小儿科药物剂量ppt课件

.,PediatricDosage小兒科藥物劑量,三軍總醫院小兒部Instructor:R2王聖儒,.,Fulidsupplement,010Kg(4MD/kg)：100ml/kg/day1020kg(2MD/kg)：1000(BW10)50/day20kg(1MD/kg)：1500(BW20)20/day,Example1:BW=25kg,KeepIVroutewith0.33%G/S_MD/minAns:(104)+(102)+(51)=65MD/minExample2:BW=30kg,KeepIVroutewith0.33%G/S_MD/min_c.c.qdAns:(104)+(102)+(101)=70MD/min(10100)+(1050)+(1020)=1700c.c./day,.,ManagementofDehydration,Accessfluiddeficit:10%(severe):LethargyorComa,Sunkenanteriorfrontanelleandeyes,Coldextremities,Weakorimpalpablepulse,Hypotension,.,ManagementofDehydration,Rehydration:First8hrLater16hrDeficit1/21/2Maintenance1/32/3e.g.:10kg,10%loss,3daysDeficit:10%x10(kg)x0.6(deficit%fromECF)X1000=600mlMaintenance:10 x100=1000mlFirst8hrlater16hrDeficit300ml300mlMaintenance333ml660ml,.,ManagementofDehydration,Shock:20ml/kgN/SorLactateRingersor10ml/kg5%albumin,blood,plasmaLoadingspeed:10ml/kg/hr,(2ml/kg/hrinCHF),.,Electrolytesupplement,Na：34mEq/kg/day3%NaCl1ml=0.5mEq0.9%NaCl500ml=77mEqK：23mEq/kg/day15%KCl1ml2mEqCa：2001000mg/kg/dayq8h-qd10%Cagluconate(100mg/1ml,1Amp10ml)NaHCO3：1mEq/kg(ifPH7.2)17mEq/20cc/amp,.,CorrectMetabolicAcidosis,Tachypnea(BE=PCO21.5xHCO3+82)BEHCO3Mild17ObservationModerate10-2017-8SlowcorrectionSevere2077%NaHCO3(17mEq/20ml)supplyhalfin2-8hours:2-4mEq/kg/doseBEx0.3xBW(15-HCO3)x0.6xBW,.,CommonDose一般劑量,20kg：錠劑磨粉40Kg：1#poqid30Kg：1#potid若可吞,不用磨20Kg：1/2#poqid10Kg：1/4#poqid20kg：糖漿一般咳嗽流鼻水糖漿多為BW/4c.c.退燒抗生素糖漿多為BW/2c.c.例外：止瀉藥水氣管擴張劑糖漿紅黴素類糖漿,.,Antipyretics退燒藥,Scanol(500mg/1#)：1015mg/kg/doseq4hq6h(50mg/kg/day)Antiphen(Acetaminophensyrup)：BW/2q4hprnifBT38.5(120mg/kg/dose)Macsafe(Ibuprofensyrup)：NSAIDs38.5:BW/4ccq6h；39.5:BW/2ccq6hDiclofen(supp)(12.5mg)：6kg1/3#suppq6hprnifBT39.5610kg1/2#suppq6hprnifBT39.510kg1#suppq6hprnifBT39.5,.,Antitussivesandexpectorants止咳化痰藥,Medicon-A(20mg/cap):CommondoseMediconsyrup(Dextromethorphan)(2.5mg/ml)：BW/4ccpoqid,1-2mg/kg/dayq6-8hMucosolven(Ambroxolliq.)(3mg/ml)(化痰):BW/4ccqid;止咳):BW/4ccqid;26y/o:2.55ccqid;612y/o510ccqid,.,AntihistaminesTab(2mg):0.1mg/kg/doseupto2mgPOtidBerotec(FenoterolHBr)syrup(0.5mg/ml):BW/4BW/5cctid;6y/o:5ccpoq12h,.,Bronchodilator氣管擴張劑,Xidanef(Ketotifen)100mlsyrup:2.5-5mlbidAtrovent(IpratropiumUDV0.5mg/2ml):1vialq6hprnEpinephrine(1:1000)：0.01ml/kg/dose(Max0.5ml)q15minSC,.,Xanthines茶鹼類,AminophyllineS.E：nausea,vomiting,insomnia,tachycardiaLoadingdose：5(26)mg/kg/doseivdripfor2030min;Maintain：1mg/kg/hrInfants=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/hrApneaofprematurity：46mg/kgiv30min,thenmaintaince:1.53mg/kg/doseivq8-12h,.,Xanthines茶鹼類,Ventol:3ml/kg/dayqidAminophyllinetab.：200mg/tabpoqid;dose=ivform,.,Steriods類固醇,Decadron：0.1mg/kg/doseimq8h.Rinderon(4mg/ml):0.1mg/kg/doseim,ivq8hPrednisolone(5mg/tab):12mg/kg/daypoqdqid;max:4#8#(2040)mg/dayfor35day.40kg給Pulmicort(steroid,200mcg/dose)：12puffbidfor3monthforpreventasthma(可有效預防氣喘再發),.,Urticaria蕁麻疹,Benadryl(Diphenhydramine):1mg/kgIMDecardon(Dexamethasone):0.1mg/kg/doseIMPeriactintab：普通劑量poqid.Prednisolone(5mg/tab.):12mg/kg/day,.,Antidiarrheals,digestivesandantiflatulents止瀉、消化、消氣劑,Kaopectin：6mons：3poqid（嚴重再給）6mons6Y/O：5poqid6Y/O：10poqid.Biofermintab：普通劑量2poqid.Simethiconetab：普通劑量poqid.Bismuth:普通劑量poqid.,.,Antiemetics止吐劑,Motilium(10mg/tab)：普通劑量poqid.Prepulsid：0.10.2mg/kg/dosepoqidNovamineorPriperammaycauseEPSEPS：Akineton=Biperidine(1#=2mg;5mg/1cc/amp)Adult：2mgper30min.max4vial(20mg),.,Laxatives輕瀉劑,Glycerineballenema：0.51#qdMgOtab：普通劑量poqid.Ducolax(Bisacodyl5mgtab)：612yo1#post.Cascara(Cascarasagrada)：12#poqhs,.,Anticonvulsants抗痙攣劑,Valium(Diazepam)(10mg/2/amp):5y/o:thesameasaboveexcept(max10mg)adolescents:5-10mg/dose;max:30mg.Neuropam(Lorazepan)(2mg/ml/amp);中效(10-15hrs)：0.03-0.1mg/kg/doseq1520min2dosemax:4mg/dose,.,Anticonvulsants抗痙攣劑,Dilantin(phenytoin)(250mg/5cc/amp)：Loading1020mg/kgivwithrate1mg/kg/min,max50mg/min,Maintain5mg/kg/dayivq12h,(不可加於Glucosesolution)Luminal(Phennobarbital)(100mg/cc/amp;32mg/1#)Loading20mg/kgivwithrate30mg/min;Maintain5-10mg/kg/daytoachieveserumlevel40ug/mlChloralhydrateenema(10%30ml)：Neonates:25-50mg/kg/dose,Children:25-100mg/kg/dose1/23/4BWccenema,.,Antibiotics抗生素,Penicillin:Bctereimia:2.5-5;Meningitis7.5-10;infection10-25(單位：萬u/kg/doseq4-6h)Ampicillin:IV100mg/kg/day,q6h.AmoxicillinCap(500mg):(Ac.tonsillitis,AOM)HiconcilCap(250mg)=50mg/kg/dayq8h.Amoxicillinsyrup=BW/2poq8h.Augmentin(amoxicillin+clavulanicacid,375mg/1#,600mg/vial):BW/2poq8h.,.,Antibiotics抗生素-Cephalosporins頭芽孢素,Cephazolin(Veterin):IV100mg/kg/day,q6h.Keflex(250mg/1#,Cephalexin1,Ceflexin500mg/1#):25-50mg/kg/daypoq6hforG(+).Keflor(2Cefaclor,250mg/1#,125mg/5cc/60cc/susp)50mg/kg/dayq8h.;BW/2q8h.(AOM)Zinacef(2Cefuroxime,250mg,750mg):2mg:250mg/dosepobidZinnat(2Cefuroxime,25mg/ml)AOM:2y/o10mlq12hCommoninfection:5mlq12hRocephin,Syntrix(3Ceftriaxone500mg/5cc/vial):50-100mg/kg/dayivq12h-qd;Meningitis:100mg/kg/dayq12h(max:4g/day)Prostaphlin(Oxacillin):IV100mg/kg/day,q6h.(Cellulitis),.,Antibiotics抗生素-Macrolides,Erythromycin(Mycoplasma,Chlamydia,Legionella)Erythrocinsyrup(40mg/cc)：BW/4ccpoq6hIlosone(250/1#):30-50mg/kg/dayq6h.(20kg1#qid,40kg2#qid)Zithromax(Azithromycin,250mg/1#,200mg/5cc/susp)child:1#qd*3day(40kg:2#)Zithromaxsyrup：BW/4ccpoqd*3daysKlaricid(Clarithromycin,250/tab):Adult12#pobid;Child:7.5mg/kgbid,.,Antibiotics抗生素-UTI,Nitrofurantoin(Ninru,100mg/1#)：57mg/kg/day,poqid(UTI),Adult:1#poqid.Prophylacticdose:1/31/4therapeuticdoseAzactam(Aztreonam1g/inj):90-120mg/kg/dayivq6-8hforG(-)andPseudomonasMycostatin(50萬u/1#):forCandida(Oralthrush):Infant:2/5#(20萬u)/doseq6hChild:1#(40-60u)/doseq6hBaktar(TMP-80+SMX-400):6-12mg/kg/daypoq12h(Contraindication1y/o;0.075-0.15mg/kg,slowIV,repeattwiceq15m,.,其他特殊用藥,Aspirin(500mg/13):Analgesic:10-15mg/kg/dosepoq6-8hAnti-rheumatic:65-100mg/kg/daypoq6-8hKawasakidisease:100mg/kg/daypoq6hIndocin:Dose:No.1No.2No.37days-5,.,其他特殊用藥,Lasix(40mg/1#,20mg/2cc/inj):1-2mg/kg/doseq6-12hMannitol(60mg/20%/300cc):0.5-1.0g/kg/doseivfor30minInsulin:DKA:0.05-0.1u/kg/hrivdrip,maintain：0.5-1u/kg/day/SCGlucoseintoleranceinprematurity:0.01-0.1u/kg/hr.DifflamAnti-InflammatorySpray（得伏寧消炎噴液劑）成份：每mL含BenzydamineHydrochloride15mg作用：Benzydamine為一抗炎止痛劑，可舒解口腔及咽喉疼痛。用法：直接噴5-10次於疼痛和發炎部位，再輕輕吞下，視需要，可每1.5-3小時重覆一次。