Classes
Topical glucocorticoid; anti-inflammatory
Indications
Dermatitis
Dosages
Dermatitis—Child, adult: Apply (valerate) cream, lotion, oint, or gel in thin layer qd-qid.
Child > 12 yr, adult: Apply (dipropionate) cream, lotion, oint sparingly qd-bid. Max 45
gram/wk for oint, cream and 50 gram/wk for lotion, gel for max of 14 day. For aerosol,
spray affected area from a distance of 6" (15 cm) for 3 sec tid-qid.
Bisacodyl PRC: C
Classes
Diphenylmethane derivative, stimulant laxative
Indications
Constipation, bowel preparation
10 PEDIATRiC DRUG
Dosages
Constipation, bowel preparation—Child 6-12 yr: 5 mg PO qd. Or suppositories (5 mg) PR
qd.
B Adult: 10-15 mg PO qd. Up to 30 mg for evacuation before examination or surgery. Or 1
suppositories (10 mg) PR qd.
Bismuth Subsalicylate PRC: C

Classes
Adsorbent; antidiarrheal
Indications
Diarrhea
H. pylori gastritis with ampicillin and metronidazole
Dosages
Diarrhea—Child 3-6 yr: 5 ml or 1/3 tab PO q 1/2-1 h to max 8 doses/24 h for max of 2 day.
Child 6-9 yr: 10 ml or 2/3 tab PO q 1/2-1 h to max 8 doses/24 h for max of 2 day.
Child 9-12 yr: 15 ml or 1 tab PO q 1/2-1 h to max 8 doses/24 h for max of 2 day.
Adult: 30 ml or 2 tabs q 1/2-1 h to max 8 doses/24 h for max 2 day.
H. pylori gastritis with ampicillin and metronidazole—Child < 10 yr: 262 mg (15 ml) PO qid
× 6 wk. Child ≥ 10 yr: 542 mg PO (tab or solution) qid × 6 wk.
Brompheniramine Maleate PRC: C

Classes
Alkylamine antihistamine; H1-receptor antagonist
Indications
Rhinitis, allergies
Hypersensitivity
Dosages
Rhinitis, allergies—Child 2-6 yr: 1 mg PO q 4-6 h. Max 6 mg/24 h.
Child 7-11 yr: 2 mg PO q 4-6 h. Max 12 mg/24 h.
Child ≥ 12 yr, adult: 4 mg PO q 4-6 h. Max 24 mg/24 h.
Hypersensitivity—Child < 12 yr: 0.5 mg/kg/day or 15 mg/m2/day SC, IM or IV in 3-4
divided doses.
Child ≥ 12 yr, adult: 5-20 mg SC, IM or IV bid. Max 40 mg/24 h.
Budesonide PRC: C
Classes
Glucocorticosteroid; anti-inflammatory
Indications
Rhinitis
Asthma
Dosages
Rhinitis—Child > 6 yr, adult: 2 sprays in each nostril morning and hs or 4 sprays in each
nostril q morning. Max 4 sprays/nostril/day.
PEDIATRiC DRUG 11
Asthma—Child ≥ 6 yr: 200 mcg oral inhalant, inhalation bid. Max 400 mg bid.
Adult: 200-400 mcg oral inhalant, inhalation bid when previously on bronchodilators or
inhaled corticosteroids; 400-800 mcg oral inhalant, inhalation bid when previously on PO
corticosteroids.
Bumetanide PRC: C C
Classes
Loop diuretic; diuretic
Indications
HF
Dosages
HF—Neonate: 0.01-0.05 mg/kg/dose q 24-48 h IV, IM, PO.
Infant, child: 0.015-0.1 mg/kg/dose q 6-24 h IV, IM, PO.
Busulfan PRC: D
Classes
Alkylating drug; antineoplastic
Indications
Dosages
Chronic myelogenous leukemia—Child: 0.06-0.12 mg/kg or 1.8-4.6 mg/m2 PO qd. Adjust
to maintain white blood cell count of 20,000/mm3.
Adult: 4-8 mg PO qd; range 1-12 mg PO qd (0.06 mg/kg or 1.8 mg/m2). Maintenance 1-3
mg PO qd.
Calcium Salts PRC: C

Classes
Ca supplement; therapeutic drug for electrolyte balance, cardiotonic
Indications
Hypocalcemia
Cardiac arrest
Hypocalcemia
Exchange transfusions
Hypocalcemic tetany
Dosages
Hypocalcemia—Infant: up to 1 mEq ca IV slowly.
Child: 1-7 mEq ca IV slowly (Max 0.7-1.8 mEq/min) as 10% gluconate solution, 2-10%
chloride solution, or 22% gluceptate solution.
Adult: 7-14 mEq ca IV slowly (max 0.7-1.8 mEq/min) as 10% gluconate solution, 2-10%
chloride solution, or 22% gluceptate solution.
Cardiac arrest—Child: 0.27 mEq/kg Ca chloride IV. Repeat in 10 min prn, after ca levels
known.
Adult: 0.027-0.054 mEq/kg chloride IV, 4.5-6.3 mEq gluceptate IV, or 2.3-3.7 mEq
gluconate IV.
12 PEDIATRiC DRUG
Hypocalcemia—Neonate: 50-150 mg/kg elem ca PO qd in divided doses. Max 1 gram/day.
Child: 45-65 mg/kg elem ca PO qd in divided doses.
Adult: 1-2 gram elem ca PO qd in divided doses.
Exchange transfusions—Neonate: 0.45 mEq IV after every 100 ml of citrated blood
C exchange.
Adult: 1.35 mEq IV with each 100-ml citrated blood exchange.
Hypocalcemic tetany—Neonate: 2.4 mEq/kg IV qd in divided doses until tetany controlled.
Child: 0.5-0.7 mEq/kg IV tid or qid until tetany controlled.
Adult: 4.5-16 mEq IV until response obtained.
Captopril PRC: C
Classes
ACE inhibitor; antihypertensive, adjunctive treatment of HF
Indications
Hypertension
HF
Dosages
Hypertension—Neonate: 0.01-0.05 mg/kg PO q 8-12 h. Infant: 0.05-0.1 mg/kg PO q 8-24
h.
Child: 0.3 mg/kg PO q 6-12 h. Max 6 mg/kg/day in divided doses.
Adolescent, adult: 12.5-25 mg PO bid-tid; increase to 50 mg bid-tid after 1-2 wk prn; if BP
uncontrolled after 1-2 wk more, add diuretic. Max 150 mg tid (450 mg/day).
HF—Adult: 25 mg PO tid; increase to 50 mg tid; max 450 mg/day. In pts taking diuretic,
6.25-12.5 mg tid.
Carbamazepine PRC: D
Classes
Iminostilbene derivative, chemically related to TCAs; anticonvulsant, analgesic
Indications
Seizures
Loading dose for rapid seizure control
Dosages
Seizures—Child < 6 yr: 10-20 mg/kg PO qd in 2-3 divided doses as tab or 4 divided doses
as susp. Increase q wk to max 35 mg/kg/24 h.
Child 6-12 yr: 100 mg PO bid as tab or 50 mg PO qid as susp. Increase q wk by 100 mg
PO qd, tid-qid. Max 1,000 mg/day. Child taking ≥ 400 mg immed-rel qd may be given
extended-release caps bid.
Child > 12 yr, adult: 200 mg PO bid as tab or 100 mg PO qid as susp on day 1. Increase
by 200 mg/day PO q wk in divided doses 6-8 h. Adjust to minimum effective level when
control achieved. Max 1,000 mg/day in child 13-15 yr, or 1,200 mg/day in child > 15 yr.
Doses up to 1,600 mg/day have been used in adult. For extended-release caps, 200 mg
PO bid. Increase q wk by up to 200 mg/day until response. For extended-release tab, 100-
200 mg PO qd or bid with meals. Increase q wk by 100 mg/day until response. For
extended-release caps and tab, max 1,000 mg/day in child 12-15 yr and 1,200 mg/day in
pts > 15 yr. Adult max 1,600 mg/day Maintenance 800-1200 mg/day.
PEDIATRiC DRUG 13
Loading dose for rapid seizure control—Child < 12 yr: 10 mg/kg oral susp in 1 dose.
Child ≥ 12 yr, adult: 8 mg/kg oral susp in 1 dose.
Castor Oil PRC: X

Classes C
Glyceride, Ricinus communis derivative; stimulant laxative
Indications
Bowel preparation, constipation
Dosages
Bowel preparation, constipation—Child < 2 yr: 1-5 ml (liq) PO in 1 dose.
Child 2-11 yr: 5-15 ml (liq) PO in 1 dose.
Child ≥ 12 yr, adult: 15-60 ml (liq) or 30-60 ml (95%) PO.
Child 2-12 yr: 15 ml (liq emulsion, 67%) or 5-15 ml (95%) mixed with 1/2-1 glass liq.
Adult: 45 ml (liq emulsion, 67%) or 15-60 ml (95%) mixed with 1/2-1 glasses liq.
Cefaclor PRC: B
Classes
2nd-generation cephalosporin; antibiotic
Indications
Respiratory tract, skin-structure infection, UTI, OM
Dosages
Respiratory tract, skin-structure infection, UTI, OM—Infant, child ≥ 1 month: 20 mg/kg
PO qd (40 mg/kg for severe infection and OM) in divided doses q 8 h (or q 12 h for OM or
pharyngitis); max 1 gram/day.
Adolescent, adult: 250-500 mg PO q 8 h; max 4 gram/day. For pharyngitis or OM, may
give in 2 divided doses q 12 h. For bronchitis, use 500 mg extended-release tab PO q 12
h × 7 day; for pharyngitis and tonsillitis or skin and soft-tissue infection, 375 mg PO q 12 h
× 10 day and 7-10 day, respectively.
Cefadroxil PRC: B
Classes
1st-generation cephalosporin; antibiotic
Indications
UTI, skin and soft-tissue infection; pharyngitis; tonsillitis
Dosages
UTI, skin and soft-tissue infection; pharyngitis; tonsillitis—Child: 30 mg/kg/day in 2 divided
doses q 12 h.
Adolescent, adult: 1-2 gram PO qd, or divided bid.
Cefazolin Sodium PRC: B

Classes
14 PEDIATRiC DRUG
Indications
Respiratory, GU, skin, soft-tissue, bone, joint infection; biliary tract infection; septicemia,
endocarditis
Perioperative prophylaxis
C Dosages
Respiratory, GU, skin, soft-tissue, bone, joint infection; biliary tract infection; septicemia,
endocarditis—Neonate ≤ 1 wk: 40 mg/kg IM or IV qd in divided doses q 12 h.
Neonate > 1 wk and < 2 kg: 40 mg/kg IM or IV qd in divided doses q 12 h.
Neonate > 1 wk and > 2 kg: 60 mg/kg IM or IV qd in divided doses q 8 h.
Infant, child > 1 month: 25-100 mg/kg/day IM or IV in divided doses q 6-8 h.
Adolescent, adult: 250 mg IM or IV q 8 h-1.5 gram q 6 h. Max 12 gram/day in life-
threatening infection.
Perioperative prophylaxis—Adolescent, adult: 1 gram IM or IV 30-60 min before surgery;
then 0.5-1 gram IM or IV q 6-8 h × 24 h. In surgery > 2 h, another 0.5-1 gram IM or IV may
be given.
Cefdinir PRC: B
Classes
3rd-generation cephalosporin; antibiotic
Indications
Community-acquired pneumonia; chronic bronchitis; sinusitis; OM; skin, soft-tissue infection
Pharyngitis, tonsillitis
Dosages
Community-acquired pneumonia; chronic bronchitis; sinusitis; OM; skin, soft-tissue
infection—Infant, child 6 month -12 yr: 7 mg/kg PO q 12 h or 14 mg/kg PO q 24 h × 10
day; max 600 mg/day. (Use q 12 h for skin infection).
Adolescent ≥ 13 yr, adult: 300 mg PO q 12 h or 600 mg PO q 24 h × 10 day. (Use q 12
h for pneumonia, skin infection.)
Pharyngitis, tonsillitis—Infant, child 6 month-12 yr: 7 mg/kg PO q 12 h × 5-10 day or 14
mg/kg PO q 24 h × 10 day.
Adolescent ≥ 13 yr, adult: 300 mg PO q 12 h for 5-10 day or 600 mg PO q 24 h × 10 day.
Cefepime Hydrochloride PRC: B

Classes
Semisynthetic 3rd- or 4th- generation cephalosporin; antibiotic
Indications
UTI
Severe UTI, pyelonephritis
Pneumonia
Skin, soft-tissue infection, febrile neutropenia
Dosages
UTI—Infant, child ≥ 2 month and < 40 kg: 50 mg/kg IV q 12 h.
Child ≥ 12 yr, adult: 0.5-1 gram IM (use IM route only for infection caused by E. coli), or
IV infusion over 30 min q 12 h × 7-10 day.
PEDIATRiC DRUG 15
Severe UTI, pyelonephritis—Infant, child ≥ 2 month and < 40 kg: 50 mg/kg IV q 12 h.

Child ≥ 12 yr, adult: 2 gram IV infusion over 30 min q 12 h × 10 day.
Pneumonia—Infant, child ≥ 2 month and < 40 kg: 50 mg/kg IV q 12 h.
Child ≥ 12 yr, adult: 1-2 gram IV infusion over 30 min q 12 h × 10 day.
Skin, soft-tissue infection, febrile neutropenia—Infant, child ≥ 2 month and < 40 kg:
50 mg/kg IV q 12 h for skin infection, q 8 h for neutropenia.
C
Child ≥ 12 yr, adult: 2 gram IV infusion over 30 min q 12 h × 10 day (7 day for febrile
neutropenia).
Cefixime PRC: B
Classes
Indications
OM, bronchitis, pharyngitis, tonsillitis, UTI, gonorrhea
Dosages
OM, bronchitis, pharyngitis, tonsillitis, UTI, gonorrhea—Infant, child 6 month -12 yr:
8 mg/kg PO qd in 1-2 divided doses.
Adolescent, adult: 400 mg PO qd in 1-2 divided doses; for gonorrhea, 400 mg PO in
1 dose.
Cefotaxime Sodium PRC: B

Classes
Indications
Lower respiratory, CNS, bone, joint, intra-abdominal, gyn, skin infection; UTI; bacteremia;
septicemia; PID
Gonorrhea
Disseminated gonococcal infection
Gonococcal ophthalmia; disseminated gonococcal infection
Dosages
Lower respiratory, CNS, bone, joint, intra-abdominal, gyn, skin infection; UTI; bacteremia;
septicemia; PID—Neonate ≤ 1 wk: 50 mg/kg IV q 12 h.
Neonate 1-4 wk: 50 mg/kg IV q 8 h.
Infant, child 1 month-12 yr and < 50 kg: 50-180 mg/kg IV qd in 4-6 divided doses.
Use higher doses for serious infection.
Child > 50 kg, adult: 1 gram IV or IM q 6-12 h. Up to 12 gram qd in life-threatening
infection.
Gonorrhea—Adolescent, adult: 1 gram IM in 1 dose.
Perioperative prophylaxis—Adult: 1 gram IV or IM 30-90 min before surgery.
Disseminated gonococcal infection—Adolescent, adult: 1 gram IV q 8 h.
Gonococcal ophthalmia; disseminated gonococcal infection—Neonate, infant: 25-50 mg/kg
IV q 8-12 h × 7 day or 50-100 mg/kg IM or IV q 12 h × 7 day.
16 PEDIATRiC DRUG
Cefpodoxime Proxetil PRC: B

Classes
Indications
C Community-acquired pneumonia
Acute bacterial exacerbations of chronic bronchitis
Uncomplicated gonorrhea in men and women; rectal gonococcal infection in women
Uncomplicated skin and soft-tissue infection
Uncomplicated UTI
OM
Dosages
Community-acquired pneumonia—Adolescent, adult: 200 mg PO q 12 h × 14 day.
Acute bacterial exacerbations of chronic bronchitis—Adolescent, adult: 200 mg PO q
12 h × 10 day.
Uncomplicated gonorrhea in men and women; rectal gonococcal infection in women—
Adolescent, adult: 200 mg PO in 1 dose. Follow with doxycycline 100 mg PO bid × 7 day.
Uncomplicated skin and soft-tissue infection—Adolescent, adult: 400 mg PO q 12 h × 7-
14 day.
Uncomplicated UTI—Adolescent, adult: 100 mg PO q 12 h × 7 day.
OM—Infant, child 5 month-12 yr: 5 mg/kg (max 200 mg) PO q 12 h × 10 day.
Pharyngitis, tonsillitis—Infant, child 5 month-12 yr: 5 mg/kg (max 100 mg) PO q 12 h ×
5-10 day.
Adolescent, adult: 100 mg PO q 12 h × 5-10 day.
Ceftizoxime Sodium PRC: B

Classes
Indications
Bacteremia; septicemia, meningitis; PID; UTI; rsp, gyn, intra-abdominal, bone, joint, skin
infection
Gonorrhea
Dosages
Bacteremia; septicemia, meningitis; PID; UTI; rsp, gyn, intra-abdominal, bone, joint, skin
infection—Infant, child > 6 month: 50 mg/kg IV or IM q 6-8 h; max 12 gram/day.
Adult: 500 mg-2 gram IV or IM q 8-12 h. In life-threatening infection, 3-4 gram IV q 8 h.
Gonorrhea—Adult: 1 gram IM in 1 dose.
Ceftriaxone Sodium PRC: B

Classes
Indications
Bacteremia; septicemia; UTI; respiratory, bone, joint, gyn, intra-abdominal, skin infection
PEDIATRiC DRUG 17
Meningitis, endocarditis
Sexually transmitted epididymitis
PID C
Anti-infective after sexual assault
Lyme disease
OM
Dosages
Bacteremia; septicemia; UTI; respiratory, bone, joint, gyn, intra-abdominal, skin infection—
Neonate < 1 wk: 50 mg/kg IV or IM qd.
Neonate 1-4 wk and ≤ 2 kg: 50 mg/kg IV or IM qd.
Neonate 1-4 wk and > 2 kg: 50-75 mg/kg IV or IM qd.
Infant, child: 50-75 mg/kg IV or IM qd divided in doses q 12 h.
Adolescent, adult: 1-2 gram IM or IV qd or in divided doses bid. Max 4 gram/day.
Meningitis, endocarditis—Neonate, infant, and child: 80-100 mg/kg IV or IM qd or
divided q 12 h × 7-21 day for meningitis and 28 day for endocarditis; max 4 gram/day.
Adolescent, adult: 1-2 gram IV or IM q 12 h × 10-14 day for meningitis and 3-4 wk for
endocarditis.
Perioperative prophylaxis—Adult: 1 gram IM or IV 30 min-2 h before surgery.
Uncomplicated gonorrhea—Child < 45 kg: 125 mg IM in 1 dose.
Child ≥ 45 kg, adolescent, adult: 125-250 mg IM in 1 dose; 1-2 gram IM or IV qd until
improvement.
Sexually transmitted epididymitis, PID—Adolescent, adult: 250 mg IM in 1 dose; follow up
with other antibiotics.
Anti-infective after sexual assault—Adolescent, adult: 125 mg IM in 1 dose with other
antibiotics.
Lyme disease—Child: 75-100 mg/kg IM or IV qd × 14-30 day.
Adult: 2 gram IM or IV qd × 14-30 day.
OM—Child: 50 mg/kg IM (max 1 gram) in 1 dose.
Cefuroxime Axetil, Cefuroxime Sodium PRC: B

Classes
2nd-generation cephalosporin; antibiotic PRC: B
Indications
Respiratory, skin and soft-tissue infection; UTI; septicemia, meningitis
Pharyngitis, tonsillitis, respiratory infection, UTI
OM, impetigo
Gonorrhea
Lyme disease
Dosages
Respiratory, skin and soft-tissue infection; UTI; septicemia, meningitis—Infant, > child 3
month: 50-100 mg/kg/day IM or IV in divided doses q 6-8 h. Some give 100-150 mg/kg/day.
For meningitis, 200-240 mg/kg/day IV in divided doses q 6-8 h, reduced to 100 mg/kg/day
when improvement.
18 PEDIATRiC DRUG
Adolescent, adult: 750 mg-1.5 gram IM or IV q 8 h × 5-10 day. For life-threatening or
infection caused by less susceptible organisms, 1.5 gram IM or IV q 6 h; for bacterial
meningitis, up to 3 gram IV q 8 h.
Pharyngitis, tonsillitis, respiratory infection, UTI—Infant, child 3 month-12 yr: 20 mg/kg/
day oral susp in divided doses bid; max 500 mg/day × 10 day. Child < 12 yr who can
C swallow pills: 125 mg tab PO bid × 10 day.
Adolescent, adult: 125-250 mg PO bid × 10 day.
OM, impetigo—Infant, child 3 month-12 yr: 30 mg/kg/day PO oral susp in 2 divided
doses (max 1 gram) × 10 day. Child who can swallow pills: 250 mg PO bid × 10 day.
Perioperative prophylaxis—Adult: 1.5 gram IV 30-60 min before surgery; then 750 mg IM
or IV q 8 h intraoperative for long surgery.
Gonorrhea—Adult: 1.5 gram IM (with PO probenecid) in 1 dose, alone or with other
antibiotics.
Lyme disease—Adolescent ≥ 13 yr, adult: 500 mg PO bid × 20 day.
Cephalexin Hydrochloride Monohydrate, Cephalexin PRC: B

Classes
Indications
Respiratory, GU, skin, soft-tissue, bone, joint infection
OM
Dosages
Respiratory, GU, skin, soft-tissue, bone, joint infection—Child: 25-50 mg/kg PO qd in 4
divided doses. Pts > 1 yr with streptococci pharyngitis or skin and soft-tissue infection,
may be given q 12 h.
Adult: 250 mg-1 gram PO q 6 h. For streptococci pharyngitis, skin and soft-tissue infection,
or uncomplicated cystitis in pts > 15 yr, 500 mg PO q 12 h. For pts with CrCl below 40 ml/
min, give reduced dose.
OM—Child: 75-100 mg/kg PO qd in 4 divided doses. For pts with CrCl below 40 ml/min,
give reduced dose.
Cetirizine Hydrochloride PRC: B

Classes
Selective H1-receptor antagonist; antihistamine
Indications
Allergic rhinitis, chronic urticaria
Dosages
Allergic rhinitis, chronic urticaria—Child: 2-5 yr: 2.5-5 mg PO qd.
Child ≥ 6 yr, adult: 5-10 mg PO qd.
Chloral Hydrate PRC: C

Classes
General CNS depressant; sedative-hypnotic
Indications
Premed for EEG
PEDIATRiC DRUG 19
Dosages
Premed for EEG—Child: 20-25 mg/kg PO or PR in 1 dose. Max 1 gram.
Chloramphenicol, Chloramphenicol Sodium Succinate PRC: C

Classes C
Dichloroacetic acid derivative; antibiotic
Indications
Meningitis, brain abscesses, bacteremia, other serious infection
External ear canal infection
Infection of conjunctiva or cornea
Dosages
Meningitis, brain abscesses, bacteremia, other serious infection—Neonate < 1 wk,
neonate 1-4 wk and ≤ 2 kg, premature infant: 25 mg/kg/day IV.
Neonate 1-4 wk and > 2 kg: 25 mg/kg IV q 12 h. Give IV for meningitis.
Infant, child, adult: 50-100 mg/kg/day IV, divided q 6 h. Max 100 mg/kg/day.
External ear canal infection—Child, adult: Instill 2-3 drops in ear canal tid or qid.
Infection of conjunctiva or cornea—Child, adult: Instill 1-2 drops solution in eye q 3-6 h
until improves. Apply small amount oint to lower conjunctival sac hs as supplement. Or
apply small amount of oint alone to lower conjunctival sac q 3-6 h or more prn. Cont for up
to 48 h after improvement.
Chlordiazepoxide, Chlordiazepoxide Hydrochloride PRC: D

Classes
Benzodiazepine; anxiolytic, anticonvulsant, sedative-hypnotic
Indications
Anxiety, tension
Preoperative apprehension, anxiety
Dosages
Anxiety, tension—Child > 6 yr, debilitated pts: 5 mg PO bid-qid. Max 10 mg PO bid-tid.
Adult: 5-10 mg PO tid-qid.
Preoperative apprehension, anxiety—Child, adolescent 12-18 yr: 25-50 mg IM 1 h before
surgery.
Adult: 5-10 mg PO tid-qid on day before surgery; or 50-100 mg IM 1 h before surgery.
Chloroquine Hydrochloride, Chloroquine Phosphate PRC: C

Classes
4-aminoquinoline; antimalarial, amebicide, anti-inflammatory
Indications
Suppressive prophylaxis of malaria
Acute malaria
Extraintestinal amebiasis
20 PEDIATRiC DRUG
Dosages
Suppressive prophylaxis of malaria—Child: 5 mg (base)/kg PO on same day once/wk
(max 300 mg base) beginning 2 wk before exposure.
Adult: 500 mg phosphate (300-mg base) PO on same day once/wk beginning 2 wk before
exposure.
C Acute malaria—Child: 10 mg (base)/kg PO; then 5 mg (base)/kg after 6 h. 3rd dose is 5
mg (base)/kg 18 h after 2nd dose; 4th dose is 5 mg (base)/kg 24 h after 3rd dose; or 5 mg
(base)/kg IM; repeat in 6 h prn. Change to PO ASAP.
Adult: 1 gram (600-mg base) PO then 500 mg (300-mg base) PO after 6 h; 3rd doses of
500 mg (300-mg base) PO 18 h after 2nd dose; 4th dose of 500 mg (300-mg base) 24 h
after 3rd dose. Or 4-5 ml (160-200-mg base) IM; repeat in 6 h prn. Change to PO ASAP.
Extraintestinal amebiasis—Child: 10 mg (base)/kg PO qd × 2-3 wk; max 300 mg base qd.
Adult: 1 gram (600-mg base) PO qd × 2 day, then 500 mg (300-mg base) qd × 2-3 wk or
4-5 ml (160-200-mg base) IM × 10-12 day. Change to PO ASAP.
Chlorpheniramine Maleate PRC: B

Classes
Propylamine-derivative antihistamine; H1-receptor antagonist
Indications
Rhinitis, allergies
Dosages
Rhinitis, allergies—Child 2-5 yr: 1 mg syrup q 4-6 h. Max 6 mg/day.
Child 6-11 yr: 2 mg tab or syrup PO q 4-6 h; or one 8-m timed-rel or caps PO in 24 h.
Max 12 mg/day.
Child ≥ 12 yr, adult: 4 mg tab or syrup PO q 4-6 h; or 8-12 mg timed-rel tab or caps PO
bid. Max 24 mg/day. For relief of allergic reactions to blood or plasma, anaphylaxis, 10-20
mg IV or IM.
Chlorpromazine Hydrochloride PRC: C

Classes
Aliphatic phenothiazine; antipsychotic, anti-emetic
Indications
Psychosis
Nausea, vomiting
Tetanus
Surgery
Dosages
Psychosis—Infant, child ≥ 6 month: 0.55 mg/kg PO q 4-6 h prn, or IM q 6-8 h prn; or
1.1 mg/kg PR q 6-8 h prn. Max IM dose 40 mg/day in child < 5 yr and 75 mg/day in child 5-
12 yr.
Adult: 25-75 mg PO qd in 2-4 divided doses. Increase twice/wk by 20-50 mg until symptoms
controlled. Most pts respond to 200 mg/day; max 800 mg/day.
Nausea, vomiting—Infant, child ≥ 6 month: 0.55 mg/kg PO q 4-6 prn, or IM q 6-8 h prn,
or 1.1 mg/kg PR q 6-8 h prn. Max IM dose 40 mg/day in child < 5 yr and 75 mg/day in child
5-12 yr.
Adult: 10-25 mg PO or 25 mg IM q 4-6 h prn, or 100 mg PR q 6-8 h prn.
PEDIATRiC DRUG 21
Tetanus—Infant, child ≥ 6 month: 0.55 mg/kg IM or IV q 6-8 h. For child < 22.7kg, max
40 mg/day; for child 22.7-45.5 kg, max 75 mg/day, except in severe cases.
Adult: 25-50 mg IM or IV tid or qid.
Surgery—Infant, child ≤ 6 month: Preoperative, 0.55 mg/kg PO 2-3 h before surgery or
IM 1-2 h before surgery; during surgery, 0.275 mg/kg IM, repeat in 30 min prn, or 1-mg IV
q 2 min up to 0.275 mg/kg; repeat IV regimen in 30 min prn; postoperative, 0.55 mg/kg PO C
or IM q 4-6 h (oral dose) or q h IM prn, if hypotension doesn’t occur.
Adult: Preoperative, 25-50 mg PO 2-3 h before surgery or 12.5-25 mg IM 1-2 h before
surgery; during surgery, 12.5 mg IM repeated in 30 min prn, or 2-mg IV q 2 min to max 25
mg; postoperative, 10-25 mg PO q 4-6 h or 12.5-25 mg IM repeated in 1 h prn.
Chlorthalidone PRC: B
Classes
Thiazide-like diuretic; antihypertensive
Indications
Edema
Hypertension
Dosages
Edema—Child: 2 mg/kg or 60 mg/m2 PO 3 times/wk.
Adult: 50-100 mg (Thalitone, 30-60 mg) PO qd or 100 mg (Thalitone, 60 mg) PO every
other day.
Hypertension—Child: 2 mg/kg or 60 mg/m2 PO 3 times/wk.
Adult: 25-100 mg (Thalitone, 15-50 mg) PO qd.
Cholestyramine PRC: C
Classes
Anion exchange resin; antilipemic, bile acid sequestrant
Indications
Hyperlipidemia, hypercholesterolemia; cardiac glycoside toxicity; pruritus from partial biliary
obstruction
Dosages
Hyperlipidemia, hypercholesterolemia; cardiac glycoside toxicity; pruritus from partial biliary
obstruction—Child > 6 yr: 80 mg/kg, or 2.35 gram/m2 PO tid.
Adult: 4 gram PO ac and hs; max 24 gram qd. Given in 1-6 divided doses.
Cimetidine PRC: B
Classes
H2-receptor antagonist; antiulcerative
Indications
Duodenal ulcer
Heartburn, acid indigestion, sour stomach
Duodenal ulcer prophylaxis
Gastric ulcer
22 PEDIATRiC DRUG
Dosages
Duodenal ulcer—Child: 20-40 mg/kg IV or PO qd in divided doses.
Adult: 800 mg PO hs for max of 8 wk. Or 400 mg PO bid or 300 mg PO qid with meals and
hs. When healing occurs, stop treatment or give hs dose only. Parenteral treatment, 300
mg dil to 20 ml by IV push over 5 min q 6 h. Or 300 mg dil in 50 ml by IV infusion over 15-
C 20 min q 6-8 h. Or 300 mg IM q 6-8 h (no dil needed). Max 2,400 mg/day.
Heartburn, acid indigestion, sour stomach—Child ≥ 12 yr, adult: 200 mg (Tagamet HB
only) PO qd-bid × 2 wk. Max 400 mg/day.
Duodenal ulcer prophylaxis—Adult: 400 mg PO hs.
Gastric ulcer—Child: 20-40 mg/kg IV or PO qd in divided doses.
Adult: 800 mg PO hs, or 300 mg qid with meals and hs for up to 8 wk.
Ciprofloxacin (Systemic) PRC: C

Classes
Fluoroquinolone; antibiotic
Indications
Resistant respiratory infection in pts with CF
UTI
Infectious diarrhea; respiratory, bone, joint infection; severe or complicated UTI
Severe or complicated respiratory, bone, joint, skin, soft tissue infection; mycobacterial
infection
Intra-abdominal infection
Dosages
Resistant respiratory infection in pts with CF—Child, adolescent 9-18 yr: 40 mg/kg PO
qd in divided doses q 12 h; or 30 mg/kg IV qd in divided dos q 8 h.
UTI—Adult: 250 mg PO or 200 mg IV q 12 h.
Infectious diarrhea; respiratory, bone, joint infection; severe or complicated UTI—Adult:
500 mg PO or 400 mg IV q 12 h.
Severe or complicated respiratory, bone, joint, skin, soft tissue infection; mycobacterial
infection —Adult: 750 mg PO or 400 mg IV q 12 h.
Intra-abdominal infection—Adult: 500 mg PO or 400 mg PO q 12 h with metronidazole.
Ciprofloxacin Hydrochloride (Ophthalmic) PRC: C

Classes
Indications
Corneal ulcer
Conjunctivitis
Dosages
Corneal ulcer—Child > 12 yr, adult: 2 drops in affected eye q 15 min × 6 h, then 2 drops
q 30 min for rest of 1st day. On day 2, 2 drops q h. On day 3-14, 2 drops q 4 h.
Conjunctivitis—Child > 12 yr, adult: 1-2 drops in conjunctival sac of affected eye q 2 h
while awake × 2 day. Then 1-2 drops q 4 h while awake × 5 day.
PEDIATRiC DRUG 23
Cisplatin (Cis-platinum) PRC: D

Classes
Alkylating drug; antineoplastic
Indications
Brain tumor
C
Dosages
Brain tumor—Child: 60 mg/m2 IV qd 2 dq × 3-4 wk.
Clarithromycin PRC: C
Classes
Macrolide; antibiotic
Indications
Acute maxillary sinusitis
Exacerbations of chronic bronchitis
Prophylaxis, treatment of disseminated MAC infection
OM
Dosages
Pharyngitis, tonsillitis—Infant, child ≥ 6 month: 7.5 mg/kg PO divided q 12 h × 10 day.
Adult: 250 mg PO q 12 h × 10 day.
Acute maxillary sinusitis—Infant, child ≥ 6 month: 7.5 mg/kg PO divided q 12 h × 10 day.
Adult: 500 mg PO q 12 h × 14 day.
Exacerbations of chronic bronchitis—Adult: 250-500 mg PO q 12 h × 7-14 day.
Uncomplicated skin, soft tissue infection—Infant, child ≥ 6 month: 7.5 mg PO q 12 h.
Adult: 250 mg PO q 12 h × 7-14 day.
Prophylaxis, treatment of disseminated MAC infection—Child > 20 month: 7.5 mg/kg PO
bid-500 mg PO bid. Adult: 500 mg PO bid.
OM—Infant, child > 6 month: 7.5 mg/kg PO bid-500 mg bid.
Chemastine Fumarate PRC: C

Classes
Ethanolamine-derivative antihistamine; H1-receptor antagonist
Indications
Rhinitis, allergies
Dosages
Rhinitis, allergies—Child 6-11 yr: 0.67 mg bid; max 4.02 mg/day.
Child ≥ 12 yr, adult: 1.34-2.68 mg PO bid-tid. Max 8.04 mg/day.
Clindamycin Hydrochloride, Clindamycin Palmitate

PRC: B
Hydrochloride, Clindamycin Phosphate
Classes
Lincomycin derivative; antibiotic
24 PEDIATRiC DRUG
Indications
Infection
Acne
Dosages
C Infection—Neonate: 15-20 mg/kg/day IV in 3-4 divided doses. Use lower dose for small
premature infant.
Infant, child > 1 month: 8-20 mg/kg/day PO in 3-4 divided doses or 20-40 mg/kg/day IV
in 3-4 divided doses.
Adult: 150-450 mg PO q 6 h, or 600-2,700 mg/day IM or IV in 2-4 divided doses.
Acne—Adult: Apply thin film of topical solution to affected areas bid.
Clonazepam PRC: C
Classes
Benzodiazepine; anti-convulsant
Indications
Seizures
Dosages
Seizures—Child < 10 yr or < 30 kg: 0.01-0.03 mg/kg PO qd; max 0.05 mg/kg/day, divided
q 8 h. Increase by 0.25-0.5 mg q 3rd day to max 0.2 mg/kg/day.
Adult: 1.5 mg PO qd, in 3 divided doses, increase by 0.5-1 mg q 3rd day until seizures
controlled. Max 20 mg/day.
Clotrimazole PRC: B
Classes
Synthetic imidazole derivative; topical antifungal
Indications
Tinea pedis, cruris, versicolor, corporis; cutaneous candidiasis
Oropharyngeal candidiasis
Vulvovag candidiasis
Dosages
Tinea pedis, cruris, versicolor, corporis; cutaneous candidiasis—Child, adult: Apply thinly
and massage into affected and surrounding area morning and pm × 1-8 wk.
Oropharyngeal candidiasis—Child > 3 yr, adult: Dissolve over 15-30 min in mouth; usual
dose: 1 lozenge 5 times/day × 14 day.
Vulvovag candidiasis—Adult: Insert 1 tab intravag hs × 7 day.
Vag cream: insert 1 applicatorful intravag hs × 7-14 day. Nonpregnant women may also
insert two 100-mg tab intravag × 3 day or 500 mg in 1 dose for less complicated cases.
Cloxacillin Sodium PRC: B

Classes
Penicillinase-resistant penicillin; antibiotic
Indications
Systemic infection
PEDIATRiC DRUG 25
Dosages
Systemic infection—Infant, child ≤ 20 kg: 50-100 mg/kg PO qd divided q 6 h.
Child > 20 kg, adult: 250-500 mg PO q 6 h.
Codeine Phosphate, Codeine Sulfate PRC: C C

Classes
Opioid; analgesic, antitussive
Indications
Pain
Cough
Dosages
Pain—Child: 0.5 mg/kg or 15 mg/m2 q 4-6 h SC, PO, IM.
Adult: 15-60 mg PO or 15-60 mg (phosphate) SC or IM q 4-6 h prn or ATC.
Cough—Child 2-6 yr: 1 mg/kg qd in 4 divided doses q 4-6 h; max 30 mg/24 h.
Child 6-11 yr: 5-10 mg q 4-6 h, max 60 mg qd.
Child ≥ 12 yr, adult: 10-20 mg PO q 4-6 h. Max 120 mg/day.
Cortisone Acetate PRC: D

Classes
Glucocorticoid, mineralocorticoid; anti-inflammatory, replacement therapy
Indications
Adrenal insufficiency, allergy, inflammation
Dosages
Adrenal insufficiency, allergy, inflammation—Child: 20-300 mg/m2 PO qd in 4 divided
doses or 7-37.5 mg/m2 IM qd or bid.
Adult: 25-300 mg PO or 20-300 mg IM qd or every other day.
Co-trimoxazole (Trimethoprim-sulfamethoxazole) PRC: C

Classes
Sulfonamide, folate antagonist; antibiotic
Indications
UTI, shigellosis
OM
Pneumocystis carinii pneumonitis
Traveler’s diarrhea
Pertussis
Cholera
Dosages
UTI, shigellosis—Infant, child > 2 month: 8 mg/kg trimethoprim and 40 mg/kg
sulfamethoxazole PO qd in 2 divided doses q 12 h (10 day for UTI; 5 day for shigellosis).
Adult: 1 double-strength or 2 regular-strength tab PO q 12 h × 10-14 day or 5 day for
shigellosis. Or 8-10 mg/kg (based on trimethoprim) IV qd in 2-4 divided doses for up to 14
day (5 day for shigellosis). Max 960 mg qd.
26 PEDIATRiC DRUG
OM—Infant, child > 2 month: 8 mg/kg trimethoprim and 40 mg/kg sulfamethoxazole PO
qd in 2 divided doses q 12 h × 10 day.
Pneumocystis carinii pneumonitis—Infant, child > 2 month, adult: 15-20 mg/kg
trimethoprim and 75-100 mg/kg sulfamethoxazole PO qd in divided doses q 6-8 h × 14-21d.
Traveler’s diarrhea—Adult: 1 double-strength or 2 regular-strength tab q 12 h × 5 day.
C Pertussis—Child: 40 mg/kg/day PO in 2 divided doses.
Adult: 320 mg PO qd in 2 divided doses.
Cholera—Child: 5 mg/kg PO bid × 3 day.
Adult: 160 mg PO bid × 3 day.
Cromolyn Sodium PRC: B

Classes
Chromone derivative; mast cell stabilizer, antasthmatic
Indications
Asthma
Allergic rhinitis
Prevention of exercise-induced bronchospasm
Allergic ocular disorders
Systemic mastocytosis
Dosages
Asthma—Child > 5 yr, adult: 2 inhalant, inhalation qid at reg intervals; aqueous solution
via nebulizer, 1 amp qid; or 1 caps (20 mg) powder for inhalant, inhalation qid.
Allergic rhinitis—Child ≥ 6 yr, adult: 1 spray (5.2 mg) nasal solution in each nostril tid or
wid; max 6 times/day.
Prevention of exercise-induced bronchospasm—Child> > 5 yr, adult: 2 metered sprays
using inhalant, inhalation, or 1 caps (20 mg) powder for inhalant, inhalation up to 1 h before
exercise. 20 mg inhalant, inhalation solution may be used in adult or child ≥ 2 yr. Repeat
inhalant, inhalation prn during long exercise.
Allergic ocular disorders—Child > 4 yr, adult: 1-2 drops in each eye 4-6 times/day at reg
intervals.
Systemic mastocytosis—Neonate, infant, child <2 yr: 20 mg/kg PO qd in 4 divided
doses.
Child 2-12 yr: 100 mg PO qid.
Adult: 200 mg PO qid.
Cyanocobalamin (Vitamin B12), Hydroxocobalamin (Vitamin B12) PRC: C

Classes
H2O soluble vitamin; nutrition supplement
Indications
Vitamin B12 deficiency from any cause except malabsorption from pernicious anemia or
other GI disease
Diagnostic test for vitamin B12
Schilling test flushing dose
PEDIATRiC DRUG 27
Dosages
Vitamin B12 deficiency from any cause except malabsorption from pernicious anemia or
other GI disease—Child: 100 mcg IM or SC over ≥ 2 wk; max 1-5 mg. Maintenance dose
60 mcg/month IM or SC.
Adult: 25 mcg PO qd as dietary suppositories, or 30-100 mcg SC or IM qd for 5-10 day
depending on severity of deficiency. (IM recommended for pernicious anemia). Maintenance
dose 100-200 mcg IM q month.
Diagnostic test for vitamin B12—Child, adult: 1 mcg IM qd × 10 day with diet low in vitamin D
B12 and folate. Reticulocytosis between day 3 and 10 confirms diagnosis of vitamin B12
deficiency.
Schilling test flushing dose—Child, adult: 1,000 mcg IM in 1 dose.
Cycloserine PRC: C
Classes
Isoxizolidone, day-alanine analogue; antituberculotic
Indications
Pulm, extrapulm TB
Dosages
Pulm, extrapulm TB—Child: 10-20 mg/kg; max 1,000 mg, qd in 2 divided doses.
Adult: 250 mg PO q 12 h × 2 wk; then, if blood levels <25-30 mg/ml and pt shows no signs
of toxicity, increase to 250 mg PO q 8 h × 2 wk. If optimum blood levels still aren’t achieved
and pt shows no signs of toxicity, increase to 250 mg PO q 6 h. Max 1 gram qd. If CNS
toxicity occurs, discontinue × 1 wk, then resume at 250 mg/day × 2 wk. If no serious toxic
effects occur, increase by 250 mg q 10 day until blood levels reach 25-30 µgram/ml.
Cyclosporine PRC: C
Classes
Polypeptide antibiotic; immunosuppressant
Indications
Prophylaxis of organ rejection in kidney, liver, heart, bone marrow, pancreas, cornea
transplant
Dosages
Prophylaxis of organ rejection in kidney, liver, heart, bone marrow, pancreas, cornea
transplant—Child, adult: 15 mg/kg PO qd 4-12 h before transplant. Continue qd dose
postoperative × 1-2 wk. Then reduce dose by 5% wkly to maintenance of 5-10 mg/kg/day.
Or IV concentrated of 5-6 mg/kg 4-12 h before transplant. Postoperative, 5-6 mg/kg qd as
IV dilute solution infusion (50 mg/20-100 ml over 2-6 h) until pt can tol PO.
Dapsone PRC: C
Classes
Synthetic sulfone; antileprotic, antimalarial
Indications
Leprosy
Prophylaxis for leprosy pt’s close contacts
Dermatitis herpetiformis
28 PEDIATRiC DRUG
Malaria suppression or prophylaxis
Pneumocystis carinii pneumonia
Prophylaxis of P. carinii pneumonia for pt intolerant to cotrimoxazole
Dosages
Leprosy—Child: 1-1.5 mg/kg PO qd. Adult: 100 mg PO qd for at least 2 yr, plus rifampin
600 mg qd × 6 month.
D Prophylaxis for leprosy pt’s close contacts—Infant < 6 month: 6 mg PO 3 times/wk.
Infant, child 6-23 month: 12 mg PO 3 times/wk.
Child 2-5 yr: 25 mg PO 3 times/wk.
Child 6-11 yr: 25 mg PO qd.
Child ≥ 12 yr, adult: 50 mg PO qd.
Dermatitis herpetiformis—Adult: 50 mg PO qd, increase prn to obtain full control. Pts with
high acetylation rates may need dose adjusted.
Malaria suppression or prophylaxis—Child: 2 mg/kg PO q wk, with pyrimethamine
0.25 mg/kg/wk.
Adolescent, adult: 100 mg PO q wk, with pyrimenthamine 12.5 mg PO q wk. Cont
prophylaxis throughout exposure and 6 month postexposure.
Pneumocystis carinii pneumonia—Adult: 100 mg PO qd. Usually with trimethoprim (20 mg/kg
qd in 4 divided doses) × 21 day.
Prophylaxis of P. carinii pneumonia for pt intolerant to cotrimoxazole—Infant, child > 1
month: 1 mg/kg PO qd. Max 100 mg PO qd.
Adolescent, adult: 50-100 mg PO qd.
Deferoxamine Mesylate PRC: C

Classes
Chelating drug; heavy metal antagonist PRC: C
Indications
Iron intoxication
Chronic iron overload from multiple transfusions
Dosages
Iron intoxication—Child > 3 yr, adult: 1 gram IM (preferred) or IV, then 500 mg IM or IV q
4 h × 2 doses; then 500 mg IM or IV q 4-12 h prn. Max IV infusion rate 15 mg/kg/h.
Max 6 gram/24 h. (IV infusion reserved for pts in cardiovascular collapse) Or 20 mg/kg
(or 600 mg/m2) IM or slow IV, then 10 mg/kg (or 300 mg/m2) q 4 h × 2 doses, then 10 mg/
kg (or 300 mg/m2) q 4-12 h prn.
Chronic iron overload from multiple transfusions—Child > 3 yr, adult: 500-1,000 mg IM qd
and 2 gram slow IV infusion in separate solution with each U of blood transfused. Max IV
infusion rate 15 mg/kg/h. Or 1-2 gram via SC infusion pump over 8-24 h.
Desipramine Hydrochloride PRC: C

Classes
Dibenzazepine; TCA
Indications
Depression
PEDIATRiC DRUG 29
Dosages
Depression—Adolescent: 25-50 mg PO qd, increase to max of 100 mg qd. For severely
ill, max 150 mg qd.
Adult: 100-200 mg PO qd in divided doses, increase to max of 300 mg qd. Or entire dose
given once qd, usually hs.
Desmopressin Acetate PRC: B

D
Classes
Posterior pituitary hormone; antidiuretic; hemostatic drug
Indications
Central cranial diabetes insipidus, temporary polyuria, polydipsia from pituitary trauma
Hemophilia A, von Willebrand’s disease
Primary nocturnal enuresis
Dosages
Central cranial diabetes insipidus, temporary polyuria, polydipsia from pituitary trauma—
Child 3 month-12 yr: 5-30 mcg (0.05-0.3 ml) intranasally qd in 1-2 doses.
Adolescent, adult: 10-40 mcg (0.1-0.4 ml) intranasally in 1-3 divided doses qd. Adjust
morning and pm doses separately for adequate diurnal rhythm of H2O turnover. Or 0.05
mg PO bid. Adjust based on response to range of 0.1-1.2 mg qd, in 2-3 divided doses.
Optimal range 0.1-1.8 mg qd in divided doses. Or give 0.5 ml (2 mcg)-1 ml (4 mcg) IV or SC
qd, usually in 2 divided doses.
Hemophilia A, von Willebrand’s disease—Infant, child > 3 month, adult: 0.3 mcg/kg dil
and infusion IV over 15-30 min. Repeat dose prn as indicated by lab response and pt
condition. Or give 150 mcg (0.1 ml)/nostril.
Primary nocturnal enuresis—Child ≥ 6 yr: 20 mcg (0.2 ml), intranasally hs (10 mcg/
nostril). Adjust dose according to response. Max 40 mcg qd. Or 0.2 mg PO hs. Adjust up
to 0.6 mg to achieve desired response. For pts previously receiving intranasal DDAVP,
start PO the night following (24 hr after) the last intranasal dose.
Dexamethasone (Ophthalmic Susp), Dexamethasone

PRC: C
Sodium Phosphate
Classes
Corticosteroid; Ophth anti-inflammatory
Indications
Uvitis; iridocyclitis; inflammation of eyelid, conjunctiva, cornea, anterior segment of globe;
corneal injury from burn or foreign body; allergic conjunctivitis; suppression of graft rejection
after keratoplasty
Dosages
Uvitis; iridocyclitis; inflammation of eyelid, conjunctiva, cornea, anterior segment of globe;
corneal injury from burn or foreign body; allergic conjunctivitis; suppression of graft rejection
after keratoplasty—Child, adult: Instill 1-2 drops susp or solution or apply 1.25-2.5 cm
oint in conjunctival sac. For severe cases, instill solution or susp in conjunctival sac q h
gradually discontinue as condition improves. In mild case, use drops 4-6 times qd or apply
oint tid or qid. As condition improves, taper dose to bid then once qd. Treatment may extend
from a few day to several wks.
30 PEDIATRiC DRUG
Dexamethasone (Systemic), Dexamethasone Acetate,

PRC: NR
Dexamethasone Sodium Phosphate
Classes
Glucocorticoid, anti-inflammatory, immunosuppressant PRC: NR
Indications
D Cerebral edema
Inflammatory conditions, allergic reactions, neoplasias
Shock (other than adrenal crisis)
Dexamethasone suppression test for Cushing’s syndrome
Adrenal insufficiency
Bacterial meningitis
Prevention of hyaline membrane disease in premature infant
Prevention of CA chemotherapy-induced nausea and vomiting
Dosages
Cerebral edema—Adult: 10 mg (phosphate) IV, then 4 mg IM q 6 h 2-4 day, then taper
over 5-7 day.
Inflammatory conditions, allergic reactions, neoplasias—Child: 0.024-0.34 mg/kg PO qd
in 4 divided doses.
Adult: 0.75-9 mg (acetate) PO qd divided bid, tid or qid. 4-16 mg intra-articularly or into soft
tissue q 1-3 wk; 0.8-1.6 mg into lesions q 1-3 wk; or 8-16 mg (phosphate) IM q 1-3 wk prn.
Or 0.2-6 mg (phosphate) intra-articularly, intralesionally, or into soft tissue; or 0.5-9 mg
(phosphate) IM.
Shock (other than adrenal crisis)—Adult: 1-6 mg/kg (phosphate) IV qd as single dose; or
40 mg IV q 2-6 h prn, for max of 48-72 h.
Dexamethasone suppression test for Cushing’s syndrome—Adult: 0.5 mg PO q 6 h × 48
h.
Adrenal insufficiency—Child: 0.024-0.34 mg/kg PO qd in 4 divided doses.
Adult: 0.75-9 mg PO qd in divided doses.
Child: 0.235-1.25 mg/m2 (phosphate) IM or IV once/day or bid.
Adult: 0.5-9 mg (phosphate) IM or IV qd.
Bacterial meningitis—Infant, child > 2 month, adult: 0.15 mg/kg (phosphate) IV q 6
h
× 2-4 day.
Prevention of hyaline membrane disease in premature infant—Adult: 5 mg (phosphate)
IM tid to mother × 2 day before delivery.
Prevention of CA chemotherapy-induced nausea and vomiting—Adult: 10-20 mg IV before
chemotherapy. Additional doses given IV or PO 24-72 h after CA, chemotherapy prn.
Dexamethasone (Topical), Dexamethasone Sodium Phosphate PRC: C

Classes
Corticosteroid; anti-inflammatory
Indications
Inflammation of corticosteroid-responsive dermatoses
PEDIATRiC DRUG 31
Dosages
Inflammation of corticosteroid-responsive dermatoses—Child, adult: Apply gel or cream
sparingly tid or qid. For aerosol on scalp, apply to dry scalp after shampooing. Spray while
moving tube to all affected areas, keeping tubeunder hair and in contact with scalp. Don’t
massage drug into scalp or spray forehead or eyes.
Dextromethorphan Hydrobromide PRC: C

Classes
D
Levorphanol derivative (dextrorotatory methyl ether); nonnarcotic antitussive
Indications
Cough
Dosages
Cough—Child 2-6 yr: 2.5-5 mg q 4 h, or 7.5 mg q 6-8 h; or sust-action liq 15 mg bid.
Max 30 mg qd.
Child 6-12 yr: 5-10 mg q 4 h, or 15 mg q 6-8 h. Or controlled-release liq bid (30 mg bid).
Max 60 mg qd.
Child ≥ 12 yr, adult: 10-20 mg q 4 h, or 30 mg q 6-8 h. Or controlled-release liq bid
(60 mg bid). Max 120 mg qd.
Diazepam PRC: NR
Classes
Benzodiazepine; anxiolytic, skeletal muscle relaxant, amnestic, anti-convulsant, sedative-
hypnotic
Indications
Anxiety
Muscle spasm
Tetanus
Adjunct to convulsive disorders
Treatment of increase seizures
Status epilepticus
Dosages
Anxiety—Infant ≥ 6 month: 1-2.5 mg PO tid or qid; increase gradually prn as tol. Or 0.04-
0.2 mg/kg IV q 3-4 h prn; max 0.6 mg/kg within 8 h.
Adult: 2-10 mg PO bid-qid or 15-30 mg extended-release caps PO qd. Or 2-10 mg IM or
IV q 3-4 h prn.
Muscle spasm— Infant, child ≥ 6 month: 1-2.5 mg PO tid or qid; increase gradually prn
as tol.
Adult: 2-10 mg PO bid-qid, or 15-30 mg extended-release caps qd. Or 5-10 mg IM or IV
q 3-4 h prn.
Tetanus—Infant > 30 day to child 5 yr: 1-2 mg IM or IV slowly q 3-4 h.
Child ≥ 5 yr: 5-10 mg IM or IV slowly q 3-4 h prn.
Adjunct to convulsive disorders—Infant, child ≥ 6 month: 1-25 mg PO tid or qid; increase
as tol prn.
32 PEDIATRiC DRUG
Adult: 2-10 mg PO bid-qid.
Treatment of increase seizures—Child 2-5 yr: 0.5 mg/kg PR; repeat in 4-12 h prn.
Child 6-11 yr: 0.3 mg/kg PR; repeat in 4-12 h prn.
Child ≥ 12 yr, adult: 0.2 mg/kg PR; repeat in 4-12 h prn.
Status epilepticus—Infant ≥ 30 day to child 5 yr: 0.2-0.5 mg IV q 2-5 min to max of 5 mg.
Child ≥ 5 yr: 1 mg IV q 2-5 min to max of 10 mg; repeat in 2-4 h prn.
D Adult: 5-10 mg IV (preferred) or IM; repeat q 10-15 min to max of 30 mg; repeat q 2-4 h prn.
Diazoxide PRC: C
Classes
Peripheral vasodilator; antihypertensive, antidiabetic
Indications
Hypertensive crisis
Hypoglycemia from hyperinsulinism
Dosages
Hypertensive crisis—Child, adult: 1-3 mg/kg IV (max 150 mg) q 5-15 min until BP
reduced. Switch to PO ASAP.
Hypoglycemia from hyperinsulinism—Neonate, infant: 10 mg/kg PO qd in 3 divided
doses q 8 h. Maintenance 8-15 mg/kg/day PO in 2-3 divided doses q 8-12 h.
Child, adult: 3-8 mg/kg/day PO in 2-3 divided doses. Pt with refractory hypoglycemia
may need higher doses.
Dicloxacillin Sodium PRC: B

Classes
Penicillinase-resistant penicillin, antibiotic
Indications
Systemic infection
Dosages
Systemic infection—Infant, child > 1 month and < 40 kg: 12.5-50 mg/kg PO qd divided
q 6 h. For serious infection 75-100 mg/kg/day in divided doses q 6 h.
Child, adult ≥ 40 kg: 125-250 mg PO q 6 h.
Dicyclomine Hydrochloride PRC: B

Classes
Anticholinergic; antimuscarinic, GI antispasmodic
Indications
IBS, other functional GI disorders
Dosages
IBS, other functional GI disorders—Infant 6-23 month: 5-10 mg PO tid or qid.
Child ≥ 2 yr: 10 mg PO tid or qid.
Adolescent, adult: 20 mg PO qid, increase to 40 mg PO qid during 1st wk of treatment
unless precluded by adverse reactions. Or 20 mg IM q 4-6 h.
PEDIATRiC DRUG 33
Didanosine PRC: B
Classes
Purine analogue; antiviral
Indications
HIV
Dosages D
HIV—Neonate, infant < 90 day: 50 mg/m2 PO q 12 h.
Child: 90-150 mg/m2 PO q 12 h. If used with other antiretrovirals, 90 mg/m2. Adolescent,
adult < 60 kg; 125 mg tab PO q 12 h, or 167 mg buffered powder PO q 12 h.
Adolescent, adult ≥ 60 kg: 200 mg tab PO q 12 h, or 250 mg buffered powder PO q 12 h.
Digoxin PRC: C
Classes
Cardiac glycoside; anti-arrhythmic, inotropic
Indications
HF atrial fibrillation and fIutter, PAT
Dosages
HF atrial fibrillation and fIutter, PAT—(Tab, elix) Neonate (premature): 20-30 mcg/kg PO
over 24 h in ≥ 2 divided doses q 6-8 h. Maintenance dose 20%-30% of total digitalizing
dose.
Neonate (full-term): 25-35 mcg/kg PO over 24 h in ≥ 2 divided doses q 6-8 h. Maintenance
dose 25-35% of total digitalizing dose.
Infant, child 1 month-2 yr: 35-60 mcg/kg PO over 24 h in ≥ 2 divided doses q 6-8 h.
Maintenance dose 25-35% of total digitalizing dose.
Child 2-5 yr: 30-40 mcg/kg PO over 24 h in ≥ 2 divided doses q 6-8 h. Maintenance dose
25-35% of total digitalizing dose.
Child 5-10 yr: 20-35 mcg/kg PO over 24 h in ≥ 2 divided doses q 6-8 h. Maintenance dose
Child ≥ 10 yr: 10-15 mcg/kg PO over 24 h in ≥ 2 divided doses q 6-8 h. Maintenance dose
Adult: For rapid digitalization, 0.75-1.25 mg PO over 24 h in ≥ 2 divided doses q 6-8 h. For
slow digitalization, 0.125-0.5 mg PO qd 5-7 day. Maintenance dose 0.125-0.5 mg qd.
(Caps) Child 2-5 yr: For rapid digitalization, 25-35 mcg/kg PO over 24 h divided as above.
Maintenance dose 25-35% of total digitalizing dose in 2-3 equal doses qd.
Child 5-10 yr: For rapid digitalization, 15-30 mcg/kg PO over 24 h divided as above.
Maintenance dose 25-35% of total digitalizing dose in 2-3 equal doses qd. Child ≥ 10 yr For
rapid digitalization, 8-12 mcg/kg PO over 24 h divided as above. Maintenance dose 25-
35% of total digitalizing dose qd as single dose.
Adult: For rapid digitalization, 0.4-0.6 mg PO, then 0.1-0.3 mg q 6-8 h prn as tol × 24 h. For
slow digitalization, 0.05-0.35 mg qd in 2 divided doses × 7-22 day prn until therapeutic
serum levels reached. Maintenance dose 0.05-0.35 mg qd in 1-2 divided doses.
(Inj) Neonate (premature): For rapid digitalization, 15-25 mcg/kg IV over 24 h divided as
above. Maintenance dose 20-30% of total digitalizing dose, in 2-3 equal doses qd. Neonate
(full-term): For rapid digitalization, 20-30 mcg/kg IV over 24 hs divided as above.
Maintenance dose 25-35% of total digitalizing dose, in 2-3 equal doses qd.
Infant, child 1 month-2 yr: For rapid digitalization, 30-50 mcg/kg IV over 24 h divided as
above. Maintenance dose 25-35% of total digitalizing dose, in 2-3 equal doses qd.
34 PEDIATRiC DRUG
Child 2-5 yr: For rapid digitalization, 25-35 mcg/kg IV over 24 h divided as above.
Maintenance dose 25-35% of total digitalizing dose in 2-3 equal doses qd.
Child 5-10 yr: For rapid digitalization, 15-30 mcg/kg IV over 24 h divided as above.
Maintenance dose 25-35% of total digitalizing dose in 2-3 equal doses qd. Child ≥ 10 yr: For
rapid digitalization, 8-12 mcg/kg IV over 24 h divided as above. Maintenance dose 25-35%
of tatal digitalizing dose given qd as single dose.
Adult: For rapid digitalization, 0.4-0.6 mg IV, then 0.1-0.3 mg IV q 4-8 h prn as tol × 24 h. For
D slow digitalization, give appropriate qd maintenance dose × 7-22 day prn until therapeutic
serum levels reached. Maintenance dose 0.125-0.5 mg IV qd in 1-2 divided doses. Pts with
hyperthyroidism may need increased dose.
Diltiazem Hydrochloride PRC: C

Classes
Calcium channel blocker; antianginal
Indications
Prinzmetal’s variant angina, chronic stable angina
Hypertension
Dosages
Prinzmetal’s variant angina, chronic stable angina—Adolescent, adult: 30 mg PO qid ac
and hs. Increase to max of 360 mg/day in 3-4 divided doses prn. Or, 120-180 mg (extended-
release) PO once qd. Adjust dose over 7-14 day prn as tol to max of 480 mg/day.
Hypertension—Adolescent, adult: 60-120 mg PO bid (surt-rel) adjust to max of 360 mg/
day prn. Or 180-240 mg (extended-release) PO once qd. Adjust based on pt response to
max of 480 mg qd.
Atrial fibrillation or flutter; paroxysmal SVT—Adolescent, adult: 0.25 mg/kg IV bolus over
2 min. Repeat after 15 min if response inadequate with 0.35 mg/kg IV over 2 min. Follow
bolus with continue IV infusion at 5-15 mg/h for up to 24 h.
Dimenhydrinate PRC: B
Classes
Ethanol-amine-derivative antihistamine; H1-receptor antagonist, antiemetic, antivertigo drug
Indications
Prophylaxis and treatment of nausea, vomiting, dizziness caused by motion sickness
Dosages
Prophylaxis and treatment of nausea, vomiting, dizziness caused by motion sickness—
Child: 1.25 mg/kg/day or 37.5 mg/m2/day PO or IM qid; max 300 mg/day; or according to
the following schedule:
Child 2-6 yr: 12.5-25 mg PO q 6-8 h; max 75 mg/day.
Child 6-12 yr: 25-50 mg PO q 6-8 h; max 150 mg/day.
Child ≥ 12 yr, adult: 50-100 mg q 4-6 h PO, IV, or IM. For IV, dil each 50-mg dose in 10 ml
NSS and inject over 2 min.
Dimercaprol PRC: NR
Classes
Chelating drug; heavy metal antagonist
PEDIATRiC DRUG 35
Indications
Severe arsenic, gold poisoning
Mild arsenic, gold poisoning
Severe gold dermatitis
Gold-induced thrombocytopenia
Mercury poisoning
Dosages
D
Severe arsenic, gold poisoning—Child, adult: 3 mg/kg deep IM q 4 h × 2 day, then qid on
day 3; then bid × 10 day.
Mild arsenic, gold poisoning—Child, adult: 2.5 mg/kg deep IM qid × 2 day, then bid on day
3; then once qd × 10 day.
Severe gold dermatitis—Child, adult: 2.5 mg/kg deep IM q 4 h × 2 day, then bid × 7 day.
Gold-induced thrombocytopenia—Child, adult: 100 mg deep IM bid × 15 day.
Mercury poisoning—Child, adult: 5 mg/kg deep IM, then 2.5 mg/kg IM qd or bid × 10 day.
Acute lead encephalopathy, blood lead level > 70 mcg/dl—Child, adult: 4 mg/kg (or 75-83
mg/m2) deep IM inj, then with edetate calcium disodium (250 mg/m2) q 4 h × 3-5 day.
Diphenhydramine Hydrochloride PRC: C

Classes
Ethanolamine-derivative antihistamine; H1-receptor antagonist, antiemetic, antivertigo drug,
antitussive, sedative-hypnotic, topical anesthetic, antidyskinetic
Indications
Rhinitis, allergies, motion sickness
Insomnia
Sedation
Dosages
Rhinitis, allergies, motion sickness—Child 2-5 yr: 6.25 mg PO q 4-6 h. Max PO dose 37.5
mg qd. Or 1.25 mg/kg IV or deep IM q 6 h. Max IM or IV dose 300 mg qd.
Child 6-11 yr: 12.5-25 mg PO q 4-6 h. Max PO dose 150 mg qd. Or 1.25 mg/kg IV or deep
IM q 6 h. Max IM or IV dose 300 mg qd.
Child ≥ 12 yr, adult: 25-50 mg PO tid or qid; or 10-50 mg IV or deep IM. Max IM or IV dose
400 mg qd.
Insomnia—Child 2-11 yr: 1 mg/kg. Max 50 mg/dose PO 30 min before hs.
Child ≥ 12 yr, adult: 50 mg PO 30 min before hs.
Sedation—Adult: 25-50 mg PO, or deep IM prn.
Diphtheria Antitoxin, Equine PRC: NR

Classes
Antitoxin, diphtheria antitoxin
Indications
Diphtheria prevention
Diphtheria treatment
36 PEDIATRiC DRUG
Dosages
Diphtheria prevention—Child, adult: 5,000-10,000 U IM (dose depends on length of time
since exposure, extent of exposure and pt condition).
Diphtheria treatment—Child, adult: 20,000-120,000 U IM or slow IV infusion. A 1:20 dil of
antitoxin infusion at 1 ml/min. Additional doses given in 24 h. IM route used in mild cases.
Begin antibiotic treatment.
D Disopyramide Phosphate PRC: C

Classes
Pyridine-derivative antiarrhythmic; antiarrhythmic
Indications
PVCs (unifocal, multifocal or coupled); VT; conversion of atrial fibrillation, atrial flutter, and
PAT to normal sinus rhythm
Dosages
PVCs (unifocal, multifocal or coupled); VT; conversion of atrial fibrillation, atrial flutter, and
PAT to normal sinus rhythm—Infant: 10-30 mg/kg PO qd in 4 divided doses q 6 h.
Child 1-4 yr: 10-20 mg/kg PO qd in 4 divided doses q 6 h.
Child 4-12 yr: 10-15 mg/kg PO qd in 4 divided doses q 6 h.
Child, adolescent 12-18 yr: 6-15 mg/kg PO qd in 4 divided doses q 6 h.
Adult: For adult> 50 kg, 150 mg PO q 6 h or 300 mg (extended-release) PO q 12 h; for
adult < 50 kg, 100 mg PO q 6 h or 200 mg (extended-release) PO q 12 h; for cardiomyopathy
or possible cardiac decompensation, 100 mg PO q 6-8 h initially, then adjust prn.
Dobutamine Hydrochloride PRC: B

Classes
Adrenergic; beta agonist, inotropic
Indications
Increase cardiac output in cardiac decompresation caused by depressed contractility
Pts with congenital heart disease undergoing cardiac catheterization
Dosages
Increase cardiac output in cardiac decompresation caused by depressed contractility—
Neonate, infant, child: 2-20 mcg/kg/min IV infusion. Begin at low dose and titrate to
desired response.
Adult: 2.5-15 mcg/kg/min IV infusion. Rarely rates up to 40 mcg/kg/min may be needed.
Titrate dose to pt response.
Pts with congenital heart disease undergoing cardiac catheterization—Child: 2 and
7.75 mg/kg/min IV over 10 min each.
Dopamine Hydrochloride PRC: C

Classes
Adrenergic; inotropic, vasopressor
Indications
Increase cardiac output, BP, urine flow in stock
PEDIATRiC DRUG 37
Dosages
Increase cardiac output, BP, urine flow in stock—Neonate: 0.5-20 mcg/kg/min continue IV
infusion. Begin at low dose; titrate to response.
Infant, child: 1-20 mcg/kg/min continue IV infusion. Titrate to response.
Adult: 1-5 mcg/kg/min IV infusion, to 20-50 mcg/kg/min, infusion rate increase by 1-4
mcg/kg/min q 10-30 min until response. In severely ill pts, infusion may begin at 5 mcg/kg/
min and gradually increase by 5-10 mcg/kg/min until response.
D
Doxacurium Chloride PRC: C
Classes
Nondepolarizing neuromuscular blocker; skeletal muscle relaxant
Indications
Skeletal muscle relaxation for ET intubation, during surgery as adjunct to general anesthesia
Maintenance of neuromuscular blockade during long procedures
Dosages
Skeletal muscle relaxation for ET intubation, during surgery as adjunct to general
anesthesia—Child> > 2 yr: Dose highly individualized; 0.03 mg/kg IV during halothane
anesthesia produces blockade in 7 min and lasts 30 min. Under same conditions, 0.05 mg/
kg produces blockade in 4 min and lasts 45 min.
Adult: Dose highly individualized: 0.05 mg/kg rapid IV produces conditions for ET intubation
in 5 min in about 90% of pts when used as part of thiopental-narcotic induction technique.
Lower doses may need longer delay before intubation possible. Neuromuscular blockade
lasts about 100 min. Adjust dose to ideal body wt in obese pts ( ≥ 30% ideal wt) to avoid
prolonged blockade.
Maintenance of neuromuscular blockade during long procedures—Child ≥ 2 yr, adult:
After initial dose 0.05 mg/kg IV, maintenance dose 0.005 and 0.01 mg/kg prolongs
neuromuscular blockade for about 30 min and 45 min, respectively. Child usually requires
more frequent maintenance doses. Adjust dose to ideal body wt in obese pts ( ≥ 30% ideal
wt) to avoid prolonged blockade.
Doxycycline, Doxycycline Calcium, Doxycycline Hyclate,

PRC: D
Doxycycline Monohydrate
Classes
Tetracycline; antibiotic
Indications
Infection
Chlamydia; nongonococcal urethritis; uncomplicated urethral, endocervical, rectal infection
PID
Prophylaxis for rape victims
Lyme disease
Dosages
Infection—Child > 8 yr and ≤ 45 kg: 4.4 mg/kg PO or IV qd divided q 12 h on day 1, then
2.2-4.4 mg/kg PO or IV qd as single or divided dose.
Child > 8 yr and > 45 kg, adult: 100 mg PO q 12 h on day 1, then 100 mg PO qd; or 200
mg IV on day 1 in 1 or 2 infusion, then 100-200 mg IV qd. Give IV infusion slowly (minimum
1 h). Infusion must be complete within 12 h (within 6 h in lactated Ringer’s solution or D5W
in lactated Ringer’s solution).
38 PEDIATRiC DRUG
Chlamydia; nongonococcal urethritis; uncomplicated urethral, endocervical, rectal infection—
Adolescent, adult: 100 mg PO bid at least 7 day.
PID—Adolescent, adult: 250 mg IM ceftriaxone, then 100 mg doxycycline PO bid 10-14
day.
Prophylaxis for rape victims—Adolescent, adult: 100 mg PO bid × 7 day after single 2-
gram PO dose of metronidazole with single 125-mg IM dose of ceftriaxone.
Lyme disease—Child ≥ 8 yr, adult: 100 mg PO bid or tid × 10-30 day.
E Econazole Nitrate PRC: C

Classes
Synthetic imidazole derivative; antifungal PRC: C
Indications
Cutaneous candidiasis
Tinea pedis, cruris, corporis, versicolor
Dosages
Cutaneous candidiasis—Child, adult: Gently rub into affected area bid in morning and
pm.
Tinea pedis, cruris, corporis, versicolor—Child, adult: Gently rub into affected area qd.
Edetate calcium disodium (calcium EDTA) PRC: NR

Classes
Indications
Lead encephalopathy or blood lead level > 70 µgram/dl
Lead poisoning without encephalopathy or asymptomatic with blood level < 70 mg/dl
Other heavy metal poisoning
Dosages
Lead encephalopathy or blood lead level > 70 µgram/dl—Child, adult: 1.5 gram/m2 IV or
IM qd in divided doses q 12 h × 3-5 day usually with dimercaprol. Give 2nd course after at
least 2 day, drug-free interval prn.
Lead poisoning without encephalopathy or asymptomatic with blood level < 70 mg/dl—
Child: 1 gram/m2 IV or IM qd in divided doses q 8-12 h × 3-5 day.
Other heavy metal poisoning—Adult: 1 gram in 500 ml of D5W or NSS inj IV over 5 h qd ×
3 day for manganese intoxication.
Edetate Disodium (EDTA) PRC: NR

Classes
Indications
Hypercalcemia
Cardiac glycoside-induced ventricular arrhythmias
Dosages
Hypercalcemia—Child: 40 mg/kg IV infusion, dil to max concentrated of 30 mg/ml in D5W
or NSS over ≥ 3 h. Max 70 mg/kg/day.
PEDIATRiC DRUG 39
Adult: 50 mg/kg qd IV infusion over ≥ 3 h to max 3 gram in 24 h. Dilute in 500 ml D5W

or NSS.
Cardiac glycoside-induced ventricular arrhythmias—Child: 15 mg/kg/h IV infusion; max
60 mg/kg/day. Dil in D5W.
Adult: 15 mg/kg/h IV infusion; max 60 mg/kg/day. Dilute in D5W.
Enalaprilat, Enalapril Maleate PRC: C

Classes
ACE inhibitor; antihypertensive E
Indications
Hypertension
To convert from IV to PO
To convert from PO to IV
Dosages
Hypertension—Adolescent, adult: For pts not receiving diuretic, 5 mg PO once qd;
adjust to response. Usual range 10-40 mg qd as single dose or 2 divided doses. Or 1.25
mg IV infusion q 6 h over 5 min. For pts receiving diuretic, 2.5 mg PO once qd. Or 0.625 mg
IV over 5 min; repeat in 1 h prn, then 1.25 mg IV q 6 h.
To convert from IV to PO—Adolescent, adult: If pt not treated with diuretic and was
receiving 1.25 mg q 6 h, then 5 mg PO once qd. If pt taking diuretic and was receiving 0.625
mg IV q 6 h, then 2.5 mg PO once qd. Adjust to response.
To convert from PO to IV—Adolescent, adult: 1.25 mg IV over 5 min q 6 h.
Ephedrine, Ephedrine Hydrochloride, Ephedrine Sulfate PRC: C

Classes
Adrenergic; bronchodilator, vasopressor (parenteral form), nasal decongestant
Indications
Hypotension
Orthostatic hypotension
Bronchodilator, nasal decongestant
Bronchospas
Enuresis
Dosages
Hypotension—Child: 3 mg/kg or 100 mg/m2 SC or IV qd in 4-6 divided doses.
Adult: 25-50 mg IM or SC, or 5-25 mg slow IV bolus. 2nd IM dose of 50 mg or IV dose of 25
mg given prn. Additional IV doses given in 5-10 min. Max 150 mg qd.
Orthostatic hypotension—Child: 3 mg/kg PO qd in 4-6 divided doses.
Adult: 25 mg PO once qd-qid.
Bronchodilator, nasal decongestant—Child ≥ 2 yr: 2-3 mg/kg or 100 mg/m2 PO qd in 4-6
divided doses.
Adult: 25-50 mg q 3-4 h prn; 12.2-25 mg IM, IV, or SC; repeat based on pt response. For
nasal decongestion, 2-3 drops in each nostril q 4 h.
Bronchospas—Adult: 12.5-25 mg IM, SC, or IV.
Enuresis—Adult: 25-50 mg PO hs.
40 PEDIATRiC DRUG
Epinephrine, Epinephrine Bitartrate, Epinephrine Hydrochloride,

PRC: C
Epinephryl Borate
Classes
Adrenergic; bronchodilator, vasopressor, cardiac stimulant, local anesthesia (adjunct),
topical antihemorrhagic, antiglaucoma drug PRC: C
Indications
Bronchospasm, hypersensitivity, anaphylaxis
E Bronchodilator
Cardiac arrest
Hemostatic use
Hemostatic use
To prolong local anesthesia effect
Nasal congestion, local superficial bleeding
Dosages
Bronchospasm, hypersensitivity, anaphylaxis—Child: 0.01 mg/kg (0.01 ml/kg 1:1,000
solution) or 0.3 mg/m2 (0.3 ml/m2 1:1,000 solution) SC. Max 0.5 mg. Repeat in 20-min-4-h
intervals prn. Or 0.02-0.025 mg/kg (0.004-0.005 ml/kg) or 0.625 mg/m2 (0.125 ml/m2)
1:200 solution. Repeat q 6 h prn. Or 0.1 mg (10 ml 1:100,000 dil) IV over 5-10 min, then 0.1-
1.5 mcg/kg/min IV infusion.
Adult: 0.1-0.5 mg (0.1-0.5 ml 1:1,000 solution) SC or IM. Repeat q 10-15 min prn. Or 0.1-
0.25 mg (1-2.5 ml 1:10,000 solution) IV over 5-10 min. Repeat q 5-15 min prn or followed
by a 1-4 mcg/min IV infusion.
Bronchodilator—Child ≥ 4 yr, adult: 1 inhalant, inhalation via metered aerosol, repeat
once prn after 1 min; subsequent doses shouldn’t be repeated for at least 3h. Or 1-2 deep
inhalant, inhalation via hand-bulb nebulizer of % (1:00) solution; may repeat q 1-2 min. Or
0.03 ml (0.3 mg) of 1% solution via IPPB.
Cardiac arrest—Infant: 0.01-0.03 mg/kg (0.1-0.3 ml/kg 1:10,000 solution) IV bolus or by
intratracheal inj. Repeat q 5 min prn.
Child: 0.01 mg/kg (0.1 ml/kg 1:10,000 solution) IV bolus or intratracheally; repeat q 5 min
prn. Or 0.1 mcg/kg/min; increase by 0.1 mcg/kg/min to max 1 mcg/kg/min. Or 0.005-0.01
mg/kg (0.05-0.1 ml/kg 1:10,000 solution) by intracardiac inj.
Adult: 0.5-1 mg (range of 0.1-1 mg usually as 1-10 ml 1:10,000 solution) IV bolus; repeat
q 3-5 min prn. Or initial dose followed by 0.3 mg SC or 1-4 mcg/min IV infusion. Or 1 mg
(10 ml 1:10,000 solution) intratracheally, or 0.1-1 mg (1-10 ml 1:10,000 solution) by
intracardiac inj.
Hemostatic use—Adult: 1:50,000-1:1,000, applied topically.
To prolong local anesthesia effect—Child, adult: 1:500,000-1:50,000 mixed with local
anesthesia.
Nasal congestion, local superficial bleeding—Child, adult: Instill 1-2 drops solution.
Erythromycin Base, Erythromycin Estolate, Erythromycin

Ethylsuccinate, Erythromycin Gluceptate, Erythromycin PRC: B
Lactobionate, Erythromycin Stearate
Classes
Erythromycin; antibiotic
Indications
PID
PEDIATRiC DRUG 41
Endocarditis prophylaxis for dental procedures in pts allergic to penicillin

Intestinal amebiasis in pt who can’t receive metronidazole
Respiratory, skin, soft-tissue infection
Syphilis
Conjunctivitis from C. trachomatis
Acne
Prophylaxis of ophthalmia neonatorum
Conjunctivitis, trachoma, other eye infection
Dosages
PID—Adolescent, adult: 500 mg IV (gluceptate, lactobionate) q 6 h × 3 day, then 250 mg F
(base, estolate, stearate) or 400 mg (ethylsuccinate) PO q 6 h × 7 day.
Endocarditis prophylaxis for dental procedures in pts allergic to penicillin—Child: 20 mg/
kg (ethylsuccinate, stearate) PO 1 h before procedure, then 10 mg/kg 6 h later.
Adult: 800 mg (ethylsuccinate) or 1 gram (stearate) PO 1 h before procedure, then 400
mg (ethylsuccinate) or 500 mg (stearate) PO 6 h later.
Intestinal amebiasis in pt who can’t receive metronidazole—Child: 30-50 mg/kg (base,
estolate, ethylsuccinate, stearate) PO qd, divided q 6 h × 10-14 day.
Adult: 250 mg (base, estolate, stearate) or 400 mg (ethylsuccinate) PO q 6 h × 10-14 day.
Respiratory, skin, soft-tissue infection—Child: 30 mg/kg-50 mg/kg (PO erythromycin
salts) PO qd in divided doses q 6 h; or 15-20 mg/kg IV qd in divided doses q 4-6 h.
Adult: 250-500 mg (base, estolate, stearate) PO q 6 h; or 400-800 mg (ethylsuccinate)
PO q 6 h; or 15-20 mg/kg (gluceptate, lactobionate) IV qd in divided doses q 6 h.
Syphilis—Adolescent, adult: 500 mg (base, estolate, stearate) PO qid × 14 day.
Conjunctivitis from C. trachomatis—Neonate: 50 mg/kg/day PO in 4 divided doses for at
least 2 wk.
Pneumonia of infancy from C. trachomatis—Infant: 50 mg/kg/day PO in 4 divided doses
for at least 3 wk.
Acne—Child, adult: Apply to affected area bid.
Prophylaxis of ophthalmia neonatorum—Neonate: Apply 1-cm long ribbon oint in lower
conjunctival sac of each eye ≤ 1 h after birth. Use new tube for each neonate; don’t flush
after instillation.
Conjunctivitis, trachoma, other eye infection—Child, adult: Apply 1-cm long ribbon oint
directly in affected eye up to 6 times qd.
Fentanyl Citrate, Fentanyl Transdermal System, Fentanyl

PRC: C
Transmucosal
Classes
Opioid agonist; analgesic; adjunct to anesthesia, anesthesia
Indications
Preoperative
Adjunct to regional anes
Induction, maintenance of anesthesia
Dosages
Preoperative—Child ≥ 2 yr and 15-39 kg: 5 mcg/kg PO as lozenge. May need 10-15
mcg/kg. Max 400 mcg.
42 PEDIATRiC DRUG
Child ≥ 2 yr and ≥ 40 kg: 5 mcg/kg PO as lozenge; max 400 mcg.
Adult: 50-100 mcg IM 30-60 min before surgery. Or 1 oralet U containing 100, 200, 300,
or 400 mcg PO 20-40 min before surgery for pt to suck until dissolved.
Adjunct to regional anes—Adult: 50-100 mcg IM or slow IV over 1-2 min.
Induction, maintenance of anesthesia—Child 2-12 yr; Reduced dose as low as 2-3
mcg/kg.
Ferrous Fumarate PRC: A

Classes
Oral iron supplement; hematinic
F Indications
Iron deficiency
Dosages
Iron deficiency—Infant: 10-25 mg/day PO in 3-4 divided doses.
Child 6 month-2 yr: Up to 6 mg/kg/day PO in 3-4 divided doses.
Child 2-12 yr: 50-100 mg PO in 3-4 divided doses or 1-1.5 mg/kg PO.
Adult: 50-100 mg PO elemental iron tid. Adjust dose gradually prn as tol.
Ferrous Gluconate PRC: A

Classes
Indications
Iron deficiency
Dosages
Iron deficiency—Infant: 10-25 mg/day PO I 3-4 divided doses.
Infant, child 6 month-2 yr: Up to 6 mg/kg/day in 3-4 divided doses.
Child 2-12 yr: 3 mg/kg/day PO in 3-4 divided doses.
Adult: 325 mg PO qid; increase to 650 mg qid prn as tol.
Ferrous Sulfate PRC: A

Classes
Indications
Iron deficiency
Dosages
Iron deficiency—Infant: 10-25 mg/day PO I 3-4 divided doses.
Infant, child 6 month-2 yr: Up to 6 mg/kg/day PO in 3-4 divided doses.
Child 2-12 yr: 3 mg/kg/day PO in 3-4 divided doses.
Adult: 300 mg PO bid; gradually increase to 300 mg qid prn as tol. For extended-release
caps, 150-250 mg PO qd-bid; extended-release tab, 160-525 mg qd-bid.
PEDIATRiC DRUG 43
Fexofenadine Hydrochloride PRC: C

Classes
H1-receptor antagonist antihistamine
Indications
Allergic rhinitis
Dosages
Allergic rhinitis—Child ≥ 12 yr, adult: 60 mg PO bid.
Fluconazole PRC: C
F
Classes
Bis-triazole derivative; antifungal
Indications
Oropharyngeal, esophageal candidiasis
Systemic candidiasis
Cryptococcal meningitis
Prophylaxis against mucocutaneous candidiasis, cryptococcosis, coccidioidomycosis,
histoplasmosis in pts with HIV
Dosages
Oropharyngeal, esophageal candidiasis—Neonate > 14 day, infant, child: 6 mg/kg PO
or IV on day 1, then 3 mg/kg for at least 2 wk.
Adult: 200 mg PO or IV on day 1, then 100 mg PO or IV once qd. Up to 400 mg qd for
esophageal disease. Cont treatment for at least 2 wk after symptoms resolve.
Systemic candidiasis—Neonate > 14 day, infant, child: 6-12 mg/kg/day PO or IV.
Adult: Up to 400 mg PO or IV once qd. Cont treatment for at least 2 wk after symptoms
resolve.
Cryptococcal meningitis—Infant, child: 12 mg/kg PO or IV on day 1, then 6 mg/kg once
qd × 10-12 wk after CSF culture negative. To suppress relapse in pts with AIDS, 6 mg/kg
once qd.
Adult: 400 mg IV or PO on day 1, then 200 mg once qd. Cont treatment 10-12 wk after
CSF culture negative. To suppress relapse in pts with AIDS, 200 mg once qd.
Prophylaxis against mucocutaneous candidiasis, cryptococcosis, coccidioidomycosis,
histoplasmosis in pts with HIV—Infant, child: 3-6 mg/kg PO qd.
Adult: 200-400 mg PO or IV qd.
Flumazenil PRC: C
Classes
Benzodiazepine antagonist, antidote
Indications
Reversal of sedative effect of benzodiazepines after anesthesia or short diagnosis
procedures
Suspected benzodiazepine overdose
44 PEDIATRiC DRUG
Dosages
Reversal of sedative effect of benzodiazepines after anesthesia or short diagnosis
procedures—Child: 0.01 mg/kg, max 0.2 mg IV over 15 sec. Repeat 0.01 mg/kg prn, max
0.2 mg after 45 sec then q 1 min to total dose of 0.05 mg/kg or 1 mg, whichever is lower.
Adult: 0.2 mg IV over 15 sec. If pt fails to reach desired level of consciousness after 45
sec, repeat q min until dose of 1 mg has been given. If resedation occurs, repeat dose after
20 min, max 1 mg/dose and 3 mg/h.
Suspected benzodiazepine overdose—Child: 0.01 mg/kg, max 0.2 mg IV over 15 sec.
Repeat q min to total dose of 1 mg.
Adult: 0.2 mg IV over 30 sec. If pt fails to reach desired level of consciousness after 30
sec, 0.3 mg over 30 sec. If pt still fails to respond, give 0.5 mg over 30 sec; then repeat 0.5
F mg doses q min until dose of 3 mg has been given. Max 5 mg over 5 min initially. If
resedation occurs, repeat dose after 20 min; max 1 mg/dose and 3 mg/h.
Fluorouracil (5-FU) PRC: D

Classes
Antimetabolite (S phase specific); antineoplastic
Indications
Colon, rectal, breast, ovarian, cervical, gastric, bladder, liver, pancreatic CA
Dosages
Colon, rectal, breast, ovarian, cervical, gastric, bladder, liver, pancreatic CA—Child,
adult: 12 mg/kg IV × 4 day then, if no toxicity, 6 mg/kg IV on day 6, 8, 10 and 12. Repeat in
30 day for maintenance treatment. Max 800 mg/day or 400 mg/day in severely ill pts.
Fluoxetine Hydrochloride PRC: B

Classes
SSRI; antidepressant
Indications
Depression, panic disorder, bipolar disorder, alcohol dependence; cataplexy; myoclonus
OCD
Obesity
Eating disorders
Dosages
Depression, panic disorder, bipolar disorder, alcohol dependence; cataplexy; myoclonus—
Child ≥ 7 yr: 20 mg PO qd for depression.
Adult: 20 mg PO qd in morning. Increase prn after several wk to 40 mg qd with dose in
morning and midday. Max 80 mg qd.
OCD—Child ≥ 7 yr: 20 mg PO qd.
Adult: 20 mg PO qd. Gradually increase dose prn as tol to 60-80 mg qd.
Obesity—Adult: 20-60 mg PO qd.
Eating disorders—Adult: 60-80 mg PO qd.
Fluticasone Propionate PRC: C

Classes
Corticosteroid; anti-inflammatory
PEDIATRiC DRUG 45
Indications
Asthma (Flovent)
Allergic rhinitis (Flonase)
Dosages
Asthma (Flovent)—Child 4-11 yr: 50 mcg inhalant, inhalation powder bid. Max 100 mcg
bid.
Child ≥ 12 yr, adult: 88-220 mcg inhalant, inhalation aerosol bid. Max 440 mcg bid.
Adolescent, adult: 100 mcg inhalant, inhalation powder bid. Max 500 mcg bid.
Allergic rhinitis (Flonase)—Child ≥ 12 yr: 1 spray in each nostril qd. Increase to 2 sprays
in each nostril for severe symptoms; depending on response, decrease to 1 spray.
Adult: 2 sprays in each nostril once qd; or 1 spray bid.
F
Folic Acid PRC: B
Classes
Folic acid derivative; vitamin supplement
Indications
Anemia from folic acid deficiency, hepatic disease, alcoholism, intestinal obstruction,
excessive hemolysis
Prevention of megaloblastic anemia from pregnancy and fetal damage
Nutritional supplement
Dosages
Anemia from folic acid deficiency, hepatic disease, alcoholism, intestinal obstruction,
excessive hemolysis—Infant: 0.05 mg PO, SC, or IM qd.
Child < 4 yr: up to 0.3 mg PO, SC or IM qd.
Child ≥ 4 yr, adult: 0.4 mg PO, SC, or IM qd × 4-5 day. Pregnant, breast-feeding pts: 0.8
mg PO, SC, or IM qd.
Prevention of megaloblastic anemia from pregnancy and fetal damage—Adult: 1 mg PO,
SC, or IM qd during pregnancy.
Nutritional supplement—Child: 0.05 mg PO qd.
Adult: 0.15-0.2 mg PO, SC, or IM qd (males); 0.15-0.18 mg PO, SC, or IM qd (females).
Foscarnet Sodium (Phosphonoformic Acid) PRC: C

Classes
Pyrophosphate analogue, antiviral
Indications
CMV retinitis in AIDS
Mucocutaneous acyclovir-resistant HSV infection
Varicella zoster infection
Dosages
CMV retinitis in AIDS—Adolescent, adult: 60 mg/kg IV as induction treatment in pts with
normal renal function. Give as IV infusion over 1 h q 8 h × 2-3 wk. Or 90 mg/kg IV over 1½
-2 h 12 h × 2-3 wk. Follow with maintenance infusion of 90 mg/kg qd over 2 h; increase prn
as tol to 120 mg/kg qd if disease progresses.
46 PEDIATRiC DRUG
Mucocutaneous acyclovir-resistant HSV infection—Adult: 40 mg/kg IV infusion over 1 h
q 8-12 h × 2-3 wk.
Varicella zoster infection—Adult: 40 mg/kg IV q 8 h × 10-21 day or until healing is complete.
Furosemide PRC: C
Classes
Loop diuretic; antihypertensive
Indications
Pulm edeme
Edema
Hypertension
G Dosages
Pulm edeme—Infant, child: 1 mg/kg IM or IV q 2 h until response. Max 6 mg/kg.
Adult: 40 mg IV slowly; then 80 mg IV within 1 h prn.
Edema—Infant, child: 2 mg/kg/day PO, increase by 1-2 mg/kg in 6-8 h prn. Max 6 mg/kg/
day.
Adult: 20-80 mg PO qd in morning, with 2nd dose given in 6-8 h; adjust up to 600 mg qd prn
or 20-40 mg IM or IV. Increase by 20 mg q 2 h until desired response. IV dose given over
1-2 min.
Hypertension—Adult: 40 mg PO bid, adjust according to response.
Gabapentin PRC: C
Classes
1-amino-methyl cyclohexoneacetic acid; anticonvulsant
Indications
Partial seizures
Dosages
Partial seizures—Child > 12 yr, adult: 300 mg PO on day 1, 300 mg PO bid on day 2, and
300 mg PO tid on day 3. Increase dose prn as tol to 1,800 mg qd in 3 divided doses. Usual
dose 300-600 mg PO tid; up to 3,600 mg/day has been well tol.
Ganciclovir (DHPG) PRC: C

Classes
Synthetic nucleoside; antiviral
Indications
CMV retinitis
Prevention of CMV in HIV
Prevention of CMV in transplant pts
Other CMV infection
Dosages
CMV retinitis—Infant, child > 3 month, adult: 5 mg/kg IV at constant rate over 1 h q 12
h × 14-21 day; then maintenance dose 5 mg/kg IV qd × 1 wk; or 6 mg/kg IV qd × 5 day. Or
maintenance dose 1,000 mg PO or 500 mg PO q 3 h while awake, or 6 times/day. May
reduce dosage if pt has neutropenia, anemia or thrombocytopenia.
PEDIATRiC DRUG 47
Prevention of CMV in HIV—Infant, child: 5 mg/kg IV qd.

Adolescent, adult: 5-6 mg/kg IV qd × 5-7 day each wk or 1 gram PO tid with meals.
Consider reducing dosage if pt has neutropenia, anemia, or thrombocytopenia.
Prevention of CMV in transplant pts—Adult: 5 mg/kg IV over 1 h q 12 h × 7-14 day, then
maintenance dose 5 mg/kg/day × 1 wk or 6 mg/kg qd × 5 day. May reduce dosage if pt has
neutropenia, anemia or thrombocytopenia.
Other CMV infection—Child, adult: 5 mg/kg IV over 1 h q 12 h × 14-21 day; or 2.5 mg/kg
IV q 8 h × 14-21 day. May reduce dosage if pt has neutropenia, anemia, or thrombocytopenia.
Gentamicin Sulfate PRC: D

Classes
Indications
G
Serious infection
Meningitis
Endocarditis prophylaxis for GI, GU procedure, surgery
PID
External ocular infection
Infection; superficial burns; skin ulcers; infected lacerations, abrasions, insect bites, minor
surgery wounds
Dosages
Serious infection—Neonate < 1 wk: 2.5 mg/kg IM or IV infusion q 12 h over 30 min-2 h.
Neonate > 1 wk, infant: 2.5 mg/kg IM or IV infusion q 8-12 h.
Child: 2-2.5 mg/kg IM or IV infusion q 8 h.
Adult: 3 mg/kg/day IM or IV infusion over 30 min-2 h in divided doses q 8 h. Give IV push
prn. For life-threatening infection, up to 5 mg/kg/day in 3-4 divided doses.
Meningitis—Child: Systemic treatment as above. Or 1-2 mg intrathecally qd.
Adult: Systemic treatment as above. Or 4-8 mg intrathecally qd.
Endocarditis prophylaxis for GI, GU procedure, surgery—Child: 2 mg/kg IM or IV 30-60
min before procedure and q 8 h after × 2 doses. Give with aqueous penicillin G or ampicillin.
Adult: 1.5 mg/kg IM or IV 30-60 min before procedure and q 8 h after × 2 doses. Give with
aqueous penicillin G or ampicillin.
PID—Adult: 2 mg/kg IM or IV; then 1.5 mg/kg q 8 h.
External ocular infection—Child, adult: 1-2 drops in eye q 4 h. In severe infection, up to 2
drops q h. Apply oint to lower conjunctival sac bid or tid.
Infection; superficial burns; skin ulcers; infected lacerations, abrasions, insect bites, minor
surgery wounds—Child > 1 yr, adult: Rub in small amount gently tid-qid, with or without
gauze dressing.
Glucagon PRC: B
Clases
Antihypoglycemic; antihypoglycemic, diagnostic drug
Indications
Severe insulin-induced hypoglycemia during diabetic treatment
Coma from insulin-shock treatment
48 PEDIATRiC DRUG
Dosages
Severe insulin-induced hypoglycemia during diabetic treatment—Neonate: 0.2 mg/kg IV
push, IM or SC. Max 1 mg.
Infant, child: 0.025 mg/kg SC, IM or IV 1 h after coma develops; repeat within 20 min prn.
For deep coma, 10-50% glucose IV for faster response. When pt responds, give additional
carbohydrate immed.
Adolescent, adult: 0.5-1 mg SC, IM, or IV; repeat q 20 mi × 2 doses prn.
Coma from insulin-shock treatment—Adult: 0.5-1 mg SC, IM, or IV 1 h after coma develops,
repeat within 25 min prn. For deep coma, glucose 10-50% IV for faster response. When pt
responds, give additional carbohydrate immed.
Griseofulvin Microsize, Griseofulvin Ultramicrosize PRC: C

G Classes
Penicillium antibiotic; antifungal
Indications
Tinea corporis, capitis, barbae, or cruris infection
Tinea pedis, unguium infection
Dosages
Tinea corporis, capitis, barbae, or cruris infection—Child > 2 yr: 7.3 mg/kg ultramicrosize
PO qd; or 125-250 mg microsize PO qd for child 14-23 kg; or 250-500 mg microsize PO qd
for child > 23 kg.
Adolescent, adult: 330 mg ultramicrosize PO qd, or 500 mg microsize PO qd.
Tinea pedis, unguium infection—Child > 2 yr: 7.3 mg/kg ultramicrosize PO qd; or 125-250
mg microsize PO qd for child 14-23 kg; or 250-500 mg microsize PO qd for child > 23 kg.
Adolescent, adult: 660 mg ultramicrosize PO qd or 1 gram microsize PO qd.
Guaifenesin PRC: C
Classes
Propanediol derivative; expectorant
Indications
Expectorant
Dosages
Expectorant—Child <2 yr: Individualize dose.
Child 2-5 yr: 50-100 mg q 4 h ; max 600 mg/day.
Child 6-11 yr: 100-200 mg q 4 h ; max 1.2 gram/day.
Child ≥ 2 yr, adult: 100-400 mg q 4 h; max 2.4 gram/day.
Child 2-6 yr: 300 mg (extended-release) q 12 h; max 600 mg/24 h.
Child 6-12 yr: 600 mg (extended-release) q 12 h, max 1,200 mg/24 h.
Child ≥ 12 yr, adult: 600-1,200 mg (extended-release) q 12 h; max 2,400 mg/24 h.
Haloperidol, Haloperidol Decanoate, Haloperidol Lactate PRC: C

Classes
Butyrophenone; antipsychotic
PEDIATRiC DRUG 49
Indications
Psychotic disorders, alcohol dependence
Nonpsychotic behavior disorders
Control of tics, vocal utterances in Tourette syndrome
Agitation, hyperkinesia
Autism
Dosages
Psychotic disorders, alcohol dependence—Child 3-12 yr and 15-40 kg: 0.05-0.15 mg/kg
PO qd divided bid-tid. Increase dose prn for severely disturbed child.
Adult: Individualize dose. 0.5-5 mg PO bid-tid; or 2-5 mg IM q 4-8 h. Increase rapidly with
severely resistant conditions.
Nonpsychotic behavior disorders—Child 3-12 yr: 0.05-0.075 mg/kg PO qd divided bid-tid.
Max 6 mg/day.
Control of tics, vocal utterances in Tourette syndrome—Child 3-12 yr: 0.05-0.075 mg/kg/ H
day PO divided bid-tid.
Adult: 0.5-5 mg PO bid or tid, increase prn.
Agitation, hyperkinesia—Child 3-6 yr: 0.01-0.03 mg/kg/day PO.
Autism—Child 3-6 yr: 0.5-4 mg/day PO.
Heparin Sodium PRC: C

Classes
Anticoagulant; anticoagulant
Indications
Disseminated intravascular coagulation
DVT, PE
Maintain patency of IV indwelling catheter
Embolism prophylaxis, post MI, cerebral thrombosis in evolving CVA, left ventricular thrombi
Dosages
Disseminated intravascular coagulation—Child: 25-50 U/kg IV q 4 h as single inj or
continue infusion. Discontinue if no improvement in 4-8 h.
Adult: 50-100 U/kg IV q 4 h as single inj or continue infusion. Discontinue if no improvement
in 4-8 h.
DVT, PE—Child: 50 U/kg IV bolus, then maintenance at 50-100 U/kg IV drip q 4 h. Cont
infusion: 20,000 U/m2 day. Adjust dose based on PTT.
Adult: 5,000-10,000 U IV push, then adjust dose based on PTT and give IV q 4 h (usually
4,000-5,000 U); or 5,000 U IV bolus, then 20,000-40,000 U in 24 h by IV infusion pump. Wait
4-6 h after bolus and adjust rate based on PTT.
Maintain patency of IV indwelling catheter—Child, adult: 10-100 U IV flush.
Embolism prophylaxis, post MI, cerebral thrombosis in evolving CVA, left ventricular
thrombi— Adult: 5,000 U SC q 8-12 h.
Hepatitis B Immune globulin, human (H BIG) PRC: C

Classes
Immune serum; hepatitis B prophylaxis
50 PEDIATRiC DRUG
Indications
Hepatitis B exposure
Dosages
Hepatitis B exposure—Neonate born to HBsAg-positive woman: 0.5 ml IM within 12 h
of birth. Initiate hepatitis B vaccine.
Child, adult: 0.06 ml/kg IM within 7 day after exposure. Repeat 28 day after exposure.
Hyaluronidase PRC: C
Classes
Protein enzyme; adjunctive agent
Indications
Increase absorption, dispersion of other inj drugs
H Increase absorption rate of fluids given by hypodermoclysis
Excretory urography
Dosages
Increase absorption, dispersion of other inj drugs—Child, adult: Add 150 USP U to
solution containing other drug.
Increase absorption rate of fluids given by hypodermoclysis—Child, adult: Inject 150
USP U into rubber tubing close to needle of running clysis solution. Usually 150 USP U will
facilitate absorption of ≥ 1 L solution; individualize dose.
Excretory urography—Child, adult: 75 USP U SC over each scapula before contrast
medium.
Hydralazine Hydrochloride PRC: C

Classes
Peripheral vasodilator; antihypertensive
Indications
Hypertension
Dosage
Hypertension—Child: 0.75 mg/kg PO qd in 4 divided doses (25 mg/m2/day); increase
over 3-4 wk to 7.5 mg/kg/day. IM or IV dose is 0.4-1.2 mg/kg/day or 50-100 mg/m2/day in
4-6 divided doses. Max initial parenteral dose 20 mg.
Adult: 10 mg PO qid × 2-4 day, then increase to 25 mg qid for rest of wk. Increase to 50 mg
qid prn. Max 200 mg/day, some pts may need 300-400 mg/day. For severe hypertension,
10-50 mg IM or 10-20 mg IV prn. Switch to PO treatment ASAP. Pregnant adult: 5 mg IV,
then 5-10 mg IV q 20-30 min until BP reduced (usual range, 5-20 mg).
Hydrochlorothiazide PRC: B
Classes
Thiazide diuretic; antihypertensive
Indications
Edema
Hypertension
PEDIATRiC DRUG 51
Dosages
Edema—Infant < 6 month: Up to 3 mg/kg PO qd divided bid. Infant > 6 month: 1-2 mg/kg
PO qd divided bid.
Adult: 25-200 mg PO qd × several day or until dry wt is attained. Maintenance dose 25-100
mg PO qd or intermittently. A few pts may need up to 200 mg qd.
Hypertension—Adult: 25-50 mg PO once qd or in divided doses.
Hydrocortisone (Systemic), Hydrocortisone Acetate,

Hydrocortisone Cypionate, Hydrocortisone Sodium Phosphate, PRC: C
Hydrocortisone Sodium Succinate
Classes
Glucocorticoid; mineralocorticoid, adrenocorticoid replacement
Indications
Severe inflammation, adrenal insufficiency H
I
Shock (other than adrenal crisis)
Life-threatening shock
Ulcerative colitis, proctitis
Dosages
Severe inflammation, adrenal insufficiency—Child: 0.56-8 mg/kg PO qd or 16-240 mg/m2
PO qd in 3-4 divided doses.
Adult: 5-30 mg PO bid, tid, or qid; max 80 mg PO qid; or 10-75 mg acetate, varies with size
of joint, into joints or soft tissue q 2-3 wk; or 15-240 mg phosphate SC, IM, or IV qd in
divided doses q 12 h; or 100-500 mg succinate IM or IV, then 50-100 mg IM as indicated.
Shock (other than adrenal crisis)— Child: 0.16-1 mg/kg or 6-30 mg/m2 phosphate or
succinate IM qd-bid. Adult: 100-500 mg IM, IV succinate q 2-6 h.
Life-threatening shock—Adult: 0.5-2 gram succinate IV; repeat q 2-6 h prn up to 72 h.
Ulcerative colitis, proctitis—Adult: 1 enema hydrocortisone (100 mg) nightly × 21 day; or
90 mg acetate (1 applicatorful) qd-bid × 2-3 wk, then every other day.
Hydrocortisone (Topical), Hydrocortisone Acetate,

Hydrocortisone Buteprate, Hydrocortisone Butyrate, PRC: C
Hydrocortisone Valerate
Classes
Glucocorticoid; anti-inflammatory
Indications
Inflammation of corticosteroid-responsive dermatoses on face, groin, armpits, under
breasts; seborrheic dermatitis of scalp
Dental lesions
Dosages
Inflammation of corticosteroid-responsive dermatoses on face, groin, armpits, under
breasts; seborrheic dermatitis of scalp—Child, adult: Apply cream, lotion, oint, foam, or
aerosol sparingly qd-qid. For aerosol, shake can well. Spray affected area from 15 cm
away. Apply × 3 sec to avoid freezing tissues. Apply to dry scalp after shampooing; don’t
rub in. Apply qd until acute phase controlled, then 1-3 times/wk prn. For rectal administration,
shake can well. Apply qd-bid × 2-3 wk, then every other day prn.
Dental lesions—Child, adult: Apply paste bid-tid and hs.
52 PEDIATRiC DRUG
Hydroxychloroquine Sulfate PRC: C

Classes
4-aminoquinoline; anti-malarial, anti-inflammatory
Indications
Prophylaxis of malaria
Acute malaria
Dosages
Prophylaxis of malaria—Infant, child: 5 mg, calculated as base/kg; on same day each wk.
Start 2 wk before exposure. If unable, give 10 mg base/kg in 2 divided doses 6 h apart.
Don’t exceed adult dose.
Adult: 400 mg sulfate (310-mg base) PO q wk on same day each wk. Start 2 wk before
entering endemic area and continue × 8 wk after leaving.
H Acute malaria—Infant, child: 10 mg base/kg; max 620 mg base/dose. Then, 5 mg base/

kg, max 310 mg base/dose, 6 h after 1st dose; 5 mg base/kg 18 h after 2nd dose; 5 mg base/
kg 24 h after 3rd dose.
Adult: 800 mg (620-mg base), then 400 mg (310-mg base) in 6-8 h and 400 mg (310-mg
base) on each of 2 consecutive day.
Hydroxyzine hydrochloride, Hydroxyzine Pamoate PRC: C

Classes
Antihistamine; anxiolytic, sedative, antipruritic, antiemetic, antispasmodic
Indications
Anxiety, tension, hyperkinesia
Preoperative, postoperative sedation; control emesis; asthma
Pruritus caused by allergies
Dosages
Anxiety, tension, hyperkinesia—Child < 6 yr; 50 mg PO qd in divided doses. Child ≥ 6 yr:
50-100 mg PO qd in divided doses.
Adult: 50-100 mg PO qid.
Preoperative, postoperative sedation; control emesis; asthma—Child: 1.1 mg/kg IM or 0.6
mg/kg PO q 4-6 h.
Adult: 25-100 mg IM or 50-100 mg PO q 4-6 h.
Pruritus caused by allergies—Child < 6 yr: 50 mg PO qd in divided doses.
Child ≥ 6 yr: 50-100 mg PO qd in divided doses.
Adult: 25 mg PO tid-qid.
Hyoscyamine, Hyoscyamine Sulfate PRC: C

Classes
Belladonna alkaloid; anticholinergic
Indications
GI disorders due to spasm; peptic ulcer
Dosages
GI disorders due to spasm; peptic ulcer—Child < 2 yr: 0.0125 mg at about 2.3 kg;
0.0167 mg at about 3.4 kg; 0.02 mg at about 5 kg; 0.025 mg at about 6.8 kg; 0.033 mg at
PEDIATRiC DRUG 53
about 10 kg; 0.05 mg at about 15 kg. Child 2-12 yr: 0.033 mg at about 10 kg; 0.0625 mg
at about 20 kg; 0.0938 mg at about 40 kg; 0.125 mg at about 50 kg. Repeat q 4 h prn; max
0.75 mg/24 h.
Adolescent, adult: 0.125-0.25 mg PO or SL qid ac and hs; 0.375-0.75 mg PO extended-
release q 12 h; or 0.25-0.5 mg IM, IV, or SC q 4 h bid-qid. Change to PO when symptoms
controlled.
Ibuprofen PRC: B
Classes
NSAID; nonnarcotic analgesic, antipyretic
Indications
Pain
Juvenile arthritis
Fever
Arthritis, gout, postextraction dental pain
Dosages
I
Pain—Child: 10 mg/kg PO q 6-8 h. Max 40 mg/kg.
Adult: 400 mg PO q 4-6 h.
Juvenile arthritis—Child: 20-40 mg/kg/day PO in 3-4 divided doses. For mild disease, 20
mg/kg/day in divided doses.
Fever—Infant, child 6 month-12 yr: 5 mg/kg PO q 6-8 h prn if temp ≤ 39.2° C; 10 mg/kg
PO if temp > 39.2° C. Max 40 mg/kg qd.
Adult: 200-400 mg PO q 4-6 h prn. Max 1,200 mg/day. Don’t take for > 3 day.
Arthritis, gout, postextraction dental pain—Adult: 300-800 mg PO tid or qid. Max 3,200
mg qd.
Imipenem and Cilastatin PRC: C

Classes
Carbapenem (thienamycin class); betalactam antibiotic
Indications
Lower respiratory, skin and skin-structure, gyn infection
Serious respiratory infection, UTI; intra-abdominal, gyn, bone, joint or skin infection; bacterial
septicemia; endocarditis
Dosages
Lower respiratory, skin and skin-structure, gyn infection—Adult ≥ 70 kg: 500-750 mg IM
q 12 h. Intra-abdominal infection- Adult ≥ 70 kg: 750 mg IM q 12 h. In pts weighing < 70 kg,
dosages vary.
Serious respiratory infection, UTI; intra-abdominal, gyn, bone, joint or skin infection; bacterial
septicemia; endocarditis—Neonate < 1 wk and ≥ 1.5 kg: 25 mg/kg IV q 12 h.
Neonate 1-4 wk and ≥ 1.5 kg: 25 mg/kg IV q 8 h.
Infant 4 wk-3 month and ≥ 1.5 kg: 25 mg/kg IV q 6 h.
Infant, child ≥ 3 month: 15-25 mg/kg IV q 6 h. Max in ped pts 2-4 gram qd. Doses as high
as 90 mg/kg qd have been used in older child with CF.
Adult ≥ 70 kg: 250 mg-1 gram IV infusion q 6-8 h. Max 50 mg/kg/day or 4 gram/day,
whichever is less. In pts weighing < 70 kg dosages vary.
54 PEDIATRiC DRUG
Imipramine Hydrochloride, Imipramine Pamoate PRC: D

Classes
Dibenzazepine-derivative; TCA
Indications
Enuresis
Depression
Dosages
Enuresis—Child 6-12 yr: 25 PO qd 1 h before bed. If no response after 1 wk, may
increase to 50 mg PO 1 h before bed.
Child > 12 yr: 25 mg PO 1 h before bed. Increase to 75 mg after 1 wk if no response.
Depression—Child < 12 yr: 1.5 mg/kg PO qd, increase prn q 3-4 day by 1 mg/kg. Max 5
mg/kg qd. Once symptoms controlled, reduce gradually to lowest effective dose.
Adult: 75-100 mg PO or IM qd in divided doses, increase by 25-50 mg up to 200 mg. Some
pts can start at lower doses (25 mg PO) and adjust by 25 mg every other day. Max 300 mg
qd. Or entire dose may be given hs. Max 200 mg/day for outpts and 300 mg/day for inpts.
I
Immune Globulin (Gamma Globulin, IG, Immune Serum
Globulin, ISG), Immune Globulin for IM Use (IGIM), PRC: C
Immune Globulin for IV Use (IGIV)
Classes
Immune serum; antibody stimulation
Indications
Agammaglobulinemia, hypogammaglobulinemia, immune deficiency
Hepatitis A exposure
Measles exposure
Postexposure prophyx of measles
Chickenpox exposure
Idiopathic thrombocytopenic purpura
Dosages
Agammaglobulinemia, hypogammaglobulinemia, immune deficiency—Child, adult:
Gamimune N: 100-200 mg/kg or 2-4 ml/kg IV q month. Infusion at 0.01-0.02 ml/kg/min × 30
min, then increase to max 0.08 ml/kg/min for rest of infusion. Gammagard S/D: 200-400
mg/kg IV, then 100 mg/kg q month. Start infusion at 0.5 ml/kg/h, increase to max 4 ml/kg/
h. Gammar-P IV: 200-400 mg/kg q 3-4 wk. Infusion at 0.01 ml/kg/min, increase to 0.02 ml/
kg/min after 15-30 min, with gradual increase to 0.06 ml/kg/min. Iveegam: 200 mg/kg IV q
month. If response inadequate, increase up to 800 mg/kg or give more often. Infusion at 1-
2 ml/min. Polygam S/D: 100 mg/kg IV q month 1st dose of 200-400 mg/kg may be given.
Start infusion at 0.5 ml/kg/h, increase to max of 4 ml/kg/h. Sandoglobulin: 200 mg/kg IV q
month, start with 0.5-1 ml/min of 3% solution; increase up to 2.5 ml/min gradually after 15-
30 min. Venoglobulin-I: 200 mg/kg IV q month; increase to 300-400 mg/kg; may be repeated
> once q month. Infusion at 0.01-0.02 ml/kg/min × 30 min, then increase to ≥ 0.04 ml/kg/min
if tolerated. Venoglobulin-S: 200 mg/kg IV q month. Increase to 300-400 mg/kg q month or
give more often if inadequate IgI levels. Start infusion at 0.01-0.02 ml/kg/min × 30 min, then
increase 5% solution to 0.04 ml/kg/min and 10% solution to 0.05 ml/kg/min if tol.
Hepatitis A exposure—Child, adult: 0.02-0.04 ml/kg IM ASAP after exposure. Up to 0.1
ml/kg after prolonged or intense exposure.
Measles exposure—Child, adult: 0.25 ml/kg IM within 6 day after exposure.
PEDIATRiC DRUG 55
Postexposure prophyx of measles—Child, adult: 0.5 ml/kg IM within 6 day after exposure.
Chickenpox exposure—Child, adult: 0.6-1.2 ml/kg IM as soon as exposed.
Idiopathic thrombocytopenic purpura—Child, adult: 400 mg/kg Sandoglobulin IV × 2-5
consecutive day; or 400 mg/kg Gamimune N 5% × 5 day or 1,000 mg/kg Gamimune N 10%
× 1-2 day. Maintenance dose 400-1,000 mg/kg IV Gamimune N 10% as single infusion to
maintain platelet count > 30,000/m3.
Indomethacin, Indomethacin Sodium Trihydrate PRC: D

Classes
Indications
Patent ductus arteriosus closure in premature infant
Arthritis, ankylosing spondylitis, juvenile RA
Idiopathic pericarditis, postpericardiotomy pericarditis
Dosages
Patent ductus arteriosus closure in premature infant—Neonate < 48 h: 0.2 mg/kg IV, then
I
2 doses of 0.1 mg/kg 12-24 h.
Neonate 2-7 day: 0.2 mg/kg IV, then 2 doses of 0.2 mg/kg q 12-24 h.
Neonate > 7 day: 0.2 mg/kg IV, then 2 doses of 0.25 mg/kg q 12-24 h.
Arthritis, ankylosing spondylitis, juvenile RA—Child 2-14 yr: 2 mg/kg PO qd in divided
doses using conventional caps. Increase to 4 mg/kg qd in divided doses, max 200 mg qd.
As symptoms subside, decrease dose to lowest effective level until drug is discontinued.
Adult: 25 mg PO bid or tid with food or antacid; increase by 25-50 mg/day q 7 day up to 200
mg qd; or 50 mg PR qid. Or sustained-release caps: 75 mg in morning or hs, then 75 mg bid
prn.
Idiopathic pericarditis, postpericardiotomy pericarditis—Child: 50-100 mg PO qd in 2-4
divided doses.
Insulin (Regular), Insulin (Lispro), Isophane Insulin Susp (NPH),

Insulin Zinc Susp (Lente), Extended Zinc Insulin Susp (Ultralente), PRC: B
Isophane Insulin Susp and Insuli Inj
Classes
Pancreatic hormone; antidiabetic
Indications
Diabetic ketoacidosis (regular insulin)
Ketosis-prone pt, type 1 DM, inadequately controlled DM
Hyperkalemia
Provocative test for growth hormone secretion
Dosages
Diabetic ketoacidosis (regular insulin)—Child: 0.5-1 U/kg in 2 divided doses, 1 given IV
and the other SC, then 0.5-1 U/kg IV q 1-2 h; or 0.1 U/kg IV bolus, then 0.1 U/kg/h IV
infusion until blood glucose drops to 250 mg/dl; then start SC insulin.
Adult: Loading dose 0.15 U/kg IV, then 0.1 U/kg/h IV infusion. Decrease rate of insulin
infusion at plasma glucose level 300 mg/dl. Infusion of D5W started separately from insulin
infusion when plasma glucose 250 mg/dl; 30 min before stopping insulin infusion, give
intermediate-acting insulin SC. Or 50-100 U IV and 50-100 U SC immed; then doses based
56 PEDIATRiC DRUG
on response and glucose, acetone, ketone levels (monitored q 1-2 h); or 2.4-7.2 U IV
loading dose, then 2.4-7.2 U/h.
Ketosis-prone pt, type 1 DM, inadequately controlled DM—Child, adult: Individualize
dose based on pt blood and urine glucose levels.
Hyperkalemia—Adult: 5-10 U regular insulin with 50 ml D5W over 5 min. Or 25 U regular
insulin SC and infusion of 1,000 ml D10W with 90 mEq Na bicarbonate; infuse 330 ml over
30 min and the rest over 3 h.
Provocative test for growth hormone secretion—Adult: Rapid IV inj of regular insulin
0.05-0.15 U/kg.
Insulin Glargine (rDNA) inj PRC: C

Classes
Pancreatic hormone; antidiabetic
Indications
Type 1 DM pts who need long acting insulin to control hyperglycemia
I Type 2 DM in pts previously treatment with PO antidiabetics
Dosages
Type 1 DM pts who need long acting insulin to control hyperglycemia—Child, adult: Pts
taking qd NPH or ultralente human insulin: start Lantus at same dose as current insulin
dose. Pts taking bid NPH human insulin: start Lantus at 20% less than current qd insulin
dose. Adjust based on pt response.
Type 2 DM in pts previously treatment with PO antidiabetics—Adults: 10 IU SC qd hs.
Adjust prn to 2 IU-100 IU SC q hs.
Ipecac Syrup PRC: C

Classes
Alkaloid emetic; emetic
Indications
Induce vomiting in poisoning
Dosages
Induce vomiting in poisoning—Infant < 1 yr: 5-10 ml PO, then 100-200 ml H2O or milk.
Child ≥ 1 yr: 15 ml PO, then 200 ml H2O or milk.
Adult: 15-30 ml PO, then 200-300 ml H2O. May repeat dose once after 20 mn prn.
Ipratropium Bromide PRC: B

Classes
Anticholinergic; bronchodilator
Indications
Bronchospasm in chronic bronchitis, emphysema
Perennial rhinitis
Rhinorrhea from common cold
Dosages
Bronchospasm in chronic bronchitis, emphysema—Child 5-11 yr: 125-250 mcg nebulizer
solution dissolved in NSS q 4-6 h via nebulizer.
PEDIATRiC DRUG 57
Child ≥ 12 yr, adult: 2 inhalant, inhalation (36 mcg) qid; pt may take additional inhalant,
inhalation prn; max 12 inhalant, inhalation/24 h or 500 mcg q 6-8 h via oral nebulizer.
Perennial rhinitis—Child ≥ 6 yr, adult: 2 sprays (0.03% nasal spray; 42 mcg) per nostril
bid-tid.
Rhinorrhea from common cold—Child ≥ 12 yr, adult: 2 sprays (0.06% nasal spray;
84 mcg) per nostril tid-qid.
Iron Dextran PRC: C

Classes
Parenteral iron supplement; hematinic
Indications
Iron-deficiency anemia
Dosages
Iron-deficiency anemia—Child, adult: Highly individualized based on pt wt and Hgb level.
Usually given IM; preservative-free solution can be given IV.
I
Isoniazid (INH) PRC: C
Classes
Isonicotinic acid hydrazine; anti-tuberculotic
Indications
Actively growing tubercle bacilli
Actively growing tubercle bacilli with other antituberculotics (except rifampin)
Prophylaxis against tubercle bacilli in pts exposed to TB or with positive skin test
Dosages
Actively growing tubercle bacilli—Infant, child: 10-20 mg/kg PO or IM qd in 1 dose. Max
300-500 mg/day × 18 month-2 yr. Adult: 5 mg/kg PO or IM qd in 1 dose. Max 300 mg/day
× 9 month-2 yr. Give with 1 other antituberculotic.
Actively growing tubercle bacilli with other antituberculotics (except rifampin)—Child:
20-40 mg/kg 2-3 times/wk. Max 900 mg/dose.
Adult: 15 mg/kg 2-3 times/wk. Max 900 mg/dose.
Prophylaxis against tubercle bacilli in pts exposed to TB or with positive skin test—Infant,
child: 10-15 mg/kg PO qd. Max 300 mg/day × 6 month-1 yr.
Adult: 300 mg PO qd × 6 month-1 yr.
Isoproterenol, Isoproterenol Hydrochloride, Isoproterenol Sulfate PRC: C

Classes
Adrenergic; bronchodilator, cardiac stimulant
Indications
Complete heart block after closure of ventricular spetal defect
Bronchospasm during asthma attack
Bronchospasm in COPD
Acute asthma attack unresponsive to inhalant, inhalation treatment or control of
bronchospasm during anesthesia
Emergency treatment of arrhythmias
58 PEDIATRiC DRUG
Heart block, Stokes-Adams attacks, shock
Dosages
Complete heart block after closure of ventricular spetal defect— Child: IV bolus, 0.01-
0.03 mg (0.5-1.5 ml 1:50,000 dilution).
Adult: IV bolus, 0.02-0.06 mg (1-3 ml 1:50,000 dilution).
Bronchospasm during asthma attack—Child, adult: Via aerosol inhalant, inhalation, 1
inhalant, inhalation (HCl), repeat prn after 1-5 min; max 6 inhalant, inhalation qd. Maintenance
1-2 inhalant, inhalation 4-6 times qd q 3-4 h. Via hand-bulb nebulizer, 5-15 deep inhalant,
inhalation of 0.5% solution; repeat in 5-10 min prn up to 5 times qd. Or 3-7 deep inhalant,
inhalation of 1% solution; repeat once in 5-10 min prn up to 5 times qd.
Child, adult: For acute dyspnea, 1 inhalant, inhalation (sulfate); repeat after 2-5 min prn.
Max 6 inhalant, inhalation qd. Maintenance 1-2 inhalant, inhalation up to 6 times qd.
Bronchospasm in COPD—Child, adult: via hand-bulb nebulizer: 5-15 deep inhalant,
inhalation (HCl) of 0.5% solution, or 3-7 deep inhalant, inhalation of 1% solution q 3-4 h.
Acute asthma attack unresponsive to inhalant, inhalation treatment or control of
bronchospasm during anesthesia— Adult: 0.01-0.02 mg (HCl; 0.5-1 ml of 1:50,000 dilution)
IV. Repeat prn.
Emergency treatment of arrhythmias—Child: May give ½ (HCl) of initial adult dose.
K Adult: 0.02-0.06 mg (HCl) IV bolus. Then 0.01-0.2 mg IV. Or 5 mcg/min adjusted to pt
response. Range 2-20 mcg/min. Or 0.2 mg IM or SC; then 0.02-1 mg IM, or 0.15-0.2 mg
SC. In extreme cases, 0.02 mg (0.1 of 1:5,000) intracardiac inj.
Heart block, Stokes-Adams attacks, shock—Child, adult: 0.5-5 mcg/min (HCl) IV infusion,
adjust to pt response; or 0.02-0.06 mg IV bolus with 0.01-0.2 mg additional dose; or 0.2 mg
IM or SC with 0.02-1 mg IM or 0.15-0.2 mg additional dose.
Ketamine Hydrochloride PRC: NR

Classes
Dissociative anesthesia; IV anesthesia
Indications
General anesthesia for short procedures not requiring skeletal muscle relaxation; adjunct
to other general anesthesia or low-potency agents
Dosages
General anesthesia for short procedures not requiring skeletal muscle relaxation; adjunct
to other general anesthesia or low-potency agents—Child, adult:1-4.5 mg/kg IV over 60
sec; or 6.5-13 mg/kg IM. Repeat half to full initial dose prn.
Ketoconazole PRC: C
Classes
Imidazole derivative; antifungal
Indications
Severe fungal infection
Tinea corporis, cruris, versicolor, pedis
Seborrheic dermatitis
Dandruff
Dosages
Severe fungal infection—Child > 2 yr: 3.3-6.6 mg/kg PO qd as single dose.
PEDIATRiC DRUG 59
Adult: 200 mg PO qd as single dose. Increase to 400 mg once qd.

Tinea corporis, cruris, versicolor, pedis—Adolescent, adult: Apply once qd-bid × 2 wk;
for tinea pedis × 6 wk.
Seborrheic dermatitis—Adolescent, adult: Apply bid × 4 wk.
Dandruff—Adolescent, adult: Apply × 1 min, rinse, then reapply × 3 min. Shampoo twice/
wk × 4 wk with at least 3 day between shampoos.
Ketotifen Fumarate PRC: C

Classes
Histamine1 antagonist, mast cell stabilizer; ophth antihistamine
Indications
Prevention of eye itching from allergic conjunctivitis
Dosages
Prevention of eye itching from allergic conjunctivitis—Child ≥ 4 yr, adult: Instill 1 drops in
affected eye q 8-12 h.
Lactulose PRC: B
Classes
Disaccharide; laxative
L
Indications
Constipation
Prevention, treatment portal-systemic encephalopathy, including hepatic precoma and
coma in pts with severe hepatic disease
After barium meal examination
Dosages
Constipation—Child: 7.5 ml (5 gram) PO qd.
Adult: 15-30 ml PO qd. Increase to 60 ml prn.
Prevention, treatment portal-systemic encephalopathy, including hepatic precoma and
coma in pts with severe hepatic disease—Infant: 2.5-10 ml qd in divided doses, to
produce 2-3 loose stools qd.
Child, adolescent: 40-90 ml qd in divided doses, to produce 2-3 loose stools qd.
Adult: 20-30 gram (30-45 ml) PO tid-qid, to produce 2-3 soft stools qd. Usual dose 60-100
gram qd in divided doses; can also be given by retention enema. Mix 300 ml lactulose with
700 ml H2O or NSS and retain for 60 min. Repeat q 4-6 h.
After barium meal examination—Adult: 5-10 ml PO bid × 1-4 wk.
Lamotrigine PRC: C
Classes
Phenyltriazine; anti-convulsant
Indications
Partial seizures
Lennox-Gastaut syndrome
60 PEDIATRiC DRUG
Dosages
Partial seizures—Adolescent > 16 yr, adult: 50 mg PO qd × 2 wk ; then 100 mg qd in 2
divided doses × 2 wk. Maintenance 300-500 mg PO qd in 2 divided doses. Pt on valproic
acid: 25 mg PO every other day × 2 wk; then 25 mg PO qd × 2 wk. Max 150 mg PO qd in 2
divided doses.
Lennox-Gastaut syndrome—Round doses down to nearest 5 mg. Child 2-12 yr: 0.6 mg/
kg PO qd in 2 divided doses × 2 wk, then 1.2 mg/kg PO qd in 2 divided doses. Increase q
1-2 wk by 1.2 mg/kg/day until maintenance 5-15 mg/kg/day (max 400 mg/day). Pt on
valproic acid: 0.15 mg/kg PO qd in 1-2 divided doses × 2 wk. If initial dose 2.5-5 mg, give 5-
mg dose on alternate day × 2 wk. For next 2 wk, 0.3 mg/kg PO qd in 1-2 divided doses.
Increase q 1-2 wk by 0.3 mg/kg/day until maintenance 1-5 mg/kg/day (max 200 mg/day in
1-2 divided doses).
Child > 12 yr, adult: 50 mg PO qd × 2 wk, then 100 mg qd in 2 divided doses × 2 wk.
Maintenance 300-500 mg PO qd in 2 divided doses. Pt on valproic acid: 25 mg PO every
other day × 2 wk, then 25 mg PO qd × 2 wk. Maintenance 100-400 mg PO qd in 1-2 divided
doses.
Levofloxacin Ophthalmic Solution PRC: C

Classes
Fluoroquinolone; antimicrobial PRC: C
L Indications
Conjunctivitis
Dosages
Conjunctivitis—Child > 1 yr, adult: 1-2 drops in affected eye q 2 h while awake, up to 8
drops qd × 2 day, then 1-2 drops in affected eye q 4 h while awake, up to qid × 5 day.
Levothyroxine Sodium (T4, L-thyroxine Sodium) PRC: A

Classes
Thyroid hormone; thyroid hormone replacement drug
Indications
Congenital hypothyroidism
Hypothyroidism
Myxedema coma
Dosages
Congenital hypothyroidism—Child < 1 yr: 25-50 mcg PO qd, increase to 50 mcg in 4-6 wk.
For pts with CV disease, adjust dose.
Hypothyroidism—Infant < 6 month: 25-50 mcg or 8-10 mcg/kg/day. Infant 6-12 month: 50-
75 mcg or 6-8 mcg/kg/day.
Child 1-5 yr: 75-100 mcg or 5-6 mcg/kg/day. Child 6-12 yr: 100-150 mcg or 4-5 mcg/kg/
day.
Child > 12 yr: 150 mcg or 2-3 mcg/kg/day.
Adult: Mild hypothyroidism: 50 mcg PO qd, increase by 25-50 mcg q PO qd 2-4 wk until
response; give IV< IM prn. Severe hypothyroidism: 12.5-25 mcg qd, in by 25-50 mcg qd q
2-4 wk until response. For pts with CV disease, adjust dose.
Myxedema coma—Adult: 300-500 mcg IV. If no response in 24 h, 100-300 mcg IV in 48 h.
Maintenance dose 50-200 mcg until pt stabilizes and drug can be given PO. For pts with
CV disease, adjust dose.
PEDIATRiC DRUG 61
Lidocaine (Lignocaine), Lidocaine Hydrochloride PRC: B

Classes
Amide derivative; ventricular antiarrhythmic; local anesthesia
Indications
Ventricular arrhythmias from MI, cardiac manipulation, cardiac glycosides
Status epilepticus
Local anesthesia of skin, mucous membranes, pain from dental extraction, stomatitis
Dosages
Ventricular arrhythmias from MI, cardiac manipulation, cardiac glycosides—Child: 0.5-1
mg/kg IV bolus, then infusion 20-50 mcg/min.
Adult: 50-100 mg (1-1.5 mg/kg) IV bolus at 25-50 mg/mi. Repeat q 3-5 min prn as
tolerated. Max 300-mg total bolus over 1 h. At same time, begin infusion of 1-4 mg/min. If
initial bolus given, give smaller bolus (usually ½ initial bolus) 5-10 min after start of infusion
to maintenance therapeutic serum level. After 24 h of infusion, dec rate to 1-2 mg/min. Or
300 mg (4.3 mg/kg) IM in deltoid muscle in early stage of acute MI. Adjust dose in pts < 50
kg and in those with HF.
Status epilepticus—Adult: 1 mg/kg IV bolus; then 0.5 mg/kg 2 min after 1st dose prn; or
infusion 30 mcg/kg/min.
Local anesthesia of skin, mucous membranes, pain from dental extraction, stomatitis—
Child, adult: 2-5% solution, oint or 15 ml Xylocaine Viscous q 3-4 h to oral, nasal mucosa. L
Liothyronine Sodium (T3) PRC: A
Classes
Thyroid hormone; thyroid hormone replacement drug
Indications
Congenital hypothyroidism
Myxedema
Goiter
Myxedema coma, precoma
Thyroid hormone replacement
Liothyronine suppression test to differentiate hyperthyroidism from euthyroidism
Dosages
Congenital hypothyroidism—Child: 5 mcg PO qd, increase by 5 mcg q 3-4 day until
response.
Myxedema—Adult: 5 mcg PO qd, increase by 5-10 mcg q 1-2 wk. Maintenance 50-100
mcg qd.
Goiter—Child: 5 mcg PO qd, increase by 5 mcg q wk until response.
Adult: 5 mcg PO qd; increase by 5-10 mcg qd q 1-2 wk to 25 mcg. Then increase by 12.5-
25 mcg qd q 1-2 wk until response. Maintenance 75 mcg qd.
Adult > 65 yr: 5 mcg PO qd, increase by 5-mcg q 1-2 wk to 25 mcg qd. Then increase by
12.5-25 mcg qd q 1-2 wk.
Myxedema coma, precoma—Adult: 25-50 mcg IV, reassess after 4-12 h, then switch to
PO ASAP. Pt with known to suspected cardiac disease 10-20 mcg IV.
Thyroid hormone replacement—Adult: 25 mcg PO qd, increase by 12.5-25 mcg q 1-2 wk
until response. Maintenance 25-75 mcg qd.
62 PEDIATRiC DRUG
Liothyronine suppression test to differentiate hyperthyroidism from euthyroidism—Adult:
75-100 mcg qd × 7 day.
Lithium Carbonate, Lithium Citrate PRC: D

Classes
Alkali metal; antimanic, antipsychotic
Indications
Mania; prevention of depression in pts with bipolar illness
Mixed bipolar disorder
Dosages
Mania; prevention of depression in pts with bipolar illness—Adolescent, adult: 900 mg
(sustained-release tab) PO in morning and hs, or 600 mg (tab or caps) morning, noon, and
hs.
Mixed bipolar disorder—Child: 15-60 mg/kg or 0.5-1.5 gram/m2 (carbonate) PO qd in 3
divided doses; range: 150-300 mg qd in divided doses. Don’t exceed usual adult dose.
Adult: 1.2-1.8 gram/day. Adjust dose based on pt response and serum lithium levels.
Loperamide Hydrochloride PRC: B

L Classes
Piperadine derivative; antidiarrheal PRC: B
Indications
Acute, nonspecific diarrhea
Chronic diarrhea
Dosages
Acute, nonspecific diarrhea—Child 2-5 yr: 1 mg tid on day 1.
Child 6-8 yr: 2 mg bid on day 1.
Child 9-11 yr: 2 mg tid on day 1.
Child ≥ 12 yr, adult: 4 mg PO, then 2 mg after each unformed stool. Max 16 mg qd.
Maintenance 1/3-1/2 initial dose.
Chronic diarrhea—Adult: 4 mg PO, then 2 mg after each unformed stool until diarrhea
subsides. Adjust to response.
Loratadine PRC: B
Classes
Tricyclic antihistamine; antihistaminic
Indications
Allergic rhinitis, idiopathic chronic urticaria
Dosages
Allergic rhinitis, idiopathic chronic urticaria—Child > 6 yr, adult: 10 mg PO qd. In pts with
glomerular filtration rate below 30 ml/min, adjust dose.
PEDIATRiC DRUG 63
Lorazepam PRC: D
Classes
Benzodiazepine anxiolytic; sedative-hypnotic
Indications
Status epilepticus
Anxiety, tension, agitation, irritability
Preoperative
Dosages
Status epilepticus—Neonate: 0.05 mg/kg IV over 2-5 min; repeat in 10-15 min prn based
on response.
Infant, child: 0.1 mg/kg IV over 2-5 min; then 0.05 mg/kg IV in 10-15 min prn. Max 4 mg/
dose.
Adult: 4 mg IV over 2-5 min; then 4 mg IV in 10-15 min prn.
Anxiety, tension, agitation, irritability—Adolescent, adult: 2-6 mg PO qd in divided doses;
max 10 mg/day.
Preoperative—Adult: 0.05 mg/kg IM 2 h before surgery (max 4 mg). Or 0.044 mg/kg (max
2 mg) IV 15-20 min before surgery; in adult < 50 yr, increase to 0.05 mg/kg (max 4 mg).
Magnesium Hydroxide (Milk of Magnesia) PRC: NR

Classes M
Magnesium salt; antacid, antiulcerative, laxative
Indications
Constipation bowel evacuation before surgery
Laxative
Antacid
Dosages
Constipation bowel evacuation before surgery—Child > 6 yr, adult: 10-20 ml concentrated
milk of magnesia PO; 15-60 ml milk of magnesia PO.
Laxative—Child 2-5 yr: 5-15 ml PO once or in divided doses.
Child 6-11 yr: 15-30 ml PO once or in divided doses.
Adolescent, adult: 30-60 ml PO, usually hs once or in divided doses.
Antacid—Child: 2.5-5 ml PO prn. Adult: 5-15 ml (liq) PO prn, up to qid; 2.5-7.5 ml (liq
concentrated) PO prn, upto qid; 2-4 tab PO prn, up to qid.
Magnesium Sulfate PRC: A

Classes
Mineral/electrolyte; anticonvulsant
Indications
Seizures, encephalopathy, HTN from hypomagnesemia in acute nephritis
Hypomagnesemic seizures
Arrhythmias
Barium poisoning, asthma
64 PEDIATRiC DRUG
Dosages
Seizures, encephalopathy, HTN from hypomagnesemia in acute nephritis—Child: 100 mg/
kg (0.2 ml/kg of 50% solution) IM q 4-6 h prn or 100-200 mg/kg slow IV as 1-3% solution.
Infusion total IV dose within 60 min and 50% of dose in 1st 15-20 min. Titrate dose according
to mg levels and seizure response.
Hypomagnesemic seizures—Adult: 1-2 gram (as 10% solution) IV over 15 min, then 1
gram IM q 4-6 h, based on response and mg levels.
Arrhythmias—Adult: Sustained VT, torsades de pointes: 2-6 gram IV over several min,
then 3-20 mg/min IV infusion × 5-48 h depending on response and mg levels. PAT: 3-4 gram
IV over 30 sec.
Barium poisoning, asthma—Adult: 1-2 gram IV.
Mannitol PRC: C
Classes
Osmotic diuretic; prevention and mgt of acute RF or oliguria, reduction of intracranial or
intraocular pressure, treatment of drug intoxication
Indications
Test dose for marked oliguria, suspected inadequate RF
Oliguria
Prevention of oliguria, acute RF
Edema, ascites
M Reduce IOP, intracranial pressure
Dosages
Test dose for marked oliguria, suspected inadequate RF—Child ≤ 12 yr: 0.2 gram/kg or
6 gram/m2 IV over 3-5 min.
Child > 12 yr, adult: 200 mg/kg or 12.5 gram as 15-20% solution IV over 3-5 min.
Response is adequate if 30-50 ml urine/h is excreted over 2-3 h.
Oliguria—Child ≤ 12 yr: 2 gram/kg or 60 gram/m2 IV.
Child > 12 yr, adult: 50-100 gram as 15-20% solution IV over 90 min-several h.
Prevention of oliguria, acute RF—Child > 12 yr, adult: 50-100 gram, then 5-10% solution
IV. Exact concentrated is determined by fluid requirements.
Edema, ascites—Child ≤ 12 yr: 2 gram/kg or 60 gram/m2 IV as 15-20% solution over 2-
6 h.
Child > 12 yr, adult: 100 gram as 10-20% solution IV over 2-6 h.
Reduce IOP, intracranial pressure—Child ≤ 12 yr: 2 gram/kg or 60 gram/m2 IV as 15-20%
solution over 30-60 min.
Child > 12 yr, adult: 1.5-2 gram/kg as 15-25% solution IV over 30-60 min, 60-90 min
before surgery.
Mebendazole PRC: C
Classes
Benzimidazole; anthelmintic
Indications
Pinworms
Roundworm, whipworm, hookworm
PEDIATRiC DRUG 65
Dosages
Pinworms—Child > 2 yr, adult: 100 mg PO in 1 dose. If infection persists × 3 wk, repeat.
Roundworm, whipworm, hookworm—Child > 2 yr, adult: 100 mg PO bid × 2 day. If
infection persists × 3 wk, repeat.
Medroxyprogesterone Acetate PRC: X

Classes
Progestin; antineoplastic
Indications
Abnormal uterine bleeding from hormonal imbalance
Contraception
Secondary amenorrhea
Endometrial, renal CA
Dosages
Abnormal uterine bleeding from hormonal imbalance—Adolescent, adult: 5-10 mg PO qd
× 5-10 day beginning on day 16 or 21 of menstrual cycle. Pt on estogen: 10 mg PO qd × 10
day beginning on day 16 of cycle.
Contraception—Adolescent, adult: 150 mg IM q 3 month; give 1st inj on 1st 5 day of
menstrual cycle.
Secondary amenorrhea—Adolescent, adult: 5-10 mg PO qd × 5-10 day.
Endometrial, renal CA—Adolescent, adult: 400-1,000 mg IM q wk.
M
Meperidine Hydrochloride (Pethidine Hydrochloride) PRC: C
Classes
Opioid; analgesic; adjunct to anesthesia
Indications
Pain
Preoperative
Support of anesthesia
Obstetric analgesia
Dosages
Pain—Child: 1.1-1.8 mg/kg PO, IM, SC q 3-4 h prn, or 175 mg/m2 qd in 6 divided doses.
Max single dose 100 mg.
Adult: 50-150 mg PO, IM, SC q 3-4 h.
Preoperative—Child: 1-2.2 mg/kg IM, SC 30-90 min before surgery. Max single dose 100
mg.
Adult: 50-100 mg IM, SC 30-90 min before surgery.
Support of anesthesia—Adult: Repeated slow IV inj of fractional doses (10 mg/ml) or IV
infusion 1 mg/ml. Titrate to response.
Obstetric analgesia—Adult: 50-100 mg IM, SC when pain becomes regular; repeat q
1-3 h prn.
66 PEDIATRiC DRUG
Methocarbamol PRC: C
Classes
Carbamate derivative of guaifenesin; skeletal muscle relaxant
Indications
Tetanus
Acute musculoskeletal pain
Dosages
Tetanus—Child: 15 mg/kg or 500 mg/m2 IV. Don’t inject faster than 180 mg/m2/min. Repeat
q 6 h prn to max 1.8 gram/m2 qd × 3 day.
Adult: 1-2 gram IV push (300 mg/min) and 1-2 gram added to IV solution. Total initial IV
dose, 3 gram. Repeat IV infusion of 1-2 gram q 6 h until NG tube can be inserted.
Acute musculoskeletal pain—Adult: 1.5 gram PO qid × 2-3 day. Maintenance: 4-4.5 gram
PO qd in 3-6 divided doses. Or 1 gram IM, IV. Max 3 gram qd IM, IV × 3 consecutive day.
Methylprednisolone (Systemic), Methylprednisolone Acetate,

PRC: C
Methylprednisolone Sodium Succinate
Classes
Glucocorticoid, anti-inflammatory, immunosuppressant
Indications
M Inflammation
Shock
Severe lupus nephritis
Motor, sensory defects from acute spinal cord injury
Dosages
Inflammation—Child: 0.117-1.66 mg/kg (systemic) qd or 3.3-50 mg/m2 PO qd in 3-4
divided doses. 0.03-0.2 mg/kg (sodium succinate) or 1-6.25 mg/m2 IM, IV qd in divided
doses.
Adult: 2-60 mg (systemic) PO qd in 4 divided doses. 10-80 mg (acetate) IM qd, or 4-80 mg
into joints and soft tissue prn q 1-5 wk; or 20-60 mg intralesionally. 10-250 mg (sodium
succinate) IM, IV q 4 h.
Shock—Adult: 100-250 mg (sodium succinate) IV q 2-6 h.
Severe lupus nephritis—Child: 30 mg/kg (sodium succinate) IV every other day × 6
doses.
Adult: 1 gram (sodium succinate) IV over 1 h × 3 day.
Motor, sensory defects from acute spinal cord injury—Adult: 30 mg/kg (sodium succinate)
IV over 15 min; after 45 min, IV infusion of 5.4 mg/kg/h × 23 h.
Metoclopramide Hydrochloride PRC: B

Classes
PABA derivative; antiemetic, GI stimulant
Indications
Prevention or reduction of nausea, vomiting from chemotherapy
Small-bowel intubation, aid in radiologic examination
Delayed gastric emptying from diabetic gastroparesis
PEDIATRiC DRUG 67
GERD
Postoperative nausea, vomiting
Dosages
Prevention or reduction of nausea, vomiting from chemotherapy—Child: 1 mg/kg IV in 1
dose. Repeat once after 1 h.
Adolescent, adult: 1-2 mg/kg IV q 2 h × 2 doses, beginning 30 min before chemotherapy,
then q 3 h × 3 doses.
Small-bowel intubation, aid in radiologic examination—Child < 6 yr: 0.1 mg/kg IV.
Child 6-14 yr: 2.5-5 mg IV.
Adolescent, adult: 10 mg IV in 1 dose over 1-2 min.
Delayed gastric emptying from diabetic gastroparesis—Adolescent, adult: 10 mg PO 30
min ac and hs × 2-8 wk; or 10 mg IV over 2 min.
GERD—Adolescent, adult: 10-15 mg PO qid prn 30 min ac and hs.
Postoperative nausea, vomiting—Adolescent, adult: 10-20 mg IM near end of surgery,
repeat q 4-6 h prn.
Metronidazole, Metronidazole Hydrochloride PRC: B

Classes
Nitroimidazole; antibiotic; antiprotozoal, amebicide
Indications
Bacterial infection
M
Clostridium difficile
H. pylori associated with peptic ulcer disease
Dosages
Bacterial infection—Neonate < 4 wk and < 1.2 kg: 7.5 mg/kg PO, IV q 48 h.
Neonate < 1wk and 1.2-2 kg: 7.5 mg/kg PO, IV q 24 h.
Neonate < 1 wk and > 2 kg: 7.5 mg/kg PO, IV q 12 h.
Neonate > 1 wk and 1.2-2 kg: 7.5 mg/kg PO, IV q 12 h.
Neonate > 1 wk and > 2 kg: 15 mg/kg PO, IV q 12 h.
Infant, child: 7.5 mg/kg PO, IV q 6 h. Max 4 gram/day.
Adult: 15 mg/kg IV over 1 h. Maintenance 7.5 mg/kg IV, PO q 6 h. Give 1st maintenance
dose 6 h after loading dose. Max 4 gram qd.
Clostridium difficile—Child: 30-50 mg/kg PO qd in 3-4 divided doses × 7-10 day. Don’t
exceed adult dose.
Adult: 750 mg-2 gram PO qd in 3-4 divided doses × 7-14 day.
H. pylori associated with peptic ulcer disease—Child: 15-20 mg/kg PO qd divided in 2
doses × 4 wk (with amoxicillin or bismuth subsalicylate).
Adult: 250-500 mg PO tid (with at least 1 other drug active against H. pylori).
Midazolam Hydrochloride
Classes
Benzodiazepine; preoperative sedative, drug for conscious sedation, adjuct for induction
of general anesthesia, amnestic
68 PEDIATRiC DRUG
Indications
Sedation of intubated pt as anesthesia or during treatment in ICU
Preoperative sedation
Preoperative or procedural sedation
Dosages
Sedation of intubated pt as anesthesia or during treatment in ICU—Preterm neonate
(< 32 wk gestation): 0.03 mg/kg/h (0.5 mcg/kg/min) IV.
Term neonate ( ≥ 32 wk gestation): 0.06 mg/kg/h (1 mcg/kg/min) IV.
Child: 0.05-0.2 mg/kg IV over 2-3 min, then IV infusion 0.06-0.12 mg/kg/h (1-2 mcg/kg/
min). Titrate by 25% of infusion rate to obtain optimal sedation. For obese child, calculate
dose based on ideal body wt.
Adult: 0.01-0.05 mg/kg IV over several min, repeat q 10-15 min until adequate sedation.
Sedation maintenance: usual infusion rate 0.02-0.10 mg/kg/h (1-7 mg/h). Titrate to desired
amount. Titrate by 25-50% of initial infusion rate to achieve optimal sedation. For child with
cardiac or respiratory compromise, high-risk surgery pt, and pts who have received
narcotics or other CNS depressants, consider lower doses.
Preoperative sedation—Adult < 60 yr: 0.07-0.08 mg/kg IM 1 h before surgery.
Preoperative or procedural sedation—(IM) Child: 0.1-0.15 mg/kg IM; up to 0.5 mg/kg in
anxious pt.
(IV) Infant, child 6 month-5 yr: 0.05-0.1 mg/kg IV over 2-3 min. Give other doses in small
increments after 2-3 min, up to 0.6 mg/kg. Max 6 mg.
M Child 6-12 yr: 0.025-0.05 mg/kg IV over 2-3 min. Give other doses in small increments
after 2-3 min, up to 0.4 mg/kg. Max 10 mg.
Child, adolescent 12-16 yr: Dose as adult. Max total dose 10 mg. (PO) Infant, child 6
month-5 yr, uncooperative pt: 0.25-1 mg/kg PO in 1 dose. Max 20 mg. Child 6-16 yr,
cooperative pt: 0.25-0.5 mg/kg PO in 1 dose. Max 20 mg. For child with cardiac or respiratory
compromise, highrisk surgery pt, and pts who have received narcotics or other CNS
depressants, consider lower doses. For obese child, calculate dose based on ideal body wt.
Minocycline Hydrochloride PRC: D

Classes
Tetracycline; antibiotic PRC: D
Indications
Infection
Gonorrhea in pt sensitive to penicillin
Syphilis in pt sensitive to penicillin
Meningococcal carrier
Uncomplicated urethral, endocervical or rectal infection
Uncompplicated gonococcal urethritis (males)
Acne
Dosages
Infection—Child ≥ 8 yr: 4 mg/kg PO, IV; then 4 mg/kg PO qd divided q 12 h. Give IV in 500-
to 1,000-ml solution without calcium over 6 h.
Adolescent, adult: 200 mg PO, IV; then 100 mg q 12 h or 50 mg PO q 6 h.
Gonorrhea in pt sensitive to penicillin—Adolescent, adult: 200 mg; then 100 mg q 12 h ×
4 day.
PEDIATRiC DRUG 69
Syphilis in pt sensitive to penicillin—Adult: 200 mg; then 100 mg q 12 h × 10-15 day.

Meningococcal carrier—Adolescent, adult: 100 mg PO q 12 h × 5 day.
Uncomplicated urethral, endocervical or rectal infection—Adult: 100 mg PO q 12 h × at
least 7 day.
Uncompplicated gonococcal urethritis (males)—Adolescent, adult: 100 mg PO q 12 h ×
5 day.
Acne—Adult: 50 mg PO qd bid-tid.
Montelukast Sodium PRC: B

Classes
Leukotriene receptor antagonist; antasthmatic
Indications
Asthma
Dosages
Asthma—Child 2-5 yr: 4 mg (chewable tab) PO once qd in pm.
Child 6-14 yr: 5 mg (chewable tab) PO once qd in pm.
Adolescent, adult: 10 mg PO once qd in pm.
Morphine Sulfate PRC: C

Classes
Opioid; narcotic analgesic
Indications
N
Pain
Chronic CA pain
Postoperative analgesia
Preoperative redation, adjunct to anesthesia
Pulm edema
Dosages
Pain—Child: 0.1-0.2 mg/kg SC, IM q 4 h. Max 15 mg. Or 0.05-0.1 mg/kg slow IV.
Adult: 10 mg q 4 h SC, IM, or 10-30 mg PO, or 10-20 mg PR q 4 h prn or ATC. Or 2.5-15
mg IV dil in 4-5 ml H2O for inj over 4-5 min. Ext-rel tab: 30 mg q 8-12 h. Epidural: 5 mg via
epidural catheter q 24 h.
Chronic CA pain—Child: 0.025-2.6 mg/kg/h IV infusion.
Adult: Loading dose 15 mg IV prn, then 0.8-10 mg IV infusion. Maintenance 0.8-80 mg/h.
Higher doses may be needed. Titrate to effect.
Postoperative analgesia—Neonate: 0.015-0.02 mg/kg/h IV infusion.
Child: 0.01-0.04 mg/kg/h IV infusion.
Preoperative redation, adjunct to anesthesia—Adult: 8-10 mg IM, SC, IV.
Pulm edema—Adult: 10-15 mg IV at 2 mg/min max.
Naloxone Hydrochloride PRC: B

Classes
Narcotic antagonist; narcotic antagonist
70 PEDIATRiC DRUG
Indications
Opiate-induced respiratory depression
Postoperative opiate drepssion
Dosages
Opiate-induced respiratory depression—Child: 0.01 mg/kg IV; then 0.1 mg/kg prn. Cont
infusion: 0.024-0.16 mg/kg/h. If IV route not available, give IM, SC in divided doses.
Adult: 0.4-2 mg IV, SC, IM q 2-3 min prn. Reconsider diagnosis in no response after
10 mg.
Postoperative opiate drepssion—Neonate (asphyxia neonatorum): 0.01 mg/kg IV in umbilical
vein q 2-3 min prn until response. Conc neonate, child: 0.02 mg/ml.
Adult: 0.1-02 mg IV q 2-3 min prn until response.
Naproxen, Naproxen Sodium PRC: B

Classes
Indications
Juvenile RA
Musculoskeletal, soft-tissue irritation
Pain, primary dysmenorrhea
Dosages
Juvenile RA—Child > 2 yr: 10 mg/kg/day (naproxen) in 2 divided doses.
N Musculoskeletal, soft-tissue irritation—Adult: 250-500 mg (naproxen) PO bid Or 250 mg
(naproxen) in morning and 500 mg in pm. Or 275-550 mg (sodium) PO bid. Or 275 mg
(sodium) in morning and 550 mg in pm.
Pain, primary dysmenorrhea—Adult: 500 mg (naproxen) PO, then 250 mg PO q 6-8 h
prn. Max 1.25 gram qd. Or 550 mg (sodium) PO, then 275 mg PO q 6-8 h prn. Max 1.375
gram qd. Self-medicated: 220 mg q 8-12 h. Max 440 mg qd if ≥ 65 yr, or 3 tab qd if < 65 yr.
Don’t use for > 10 day.
Neomycin Sulfate PRC: C

Classes
Indications
Infection diarrhea caused by E. coli
Suppression of intestinal bacteria preoperative
Hepatic coma
Otitis externa
Topical bacterial infection, burn, wound, skin graft, lesion, pruritus, trophic ulceration,
edema, postoperative
Dosages
Infection diarrhea caused by E. coli—Child: 50-100 mg/kg PO qd divided q 4-6 h × 2-3 day.
Adult: 50 mg/kg PO qd in 4 divided doses × 2-3 day.
Suppression of intestinal bacteria preoperative—Child: 88 mg/kg PO in 6 doses q 4 h.
Give saline cathartic before 1st dose.
PEDIATRiC DRUG 71
Adult: 1 gram PO q 1 h in 4 doses, then 1 gram q 4 h for rest of 24 h. Give saline cathartic
before 1st dose. Or for surgery scheduled at 8 morning, 1 gram neomycin with 1 gram
erythromycin base at 1,2 and 11 pm on day before surgery.
Hepatic coma—Child: 50-100 mg/kg PO qd in divided doses × 5-6 day.
Adult: 1-3 gram PO qid × 5-6 day; 200 ml 1% or 100 ml 2% solution as enema retained for
20-60 min q 6 h.
Otitis externa—Child, adult: 2-5 drops in ear canal tid-qid.
Topical bacterial infection, burn, wound, skin graft, lesion, pruritus, trophic ulceration,
edema, postoperative—Child, adult: Rub in small amount gently bid, tid or as directed.
Neostigmine Bromide, Neostigmine Methylsulfate PRC: C

Classes
Cholinesterase inhibitor; muscle stimulant
Indications
Antidote for nondepolarizing neuromuscular blocker
Myasthenia gravis
Dosages
Antidote for nondepolarizing neuromuscular blocker—Neonate, infant: 0.04 mg/kg IV
with 0.02 mg/kg atropine.
Adult: 0.5-2 mg slow IV. Repeat prn. Max total dose, 5 mg. Give 0.6-1.2 mg atropine sulfate
IV before antidote dose if pt bradycardic.
Myasthenia gravis—Neonate: 0.1-0.2 mg SC or 0.03 mg/kg IM q 2-4 h, or 1-4 mg PO q
2-3 h. Gradually reduce dose untill drug can be discontined. N
Child: 7.5-15 mg PO tid-qid. Or 0.333 mg/kg IM or 10 mg/m2 PO 6 times qd.
Adult: 0.5 mg SC or IM. Or 15-375 mg/day PO.
Niacin (nicotinic acid, vitamin B3) PRC: A

Classes
B-complex vitamin; antilipemic, peripheral vasodilator
Indications
Pellagra
Peripheral vascular disease, circulatory disorder
Hyperlipidemia
Dietary supplement
Dosages
Pellagra—Child: 100-300 mg PO qd in divided doses. Adult: 300-500 mg PO qd in divided
doses. Max 500 mg qd.
Peripheral vascular disease, circulatory disorder—Adult: 100-150 mg PO 3-5 times qd.
Hyperlipidemia—Adult: 1.5-3 gram qd in 3 divided doses with meals or pc; max 9 gram qd.
Dietary supplement—Adult: 10-20 mg PO qd.
Nifedipine PRC: C
Classes
Calcium channel blocker; antianginal
72 PEDIATRiC DRUG
Indications
Prinzmetal’s, variant angina, chronic stable angina
Hypertension
Dosages
Prinzmetal’s, variant angina, chronic stable angina—Adolescent, adult: 10 mg PO tid.
Range: 10-20 mg tid. Some pts may need up to 30 mg qid. Max 180 mg qd (caps); 120 mg
qd (ext-rel tab).
Hypertension—Adolescent, adult: 30-60 mg PO once qd (extended-release tab). Adjust
dose q 7-14 day. Max 120 mg qd.
Nitrofurantoin, Nitrofurantoin Macrocrystals PRC: B

Classes
Nitrofuran; urinary tract anti-infective
Indications
UTI
Suppression treatment
Dosages
UTI—Infant, child 1 month-12 yr: 5-7 mg/kg PO qd divided qid.
Child ≥ 12 yr, adult: 50-100 mg PO qid or 100-mg dual-rel caps q 12 h.
Suppression treatment—Child: 1 mg/kg/day in 1 dose hs or 2 divided doses.
Adult: 50-100 mg PO qd hs.
N
Nitroprusside Sodium PRC: C
Classes
Vasodilator; antihypertensive
Indications
Hypertension emergencies
HF
Dosages
Hypertension emergencies—Child, adult: 0.3-10 mcg/kg/min IV infusion. Max 10 mcg/
kg/min × 10 min.
HF—Child, adult: IV infusion titrated to cardiac output and systemic BP. Same dose range
as for hypertension emergencies.
Norepinephrine Bitartrate PRC: C

Classes
Direct-acting adrenergic; vasopressor
Indications
Acute hypotension
Dosages
Acute hypotension—Child: 2 mcg/min or 2 mcg/m2/min IV infusion; titrate to maintenance BP.
Adult: 8-12 mcg/min IV infusion, titrate to maintain BP; maintenance: 2-4 mcg/min.
PEDIATRiC DRUG 73
Advanced cardiac life support during CPR—Child: 0.1 mcg/kg/min IV infusion; titrate rate
based on response.
Nortriptyline Hydrochloride PRC: NR

Classes
TCA; antidepressant
Indications
Depression, panic disorder
Dosages
Depression, panic disorder —Child 6-12 yr: 10-20 mg PO qd in divided doses.
Adolescent: 25-50 mg PO qd or in divided doses.
Adult: 25 mg PO tid-qid, gradually increase to max 150 mg qd. Entire dose may be given
hs.
Nystatin PRC: B
Classes
Polyene macrolide; anti-fungal
Indications
Oral, vag, intestinal infection
Cutaneous, mucocutaneous candidal infection
Dosages
Oral, vag, intestinal infection—Neonate, premature infant: 100,000 U PO susp qid.
Infant > 3 month, child: 250,000-500,000 U PO susp qid. O
Adult: 500,000-1 million U PO susp tid for oral candidiasis. Or 200,000-400,000 U (lozenges)
4-5 times qd; let dissolve in mouth.
Cutaneous, mucocutaneous candidal infection—Adolescent, adult: Apply (topical) to
affected area bid-tid until healed. Or 100,000 U (as vag tab) inserted high into vag qd-bid
× 14 day.
Ofloxacin PRC: C
Classes
Indications
Conjunctivitis
Keratitis
Otitis externa
Chronic OM
Acute OM in child with tubes
UTI
Dosages
Conjunctivitis—Child > 1 yr, adult: 1-2 drops in conjunctival sac q 2-4 h while awake × 2
day, then qid up to 5 day.
74 PEDIATRiC DRUG
Keratitis—Child > 1 yr, adult: 1-2 drops in affected eye q 30 min while awake, then 4 and
6 h after retiring × 2 day. On day 3, 1-2 drops in affected eye q h while awake up to 6 mare
day. Then 1-2 drops qid until clear.
Otitis externa—Child 1-12 yr: 5 drops in affected ear canal bid × 10 day. Adolescent,
dult: 10 drops in affected ear canal bid × 10 day.
Chronic OM—Adolescent, adult: 10 drops in affected ear canal bid × 14 day.
Acute OM in child with tubes—Child 1-12 yr: 5 drops in affected ear canal bid × 10 day.
UTI—Adult: Cystitis caused by E. coli or K. pneumoniae, 200 mg PO, IV q 12 h × 3 day;
Cystitis caused by other organisms, 200 mg PO, IV q 12 h × 7 day.
Ondansetron Hydrochloride PRC: B

Classes
Serotonin (5-HT3) receptor antagonist antiemetic
Indications
Prevention of nausea, vomiting with chemotherapy
Prevention of nausea, vomiting with radiation
Prevention of postoperative nausea, vomiting
Dosages
Prevention of nausea, vomiting with chemotherapy—(PO) Child 4-12 yr: 4 mg PO 30 min
before chemotherapy, then 4 mg PO 4 and 8 h after 1st dose, then 4 mg q 8 h × 1-2 day after
chemotherapy.
Child > 12 yr, adult: 8 mg PO 30 min before chemotherapy, then 8 mg PO 8 h after 1st
dose, then 8 mg q 12 h × 1-2 day after chemotherapy.
(IV) Child > 4 yr, adult: 0.15 mg/kg IV over 15 min 30 min before chemotherapy, then 0.15
O mg/kg IV 4 and 8 h after 1st dose. Or 32 mg IV over 15 min in 1 dose 30 min before
chemotherapy.
Prevention of nausea, vomiting with radiation—Adult: 8 mg PO tid.
Prevention of postoperative nausea, vomiting—Child 2-12 yr and ≤ 40 kg: 0.1 mg/kg IV
over 2-5 min immed before anesthesia or shortly postoperative.
Child 2-12 yr and > 40 kg: 4 mg IV over 2-5 min immed before anesthesia or shortly
postoperative.
Adult: 16 mg PO 1 h before anesthesia or 4 mg IV immed before anesthesia or shortly
postoperative.
Oxacillin Sodium PRC: B

Classes
Penicillinase-resistant penicillin; antibiotic
Indications
Systemic infection
Upper respiratory, skin, skin-structure infection
Severe lower respiratory infection, disseminated infection, osteomyelitis
Dosages
Systemic infection—Neonate < 1 wk and < 2 kg: 50 mg/kg IM, IV qd divided 12 h.
Neonate < 1 wk and > 2 kg or > 1 wk and < 2 kg: 75 mg/kg IM, IV qd in divided
doses q 8 h.
PEDIATRiC DRUG 75
Neonate > 1 wk and > 2 kg: 100 mg/kg IM, IV qd in divided doses q 6 h.
Upper respiratory, skin, skin-structure infection—Infant, child > 1 month and < 40 kg:
50 mg/kg PO, IM, IV qd in divided doses q 6 h.
Child > 40 kg, adult: 500 mg PO q 4-6 h; or 250-500 mg IM, IV q 4-6 h. In adult with CrCl
< 10 ml/min, 1 gram IM, IV q 4-6 h.
Severe lower respiratory infection, disseminated infection, osteomyelitis—Infant, child >
age 1 month and < 40 kg: 100-200 mg/kg IM, IV qd in divided doses q 4-6 h.
Child > 40 kg, adult: 1 gram IM, IV q 4-6 h. In adult with CrCl < 10 ml/min, 1 gram IM, IV q
4-6 h.
Oxcarbazepine PRC: C
Classes
Carboxamide derivative; antiepileptic
Indications
Seizures
Conversion to monotherapy for partial seizures
Monotherapy for partial seizures
Dosages
Seizures—Child 4-16 yr: 8-10 mg/kg/day PO divided bid. Max 600 mg/day. Maintenance
dose depends on pt wt; divided bid. If pt weighs 20-29 kg, maintenance 900 mg/. If 29.1-39
kg, maintenance 1,200 mg/day. If > 39 kg, maintenance 1,800 mg/day.
Adult: 300 mg PO bid. Increase by max 600 mg/day (300 mg PO bid) q wk. Recommended
dose 1,200 mg PO divided bid.
Conversion to monotherapy for partial seizures—Adult: 300 mg PO bid, with decrease in
dose of other antiepileptics. Increase by max 600 mg/day q wk over 2-4 wk. Recommended
dose 2,400 mg PO divided bid. Discontinue other antiepileptics over 3-6 wk.
Monotherapy for partial seizures—Adult: 300 mg PO bid. Increase by 300 mg/day q 3rd P
day to 1,200 mg/day divided bid.
Penicillamine PRC: D
Classes
Chelate; heavy metal antagonist, antirheumatic
Indications
Cystinuria
Heavy metal poisoning
RA, Felty’s syndrome
Dosages
Cystinuria—Child: 30 mg/kg PO qd divided qid 0.5-1 h ac and ≥ 2 h after pm meal. Adjust
dose to urinary cystine excretion < 100 mg qd with renal calculi or 100-200 mg qd without
calculi.
Adult: 250 mg PO qd in 4 divided doses, then increase dose. Usual dose, 2 gram qd.
Adjust dose to urinary cystine excretion < 100 mg qd with renal calculi or 100-200 mg qd
without calculi.
Heavy metal poisoning—Child: 30-40 mg/kg or 600-750 mg/m2 PO qd × 1-6 month.
Adult: 500-1,500 mg PO qd × 1-2 month.
76 PEDIATRiC DRUG
RA, Felty’s syndrome—Adolescent, adult: 125-250 mg PO qd, increase by 5-250 mg qd
q1-3 month prn. Max 1.5 gram qd.
Penicillin G Benzathine PRC: B

Classes
Natural penicillin; antibiotic
Indications
Congenitalsyphilis
Untreated congenital syphilis
Group A streptococci upper respiratory tract infection
Group A streptococci pharyngitis, prevention of rheumatic fever
Primary, secondary syphilis
Dosages
Congenitalsyphilis—Asymptomatic neonate with normal CSF whose mother maynot
have received treatment during pregnancy: 50,000 U/kg IM in 1 dose.
Child < 2 yr: 50,000 U/kg IM in 1 dose.
Untreated congenital syphilis—Child > 1 yr: 50,000 U/kg IM q wk × 3 wk after 10-14 day
of penicillin G potassium or sodium treatment.
Group A streptococci upper respiratory tract infection—Child < 27 kg: 300,000-600,000
U IM in 1 dose.
Child ≥ 27 kg: 900,000 U IM in 1 dose.
Adult: 1.2 million U IM in 1 dose.
Group A streptococci pharyngitis, prevention of rheumatic fever—Child ≤ 27 kg: 600,000
U IM in 1 dose.
Child > 27 kg, adult: 1.2 million U IM in 1 dose.
P Primary, secondary syphilis—Infant, child ≥ 1 month: 50,000 U/kg IM in 1 dose. Max 2.4
million U.
Adolescent, adult: 2.4 million U IM in 1 dose.
Penicillin G Potassium, Penicillin G Sodium PRC: C

Classes
Indications
Congenital syphilis
Untreated congenital syphilis
Systemic infection
Meningitis caused by group B streptococci
Dosages
Congenital syphilis—Symptomatic neonate, neonate with congenital syphilis: 50,000
U/kg IV q 12 h × 1st 7 day of life, then q 8 h × 3 day to total 10 day.
Untreated congenital syphilis—Infant: 50,000 U/kg IV q 4-6 h × 10-14 day.
Systemic infection—Neonate < 1 wk and 1.2-2 kg: 25,000 U IM, IV q 12 h.
Neonate < 1 wk and > 2 kg: 25,000 U IM, IV q 8 h.
Neonate 1-4 wk and 1.2-2 kg: 25,000 U IM, IV q 8 h.
PEDIATRiC DRUG 77
Neonate 1-4 wk and > 2 kg: 25,000 U IM, IV q 6 h.

Neonate ≥ 4 wk and < 1.2 kg: 25,000 U IM, IV q 12 h.
Infant, child ≥ 1 month: 25,000-50,000 U/kg qd IM or IV in 4 divided doses. Severe
infection: 250,000-400,000 U/kg IM, IV qd in divided doses q 4-6 h.
Child ≥ 12 yr, adult: 5-15 million U IM, IV qd in divided doses q 4 h.
Meningitis caused by group B streptococci—Neonate < 1 wk: 250,000-450,000 U/kg IV
qd in 3 divided doses.
Neonate > 1 wk: 450,000 U/kg IV qd in 4 divided doses.
Infant, child ≥ 1 month: 250,000-400,000 U/kg IV qd in divided doses q 4-6 h.
Penicillin G Procaine PRC: B

Classes
Indications
Congenital syphilis
Systemic infection, pneumococcal pneumonia
Dosages
Congenital syphilis—Symptomatic neonate, neonate with congenital syphilis: 50,000
U/kg IM once qd × 10-14 day.
Systemic infection, pneumococcal pneumonia—Child < 27 kg: 300,000 U IM qd in 1 dose.
Adult: 600,000-1.2 million U IM qd in 1 dose or q 6-12 h.
Uncomplicated gonorrhea—Child > 12 yr, adult: 1 gram probenecid, then 30 min later, 4.8
million U penicillin G procaine IM divided in 2 inj sites.
Penicillin V Potassium PRC: B P

Classes
Indications
Infection
Group A streptococci pharyngitis, prevention of rheumatic fever
Endocarditis prophylaxis
Necrotizing ulcerative gingivitis
Lyme disease
Dosages
Infection—Infant, child 1 month-12 yr: 15-62.5 mg/kg (25,000-100,000 U/kg) PO qd in
divided doses q 4-8 h. Adolescent, adult: 125-250 mg PO q 6-8 h, or 500 mg PO q 12 h
× 10 day. Severe infection: 250-500 mg PO q 6 h while pt afebrile × 2 day.
Group A streptococci pharyngitis, prevention of rheumatic fever—Child: 250 mg PO bid-tid
× 10 day. Adolescent, adult: 500 mg PO bid-tid × 10 day.
Endocarditis prophylaxis—Child < 30 kg: ½ adult dose. Adult: 2 gram PO 30-60 min
before procedure, then 1 gram 6 h later.
Necrotizing ulcerative gingivitis—Child ≥ 12 yr, adult: 250-500 mg PO q 6-8 h.
Lyme disease—Child < 9 yr: 25-50 mg/kg PO qd in 3 divided doses × 10-30 day.
78 PEDIATRiC DRUG
Adult: 250-500 mg PO qid × 10-20 day.
Prophylaxis for pneumococcal infection in pt with asplenia—Child < 5 yr: 125 mg PO bid.
Child ≥ 5 yr: 250 mg PO bid.
Pentamidine Isethionate PRC: C

Classes
Diamidine derivative; antiprotozoal
Indications
P. carinii pneumonia (PCP)
Prophylaxis of PCP
Prophylaxis of Trypanosoma gambiense
Leishmaniasis
Dosages
P. carinii pneumonia (PCP)—Child, adult: 3-4 mg/kg IV, IM once qd × 14-21 day. Or, in
child, 150 mg/m2 qd × 5 day, then 100 mg/m2 for rest of treatment.
Prophylaxis of PCP—Child, adult: 300 mg by inhalant, inhalation with Respirgard II jet
nebulizer once q 4 wk.
Prophylaxis of Trypanosoma gambiense—Child, adult: 4 mg/kg IV, IM q 3-6 month.
Leishmaniasis—Child, adult: 2-4 mg/kg IV or IM qd or every other qd, up to 15 doses.
Phenobarbital, Phenobarbital Sodium PRC: D

Classes
Barbiturate; anticonvulsant, sedative-hypnotic
Indications
Epilepsy, febrile seizures
P Status epilepticus
Sedation
Preoperative sedation
Dosages
Epilepsy, febrile seizures—Child: 1-6 mg/kg PO once qd or divided q 12 h. Or 4-6 mg/kg
IV, IM qd.
Adult: 60-100 mg PO daily divided tid or as single dose hs. Or 200-300 mg IM or IV repeat
q 6 h prn.
Status epilepticus—Child: 100-400 mg IV. Repeat prn up to 20 mg/kd.
Adult: 200-600 mg IV. Repeat prn up to 20 mg/kg.
Sedation—Child: 8-32 mg PO qd.
Adult: 30-120 mg PO, IM, IV qd in 2-3 divided doses.
Preoperative sedation—Child: 1-3 mg/kg IV, IM 60-90 min preoperative.
Adult: 100-200 mg IM 60-90 min preoperative.
Phenylephrine Hydrochloride PRC: C

Classes
Adrenergic; vasoconstrictor
PEDIATRiC DRUG 79
Indications
Hypotensive emergency during spinal anesthesia
Prevention hypotension during spinal, inhalant, inhalation anesthesia
Hypotension
Nasal, sinus, eustachian tube congestion
Dosages
Hypotensive emergency during spinal anesthesia—Child: 0.044-0.088 mg/kg IM, SC.
Adult: 0.1-0.2 mg IV.
Prevention hypotension during spinal, inhalant, inhalation anesthesia—Adult: 2-3 mg SC,
IM 3-4 min before anesthesia.
Hypotension—Child: 0.1 mg/kg or 3 mg/m2 IM, SC.
Adult: 1-10 mg SC, IM (max 5 mg initially). Repeat q 1-2 h prn. Or 0.1-0.5 mg slow IV (max
0.5 mg initially). Repeat q 10-15 min prn.
Nasal, sinus, eustachian tube congestion—Child < 6 yr: 2-3 drops or sprays 0.125 or
0.16% solution in each nostril q 4 h prn.
Child 6-12 yr: 2-3 drops or 1-2 sprays in each nostril q 4 h prn.
Child > 12 yr, adult: 2-3 drops or 1-2 sprays 0.25-1% solution in each nostril; or small
amount 0.5% nasal jelly in each nostril q 4 h prn.
Phenytion, Phenytoin Sodium, Phenytoin Sodium (Extended) PRC: D

Classes
Hydantoin derivative; anticonvulsant
Indications
Seizures
Neuritis pain
Skeletal muscle relaxant P
Seizure prophylaxis during neurosurg
Dosages
Seizures—Child: Loading dose: 15-20 mg/kg IV at 1-3 mg/kg/min, or 5 mg/kg PO or 250
mg/m2 PO qd divided q 8-12 h; maintenance: 4-8 mg/kg PO, IV qd divided q 12 h. Max
300 mg qd.
Adult: Loading dose:10-15 mg/kg slow IV, max 50 mg/min; PO loading dose: 1 gram in 3
divided doses (400,300,300 mg) q 2 h. Maintenance: 300 mg PO qd (ext only); initially
divided dose tid (ext or prompt).
Neuritis pain—Adult: 200-600 mg PO qd in divided doses.
Skeletal muscle relaxant—Adult: 200-600 mg PO qd prn.
Seizure prophylaxis during neurosurg—Adult: 100-200 mg IV q 4 h perioperative,
postoperative.
Physostigmine Salicylate, Physostigmine Sulfate PRC: C

Classes
Cholinesterase inhibitor; antimuscarinic antidote, antiglaucoma drug
Indications
TCA, anticholinergic poisoning
Postanesth
80 PEDIATRiC DRUG
Dosages
TCA, anticholinergic poisoning—Child: 0.02 mg/kg (salicylate) IV, IM. Repeat q 5-10 min
prn. Max 2 mg.
Adult: 0.5-2 mg IM, slow IV (max 1 mg/min IV). Repeat prn q 10 min.
Postanesth—Adult: 0.5-1 mg IM, slow IV (max 1 mg/min). Repeat prn q 10-30 min.
Pilocarpine Hydrochloride, Pilocarpine Nitrate PRC: C

Classes
Cholinergic agonist; miotic
Indications
Open-angle glaucoma; before or instead of surgery in acute angle-closure glaucoma
Acute angle-closure glaucoma
Dosages
Open-angle glaucoma; before or instead of surgery in acute angle-closure glaucoma—
Child, adult: 1-2 drops 1-4% solution q 4-12 h or ½ inch ribbon 4% gel (Pilopine HS) hs.
Or 1 Ocusert Pilo (20-40 mcg/h) q 7 day.
Acute angle-closure glaucoma—Child, adult: 1 drops 2% solution q 5 min × 3-6 doses,
then 1 drops q 1-3 h until pressure controlled.
Piperacillin Sodium PRC: B

Classes
Extended-spectrum penicillin, acyclamino-penicillin; antibiotic
Indications
Infection
P Prophylaxis of surgery infection
Dosages
Infection—Neonate < 1 wk and < 2 kg: 50 mg/kg IM, IV q 12 h.
Neonate < 1 wk and ≥ 2 kg: 50 mg/kg IM, IV q 8 h.
Neonate > 1 wk and ≥ 2 kg: 50 mg/kg IM, IV q 8 h.
Neonate > 1 wk and ≥ 2 kg: 50 mg/kg IM, IV q 6 h.
Infant, child 1 month-12 yr: 50 mg/kg IV over 30 min q 4 h.
Child 3-14 yr: 1.5 gram/m2 IV over 30 min q 4 h.
Child > 12 yr, adult : Serious infection: 12-18 gram/day IV in divided doses q 4-6 h; UTI,
community-acquired pneumonia: 6-8 gram/day IV in divided doses q 6-12 h; complicated
UTI: 8-16 gram/day IV in divided doses q 6-8 h; gonorrhea: 2 gram IM in 1 dose. Max 24
gram qd.
Prophylaxis of surgery infection—Adult: intra-abdominal surgery: 2 gram IV preoperative,
2 gram perioperative, and 2 gram q 6 h postoperative × 24 h max; vag hysterectomy: 2
gram IV preoperative, 2 gram 6 h after 1st dose, then 2 gram 12 h after 2nd dose; c-section:
2 gram IV after cord clamped, then 2 gram q 4 h × 2 doses; abdominal hysterectomy; 2
gram IV preoperative: 2 gram in postanesth care unit, 2 gram after 6 h.
Polysaccharide Iron Complex PRC: NR

Classes
PEDIATRiC DRUG 81
Indications
Iron-deficiency anemia
Dosages
Iron-deficiency anemia—Child 2-6 yr: ½ tsp elix PO qd.
Child 6-12 yr: 150-300 mg tab PO qd or 1 tsp elix PO qd.
Child ≥ 12 yr, adult: 150-300 mg caps, tab PO qd or 1-2 tsp elix PO qd.
Potassium Iodide (KI, SSKI) PRC: D

Classes
Electrolyte; antihyperthyroid drug, expectorant
Indications
Preoperative thyroidectomy
Nuclear radiation protection
To replenish iodine
Graves’ disease
Thyrotoxic crisis
Dosages
Preoperative thyroidectomy—Child, adult: 50-250 mg (1-5 drops) SSKI tid; or 0.1-0.3 ml
(3-5 drops) Lugol’s solution tid × 10-14 day before surgery.
Nuclear radiation protection—Infant: ½ adult dose.
Child, adult: 0.13 ml PO SSKI (130 mg) immed before or after initial exposure blocks 90%
radioactive iodine. Same dose 3-4 h after exposure provides 50% block. Give up to 10 day.
To replenish iodine—Child: 1 mg/day.
Adult: 5-10 mg/day.
Graves’ disease—Neonate: 1 drops strong iodine solution PO q 8 h. P
Thyrotoxic crisis—Adult: 500 mg PO q 4 h (10 drops potassium iodide solution containing
1 gram/ml). Or 1 ml strong iodine solution PO tid.
Potassium Salts, Oral, Potassium Acetate, Potassium

PRC: C
Bicarbonate, Potassium Chloride, Potassium Gluconate
Classes
K supplement; treatment for electrolyte balance
Indications
Hypokalemia
Prevention of hypokalemia
K replacement
Dosages
Hypokalemia—Child, adult: 40-100 mEq tab divided in 2-4 doses qd. Use IV when PO
isn’t feasible or with life-threatening hypokalemia. Dose up to 20 mEq/h in concentrated of
< 60 mEq/L. Max 150 mEq qd/(3 mEq/kg qd in child).
Prevention of hypokalemia—Child, adult: 20 mEq PO qd in divided doses.
K replacement—Child, adult: Dil in suitable IV solution (max 40 mEq/L); give at < 20
mEq/h. Max 400 mEq/day (3 mEq/kg/day or 40 mEq/m2/day for child).
82 PEDIATRiC DRUG
Prazosin Hydrochloride PRC: C

Classes
Alpha blocker; antihypertensive
Indications
Hypertension
Dosages
Hypertension—Child: 0.05-0.4 mg/kg PO qd in 2-3 divided doses. Max 7 mg/dose and 15
mg qd.
Adult: 1mg PO bid-tid. Max 20 mg qd. Maintenance: 6-15 mg qd in divided doses. If other
antihypertensives or diuretics added, reduce dose to 1-2 mg tid and increase prn.
Prednisolone (Systemic), Prednisolne Acetate, Prednisolone

Acetate and Prednisolone Sodium Phosphate, Prednisolone PRC: C
Sodium Phosphate, Prednisolone Tebutate
Classes
Glucocorticoid, mineralocorticoid; anti-inflmmatory; immunosuppressant PRC: C
Indications
Inflammation, immunosuppression
Dosages
Inflammation, immunosuppression—Child: 0.14-2 mg/kg for 4-6 mg/m2 qd in divided
doses.
Adult: 2.5-15 mg PO bid, tid, qid; 2-30 mg (acetate) IM q 12 h; 2-30 mg (sodium phosphate)
IM, IV q 12 h, or into joints, lesions, soft tissue prn; 4-40 mg (tebutate) into joints, lesions
prn; or 0.25-1 ml (acetate and sodium phosphate susp) into joints wkly prn.
P
Prednisolone acetate (ophthalmic), Prednisolone
PRC: C
Sodium Phosphate
Classes
Corticosteroid; ophth anti-inflammatory
Indications
Eye inflammation; corneal injury; graft rejection
Dosages
Eye inflammation; corneal injury; graft rejection—Child, adult: 1-2 drops into eye q h or
4-6 times qd based on severity.
Prednisone PRC: C
Classes
Adrenocorticoid; anti-inflammatory, immunosuppressant
Indications
Inflammation, immunosuppression
MS
P. carinii pneumonia
PEDIATRiC DRUG 83
Dosages
Inflammation, immunosuppression—Child: 0.14-2 mg/kg or 4-60 mg/m2 PO qd in 4 divided
doses. Or:
Child 18 month-4 yr: 7.5-10 mg PO qid.
Child 5-10 yr: 15 mg PO qid.
Child, adolescent 11-18 yr: 20 mg PO qid.
Adult: 5-60 mg PO qd in single or divided doses. Max 250 mg qd. Maintenance dose: once
qd or every other day.
MS—Adolescent, adult: 200 mg PO qd × 1 wk, then 80 mg every other day × 1 month.
P. carinii pneumonia—Child > 13 yr, adult with AIDS: 40 mg PO bid × 5 day; then 40 mg.
PO once qd × 5 day; then 20 mg PO once qd × 11 day (or until anti-infection complete).
Primaquine Phosphate PRC: C

Classes
8-Aminoquinoline; antimalarial PRC: C
Indications
Malaria
Dosages
Malaria—Child: 0.3 mg (base)/kg/day × 14 day, or 0.9 mg (base)/kg/day once q wk × 8 wk.
Adult: 15 mg (base) PO qd × 14 day (26.3-mg tab = 15 mg base), or 79 mg (45-mg base)
once q wk × 8 wk.
Primidone PRC: NR
Classes
Barbiturate analogue; anticonvulsant
P
Indications
Seizures
Benign familial tremor
Dosages
Seizures—Child < 8 yr: 50 mg PO hs on day 1-3; 50 mg PO bid on day 4-6; 100 mg PO
tid on day 7-9; maintenance: 125-250 mg PO tid on day 10.
Child ≥ 8 yr, adult: 100-125 mg PO hs on day 1-3; 100-125 mg PO bid on day 4-6;
100-125 mg PO tid on day 7-9. Maintenance: 250 mg PO tid on day 10. May need up to 2
gram/day.
Benign familial tremor—Adolescent, adult: 750 mg PO qd.
Probenecid PRC: B
Classes
Sulfonamide-derivative; uricosuric
Indications
Adjunct to penicillin treatment
Gonorrhea
84 PEDIATRiC DRUG
Dosages
Adjunct to penicillin treatment—Child 2-14 yr or < 50 kg: 25 mg/kg or 700 mg/m2 PO qd,
then 40 mg/kg or 1.2 gram/m2 divided qid.
Child > 14 yr or > 50 kg, adult: 500 mg PO qid.
Gonorrhea—Child ≥ 45 kg, adult: 1 gram PO with penicillin, or 1 gram PO 30 min before
IM penicillin.
Procainamide Hydrochloride PRC: C

Classes
Procaine derivative; ventricular; supraventricular antiarrhythmic
Indications
PVCs, VT, atrial fibrillation, flutter, PAT
Prevention atrial fibrillation or PAT
Prevention VT
Dosages
PVCs, VT, atrial fibrillation, flutter, PAT—Child: 40-60 mg/kg PO qd in 4-6 divided doses or
1.5 gram/m2 PO qd in 4-6 divided doses. Or 2-5 mg/kg IV (max 100 mg) q 10-30 min prn.
Max 30 mg/kg in 24 h.
Adult: 50-100 mg q 5 min slow IV push, max 25-50 mg/min, until arrhythmias disappear,
adverse effects develop, or 500 mg given. Then continue infusion of 1-6 mg/min. If
arrhythmias recur, repeat bolus and increase infusion rate. Or 50 mg/kg IM divided q 3-6
h; perioperative: 100-500 mg IM. Or 50 mg/kg PO in divided doses q 3 h. Once pt stable,
may give sustained-release form q 6 h or extended-release form at 50 mg/kg in 2 divided
doses q 12 h.
Prevention atrial fibrillation or PAT—Adult: 1-1.25 gram PO. If arrhythmias persist after 1
h, give 750 mg. If no change, give 500 mg-1 gram q 2 h until arrhythmias disappear or
P adverse effects occur.
Prevention VT—Adult: 1 gram PO. Maintenance: 50 mg/kg/day q 3 h; avg 250-500 mg q
4 h but may need 1-1.5 gram q 4-6 h.
Promethazine Hydrochloride PRC: C

Classes
Phenothiazine derivative; antiemetic; antivertigo drug, antihistamine, preoperative,
postoperative, or obstetric sedative and adjunct to analgesics
Indications
Motion sickness
Nausea
Rhinitis, allergies
Sedation
Preoperative, postoperative sedation; adjunct to analgesics
Dosages
Motion sickness—Child: 12.5-25 mg PO, IM, PR bid.
Adult: 25 mg PO bid.
Nausea—Child: 0.25-0.5 mg/kg IM, PR q 4-6 h prn, or 7.2-15 mg/m2 q 4 h prn.
Adult: 12.5-25 mg PO, IM, PR q 4-6 h prn.
PEDIATRiC DRUG 85
Rhinitis, allergies—Child: 6.25-12.5 mg PO tid or 25 mg PO, PR hs.

Adult: 12.5-25 mg PO ac and hs or 25 mg PO hs.
Sedation—Child: 12.5-25 mg PO IM, PR hs.
Adult: 25-50 mg PO, IM hs or prn.
Preoperative, postoperative sedation; adjunct to analgesics—Child: 12.5-25 mg IM, IV,
PO.
Adult: 25-50 mg IM, IV, PO.
Propranolol Hydrochloride PRC: C

Classes
Beta blocker; antihypertensive, antianginal, antiarrhythmic; adjunctive therapy for migraine,
adjunctive therapy for MI PRC: C
Indications
Hypertension
Supraventricular, ventricular, atrial arrhythmias; tachyarrhythmias during anesthesia;
hyperthyroidism, pheochromocytoma
Prevention of migraine, vascular headache
Dosages
Hypertension—Child: 0.5-1 mg/kg PO qd in 2-4 divided doses. Maintenance: 2-4 mg/kg
qd in 2 divided doses. Max 16 mg/kg/day.
Adult: 80 mg PO qd in 2-4 divided doses or sustained-release form once qd. Increase q
3-7 day. Max 640 mg qd. Maintenance: 160-480 mg qd.
Supraventricular, ventricular, atrial arrhythmias; tachyarrhythmias during anesthesia;
hyperthyroidism, pheochromocytoma—Child (arrhythmias only): 0.01-0.1 mg/kg slow
IV push over 10 min. Max 1 mg/kg. Repeat q 6-8 h prn.
Adult: 1-3 mg slow IV in 50 ml D5W or NSS. Max rate 1 mg/min. After 3 mg infusion give
another dose in 2 min; subsequent doses ≥ q 4 h. Maintenance: 10-30 mg PO tid-qid.
P
Prevention of migraine, vascular headache—Adult: 80 mg PO qd in divided doses or 1
sustained-release caps once qd. Maintenance: 160-240 mg qd, divided tid-qid.
Propylthiouracil (PTU) PRC: A

Classes
Thyroid hormone antagonist; antihyperthyroid drug PRC: D
Indications
Neonatal thyrotoxicosis
Hyperthyroidism
Dosages
Neonatal thyrotoxicosis—Neonate: 5-10 mg/kg PO in divided doses q 8 h.
Hyperthyroidism—Child 6-9 yr: 50-150 mg PO qd in divided doses q 8 h.
Child ≥ 10 yr: 100 mg PO tid. Cont until pt euthyroid; then maintenance: 25 mg tid-100 mg
bid.
Adult: 300-450 mg PO qd in divided doses. Cont until pt euthyroid; then maintenance: 100
mg qd-tid.
86 PEDIATRiC DRUG
Protamine Sulfate PRC: C

Classes
Antidote; heparin antagonist
Indications
Heparin overdose
Dosages
Heparin overdose—Child, adult: Dose based on venous blood coagulation studies,
usually 1 mg for each 90-115 U heparin by slow IV inj over 1-3 min. Max 50 mg in 10-min.
Pseudoephedrine Hydrochloride, Pseudoephedrine Sulfate PRC: B

Classes
Adrenergic; decongestant
Indications
Nasal, Eustachian tube decongestant
Dosages
Nasal, Eustachian tube decongestant—Child 2-5 yr: 15 mg PO q 4-6 h. Max 60 mg/day,
or 4 mg/kg or 125 mg/m2 PO divided qid.
Child 6-11 yr: 30 mg PO q 4-6 h. Max 120 mg qd.
Child ≥ 12 yr, adult: 60 mg PO q 4-6 h. Max 240 mg qd, or 120 mg PO extended-release
tab q 12 h.
Pyrantel Pamoate PRC: C

Classes
Pyrimidine derivative; anthelmintic
P
Indications
Roundworm, pinworm infection
Dosages
Roundworm, pinworm infection—Child ≥ 2 yr, adult: 11 mg/kg PO in 1 dose. Max 1 gram.
For pinworm infection, repeat in 2 wk.
Pyridoxine Hydrochloride (Vitamin B6) PRC: A

Classes
H2O soluble vitamin; nutritional supplement
Indications
Vitamin B6 deficiency
Seizures due to vitamin B6 deficiency, dependency
Vitamin B6-responsive anemias, dependency syndrome (inborn errors of metabolism)
Seizures from isoniazid overdose
Dosages
Vitamin B6 deficiency—Child: 10-100 mg IM, IV to correct deficiency, then adequate diet
with supplementary RDA doses to prevention recurrence.
Adult: 2.5-10 mg PO, IM, IV qd × 3 wk, then 2-5 mg qd as supplement to proper diet.
PEDIATRiC DRUG 87
Seizures due to vitamin B6 deficiency, dependency—Child, adult: 100 mg IM, IV in 1 dose.

Vitamin B6-responsive anemias, dependency syndrome (inborn errors of metabolism)—
Child: 100 mg IM, IV, then 2-10 mg IM or 10-100 mg PO qd.
Adult: 100-200 mg qd × 3 wk, then 2.5-100 mg qd until symptoms subside; then 50 mg qd.
Seizures from isoniazid overdose—Child, adult: Give dose of pyridoxine equal to amount
of isoniazid ingested; 1-4 gram IV then 1 gram IM q 30 min until entire dose given.
Quinidine Gluconate, Quinidine Polygalacturonate,

PRC: B
Quinidine Sulfate
Classes
Cinchona alkaloid; antiarrhythmic PRC: C
Indications
PAC, PVCs, PAT, paroxysmal AV junctional rhythm, paroxysmal ventricular tachycardia,
maintenance of cardioversion
Atrial flutter, atrial fibrillation
PSVT
Malaria (when quinine dihydrochloride unavailable)
Dosages
PAC, PVCs, PAT, paroxysmal AV junctional rhythm, paroxysmal ventricular tachycardia,
maintenance of cardioversion—Child: Test dose: 2 mg/kg, then 30 mg/kg/day PO or 900
mg/m2/day PO in 5 divided doses.
Adult: Test dose: 50-200 mg (sulfate) PO or 200 mg (gluconate) IM; then 200-400 mg
(sulfate) PO or equivalent base q 4-6 h; or 600 mg (gluconate) IM, then up to 400 mg q 2
h prn; or 800 mg (gluconate) IV dil in 40 ml D5W at 16 mg (1 ml)/min. Or 300-600 mg (sulfate
ext-rel) or 324-648 mg (gluconate extended-release) q 8-12 h.
Atrial flutter, atrial fibrillation—Adult: 200 mg (sulfate or equivalent base) PO q 2-3 h × 5-8
doses with qd increase until sinus rhythm or toxic effect develop. Give only after digitalization
to avoid increasing AV conduction. Max 3-4 gram qd. Maintenance: 200-400 mg PO tid-qid
or 600 mg PO q 8-12 h qd (ext-rel). Q
PSVT—Adult: 400-600 mg (sulfate) PO q 2-3 h until toxic effects develop or arrhythmia
subsides.
Malaria (when quinine dihydrochloride unavailable)—Adult: Loading dose: 10 mg/kg dil in
250 ml NSS inj IV over 1-2 h, then continue infusion 0.02 mg/kg/min (20 mcg/kg/min) × 72
h or until parasitemia reduced to < 1% or PO treatment can begin; or 10 mg/kg (sulfate) PO
q 8 h × 5-7 day.
Quinine Sulfate PRC: X

Classes
Cinchona alkaloid; antimalarial
Indications
Malaria (chloroquine-resistant)
Dosages
Malaria (chloroquine-resistant)—Child: 25 mg/kg/day in 3 divided doses × 10 day.
Adult: 650 mg PO q 8 h × 10 day, with 25 mg pyrimethamine q 12 h × 3 day and with 500
mg sulfadiazine qid × 5 day.
88 PEDIATRiC DRUG
Ranitidine PRC: B
Classes
H2-receptor antagonist; antiulcerative
Indications
Duodenal, gastric ulcer; hypersecretory conditions; such as Zollinger-Ellison syndrome
Maintenance treatment in duodenal ulcer
Prophylaxis of stress ulcer
GERD
Heartburn, indigestion, sour stomach
Dosages
Duodenal, gastric ulcer; hypersecretory conditions; such as Zollinger-Ellison syndrome—
Child (duodenal, gastric ulcer treatment): 2-4 mg/kg PO bid or 2-4 mg/kg IV qd dil
given over 15-20 min. Max 300 mg/day.
Adolescent, adult: 150 mg PO bid or 300 mg hs. Up to 6 gram/day in pt with Zollinger-
Ellison syndrome. Or 50 mg IV, IM q 6-8 h.
Maintenance treatment in duodenal ulcer—Adolescent, adult: 150 mg PO hs.
Prophylaxis of stress ulcer—Adolescent, adult: 150 mg IV infusion in 250 ml compatible
solution at 6.25 mg/h with pump.
GERD—Child: 2-8 mg/kg IV, PO tid.
Adolescent, adult: 150 mg PO bid.
Heartburn, indigestion, sour stomach—Adolescent ≥ 12 yr, adult: 75 mg (OTC) once qd
or bid. Max 150 mg in 24 h.
Respiratory Syncytial Virus Immune Globulin Intravenous,

PRC: C
Human (RSV-IGIV)
Classes
R Immunoglobulin G; immune serum PRC: C
Indications
Prevention of RSV in child with bronchopulmonary dysplasia or premature birth (< 35 wk
gestation)
Dosages
Prevention of RSV in child with bronchopulmonary dysplasia or premature birth (< 35 wk
gestation)—Premature neonate, infant < 2 yr: 1.5 ml/kg/h IV × 15 min. If condition allows,
increase to 3 ml/kg/h × 15 min, then 6 ml/kg/h until end of infusion once q month. Max 750
mg/kg q month.
Ribavirin PRC: X
Classes
Synthetic nucleoside; antiviral
Indications
RSV infection
Dosages
RSV infection—Infant, young child: 20 mg/ml solution via Viratek Small Particle Aerosol
Generator (SPAG-2), which produces mist of 190 mcg/L. Treat × 12-18 h/day for at least 3
PEDIATRiC DRUG 89
but no > 7 day at 12.5 L mist/min. Ventilated pt: same dose with pressure- or volume-cycled
ventilator and SPAG-2.
Rifampin PRC: C
Classes
Semisynthetic rifamycin B derivative (macro-cyclic antibiotic); antituberculotic
Indications
TB
Meningococcal carriers
H. influenzae type B prophylaxis
Dosages
TB—Neonate, infant, child: 10-20 mg/kg PO, IV qd in 1 dose 1 h ac or 2 h pc. Max
600 mg qd.
Adolescent, adult: 600 mg PO, IV qd in 1 dose 1 h ac or 2 h pc.
Meningococcal carriers—Neonate: 5 mg/kg PO bid × 2 day.
Infant, child > 1 month: 10 mg/kg (max 600 mg) PO bid × 2 day.
Adolescent, adult: 600 mg PO bid × 2 day.
H. influenzae type B prophylaxis—Neonate: 10 mg/kg PO once qd × 4 day.
Infant, child, adult: 20 mg/kg (max 600 mg) PO once qd × 4 day.
Salmeterol Xinafoate PRC: C

Classes
Selective beta2 stimulating agonist, bronchodilator
Indications
Asthma maintenance, prevention of bronchospasm for nocturnal asthma or reversible
obstructive airway disease
Prevention exercise-induced bronchospasm
Dosages
Asthma maintenance, prevention of bronchospasm for nocturnal asthma or reversible
obstructive airway disease—Child ≥ 4 yr, adult: 1 inhalant, inhalation (powder) bid in S
morning and pm.
Child > 12 yr, adult: 2 inhalant, inhalation (aerosol) bid in morning and pm.
Prevention exercise-induced bronchospasm—Child ≥ 4 yr, adult: 1 inhalant, inhalation
(powder) at least 30 min before exercise; no doses for 12 h.
Child > 12 yr, adult: 2 inhalant, inhalation (aerosol) 30-60 min before exercise; no additional
doses for 12 h.
Silver Nitrate PRC: C

Classes
Heavy metal (silver compound); ophth antiseptic; topical cauterizing compound
Indications
Gonorrheal ophth neonatorum prevention
Treatment wounds, destroy granulations, freshen edges of ulcers, fissures, provide styptic
action, treatment vesicular bullous or aphthous lesions
90 PEDIATRiC DRUG
Dosages
Gonorrheal ophth neonatorum prevention—Neonate: 2 drops 1% solution in lower
conjunctival sac of each eye so that solution contacts entire conjunctival sac ≥ 30 sec.
Treatment wounds, destroy granulations, freshen edges of ulcers, fissures, provide styptic
action, treatment vesicular bullous or aphthous lesions—Adult: Apply oint to lesion × 5 day
or cotton applicator dipped in solution to affected area 2-3 times wk × 2-3 wk.
Sodium Bicarbonate PRC: C

Classes
Systemic, urinary alkalizer, systemic hydrogen ion buffer, oral antacid
Indications
Adjunct to advanced cardiac life support
Metabolic acidosis
Urinary alkalization
Antacid
Dosages
Adjunct to advanced cardiac life support—Infant, child: 1 mEq/kg IV bolus 4.2% solution.
Repeat q 10 min. Max 8 mEq/kg qd.
Adult: 1 mEq/kg IV bolus 4.2% solution. Repeat 0.5 mEq/kg q 10 min. Max 8 mEq/kg qd.
Metabolic acidosis—Child, adult: 90-180 mEq/L IV during 1st h. Adjust prn.
Urinary alkalization—Child: 1-10 mEq (84-840 mg)/kg qd.
Adult: 325 mg-2 gram PO up to qid. Max 17 gram in pt < 60 yr or 8 gram in pt > 60 yr.
Antacid—Adult: 300 mg-2 gram PO 1-4 times qd.
Sodium Fluoride PRC: C

Classes
Trace mineral; prophylactic for dental caries PRC: C
Indications
Prevention of dental caries
S Dosages
Prevention of dental caries—(Oral) Infant, child 6 month-2 yr: 0.25 mg qd.
Child 3-5 yr: 0.5 mg qd.
Child, adolescent 6-16 yr: 1 mg qd. If fluoride in drinking H2O < 0.3 parts per million (ppm),
give dose listed; if 0.3-0.6 ppm, give ½ dose; if > 0.6 ppm, don’t give.
(Topical) Child 6-12 yr: 5 ml 0.09% (0.2% fluoride ion) solution once wk.
Child > 12 yr, adult: 10 ml 0.09% (0.2% fluoride ion) once wk.
Sodium Phosphates (Sodium Phosphate and Sodium

PRC: C
Biphosphate)
Classes
Acid salt; NaCl laxative
Indications
Constipation
PEDIATRiC DRUG 91
Bowel evacuation
Dosages
Constipation—Child 5-9 yr; 5 ml solution with 4 oz cold H2O PO.
Child 10-11 yr: 10 ml solution with 4 oz cold H2O PO.
Adult: 20-30 ml solution with 4 oz cold H2O PO.
Bowel evacuation—Adult: 45 ml solution with 4 oz cold H2O PO.
Somatropin PRC: C
Classes
Anterior pituitary hormone; purified growth hormone
Indications
Growth hormone deficiency
Growth failure from chronic renal insufficiency
Dosages
Growth hormone deficiency—Child: Humatrope: up to 0.06 mg/kg SC, IM 3 × q wk. Nutropin:
0.30 mg/kg SC q wk in divided doses qd.
Growth failure from chronic renal insufficiency—Child: Nutropin: 0.35 mg/kg SC q wk in
divided doses qd.
Spironolactone PRC: C
Classes
Potassium-sparing diuretic; mgt of edema, antihypertensive, diagnosis aid for primary
hyper-aldosteronism
Indications
Edema
Hypertension
PMS
Acne vulgaris
Dosages
Edema—Child: 3.3 mg/kg or 60 mg/m2 PO qd in divided doses.
S
Adult: 25-200 mg PO qd in divided doses.
Hypertension—Adult: 50-100 mg PO qd in divided doses.
PMS—Adult: 25 mg qid PO on day 14 of menstrual cycle.
Acne vulgaris—Adult: 100 mg PO qd.
Stavudine (d4T) PRC: C

Classes
Synthetic thymidine nucleoside analogue; antiviral
Indications
HIV infection
Dosages
HIV infection—Child < 30 kg: 1 mg/kg PO q 12 h.
92 PEDIATRiC DRUG
Child, adult < 59 kg: 30 mg PO q 12 h.
Child, adult ≥ 60 kg: 40 mg PO q 12 h. For pts who develop peripheral
neuropathy, discontinue treatment. If symptoms resolve completely, resume
treatment with dose adjustment. Manage significant elevations of hepatic transaminase
levels similarly.
Streptomycin Sulfate PRC: D

Classes
Indications
TB
Infection
Dosages
TB—Child: 20-40 mg/kg IM qd in divided doses or 25-30 mg/kg IM 2-3 times wk.
Max 1 gram qd regimen and 1.5 gram qd for intermittent regimen.
Adolescent, adult: 1 gram or 15 mg/kg IM qd × 2-3 month, then 1 gram 2 times/wk.
Max 1 gram qd.
Infection—Child: 20-40 mg/kg or 1 gram/m2 IM qd in divided doses q 6-12 h.
Adult: 1-2 gram IM q in divided doses q 6-12 h.
Sulfacetamide Sodium PRC: C

Classes
Sulfonamide; antibiotic
Indications
Conjunctivitis, corneal ulcer, trachoma, ocular infection prophylaxis
Dosages
Conjunctivitis, corneal ulcer, trachoma, ocular infection prophylaxis— Child, adult:
1-2 drops 10% solution in lower conjunctival sac q 2-3 h during day, less often at
night. Or 1-2 drops 15% solution in lower conjunctival sac q 1-2 h, increase interval
as condition responds. Or 1 drops 30% solution in in lower conjunctival sac q 2 h.
S Oint: 1.25-2.5 cm (1/2"-1") 10% solution in conjunctival sac qid and hs. Usual duration
7-10 day.
Sulfasalazine PRC: B
Classes
Indications
Ulcerative colitis
Dosages
Ulcerative colitis—Child ≥ 2 yr: 40-60 mg/kg PO qd in 3-6 divided doses; then 30 mg/kg
qd in 4 divided doses. Max 2 gram qd.
Adult: 3-4 gram PO qd in divided doses. Maintenance: 2 gram PO qd in divided
doses q 6 h.
PEDIATRiC DRUG 93
Sulfisoxazole, Sulfisoxazole Diolamine PRC: C

Classes
Indications
UTI, systemic infection
Conjunctivitis, corneal ulcer, superficial ocular infection; adjunct in trachoma
Dosages
UTI, systemic infection—Infant > 2 month, child: 75 mg/kg (or 2 gram/m2) PO in 1 dose
then 150 mg/kg (or 4 gram/m2) PO qd in divided doses 4-6 h. Max 6 gram/day.
Adult: 2-4 gram PO; then 4-8 gram PO qd in divided doses q 4-6 h. Max 6 gram/24 h. If
CrCl is 10-50 ml/min, give recommended dose every 8-12 h. If < 10 ml/min, give
recommended dose every 24 h.
Conjunctivitis, corneal ulcer, superficial ocular infection; adjunct in trachoma—Adolescent,
adult: 1-2 drops in lower conjunctival sac q 1-4 h. If CrCl is 10-50 ml/min, give recommended
dose every 8-12 h. If < 10 ml/min, give recommended dose every 24 h.
Terbinafine Hydrochloride PRC: B

Classes
Synthetic allylamine derivative; antifungal
Indications
Interdigital tinea pedis, tinea cruris, tinea corporis
Tinea unguium
Dosages
Interdigital tinea pedis, tinea cruris, tinea corporis—Child > 12 yr, adult: Pedis: Cover
affected surrounding areas bid until improves. Cruris, corporis: Cover affected surrounding
areas 1-2 times qd until improves. Max 4 wk.
Tinea unguium—Adolescent > 12 yr, adult: Fingernails: 250 mg/day PO × 6 wk: toenails:
250 mg/day PO × 12 wk.
Terbutaline Sulfate PRC: B

Classes
Adrenergic (beta2 agonist); bronchodilator, tocolytic (premature labor inhibitor)
T
Indications
Bronchospasm
Premature labor
Dosages
Bronchospasm—Adolescent 12-14 yr: 2.5 mg PO tid. Max 7.5 mg qd. Or 2 inhalant,
inhalation q 4-6 h with 1 min between inhalant, inhalation.
Adolescent ≥ 15 yr, adult: 5 mg PO tid q 6 h. Max 15 mg qd. Decrease to 2.5 mg PO tid
if adverse effects. Or 0.25 mg SC; repeat in 15-30 min. Max 0.5 mg q 4 h. Or 2 inhalant,
inhalation q 4-6 h with 1 min between inhalant, inhalation.
Premature labor—Adult: 10 mcg/min IV. Max 80 mcg/min. Maintain IV at minimum effective
dose × 4 h. Maintenance treatment until term: 2.5 mg PO q 4-6 h.
94 PEDIATRiC DRUG
Testosterone, Testosterone Cypionate, Testosterone Enanthate,

PRC: X
Testosterone Propionate
Classes
Androgen replacement; antineoplastic
Indications
Male hypogonadism
Delayed puberty in males
Inoperable breast CA
Dosages
Male hypogonadism—Adult: 10-25 mg (testosterone, propionate) IM 2-3 times/wk. Or
50-400 mg (cyp, enan) IM q 2-4 wk.
Delayed puberty in males—Child: 25-50 mg (testosterone, propionate) IM 2-3 times/wk
up to 6 month. Or 50-200 mg (cypionate, enanthate) IM q 2-4 wk up to 6 month.
Inoperable breast CA—Adult: 50-100 mg (propionate) IM 3 times/wk. Or 200-400 mg
(cypionate, enanthate) IM q 2-4 wk. Or 100 mg (testosterone) IM 3 times/wk.
Postpubertal cryptorchidism—Adult: 10-25 mg (testosterone, propionate) IM 2-3 times/wk.
Tetanus Immune Globulin (TIG) PRC: C

Classes
Immune serum; tetanus prophylaxis
Indications
Tetanus prophylaxis
Tetanus treatment
Dosages
Tetanus prophylaxis—Child < 7 yr: 4 U/kg IM.
Child ≥ 7 yr, adult: 250 U IM. Severe or highly contaminated wounds, delayed treatment
× 24 h: 500 U IM.
Tetanus treatment—Child: 500-3,000 U IM in 1 dose.
Adult: 3,000-6,000 U IM in 1 dose.
Tetanus Toxoid, Adsorbed PRC: C

T Classes
Toxoid; tetanus prophylaxis
Indications
Immunization (adsorbed)
Immunization (fluid)
Dosages
Immunization (adsorbed)—Infant 2-12 month: 0.5 ml IM 4-8 wk apart × 3 doses, 4th
dose: 0.5 ml 6-12 month after 3rd dose. Booster 0.5 ml IM q 5-10 yr.
Child ≥ 1 yr, adult: 0.5 ml IM 4-8 wk apart × 2 doses, 3rd dose 6-12 month after 2nd dose.
Immunization (fluid)—Child, adult: 0.5 ml IM or SC 4-8 wk apart × 3 doses, 4th dose 6-12
month after 3rd dose. Booster 0.5 ml IM or SC q 10 yr.
PEDIATRiC DRUG 95
Tetracycline Hydrochloride PRC: D

Classes
Tetracycline; antibiotic
Indications
Infection
Gonorrhea in pt sensitive to penicillin
Syphilis in pt sensitive to penicillin
Acne
Lyme disease
Infection prophylaxis in minor skin abrasions; superficial infection treatment
Dosages
Infection—Child > 8 yr: 25-50 mg/kg PO qd, in 2-4 divided doses. Adult; 1-2 gram PO in 2-
4 divided doses.
Gonorrhea in pt sensitive to penicillin—Adolescent, adult: 1.5 gram PO; then 500 mg q 6
h × 4 day.
Syphilis in pt sensitive to penicillin—Adolescent, adult: 500 mg PO qid × 14 day.
Acne—Adolescent, adult: 500-1,000 mg PO divided qid; then 125-500 mg PO qd to
every other day. Apply oint generously to affected area bid until skin is wet.
Lyme disease—Child > 8 yr: 6.25-12.5 mg/kg PO qid.
Adult: 250-500 mg PO qid × 10-30 day.
Infection prophylaxis in minor skin abrasions; superficial infection treatment—Child, adult:
Apply oint to infected area 1-5 times qd.
Theophylline PRC: C
Classes
Xanthine derivative; bronchodilator PRC: C
Indications
Bronchospasm in pt not on drug
Bronchospasm in pt on drug
Bronchial asthma prophylaxis, bronchospasm of chronic bronchitis emphysema
Apnea of prematurity
Severe bronchospasm in CF T
Dosages
Bronchospasm in pt not on drug—Neonate, infant < 6 month: Dose highly individualized.
Keep serum theophylline levels < 10 mg/ml in neonate, 20 mg/ml in older infant. For PO, IV
loading dose for pt < 6 month, 1 mg/kg PO, IV for each 2 mg/ml increase in theophylline
level desired, then: Premature neonate (< 40 wk gestational age): 1 mg/kg q 12 h.
Neonate < 4 wk: 1-2 mg/kg q 12 h.
Infant 4-8 wk: 1-2 mg/kg q 8 h.
Infant > 8 wk-6 month: 1-3 mg/kg q 6 h. For PO loading dose, 6 mg/kg PO anhydrous
theophylline, then:
Infant, child 6 month-9 yr: 4 mg/kg PO q 4 h × 3 doses; then 4 mg/kg PO q 6 h.
96 PEDIATRiC DRUG
Child, adolescent 9-16 yr; young adult smokers: 3 mg/kg PO q 4 h × 3 doses; then 3
mg/kg PO q 6 h.
Infant, child 6 month-9 yr: 0.95 mg/kg/h (1.2 mg/kg/h anhydrous aminophylline) × 12 h;
then 0.79 mg/kg/h (1 mg/kg/h anhydrous aminophylline).
Child 9-16 yr: 0.79 mg/kg/h (1 mg/kg/h anhydrous aminophylline) × 12 h; then 0.63 mg/kg/h
(0.8 mg/kg/h anhydrous aminophylline).
Bronchospasm in pt on drug—Child, adult: Each 0.5 mg/kg IV, PO (loading dose) increase
plasma level by 1 mg/ml. Base dose on current theophylline level and lean body wt. In
emergency: 2.5 mg/kg PO rapidly absorbed form if no signs of theophylline toxicity.
Bronchial asthma prophylaxis, bronchospasm of chronic bronchitis emphysema—
Individualize dose. Use peak plasma and trough levels to estimate dose. Therapeutic
range: 10-20 mg/ml. Dose based on theophylline, anhydrous and lean body wt. Child,
adult: Rapidly absorbed form: 16 mg/kg or 400 mg PO qd (whichever less) divided q 6-8
h; increase by 25% q 2-3 day. Ext-rel: 12 mg/kg or 400 mg PO qd (whichever less) divided
q 8-12 h; increase by 2-3 mg/kg qd q 3 day. Max qd dose:
Child < 9 yr: 24 mg/kg PO qd in divided doses.
Child 9-12 yr: 20 mg/kg PO qd in divided doses.
Adolescent 12-15 yr: 18 mg/kg PO qd in divided doses.
Adolescent ≥ 16 yr, adult: 13 mg/kg PO or 900 mg PO qd in divided doses.
Apnea of prematurity—Neonate: 4 mg/kg PO loading dose; then 1-1.5 mg/kg PO q 12 h.
Start maintenance dose 12 h after loading dose.
Severe bronchospasm in CF—Infant: 10-12 mg/kg IV qd.
Thiamine Hydrochloride (Vitamin B1) PRC: A

Classes
H2O-soluble vitamin; nutritional supplement
Indications
Thiamine deficiency
Beriberi
Anemia from thiamine deficiency; polyneuritis from alcoholism, pregnancy, pellagra
Dosages
Thiamine deficiency—Child: 10-50 mg PO qd in divided doses.
Beriberi—Child: 10-25 mg, IM, IV qd × several wk with adequate dietary intake.
T Adult: 10-20 mg IM (up to 100 mg IM, IV for severe cases) tid × 2 wk, then dietary
correction and multivitamin supplement with 5-30 mg thiamine qd in 1-3 divided doses × 1
month.
Anemia from thiamine deficiency; polyneuritis from alcoholism, pregnancy, pellagra—Child,
adult: PO dose based on RDA for age.
Thiopental Sodium PRC: C

Classes
Barbiturate; anesthesia
Indications
General anesthesia for short procedure
Seizures after anesthesia
Basal anesthesia
PEDIATRiC DRUG 97
Dosages
General anesthesia for short procedure—Child, adult: 2-4 ml 2.5% solution (50-100 mg)
IV for induction, repeat as maintenance dose. Individualize dose.
Seizures after anesthesia—Adult: 50-125 mg (2-5 ml 2.5% solution) IV
Basal anesthesia—Child, adult: 30 mg/kg PR.
Thioridazine, Thioridazine hydrochloride PRC: C

Classes
Phenothiazine (piperidine derivative); anti-psychotic
Indications
Dysthymic disorder (neurotic depression), severe behavioral problems in child
Psychosis
Dosages
Dysthymic disorder (neurotic depression), severe behavioral problems in child—Child
2-12 yr: 0.5-3 mg/kg/day PO in divided doses. Moderate disorder: 10 mg bid-tid. Hospitalized
child: 25 mg bid-tid. Max 3 mg/kg qd.
Adult: 25 mg PO tid. Maintenance 20-200 mg qd.
Psychosis—Adult: 50-100 mg PO tid, gradual increase to 800 mg qd in divided doses prn.
Ticarcillin Disodium PRC: B

Classes
Extended-spectrum penicillin, alphacarboxypenicillin antibiotic
Indications
Serious infection
UTI
Dosages
Serious infection—Neonate < 1 wk and < 2 kg: 75 mg/kg IM, IV q 12 h.
Neonate < wk and > 2 kg: 75 mg/kg IM, IV q 8 h.
Neonate > 1 wk and < 2 kg: 75 mg/kg IM, IV q 8 h.
Neonate > 1 wk and > 2 kg: 100 mg/kg IM, IV q 8 h.
Infant, child > 1 month and < 40 kg: 200-300 mg/kg IV qd in divided doses q 4-6 h.
Child ≥ 40 kg, adult: 200-300 mg/kg IV qd in divided doses q 3, 4, or 6 h. T
UTI—Infant, child > 1 month and < 40 kg: Complicated infection: 150-200 mg/kg IV qd
in divided doses q 4-6 h. Uncomplicated infection: 50-100 mg/kg IV, IM qd in divided doses
q 6-8 h. Total qd dose in child shouldn’t exceed adult dose.
Child ≥ 40 kg, adult: Complicated infection: 150-200 mg/kg IV qd in divided doses q 4-6 h.
Uncomplicated infection: 1 gram IV, IM q 6 h.
Ticarcillin Disodium/Clavulanate Potassium PRC: B

Classes
Extended-spectrum penicillin, beta-lactamase inhibitor; antibiotic
Indications
Mild-moderate infection
Severe infection
98 PEDIATRiC DRUG
Lower respiratory, bone, joint, skin, skin-structure infection, septicemia, UTI
Dosages
Mild-moderate infection—Infant, child 3 month-16 yr and < 60 kg: 200 mg ticarcillin
component/kg IV qd in divided doses q 6 h.
Infant, child 3 month-16 yr and ≥ 60 kg: 3.1 gram (3 gram ticarcillin, 0.1 gram clavulanate
potassium) IV q 6 h.
Severe infection—Infant, child 3 month-16 yr and < 60 kg: 300 mg ticarcillin/kg IV qd in
divided doses q 4 h.
Infant, child 3 month-16 yr and ≥ 60 kg: 3.1 gram (3 gram ticarcillin, 0.1 gram clavulanate
potassium) IV q 4 h.
Lower respiratory, bone, joint, skin, skin-structure infection, septicemia, UTI—Adult: 3.1
gram (3 gram ticarcillin, 0.1 gram clavulanate potassium) dil in 50-100 ml D5W, saline,
lactated Ringer’s inj IV infusion over 30 min q 4-6 h.
Timolol Maleate PRC: C

Classes
Beta blocker; antihypertensive, adjunct in MI, antiglaucoma drug
Indications
Glaucoma
Hypertension
Angina
Dosages
Glaucoma—Infant, child < 10 yr: 1 drops 0.25% solution to conjunctiva once qd-bid.
Child ≥ 10 yr, adult : 1 drops 0.25% or 0.5% solution to conjunctiva once qd-bid; or 1
drops 0.25% or 0.5% gel to conjunctiva once qd.
Hypertension—Adult: 10 mg PO bid. Maintenance 20-40 mg/day. Max 60 mg/day.
Angina—Adult: 15-45 mg PO qd in 3 divided doses.
Tobramycin, Tobramycin Ophthalmic, Tobramycin Sulfate,

PRC: D
Tobramycin Solution for Inhalation
Classes
T Indications
Serious infection
CF with P. aeruginosa
External ocular infection
Dosages
Serious infection—Neonate < 1 wk: Up to 4 mg/kg IM, IV qd divided q 12 h. IV: dil in 50-100
ml NSS or D5W for adult, less volume for child. Give over 20-60 min.
Child, adult: 3 mg/kg IM, IV qd divided q 8 h. Up to 5 mg/kg IM, IV qd divided q 6-8 h for
life-threatening infection.
CF with P. aeruginosa—Child > 6 yr, adult: 1 single-use amp (300 mg) q 12 h × 28 day,
then off × 28 day, then on × 28 day.
PEDIATRiC DRUG 99
External ocular infection—Child, adult: Mild-moderate infection: 1-2 drops in affected eye
q 4-6 h. Severe infection: 2 drops in affected eye q 1 h or small amount oint in conjunctival
sac tid-qid.
Topiramate PRC: C
Classes
Sulfamate-substituted monosaccharide; antiepileptic
Indications
Partial onset seizures, primary generalized tonic-clonic seizures
Dosages
Partial onset seizures, primary generalized tonic-clonic seizures—Child, adolescent 2-
16 yr: 25 mg (or 1-3 mg/kg/day) PO q hs × 1st wk. Increase based on response q 1-2 wk
1 to 3 mg/kg/day in 2 divided doses. Total qd dose 5-9 mg/kg/day PO in 2 divided doses.
Adult: Wk 1, 50 mg PO in prn; wk 2, 50 mg PO bid; wk 3, 50 mg PO in morning, 100 mg PO
in pm; wk 4, 100 mg PO bid; wk 5, 100 mg PO in morning, 150 mg PO in pm; wk 6, 150 mg
PO bid; wk 7, 150 mg PO in morning, 200 mg PO in pm; wk 8, 200 mg PO bid.
Triamcinolone Acetonide PRC: C

Classes
Glucocorticoid; anti-inflammatory, immunosuppressant
Indications
Dosages
Severe inflammation, immunosuppression—Child 6-12 yr: 0.03-0.2 mg/kg IM q 1-7 day.
Child > 12 yr, adult: 60 mg IM. Then 20-100 mg prn q 6 wk. Or 2.5-15 mg intra-articularly,
or up to 1 mg intralesionally prn.
Triamcinolone Diacetate PRC: C

Classes
Glucocorticoid; anti-inflammatory, immunosuppressant
Indications
Dosages
Severe inflammation, immunosuppression—Child: 0.117-1.66 mg/kg/day PO divided qid.
V
Adult: 40 mg IM once wk; or 2-40 mg intra-articularly, intrasynovially, intralesionally q 1-8
wk; or 4-48 mg PO divided qid.
Vancomycin hydrochloride PRC: C

Classes
Glycopeptide; antibiotic
Indications
Severe staphylococci infection
100 PEDIATRiC DRUG
Antibiotic-associated pseudomembranous, staphylococci enterocolitis
Endocarditis prophylaxis for GI, biliary, GU procedure; surgery prophylaxis in pt allergic to
penicillin
Dosages
Severe staphylococci infection—Neonate < 1 wk and < 2 kg: 10-15 mg/kg IV q
12-18 h.
Neonate < 1 wk and ≥ 2 kg: 10-15 mg/kg IV q 8-12 h.
Neonate < 1 wk and < 2 kg: 10-15 mg/kg IV q 8-12 h.
Neonate < 1 wk and < 2 kg: 15-20 mg/kg IV q 8 h.
Neonate < 4 wk and < 1.2 kg: 15 mg/kg IV q 24 h.
Infant, child: 4. mg/kg IV qd divided q 6 h or 1.2 gram/m2/day given in divided doses;
severe infection: 40-60 mg/kg qd in 4 divided doses. Max 2 gram qd.
Adult: 500 mg IV q 6 h, or 1 gram q 12 h.
Antibiotic-associated pseudomembranous, staphylococci enterocolitis—Child: 40 mg/kg
PO qd divided q 6-8 h × 7-10 day. Max 2 gram/day.
Adult: 125-500 mg PO q 6 h × 7-10 day.
Endocarditis prophylaxis for GI, biliary, GU procedure; surgery prophylaxis in pt allergic to
penicillin— Child: 20 mg/kg IV over 1-2 h; complete infusion within 30 min of procedure.
High-risk pt: give with gentamicin.
Adult: 1 gram IV over 1 h, starting 1 h before procedure. High-risk pt: give with
gentamicin.
Verapamil Hydrochloride PRC: C

Classes
Calcium channel blocker; antianginal, antihypertensive, antiarrhythmic
Indications
Supraventricular tachyarrhythmias
Control of ventricular rate in digitalized pt with chronic atrial flutter or fibrillation
Hypertension
Dosages
Supraventricular tachyarrhythmias—Infant < 1 yr: 0.1-0.2 mg/kg (0.75-2 mg) IV bolus
over 2 min. Repeat in 30 min if no response.
Child 1-15 yr: 0.1-0.3 mg/kg (2-5 mg) IV bolus over 2 min; max 5 mg. Repeat in 30 min if
no response; max 10 mg.
V Adult: 0.075-0.15 mg/kg (5-10 mg) IV push over 2 min. If no response, give 10 mg
(0.15 mg/kg) 15-30 min after 1st dose.
Control of ventricular rate in digitalized pt with chronic atrial flutter or fibrillation—Adult:
240-320 mg PO qd in 3-4 divided doses.
Hypertension—Adult: 80 mg PO tid, increase to 360-480 prn. Start with sustained-release
caps at 180 mg (240 mg for Verelan) qd in morning. 120 mg may be needed in pt who may
have increase response to drug. Increase by 120 mg qd to max 480 mg qd. Give sustained-
release caps once qd.
Vinblastine Sulfate (VLB) PRC: D

Classes
Vinca alkaloid (M phase specific); antineoplastic
PEDIATRiC DRUG 101
Indications
Breast, testicular CA; Hodgkin’s, malignant lymphoma; choriocarcinoma; lymphosarcoma;
neuroblastoma; lung CA; mycosis fungoides; histicytosis; Kaposi’s sarcoma
Dosages
Breast, testicular CA; Hodgkin’s, malignant lymphoma; choriocarcinoma; lymphosarcoma;
neuroblastoma; lung CA; mycosis fungoides; histicytosis; Kaposi’s sarcoma—Child: 2.5
mg/m2 IV in 1 dose q wk, increase q wk by 1.25 mg/m2. Max 12.5 mg/m2 less than this
amount q wk.
Adult: 0.1 mg/kg or 3.7 mg/m2 IV q wk or q 2 wk. Increase by 50 mcg/kg or 1.8-1.9 mg/m2
q wk to max 0.5 mg/kg or 18.5 mg/m2 IV q wk. Don’t repeat dose if WBC count <
4,000/mm3.
Vitamin A (Retinol) PRC: A

Classes
Fat-soluble vitamin; vitamin
Indications
Vitamin A deficiency with xerophthalmia
Vitamin A deficiency
Dosages
Vitamin A deficiency with xerophthalmia—Child ≥ 8 yr, adult: 500,000 IU PO qd × 3 day;
then 50,000 IU PO qd × 14 day; then maintenance 10,000-20,000 IU PO qd × 2 month, then
adequate nutrition and RDA vitamin A supplements.
Vitamin A deficiency—Infant < 1 yr: 7,500-15,000 IU IM qd × 10 day.
Child 1-8 yr: 17,500-35,000 IU IM qd × 10 day.
Child ≥ 8 yr, adult: 100,000 IU PO, IM qd × 3 day; then 50,000 IU PO, IM qd × 14 day; then
maintenance 10,000-20,000 IU PO qd × 2 month; then adequate nutrition and RDA vitamin
A supplements.
Zafirlukast PRC: B
Classes
Leukotriene receptor antagonist; antasthmatic
Indications
Asthma
Dosages
Asthma—Child 7-11 yr: 10 mg PO bid 1 h ac or 2 h pc.
Child ≥ 12 yr, adult: 20 mg PO bid 1 h ac or 2 h pc. Z
Zidovudine (AZT) PRC: C
Classes
Thymidine analogue; antiviral
Indications
Symptomatic HIV, AIDS, advanced AIDS-related complex
Asymptomatic HIV infection
Maternal-fetal HIV transmission
102 PEDIATRiC DRUG
Dosages
Symptomatic HIV, AIDS, advanced AIDS-related complex—Infant, child 3 month-12 yr:
180 mg/m2 q 6 h (720 mg/m2/day). Max 200 mg q 6 h.
Child ≥ 12 yr, adult: 100 mg PO q 4 h (600 mg qd). Or 1 mg/kg IV infusion at constant rate
over 1 h q 4 h to total 6 mg/kg/day.
Asymptomatic HIV infection—Infant, child 3 month-12 yr: 180 mg/m2 q 6 h (720 mg/m2
PO qd) in divided doses q 6 h. Max 200 mg q 6 h.
Child ≥ 12 yr, adult: 100 mg PO q 4 h while awake (500 mg qd). Or 1 mg/kg IV orier 1 h
q 4 h while awake (5 mg/kg qd).
Maternal-fetal HIV transmission—Neonate: 2 mg/kg PO or 1.5 mg/kg IV q 6 h over 30 min
starting 12 h after birth until age 6 wk.
Adult: Maternal dose: 100 mg PO q 4 h while awake (5 doses qd) until onset of labor.
During labor, delivery: 2 mg/kg IV over 1 h then 1 mg/kg/h continue infusion until umbilical
cord clamped.
Z
PEDIATRiC DRUG 103
Appendix 1: Vaccines Considered Essential in Childhood
Vaccine Age Route/Dose Remarks Adverse reactions

BCG Birth 0.1 ml Use reconstituted Usual reaction is a
intradermal vaccine in 4-6 hours papule or nodule after
over left Use sterile water to 2-3 weeks with
deltoid region wipe the skin; if ulceration and scar
alcohol is used at 4-6 weeks
allow it to dry before Regional adenitis
giving vaccine
OPV Birth, 2 drops Store in freezer None
6,10,14 orally Avoid repeated
weeks, thawing
15-18 Pulse polio doses
4-5 years are additional
DPT Birth 0.5 ml IM DT is used if DPT Pain, fever
6,10,14 anterolateral is contraindicated in High pitched cry
weeks, aspect of mid progressive neurological Hypotonic
15-18 thigh/over conditions or severe hyporesponsive
months, right deltoid reaction to previous syndrome
4-5 years dose and prolonged Convulsions
crying syndrome Acute
encephalopathy
Measles 9 months 0.5 ml Use reconstituted Fever and transient
subcutaneous vaccine with 4-6 rash 5-10 days
over right hours after vaccination
deltoid
MMR 15 months 0.5 ml Similar to measles
subcutaneous vaccine
over right
deltoid
TT 10,16 years 0.5 ml IM
Booster
Hepatitis Birth, 6 0.5 ml over Avoid gluteal region Soreness at
B weeks, right deltoid/ Avoid first dose injection site
6 months anterolateral within 12 hours Mild fever
aspect of mid of birth
thigh (in
newborns
only)
Source: Standard treatment guidelines 2002 pages 527-28.
104 PEDIATRiC DRUG
Appendix 2: Newer Vaccines in Childhood

(these are optional vaccines, can be offered on parental request or under special
circumstances)
Vaccine Age/ Route/Dose Remarks Adverse reactions

Typhoid
Killed TA 0.25 ml, SC, deltoid Inexpensive and highly Severe local pain,
vaccine 2 doses, 4 weeks apart effective fever systemic
from 6-9 months; symptoms
booster dose every
3 years
Typhoid VI 0.5 ml SC/IM, single Expensive Fever and local reaction
polysaccharide dose, anterolateral thigh
antigen or deltoid; start from
vaccine 2 years of age; booster
every 3 years
Oral Ty 21a One capsule on Avoid antibiotics Minor gastrointestinal
attenuated alternate days x 3 days. effective against S. typhi symptoms
From 5 years of age; 1 week earlier and later
booster every 3 years Strict cold chain required
H. influenza 0.5 ml IM/SC anterolateral Maximum 5 years
b. conjugate thigh; After15 months only
vaccine 2-6 months 3 doses; one primary with no booster
7-11 months 2 doses
with 1-2 months interval;
12-15 months one dose;
only one booster for
all three regimens
at 15-18 months
Pneumococcal 0.5 ml SC/IM 2 years and above None
vaccine anterolateral thigh, Indicated in asplenia and
single dose; booster immunocompromized
every 5 years children
Cholera A. SC/IM Avoid in acute illness Local reaction, fever,
inactivated B. 2 doses at 4 weeks malaise, neurologic,
whole cell interval psychiatric symptoms
suspension C. <1 years avoid
D. 1-5 years 0.1 ml
E. 6-10 years 0.3 ml
F. > 10 years 0.5 ml
Hepatitis A 0.5 ml IM over deltoid > 2 years Mild fever and local pain
2 doses at 6-month
interval.
Varicella 0.5 ml SC in left arm; a. Children > 1 year Local reaction
single dose b. Immunocompromized
c. Parents/contacts of
immunocompromized
children
Japanese- B 2 doses at 1-4 weeks Only in endemic areas Local redness
encephalitis interval; 1 ml SC during epidemic situations
booster after
3-4 years
Source: Standard treatment guidelines 2002 pages 527-28.
PEDIATRiC DRUG 105
Appendix 3: Laboratory References

Test Arterial or Age Reference Comments
venous range(s)
specimens:
volume
required (mL)
Acid/base (P) 0.5 Arterial or capillary samples only
are suitable for pH, Pco2
pH 1d 7.30-7.46
2d-1m 7.23-7.46
>1m 7.34-7.43
Pco2 32-45 mmHg Higher values seen in newborn
Base excess -4-+3 mmol/L Lower values seen in newborn
Actual bicarbonate 18-25 mmol/L
Alkaline phosphatase-ALP 0.5 0-2 y 100-350 U/L Higher values may be seen during
(S, P) 2-10 y 100-300 U/L periods of rapid growth
10-16 y 100-350 U/L
Adult 30-120 U/L
Aspartate aminotransferase 0.5 <1y 20-80 U/L Formerly SGOT. Upper limit of
- AST (S, P) 1-3 y 15-60 U/L reference range, particularly in
3-16 y 10-45 U/L infancy, not well defined
> 16 y 0-40 U/L
Bilirubin - unconjugated (S, P) 0.5 Full term Higher values in newborn due to
0-24 h < 65 mmol/L indirect (unconjugated) fraction.
24-48 h < 115 mmol/L Even higher values in premature
3-5 d < 155 mmol/L infants
1m < 10 mmol/L
Bilirubin - conjugated <1m < 10 mmol/L Positive interference by
(S,P) >1m sulphasalazine, nitrofurantoin
Calcium-ionised (P) 0.5 Adult 1.19-1.29 mmol/L Whole blood specimen needed.
Must be collected anaerobically,
in special syringe.
Consult laboratory for details
Calcium-total (S, P) 0.5 <2w 1.90-2.70 mmol/L Lower limit of normal range in
2w-1y 2.10-2.70 mmol/L neonates not well defined
>1y 2.10-2.60 mmol/L
Chloride 98-110 mmol/L
Cholesterol-total (S, P) 0.5 6m 2.3-4.9 mmol/L Reference ranges based on
1y 2.5-4.9 mmol/L USA data
2-14 y 3.1-5.4 mmol/L
Creatine kinase - CK 0.5 40-240 units/L Higher values in newborn.
(S, P) Specimens on three separate
occasions recommended when
testing for carriers for Duchenne
muscular dystrophy
Creatinine (S, P) 0.5 1 mg-1 y 0.01-0.03 mmol/L Reference range related to muscle
1-4 y 0.01-0.05 mmol/L Higher values seen in newborns
4-10y 0.02-0.06 mmol/L mass.
10-16y 0.03-0.08 mmol/L
>16y 0.05-0.11 mmol/L
Glucose f (S, P) 0.5 2d-1m 2.2-5.0 mmol/L Lower values may be seen on day 1
>1m 3.6-5.4 mmol/L and in premature infants. Therapy
for hypoglycemia should aim to
keep the glucose level >3mmol/L.
Whole blood glucose approximately
10% lower than plasma
g-Glutamyltransferase- 0.5 0-1m <225 U/L New borns have very high levels of
GGT (S, P) >3m <40 U/L GGT that rapidly decrease to adult
levels by about 3 months.
Higher levels of GGT may be seen
if on anticonvulsants or alcohol
Iron (S, P) 0.5 9-27 µmol/L
Magnesium (S, P) 0.5 0.7-1.0 mmol/L
Osmolality (S, P) 1 265-295 mmol/kg
Phosphorus - inorganic 0.5 <2w 1.7-3.0 mmol/L
(S, P) 2w-2y 1.3-2.3 mmol/L
2-16y 1.1-1.8 mmol/L Continued on next page
106 PEDIATRiC DRUG
Appendix 3: Laboratory References (Contd)

venous range(s)
specimens:
volume
required (mL)
Po2 (P) 0.5 <2w 55-100 mmHg
Arterial only >2w 80-100 mmHg
Potassium 2d-2W 3.7-6.0 mmol/L Ranges quoted are based on
2w-3m 3.7-5.7mmol/L arterial/venous specimens.
3m-1y 3.5-5.1mmol/L Capillary samples have higher
1-16y 3.5-5.0mmol/L potassium concentrations
>16y 3.5-5.0mmol/L (up to 0.6 mmol/L higher)
Proteins (S) 0.5
Total protein <1m 45-70 g/L
1m-1y 50-71 g/L
1-4y 55-74 g/L
4-16y 57-80 g/L
>16y 60-80 g/L
Albumin <1m 23-43 g/L
1m-1y 29-45 g/L
1-16y 33-47g/L
>16y 35-50 g/L
Total globulins <1m 10-31 g/L Consult with immunology laboratory
1m-1y 12-27 g/L regarding specific globulin fractions
1-4y 14-37 g/L
4-16y 17-38 g/L
Sodium 135-145 mmol/L
Thyroid function (S, P) 3
Thyroxine 1-3d 130-270 nmol/L
total (TT4) 1-2w 125-215 nmol/L
2-4w 105-215 nmol/L
1-4m 90-190 nmol/L
4m-1y 70-175 nmol/L
>1y 70-155 nmol/L
free (FT4) Adult 9-26 pmol/L Higher values in infants
T3 Resin uptake <1m 70-115%
(T3 RU) 1-4m 70-110%
4m-1y 70-110%
>1y 75-115%
Free thyroxine index <1m 80-210%
(FTI) 1-4m 70-180%
4m-1y 60-160%
>1y 60-155%
Triiodothyronine (T3) Adult 1.0-2.7 nmol/L Higher values in infants and children
Thyroxine binding Adult 12-28 mg/L Higher values in infants
globulin (TBG)
Thyroid-stimulating 1-3d <40mU/L
hormone (TSH) 3-7d <25mU/L
7-14d <10 mU/L
>14d <5mU/L
Triglycerides f(P) 0.5 Adult 0.9-2.0 mmol/L Note: fasting is essential
Urea (S, P) 0.5 <1m 1.3-5.7 mmol/L Related to protein intake. Lower
1m-4y 1.3-6.6 mmol/L values in breast-fed infants and
>4y 2.1-6.5 mmol/L newborns
Uric acid (S, P) 0.5 Prepubertal 0.13-0.39 mmol/L Higher values may be seen in the
Adult male 0.18-0.48 mmol/L first 2 years and following the onset
Adult female 0.11-0.42 mmol/L of puberty
Zinc (S, P) 2 11-22mmol/L
h,hour; d, day; w, week; m, month; y, year; f, fasting; P, plasma; S, serum; U, urine.
Source: Paediatric Hand Book, 6th ed.2000, Blackwell Science Asia. Page 527-31.
PEDIATRiC DRUG 107
Appendix 4: Urinalysis
venous range(s)
specimens:
volume
required (mL)
Volume(ml/day) Upto 1m 50-300
1m-2 y 350-500
Up to 8 y 500-1000
9-15 y 700-1400
After 800-1600
Calcium 24h <0.12 mmol/kg Include weight of patient on
per day request card. Specimen must
be collected into special
bottle containing acid
Calcium/creatinine ratio Random >2 y <0.7 mmol/day
Creatinine clearance 24 h 1.4-2.4 mL/s per Plasma sample for creatinine
1.73 m2 required during urine
collection period. Height and
weight must be recorded on
request card.
Drugs screen Random (20 mL)
Potassium Random Variable (mmol/L) Many factors determine
excretion rates; e.g. intake,
renal function, hormonal
influences and drug therapy
Protein Timed collection mg/h per m2 <4 The height and weight of the
overnight patient must be recorded on
request card
Protein/creatinine ratio Random (early morning) mg/mmol <30 Consult the laboratory
Sodium Random Variable (mmol/L) Many factors influence
urinary sodium concentra-
tion. This test is of value in
differentiating causes of
hyponatremia
Microscopic
• Leucocytes All ages 0-4/HPF
• Red cells Rare
• Casts Rare
Osmolarity NB/IN 50-600 mOsm/litre
after 50-1400
After fluid restriction > 850
pH Upto 1m 5.0-7.0
after 4.8-7.8
Specific gravity, Upto 2y 1.001-1.020
random after 1.001-1.030
After fluid restriction > 1.025
Sugar All ages Negative
24 hours protein All ages 50-150 mg/24 hours
h-hour; y-year; m-month
Source: Mittal SK, Agarwal V. An approach to pediatric problems, 1998.

108 PEDIATRiC DRUG
Appendix 5: Inhalational Drug References

Drug Dosage
Albuterol 0.01- 0.05 mL/kg of 0.5% solution in 2-3 mL NS
Continuous nebulization: 0.3 mg/kg/hr
Infants and toddlers: maximum dose 10 mg/hr
Older children/adolescents/adults: maximum dose 15 mg/hr
Atropine sulfate Bradycardia: 0.02 mg/kg (minimum dose 0.1 mg) Intratracheal
Infants and children: maximum dose 0.5 mg
Adolescents and adults: maximum dose 1 mg
Bronchospasm: 0.03 -0.05 mg/kg/dose
Cromolyn sodium 20 mg in 2 mL NS (prepackaged)
Dexamethasone Infants and children: 1-2 mg in 2 mL NS
Adolescents and adults: 4 mg
Epinephrine - racemic Bradycardia: 0.1-0.2 mg/kg (0.1-0.2 mL/kg 1: 1000) intratracheal
Bronchospasm: 0.25-0.5 mL of 2.25% solution in 2-3 mL NS
Ipratropium Infants and children < 12 yr: 125-250µg in 2-3 mL NS
Children > 12 yr: 500 µg in 2-3 mL NS
Isoproterenol 0.01 mL/kg of 1% solution in 2-3 mL NS
Minimum dose 0.1 mg
Maximum dose 5 mg
Metaproterenol Infants and children: 0.01-0.02 mL/kg of 5% solution in 2-3 mL NS;
maximum dose 0.1 mL
Adolescents and adults: 0.2-0.3 mL of 5% solution in 2-3 mL NS
Terbutaline 0.01-0.03 mg/kg in 2-3 mL NS
Minimum dose 0.1 mg
Maximum dose 2.5 mg
Note: These are inhalation doses only.
Source: David G Dharmapuri Vidyasagar. Hand book of Pediatric and Neonatal Transport Medicine, 2nd ed 2002.
PEDIATRiC DRUG 109
Appendix 6: Management of Fever in Infants and Young Children

Nontoxic Young infant with Fever
Previously healthy, nontoxic young infant (≤ 3 months of age)
with a temperature of 38°C (100.4°F) without source
> 1 month of age ≤1 month of age
Consider low-risk criteria Admit infant to hospital for blood and

Generally well appearence urine cultures, lumbar puncture and
No focal infection parenteraly administered antibiotics.
WBC count of 5,000 to 15,000 per mm3 Alternatively, if the risk of bacteremia is
Absolute band cell count of less than 1,500 per mm3 low, consider admission and
Normal urinalysis observation without antibiotic therapy
If diarrhea < 5 WBCs per high-power field on pending culture results.
microscopic examination of stool
Infant does not meet Infant meets

low-risk criteria low-risk criteria
Admit infant to hospital for blood and Option1: blood and urine cultures, Option2: urine culture and
urine cultures, lumbar puncture and lumbar puncture, parenterally careful observation
parenterally administered antibiotics administered antibiotics
Re-evaluate infant within 24 hours
Source: Baraff LJ, Bass JW, Fleisher GR et al. Practice guideline for the management of infants and children 0 to 36 months
of age with fever without source. Pediatrics 1993;92:1-12; In Michael L. Am Fam Physician 2001;64:1219-26.
110 PEDIATRiC DRUG
Appendix 7: Management of Severe Asthma Exacerbation in a Child

Rapidly assess cardiorespiratory status
without a delay in initial therapeutic measures.
Provide relief of bronchospasm

Administer supplemental humidified oxygen to maintain oxygen saturation of >92%.
Administer albuterol by nebulizer, 0.15 mg per kg (maximum: 5 mg per dose),
diluted in 3 mL of normal saline (may repeat every 20 minutes, as required, for 3 doses).
Administer ipratropium by nebulizer, 2.5 to 5.0 mL of solution (500 mcg per 2.5 mL)
concurrently with first doses of albuterol.
Consider administration of subcutaneous epinephrine (1:1,000), 0.01mL per Kg (maximum dose: 0.5mL)
in severe attacks, when inhaled drugs may not reach the targeted small airways.
Modulation of airway inflammation

Administer prednisolone, 2mg per kg orally (loading dose)
or
Administer methylprednisolone, 2 mg per kg IV or IM (loading dose).
Response to therapy
Good response Incomplete or poor response Respiratory failure

Minimal symptoms persist Persistent shortness of breath Extreme distress
Improvement on examination Continued increased effort of breathing Absent breath sounds
Oxygen saturation >92% Mild to marked wheezing Impaired alertness
Peak flow >70% Peak flow < 70% Low oxygen saturation
Continue appropriate therapy as an Prepare patient for transfer to ED. Patient in respiratory failure
outpatient. should be intubated before transport or transported by persons skilled
in intubation and airway support.
(ED = emergency department; IM = intramuscularly; IV = intravenously)
Source: Derek S, Mark L et al., Pediatrics emergency preparedness in the office. AAFP 2000; 61: 3333-42.
PEDIATRiC DRUG 111
Appendix 8: Evaluation and Treatment of Diarrhea

Assessment of dehydration in a patient with diarrhea
Clinical signs
General condition Well, alert “Restless, irritable” “Lethargic or unconscious”, floppy
Eyes Normal Sunken Very sunken and dry
Tears Present Absent Absent
Mouth and tongue Moist Dry Very dry
Thirst Drinks normally, “Thirsty, drinks “Drinks poorly” or
not thirsty eagerly” not able to dribk
Skinpinch “Goes back quickly” “Goes back slowly” “Goes back very slowly”
Decide hydration status The patient has no If the patient has If the patient has two
signs of dehydration two or more signs, or more signs, including
including one (key) one (key) sign, there is
sign, then there is severe dehydration
some dehydration
Treatment Plan Plan A Plan B Plan C
Composition and concentration of WHO/UNICEF

recommended oral dehydration salts (ORS)
Ingredients Composition Concentration
(Grams/L) (mEq/L)
Sodium chloride 3.5 Sodium 90
Potassium chloride 1.5 Chloride 80
Trisodium citrate 2.9 Citrate 10
anhydrous
Glucose 20.0 Glucose 111 mmol/L
(anhydrous) Osmolality 311
Note: Soda bicarb is not recommended now.
Guidelines for replacement of fluid and electrolytes

in children with ‘No dehydration’ (Plan A)*
Age After each loose stool, offer
< 6 months Quarter glass or cup (50 ml)
7 months-2 years Quarter to half glass or cup (50-100 ml)
2-5 years Half to one glass or cup (100-200 ml)
Older Children As much as the child can take
* Fluids which can be used include ORS, lemon water, butter milk, rice kanji, lentil soup, light tea, etc. ORS in plan A
treatment is optional only.
112 PEDIATRiC DRUG
Deficit fluid therapy for ‘Severe dehydration’

(Plan C) (100 ml/kg body weight)
Age Type of fluid Volume of fluid Monitoring
and duration
Infants < 1 year Ringer’s lactate 30 ml/kg body weight Reassess after every 1-2 hours:
within first hour, followed * if not improving, give IV
by 70 ml/kg body weight drip more rapidly
70 ml/kg body weight * encourage oral feeding by
over next 5 hours giving ORS 5 ml/kg/hour,
alongwith IV fluids, as soon
as child is able to drink
Children > 1 year Ringer’s lactate 30 ml/kg body weight Reassess hydration status:
within 1/2 hour, * After 6 hours (infants) and
followed by 3 hours (older children)
70 ml/kg/body weight assess hydration status and
over next 2 1/2 hours choose appropriate plan for
hydration (Plan A, B and C)
Antimicrobials used to treat specific causes of

diarrhea in children
Causes Drugs of Choice Doses
Cholera Tetracyclin 30 mg/day in 4 divided doses x 2-3 days
Furazolidone 5 mg/kg/day in 4 divided doses x 3 days
or
Trimethoprim (TMP)- TMP 5 mg/kg and SMX 25 mg/kg, in 2 divided
sulfamethoxazole (SMX) doses x 3 days
Dysentery Trimethoprim (TMP)- TMP 5 mg/kg and
sulfamethoxazole (SMX) SMX 25 mg/kg
or in 2 divided doses x 5 days
Nalidixic acid 15 mg/kg 4 times a day x 5 days
or
Ampicillin 25 mg/kg 4 times a day x 5 days
Amoebic dysentery Metronidazole 30 mg/kg/day in 3 divided doses x 5-10 days
Acute giardiasis Metronidazole 15 mg/kg/day in 3 divided doses x 5 days
Tinidazole 10-15 mg/kg/day in 3 divided doses x 5 days
PEDIATRiC DRUG 113
Index
A Cefdinir 14
Cefepime Hydrochloride 14
Acetaminophen 1 Cefixime 15
Adenosine 1 Cefotaxime Sodium 15
Albuterol Sulfate 1 Cefpodoxime Proxetil 16
Allopurinol; Allopurinol Sodium 2 Ceftizoxime Sodium 16
Alprostadil 2 Ceftriaxone Sodium 16
Amantadine Hydrochloride 2 Cefuroxime Axetil, Cefuroxime Sodium 17
Amikacin Sulfate 3 Cephalexin Hydrochloride Monohydrate,
Aminophylline 3 Cephalexin 18
Amoxicillin Trihydrate 4 Cetirizine Hydrochloride 18
Amoxicillin/Clavulanate Potassium 4 Chemastine Fumarate 23
Amphotericin B 4 Chloral Hydrate 18
Amphotericin B Cholesteryl Sulfate Chloramphenicol, Chloramphenicol
Complex 5 Sodium Succinate 19
Ampicillin, Ampicillin Sodium, Ampicillin Chlordiazepoxide, Chlordiazepoxide
Trihydra 5 Hydrochloride 19
Ampicillin Sodium/Sulbactam Sodium 6 Chloroquine Hydrochloride, Chloroquine
Ascorbic Acid (Vitamin C) 6 Phosphate 19
Aspirin 6 Chlorpheniramine Maleate 20
Atropine Sulfate 7 Chlorpromazine Hydrochloride 20
Azelastine Hydrochloride, Ophthalmic Chlorthalidone 21
Solution 7 Cholestyramine 21
Aztreonam 8 Cimetidine 21
Ciprofloxacin (Systemic) 22
Ciprofloxacin Hydrochloride
B (Ophthalmic) 22
Cisplatin (Cis-platinum) 23
Bacitracin (Systemic) 8 Clarithromycin 23
Beclomethasone Dipropionate (Oral Clindamycin Hydrochloride, Clindamycin
Inhalant) 8 Palmitate H 23
Beclomethasone Dipropionate Clonazepam 24
Monohydrate (Nasal) 8 Clotrimazole 24
Betamethasone (Systemic), Cloxacillin Sodium 24
Betamethasone Sodium Pho 9 Co-trimoxazole (Trimethoprim-
Betamethasone Dipropionate, sulfamethoxazole) 25
Betamethasone Dipropio 9 Codeine Phosphate, Codeine Sulfate 25
Bisacodyl 9 Cortisone Acetate 25
Bismuth Subsalicylate 10 Cromolyn Sodium 26
Brompheniramine Maleate 10 Cyanocobalamin (Vitamin B12),
Budesonide 10 Hydroxocobalamin (Vi 26
Bumetanide 11 Cycloserine 27
Busulfan 11 Cyclosporine 27
C D
Calcium Salts 11 Dapsone 27
Captopril 12 Deferoxamine Mesylate 28
Carbamazepine 12 Desipramine Hydrochloride 28
Castor Oil 13 Desmopressin Acetate 29
Cefaclor 13 Dexamethasone (Ophthalmic Susp),
Cefadroxil 13 Dexamethasone Sod 29
Cefazolin Sodium 13
114 PEDIATRiC DRUG
Dexamethasone (Systemic), G
Dexamethasone Acetate, D 30
Dexamethasone (Topical), Gabapentin 46
Dexamethasone Sodium Phos 30 Ganciclovir (DHPG) 46
Dextromethorphan Hydrobromide 31 Gentamicin Sulfate 47
Diazepam 31 Glucagon 47
Diazoxide 32 Griseofulvin Microsize, Griseofulvin
Dicloxacillin Sodium 32 Ultramicrosiz 48
Dicyclomine Hydrochloride 32 Guaifenesin 48
Didanosine 33
Digoxin 33
Diltiazem Hydrochloride 34 H
Dimenhydrinate 34
Dimercaprol 34 Haloperidol, Haloperidol Decanoate,
Diphenhydramine hydrochloride 35 Haloperidol La 48
Diphtheria Antitoxin, Equine 35 Heparin Sodium 49
Disopyramide Phosphate 36 Hepatitis B Immune globulin, human
Dobutamine Hydrochloride 36 (H BIG) 49
Dopamine Hydrochloride 36 Hyaluronidase 50
Doxacurium Chloride 37 Hydralazine Hydrochloride 50
Doxycycline, Doxycycline Calcium, Hydrochlorothiazide 50
Doxycycline Hycl 37 Hydrocortisone (Systemic), Hydrocortisone
Acetate, 51
Hydrocortisone (Topical), Hydrocortisone
E Acetate, 51
Hydroxychloroquine Sulfate 52
Econazole Nitrate 38 Hydroxyzine hydrochloride, Hydroxyzine
Edetate calcium disodium Pamoate 52
(calcium EDTA) 38 Hyoscyamine, Hyoscyamine Sulfate 52
Edetate Disodium (EDTA) 38
Enalaprilat, Enalapril Maleate 39
Ephedrine, Ephedrine Hydrochloride, I
Ephedrine Sulf 39
Epinephrine, Epinephrine Bitartrate, Ibuprofen 53
Epinephrine H 40 Imipenem and Cilastatin 53
Erythromycin Base, Erythromycin Estolate, Imipramine Hydrochloride, Imipramine
Erythrom 40 Pamoate 54
Immune Globulin (Gamma Globulin, IG,
Immune Serum 54
F Indomethacin, Indomethacin Sodium
Trihydrate 55
Fentanyl Citrate, Fentanyl Transdermal Insulin (Regular), Insulin (Lispro),
System, Fen 41 Isophane Insu 55
Ferrous Fumarate 42 Insulin Glargine (rDNA) inj 56
Ferrous Gluconate 42 Ipecac Syrup 56
Ferrous Sulfate 42 Ipratropium Bromide 56
Fexofenadine Hydrochloride 43 Iron Dextran 57
Fluconazole 43 Isoniazid (INH) 57
Flumazenil 43 Isoproterenol, Isoproterenol
Fluorouracil (5-FU) 44 Hydrochloride, Isopro 57
Fluoxetine Hydrochloride 44
Fluticasone Propionate 44
Folic Acid 45 K
Foscarnet Sodium
(Phosphonoformic Acid) 45 Ketamine Hydrochloride 58
Furosemide 46 Ketoconazole 58
Ketotifen Fumarate 59
PEDIATRiC DRUG 115
L O
Lactulose 59 Ofloxacin 73
Lamotrigine 59 Ondansetron Hydrochloride 74
Levofloxacin Ophthalmic Solution 60 Oxacillin Sodium 74
Levothyroxine Sodium (T4, L-thyroxine Oxcarbazepine 75
Sodium) 60
Lidocaine (Lignocaine), Lidocaine
Hydrochloride 61
P
Liothyronine Sodium (T3) 61
Penicillamine 75
Lithium Carbonate, Lithium Citrate 62
Penicillin G Benzathine 76
Loperamide Hydrochloride 62
Penicillin G Potassium, Penicillin G
Loratadine 62
Sodium 76
Lorazepam 63
Penicillin G Procaine 77
Penicillin V Potassium 77
M Pentamidine Isethionate 78
Phenobarbital, Phenobarbital sodium 78
Magnesium Hydroxide Phenylephrine Hydrochloride 78
(Milk of Magnesia) 63 Phenytion, Phenytoin Sodium, Phenytoin
Magnesium Sulfate 63 Sodium (Ext 79
Mannitol 64 Physostigmine Salicylate, Physostigmine
Mebendazole 64 Sulfate 79
Medroxyprogesterone Acetate 65 Pilocarpine Hydrochloride, Pilocarpine
Meperidine Hydrochloride (Pethidine Nitrate 80
Hydrochloride) 65 Piperacillin Sodium 80
Methocarbamol 66 Polysaccharide Iron Complex 80
Methylprednisolone (Systemic), Potassium Iodide (KI, SSKI) 81
Methylprednisolone 66 Potassium Salts, Oral, Potassium Acetate,
Metoclopramide Hydrochloride 66 Potassiu 81
Metronidazole, Metronidazole Prazosin Hydrochloride 82
Hydrochloride 67 Prednisolone (Systemic), Prednisolne
Midazolam Hydrochloride 67 Acetate, Pred 82
Minocycline Hydrochloride 68 Prednisolone acetate (ophthalmic),
Montelukast Sodium 69 Prednisolone So 82
Morphine Sulfate 69 Prednisone 82
Primaquine Phosphate 83
Primidone 83
N Probenecid 83
Procainamide Hydrochloride 84
Naloxone Hydrochloride 69
Promethazine Hydrochloride 84
Naproxen, Naproxen Sodium 70
Propranolol Hydrochloride 85
Neomycin Sulfate 70
Propylthiouracil (PTU) 85
Neostigmine Bromide, Neostigmine
Protamine Sulfate 86
Methylsulfate 71
Pseudoephedrine Hydrochloride,
Niacin (nicotinic acid, vitamin B3) 71
Pseudoephedrine Sul 86
Nifedipine 71
Pyrantel Pamoate 86
Nitrofurantoin, Nitrofurantoin
Pyridoxine Hydrochloride (Vitamin B6) 86
Macrocrystals 72
Nitroprusside Sodium 72
Norepinephrine Bitartrate 72 Q
Nortriptyline Hydrochloride 73
Nystatin 73 Quinidine Gluconate, Quinidine
Polygalacturonate, 87
Quinine Sulfate 87
116 PEDIATRiC DRUG
R Tetanus Immune Globulin (TIG) 94

Tetanus Toxoid, Adsorbed 94
Ranitidine 88 Tetracycline hydrochloride 95
Respiratory Syncytial Virus Immune Theophylline 95
Globulin Intrav 88 Thiamine Hydrochloride (Vitamin B1) 96
Ribavirin 88 Thiopental Sodium 96
Rifampin 89 Thioridazine, Thioridazine
Hydrochloride 97
Ticarcillin Disodium 97
S Ticarcillin Disodium/Clavulanate
Potassium 97
Salmeterol Xinafoate 89 Timolol Maleate 98
Silver Nitrate 89 Tobramycin, Tobramycin Ophthalmic,
Sodium Bicarbonate 90 Tobramycin Sulf 98
Sodium Fluoride 90 Topiramate 99
Sodium Phosphates (Sodium Phosphate Triamcinolone Acetonide 99
and Sodium Bip 90 Triamcinolone Diacetate 99
Somatropin 91
Spironolactone 91
Stavudine (d4T) 91 V
Streptomycin Sulfate 92
Sulfacetamide Sodium 92 Vancomycin hydrochloride 99
Sulfasalazine 92 Verapamil Hydrochloride 100
Sulfisoxazole, Sulfisoxazole Diolamine 93 Vinblastine Sulfate (VLB) 100
Vitamin A (Retinol) 101
T
Z
Terbinafine Hydrochloride 93
Terbutaline Sulfate 93 Zafirlukast 101
Testosterone, Testosterone Cypionate, Zidovudine (AZT) 101
Testosterone 94

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PEDIATRIC

Drug and Dosages

Pediatrics is an everchanging field, but as new research and clinical

Researched, Edited, Printed and Published by :

All rights reserved. No part of this print/electronic publication

This is a concise and “reader friendly” version of a pediatrician’s

ABG arterial blood gases GI gastrointestinal

ALL acute lymphocytic leukemia hs at bedtime

AML acute myelogenous leukemia HSV herpes simplex virus

amp ampule Hz0 water

bid twice a day IM intramuscular

BM bowel movement inj injection

BMT bone marrow transplantation INR international normalized ratio

BSA body surface area K potassium

Ca calcium KCI potassium chloride

CF cystic fibrosis IPPB Intermittent positive-pressure

CSF cerebrospinal fluid max maximum

CSS Controlled Substance mcg microgram

NaCI sodium chloride RDA recommended daily allowance

Pregnancy Risk Category: PRC

X: Studies in animals and humans show fetal abnormalities, or reports of adverse

Pregnancy Risk Category: PRC ...................................................................................... vi

Pediatrics Drug Facts .......................................................................................................1

Appendix 1: Vaccines Considered Essential in Childhood ..........................................103

Appendix 2: Newer Vaccines in Childhood ..................................................................104

Appendix 3: Laboratory References ...........................................................................105

Appendix 4: Urinalysis .................................................................................................107

Appendix 5: Inhalational Drug References ..................................................................108

Appendix 6: Management of Fever in Infants and Young Children ..............................109

Appendix 7: Management of Severe Asthma Exacerbation in a Child ........................110

Appendix 8: Evaluation and Treatment of Diarrhea .....................................................111

Composition and concentration of WHO/UNICEF

Guidelines for replacement of fluid and electrolytes

Deficit fluid therapy for ‘Severe dehydration’

Antimicrobials used to treat specific causes of

Albuterol Sulfate PRC: C

Allopurinol; Allopurinol Sodium PRC: C

Amantadine Hydrochloride PRC: C

Amikacin Sulfate PRC: D

Amoxicillin/Clavulanate Potassium PRC: B

Amoxicillin Trihydrate PRC: C

Amphotericin B Cholesteryl Sulfate Complex PRC: B

Ampicillin, Ampicillin Sodium, Ampicillin Trihydrate PRC: B

Ampicillin Sodium/Sulbactam Sodium PRC: B

Ascorbic Acid (Vitamin C) PRC: A

Mild pain, fever—Child 2-11 yr: 1.5 gram/m2 PO or PR qd or 65 mg/kg PO or PR qd divided

Atropine Sulfate PRC: C

Azelastine Hydrochloride, Ophthalmic Solution PRC: C

Bacitracin (Systemic) PRC: C

Beclomethasone Dipropionate (Oral Inhalant) PRC: C

Beclomethasone Dipropionate Monohydrate (Nasal) PRC: C

Betamethasone (Systemic), Betamethasone Sodium Phosphate,

Betamethasone Dipropionate, Betamethasone Dipropionate,

Bismuth Subsalicylate PRC: C

Brompheniramine Maleate PRC: C

Calcium Salts PRC: C

Castor Oil PRC: X

Cefazolin Sodium PRC: B

Cefepime Hydrochloride PRC: B

Severe UTI, pyelonephritis—Infant, child ≥ 2 month and < 40 kg: 50 mg/kg IV q 12 h.

Cefotaxime Sodium PRC: B

Cefpodoxime Proxetil PRC: B

Ceftizoxime Sodium PRC: B