《小儿科药物剂量》由会员分享，可在线阅读，更多相关《小儿科药物剂量（32页珍藏版）》请在金锄头文库上搜索。
1、Pediatric Dosage 小兒科藥物劑量三軍總醫院 小兒部 Instructor:R2王聖儒Fulid supplement 010Kg (4 MD/kg)：100ml/kg/day 1020kg(2 MD/kg)：1000( BW10 ) 50/day 20kg (1 MD/kg)：1500( BW20 ) 20/day Example 1:BW=25 kg,Keep IV route with 0.33%G/S _MD/minAns: (10 4) + (10 2) + (5 1) = 65 MD/minExample 2:BW=30 kg,Keep IV route with 0
2、.33%G/S _MD/min_c.c. qdAns: (10 4) + (10 2) + (10 1) = 70 MD/min(10 100) + (10 50) + (10 20) = 1700 c.c./dayManagement of DehydrationAccess fluid deficit:Access fluid deficit: 10%(severe): Lethargy or Coma, Sunken anterior frontanelle and eyes, Cold extremities, Weak or impalpable pulse, Hypotension
3、 Management of Dehydration Rehydration: First 8 hr Later 16 hrDeficit 1/2 1/2Maintenance 1/3 2/3 e.g.: 10kg, 10% loss, 3 days Deficit : 10% x 10 (kg) x 0.6(deficit% from ECF ) X 1000 = 600 ml Maintenance: 10 x 100 = 1000 mlFirst 8 hr later 16 hrDeficit 300ml 300mlMaintenance 333ml 660ml Management o
4、f Dehydration ShockShock: 20ml/kg N/S or Lactate Ringers or 10ml/kg 5% albumin, blood, plasma Loading speed: 10ml/kg/hr, ( 2ml/kg/hr in CHF ) Electrolyte supplement Na：34 mEq/kg/day 3%NaCl 1ml = 0.5 mEq 0.9% NaCl 500ml = 77mEq K： 23 mEq/kg/day 15%KCl 1ml2 mEq Ca：2001000 mg/kg/day q8h-qd 10% Ca gluco
5、nate(100mg/1ml,1Amp10ml) NaHCO3：1 mEq/kg ( if PH7.2 ) 17 mEq/20cc/amp Correct Metabolic AcidosisTachypnea (BE=PCO2 1.5 x HCO3 + 8 2 )BE HCO3Mild 17 Observation Moderate 10-20 17-8 Slow correctionSevere 20 77% NaHCO3 ( 17 mEq/20ml ) supply half in 2-8 hours: 2-4 mEq/kg/dose BE x 0.3 x BW ( 15-HCO3 )
6、x 0.6 x BWCommon Dose 一般劑量 20kg：錠劑磨粉 40Kg：1 # po qid 30Kg：1 # po tid 若可吞,不用磨 20Kg：1/2# po qid 10Kg：1/4# po qid 20kg：糖漿一般咳嗽一般咳嗽流鼻水糖漿多為流鼻水糖漿多為BW/4 c.c.BW/4 c.c. 退燒退燒抗生素糖漿多為抗生素糖漿多為BW/2 c.c.BW/2 c.c. 例外例外：止瀉藥水止瀉藥水 氣管擴張劑糖漿氣管擴張劑糖漿 紅黴素類糖漿紅黴素類糖漿Antipyretics 退燒藥 Scanol (500mg/1#) ： 1015mg/kg/dose q4hq6h (50
7、mg/kg/day) Antiphen (Acetaminophen syrup)： BW/2 q4h prn if BT 38.538.5(120mg/kg/dose) Macsafe(Ibuprofen syrup)：NSAIDs 38.5 : BW/4 cc q6h； 39.539.5 : BW/2 cc q6h Diclofen (supp)( 12.5mg )： 6kg 1/3# supp q6h prn if BT 39.5 610kg 1/2# supp q6h prn if BT 39.5 10kg 1# supp q6h prn if BT 39.5 Antitussives
8、 and expectorants 止咳化痰藥 Medicon-A ( 20mg/cap ): Common dose Medicon syrup (Dextromethorphan)(2.5mg/ml) ： BW/4 cc po qid ,1-2mg/kg/day q6-8h Mucosolven (Ambroxol liq.)(3mg/ml) (化痰): BW/4 cc qid ;止咳): BW/4 cc qid ; 26y/o:2.55 cc qid ; 612y/o 510cc qid Antihistamines Tab(2mg): 0.1 mg/kg/dose up to 2 mg
9、 PO tid Berotec(Fenoterol HBr) syrup(0.5mg/ml) : BW/4BW/5 cc tid ;6y/o:5 cc po q12h Bronchodilator 氣管擴張劑 Xidanef (Ketotifen)100 ml syrup: 2.5-5ml bid Atrovent (Ipratropium UDV 0.5mg/2ml): 1 vial q6h prn Epinephrine(1:1000) ： 0.01ml/kg/dose(Max 0.5ml) q15minSC Xanthines茶鹼類 Aminophylline S.E：nausea, v
10、omiting, insomnia, tachycardia Loading dose：5(26)mg/kg/dose iv drip for 20 30 min;Maintain：1mg/ kg/hr Infants= 0.20.9mg/kg/hr,1-9y/o=11.2mg/kg/hr; 9-16y/o=0.81mg/kg/hr; youngsmoker:0.81mg/kg/hr, nonsmoker:0.50.7mg/kg/hr Apnea of prematurity：46mg/kg iv 30 min ,then maintaince : 1.53 mg/kg/dose iv q8-
11、 12h Xanthines茶鹼類 Ventol:3ml/kg/day qid Aminophylline tab.：200mg/tab po qid ; dose = iv form Steriods 類固醇 Decadron：0.1 mg/kg/dose im q8h. Rinderon (4mg/ml): 0.1 mg/kg/dose im,iv q8h Prednisolone(5mg/tab):12mg/kg/day po qdqid ; max:4#8#(2040) mg/day for 35 day. 40kg給Pulmicort (steroid ,200mcg/dose) ：
12、 12 puff bid for 3 month for prevent asthma(可有效 預防氣喘再發)Urticaria 蕁麻疹 Benadryl (Diphenhydramine):1mg/kg IM Decardon (Dexamethasone): 0.1mg/kg/dose IM Periactin tab：普通劑量 po qid. Prednisolone(5mg/tab.) :12 mg/kg/dayAntidiarrheals, digestives and antiflatulents止瀉、消化、消氣劑 Kaopectin： 6 mons：3 po qid（嚴重再給）
13、6 mons6 Y/O：5 po qid 6 Y/O：10 po qid. Biofermin tab：普通劑量2 po qid. Simethicone tab：普通劑量 po qid. Bismuth: 普通劑量po qid.Antiemetics止吐劑 Motilium(10 mg/tab) ：普通劑量 po qid. Prepulsid：0.10.2mg/kg/dose po qid Novamine or Priperam may cause EPS EPS： Akineton=Biperidine(1#=2mg;5mg/1cc/a mp) Adult：2mg per 30 min.
14、max 4 vial(20mg) Laxatives 輕瀉劑 Glycerine ball enema：0.51# qd MgO tab：普通劑量 po qid. Ducolax (Bisacodyl 5mg tab) ：612 yo 1# po st. Cascara (Cascara sagrada) ：12# po qhsAnticonvulsants 抗痙攣劑 Valium(Diazepam)(10mg/2/amp): 5y/o: the same as above except (max 10 mg) adolescents: 5-10 mg/dose; max: 30mg. Neuropam(Lorazepan)(2mg/ml/amp) ;中效(10- 15 hrs)： 0.03-0.1mg/kg/dose q1520min 2 dose max: 4mg/doseAnticonvulsants 抗痙攣劑 Dilantin(phenytoin) (250mg/5cc/amp)： Loading 1020mg/kg iv with rate 1mg/kg/min,max50mg/min ,Maintain 5mg/
