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Common Medications Used in Paediatrics: Antipyretics
Common Medications Used in Paediatrics: Antipyretics
Antipyretics
Mechanism Available
Drugs Dose Remarks
of action dosage forms
Paracetamol Centrally acting • Tablet PO / IV: To be used with
analgesic and • 10 - 15 caution in patients
antipyretic with • Syrup mg/kg/dose with hepatic
minimal anti- Q4-6H impairment
inflammatory • Injection
properties
• Suppository PR / Suppository: Hepatotoxicity
• 10 - 20 with over-doses
Inhibits mg/kg/dose
formulation and Q4-6H
release of
prostaglandins in
the CNS Max doses:
• PO / PR: 90
mg/kg/day
Inhibits
endogenous • No more than
pyrogens at the 5 doses per
hypothalamic day
thermosregulator
centre • IV:
60 mg/kg/day
(< 2 years),
75 mg/kg/day
(> 2 years)
1
Ibuprofen Exhibits • Tablet 5 – 10 mg/kg/dose Common side
analgesic and Q6-8H effects include
antipyretic • Syrup gastric discomfort,
activities by Max dose: hence
inhibiting 40 mg/kg/day recommended to
prostaglandin be taken after
synthesis Usual adult food
max: 1.2 g/day
(OTC max)
To be used with
caution in patients
Diclofenac • Tablet 1 mg/kg/dose Q8-
with renal
12H
impairment /
• Suppository
nephrotoxic drugs
Max dose:
3 mg/kg/day
Not commonly
Usual adult
used in oncology
max: 150 mg/day
patients, patients
with dengue fever
Ibuprofen: Fewer
side effects than
other NSAIDs but
also has weaker
anti-inflammatory
properties
2
Antihistamine
• Fexofenadine
Note: Promethazine is
• Desloratadine contraindicated in < 2
years old due to potential
• Loratadine for fatal respiratory
depression
3
Drugs Available Usual doses Max dose (Usual) Age
dosage limits
form
1st Generation
Chlorpheniramine • Syrup 0.35 mg/kg/day 0.35 mg/kg/day > 6 months
Q6-8H
• Tablet Usual adult max:
24 mg/day
Promethazine • Syrup 0.2 - 0.5 Usual adult max: > 2 years old
mg/kg/dose 10 - 25 mg Q6-8H
• Tablet Q6-8H
2nd Generation
Cetirizine • Syrup 6 - 12 months: 2.5 mg once daily > 6 months
2 - 5 yr: 5 mg/day
4
Fexofenadine • Syrup 6 mth - 2 yr: 15 180 mg/day > 6 months
mg BD
• Tablet
2 - 11 yr: 30 mg
BD
> 12 yr: 60 mg
BD
1 - 5 yrs old:
1.25 mg
6 - 11 yrs old:
2.5 mg
5
Mucolytics
Mechanism of Available
Drugs Dosage Remarks
action dosage forms
Acetylcysteine Exerts mucolytic • Oral sachet 2 - 6 yrs = 1 Common side
/ action through its (100 sachet effect would be
Carbocysteine free sulfhydryl group mg/sachet) cough, usually
which opens up the > 6 yrs = 2 would advise
disulphide bonds in • Effervescent sachets patient not to
the mucoproteins tablet (600 Q8-12H take to near
thus reduces sputum mg/tab) bedtime.
viscosity Usual adult
max:
600 mg once Contraindicated
daily in children
below 2 years
old (risk of
Bromhexine Increases the • Syrup 0.15 - 0.2
aggravation of
production of serous mg/kg/dose
respiratory
mucous in the • Tablet Q8H
symptoms
respiratory tract and
including
makes the phlegm Usual adult
obstruction)
thinner and less max: 24
sticky. In turn, it mg/day
helps the cilia to
transport the phlegm
out of the lungs.
6
Topical decongestants
Topical decongestants can be used for short duration in acute illnesses to relieve nasal
congestion.