Table 443. Pediatric Drug Dosages.

Drug
Acetaminophen

Comment
Rectal PO Maximum (per day)

Dosage
40 mg/kg 1020 mg/kg 60 mg/kg 0.1 mg/kg 0.2 mg/kg 12 mg 1.252.5 mg in 2 mL saline 2025 g/kg 13 g/kg/min 5 mg/kg 5 mg/kg 510 g/kg/min 20 mg/kg/day 56 mg/kg 0.50.9 mg/kg/h 50 mg/kg 50 mg/kg 2550 mg/kg 0.751 mg/kg 510 g/kg/min 0.010.02 mg/kg 0.02 mg/kg 0.1 mg 0.030.05 mg/kg 0.5 mg/kg 5 mg/kg 10 mg/kg 520 mg/kg 15100 mg/kg 0.52 J/kg 25 mg/kg

Adenosine

Rapid IV bolus Repeat dose Maximum dose

Albuterol Alfentanil Amiodarone

Nebulized Anesthetic supplement (IV) Maintenance infusion Loading dose (IV) Repeat dose (slowly) Infusion Maximum dose

Aminophylline

Loading dose administered over 20 min (IV) Maintenance dose (therapeutic level: 1020 mg/mL)

Amoxicillin Ampicillin Ampicillin/sulbactam Amrinone Atropine

PO IV IV Loading (IV) Maintenance IV IM Minimum dose Premedication (PO)

Atracurium Bretylium Caffeine Calcium chloride Calcium gluconate Cardioversion Cefazolin

Intubation (IV) Loading dose (IV) IV IV (slowly) IV (slowly) See Table 473 IV

Cefotaxime Cefotetan Cefoxitin Ceftazidime Ceftriaxone Cefuroxime Chloral hydrate Cimetidine Cisatracurium Clindamycin Dantrolene Defibrillation Desmopressin Dexamethasone Dextrose Diazepam Digoxin Diltiazem Diphenhydramine Dobutamine Dolasetron Dopamine Droperidol Edrophonium Ephedrine Epinephrine

IV IV IV IV IV IV PO Rectal IV or PO Intubation (IV) IV Initial dose (IV) Maximum dose First attempt Subsequent attempts IV IV D25W or D50W (IV) Sedation (IV) Three divided doses over 24 h (IV) IV over 2 min IV, IM, or PO Infusion IV Infusion IV Depends on degree of paralysis (IV) IV IV bolus Endotracheal dose Infusion

2550 mg/kg 2040 mg/kg 3040 mg/kg 3050 mg/kg 2550 mg/kg 25 mg/kg 25100 mg/kg 50 mg/kg 510 mg/kg 0.15 mg/kg 20 mg/kg 2.5 mg/kg 10 mg/kg 2 J/kg 4 J/kg 0.20.4 g/kg 0.10.5 mg/kg 0.51 g/kg 0.10.2 mg/kg 1530 g/kg 0.25 mg/kg 1 mg/kg 220 g/kg/min 0.35 mg/kg 220 g/kg/min 5075 g/kg 0.51 mg/kg 0.10.3 mg/kg 0.01 mg/kg 0.1 mg/kg 0.11.0 g/kg/min 0.05 mL/kg in 3 mL saline 0.10.5 mg/kg 25200 g/kg/min 0.15 mg/kg

Epinephrine, 2.25% racemic Esmolol (bolus) Esmolol (infusion) Famotidine

Nebulized IV IV IV

Fentanyl

Pain relief (IV) Pain relief (Intranasal) Premedication (Actiq) Anesthetic adjunct (IV) Maintenance infusion Main anesthetic (IV)

12 g/kg 2 g/kg 1015 g/kg 15 g/kg 24 g/kg/h 50100 g/kg 0.01 mg/kg 1520 mg/kg 0.21 mg/kg 2 mg/kg 0.51 g/kg 0.51 mg 0.01 mg/kg 0.04 mg/kg 100 U/kg 1 mg/kg 1520 g/kg 410 mg/kg 1525 mg/kg 0.020.1 U/kg/h 0.11 g/kg/min 12 mg/kg 610 mg/kg 10 mg/kg 2575 g/kg/min 610 mg/kg 23 mg/kg 0.51 mg/kg 0.50.75 mg/kg 0.25 mg/kg 1 mg/kg 2050 g/kg/min 2550 mg/kg 2g 0.251 g/kg 0.20.5 mg/kg 1 mg/kg

Flumazinil Fosphenytoin Furosemide Gentamicin Glucose Glucagon Glycopyrrolate Granisetron Heparin Hydrocortisone Hydromorphone Ibuprofen Imipenem Insulin Isoproterenol Ketamine

IV IV IV IV IV IV IV IV IV IV IV PO IV Infusion Infusion Induction (IV) Induction (IM) Induction (per rectum) Maintenance infusion Premedication (PO) Sedation (IV) Sedation (IV)

Ketorolac Labetalol Lidocaine Magnesium Mannitol Meperidine

IV IV Loading Maintenance IV (slowly) Maximum single dose IV Pain relief (IV) Premedication (IM)

Methohexital

Induction (IV) Induction (per rectum) Induction (IM)

12 mg/kg 2530 mg/kg 10 mg/kg 24 mg/kg 0.15 mg/kg 7.5 mg/kg 0.5 mg/kg 20 mg 0.10.15 mg/kg 7.5 mg 0.05 mg/kg 5070 g/kg 0.3750.75 g/kg/min 0.20.3 mg/kg 324 g/kg/min 0.0250.1 mg/kg 0.1 mg/kg 0.01 mg/kg 0.040.07 mg/kg 0.53 g/kg/min 0.58 g/kg/min 0.12 g/kg/min 0.1 mg/kg 50 mg/kg 0.1 mg/kg 50,000 U/kg 46 mg/kg 13 mg/kg 520 mg/kg 30 g/kg 110 g/kg 520 mg/kg 0.010.03 mg/kg 1 mg/kg 1 mg/100 U heparin 15 mg/kg

Methylprednisolone Metoclopramide Metronidazole Midazolam

IV IV IV Premedication (PO) Maximum dose (PO) Sedation (IM) Maximum dose (IM) Sedation (IV)

Milrinone

Loading (IV) Maintenance

Mivacurium Morphine Naloxone Neostigmine Nitroglycerin Nitroprusside Norepinephrine Ondansetron Oxacillin Pancuronium Penicillin G Pentobarbital Phenobarbital Phentolamine Phenylephrine Phenytoin Physostigmine Prednisone Protamine Procainamide

Intubation (IV) Infusion Pain relief (IV) Premedication (IM) IV Depends on degree of paralysis (IV) IV Infusion Infusion IV IV IV IV Premedication (IM) Sedation (IV or IM) Anticonvulsant dose (IV) IV IV Slowly IV IV PO IV Loading dose (IV)

Propanolol Propofol Prostaglandin E1 Ranitidine Remifentanil (bolus) Remifentanil (infusion) Rocuronium Scopolamine Sodium bicarbonate Succinylcholine Sufentanil

IV Induction (IV) Maintenance infusion Infusion IV IV IV Intubation (IV) IV IV Intubation (IV) Intubation (IM) Premedication (Intranasal) Anesthetic adjunct (IV) Maintenance infusion Main anesthetic (IV)

1025 g/kg 23 mg/kg 60250 g/kg/min 0.050.1 g/kg/min 0.251.0 mg/kg 0.251 g/kg 0.052 g/kg/min 0.61.2 mg/kg 0.01 mg/kg 1 mEq/kg 23 mg/kg 46 mg/kg 2 g/kg 0.51 g/kg 0.52 g/kg/h 1015 g/kg 56 mg/kg 2530 mg/kg 45 mg/kg 20 mg/kg 0.1 mg/kg 0.10.3 mg/kg

Thipental

Induction (IV) (per rectum)

Trimethoprim/sulfamethoxazole IV Vancomycin Vecuronium Verapamil IV IV IV

Table 18-2 Induction Characteristics and Dosage Requirements for the Currently Available Sedative-Hypnotic Drugs INDUCTIO PAIN ON HEAR BLOOD DRUG N DOSE ONSE DURATIO EXCITATOR INJECTIO T PRESSUR NAME (mg/kg) T (sec) N (min) Y ACTIVITY N RATE E Thiopental 36 <30 510 + 0+ Methohexita 13 <30 510 ++ + l Propofol 1.52.5 1545 510 + ++ 0 Midazolam 0.20.4 3090 1030 0 0 0 0/ Diazepam 0.30.6 4590 1530 0 +/+++ 0 0/ Lorazepam 0.030.06 60120 60120 0 ++ 0 0/ Etomidate 0.20.3 1545 312 +++ +++ 0 0 Ketamine 12 4560 1020 + 0 0, none; +, minimal; ++, moderate; +++, severe; , decrease; , increase. From White PF. Textbook of Intravenous Anesthesia. Baltimore, Williams & Wilkins, 1997, pp. 2746 and 7792.

Table 19-4 Dosage for Fentanyl, Sufentanil, Alfentanil, and Remifentanil During Elective Surgery in Adultsa ANESTHETIC PHASE FENTANYL SUFENTANIL ALFENTANIL REMIFENTANIL Premedication (g) 2550 25 250500 Induction With hypnotic 1.55 0.11 1050 0.51.0 (g/kg) and/or 0.250.5 g/kg/min With 6070% N2O 823 1.32.8 (g/kg) High-dose opioid 50 1030 120 25 (g/kg) +/or 2 g/kg/min Maintenance Balanced anesthesia Intermittent bolus 25100 520 250500 2550 (g) Infusion 0.033 0.0050.015 0.51.5 0.250.05 (g/kg/min) High dose opioid 0.5 2.510 1.03.0 (g/kg/min) 0.050.15 Transition to PACU (g/kg/min) Monitored Anesthesia Care Intermittent bolus 12.550 2.510 125250 12.525 (g) Infusion (g/kg/min) 0.010.2 PACU, postanesthesia care unit. a Doses are guidelines for hemodynamically stable adults. They should be adjusted downward for elderly patients and those with cardiac dysfunction and hemodynamic instability.

Table 71. Partition Coefficients of Volatile Anesthetics at 37c.1

Agent
Nitrous oxide Halothane Isoflurane Desflurane Sevoflurane

Blood/Gas
0.47 2.4 1.4 0.42 0.65

Brain/Blood
1.1 2.9 2.6 1.3 1.7

Muscle/Blood
1.2 3.5 4.0 2.0 3.1

Fat/Blood
2.3 60 45 27 48

These values are averages derived from multiple studies and should be used for comparison purposes, not as exact numbers.