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Drugs 1
Drugs 1
Zahraa)
1- Adrenalin
Injectable forms (ampule) …1mg/1000 (1mg/ml) given IM (anaphylaxis or status asthmatics)
…1mg/10000 (0.1mg/ml) given IV (Resuscitation)
Does (in resuscitation): 0.1 - 0.3 ml/kg (0.01-0.03mg/kg), can be repeated in (10-15 min) up to 3 shoots if
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no response declares patient death
Adrenalin should always be given with flush of (Normal saline) 5cc or even 10cc immediately after
administration of adrenaline to ensure reaching to the heart in cases of bradycardia or asystole
Indication:
1- cardiac arrest 5. Angioneurotic edema
2- anaphylactic shock 6. Stokes-Adams syndrome
3- status asthmaticus 8. Local bleeding (Epistaxis)
4- resuscitation (3 shoots) 9. Symptomatic bradycardia Not res ponding to ventilation and oxygenation
(HR< 60 + apnea endotracheal intubation with cardiac massage (for 15 sec) …if no response give
first shoot of adrenalin (for 15 min) …if no response give the second then the third shoot)
(because in neonate usual cause of standstill respiratory better prognosis when given adrenaline in
resuscitation than adult in whom the problem is usually cardiac)
Example: 3 kg patient and we need (1/10000) preparation what’s the dose and how to give?
3* (0.1 – 0.3) = (0.3 – 0.9) ml … (if we take 0.3) = 30 units in insulin syringe. Each insulin unit = 0.01ml(cc)
, Hypo kalemia،arrythmia
side effects: hypertension, tachycardia, agitation and irritability
Side effects: dry mouth, blurry vision, tachycardia, urinary retention, constipation
2. Apnea of prematurity.
3- Aminophylline 3. Drug induced apnea (Diazepam)
Indications:
4. LVF.
1- Apnea of prematurity (it induces respiratory center)
2- asthma
Advantage: CNS stimulation and reduce pulmonary vascular resistance (effective in pulmonary hypertension)
Preparation: 250mg/10cc
Dose: 5 – 8 mg/kg infused during 30 min (loading) and 1- 2 mg/kg/hr. (maintenance) (Caffeine citrate has less side
effects than aminophylline better in (maintenance))
5- Dexamethasone (Decadron)
Indication:
1-croup
2-status asthmatics
3-meningitis (to reduce complication)
4-angioedema (lifesaving)
6- Prednisone
Indications:
1-asthma
2-anaphylaxis
3- autoimmune diseases (nephrotic syndrome, ITP, SLE, hemolytic anemia)
Tapering (important to avoid relapse especially in nephrotic syndrome) : indicated in any use of
steroid more than 1 week (7-10 days) ..decreasing the dose either by 5mg every 3-5 days or
decreasing by 10mg per week ( the slower the tapering the better the results)
2-guillain barre drug of choice 700mg - 1g /kg/day (shoot) or by 2,3 doses to reduce side
effects
3-immune deficiency 300 – 400 mg/kg
4-Kawaski disease drug of choice
5-autoimunhemolytic anemia newborn with ABO or RH incompatibility (hyperbilirubinemia
and jaundice in first 24 hrs.) give either albumin or Ig ( Ig thought to saturate FC receptor on RBC
which will reduce hemolysis) ….but Ig costly so they use albumin
Indication:
1-acute heart failure
2-fluid overload Over rehydration,edema,hypertension,cerebral edema,
3-Pulmonary hypertension
4-Hyperkalemia
Dose: 1 – 2mg /kg/dose (can reach 8 or 10 in chronic renal failure)
9- Glucose water
Indication: hypoglycemia if symptomatic (fits ,etc.) or 30 > in neonate
Preparations: G/W 5% 500cc
G/W 10% 500cc
G/W 25% 10cc (ampule) each cc = 0.25 g
G/W 50% 20cc (vial) each cc = 0.5 g
10- calcium
Indication:
1-renal failure
2-Symptomatic hypocalcemia (Hypocalcemic tetany,seizure)
3-exchange transfusion (every 100ml because blood can cause hypocalcemia ..it
contain citrate)
4-Hyperkalemia
Hyperphosphatemia,
,Magnesium intoxication,
Alkalosis,
Calcium channel blocker overdose,
Septic shock and blood transfusion .
(when give IV calcium we should ensure the cannula is (IN) because it can lead to tissue necrosis and even limb
amputation in neonate!)
Dose: role of 10 (dose not more than 10cc) ..100- 200 mg/kg
11-Potassium
(normal range:3.5- 5 mmol/l)
Indications:
1-DKA 10- 20 mmol/kg (must given infusion drips not direct and not exceeding 10mg/kg/hr.)
2. Hyperkalemia
Hypochloremia
Indications : 1. Acute attack of epilepsy
2. Febrile convulsion
4. Drug withdrawal
5. Sedation
Side effects: apnea source of O2 must be present (not given to less than 6 months)
Indications :
1. Generalized tonic clonic seizure
2. Partial seizure
3. Migrain phophylaxis
4. Head injury
5. Digitalis toxicity (as an antiarrhythmic)
6-subarchanoid hemorrhage
13- magnesium
Indications:
1-preedclampsia (gynae)
2-status asthmaticus
3-arrythmeia
Dose: 50mg/kg
14- Vit D
Indication: rickets
(avoid large amount of vit D without calcium supplement bone resorption and sever bone pain)
15-Zinc
Indications:
1-diarrhea
2-pneumonia
4-celiac or any severe malnutrition which lead to sever zinc deficiency 1- 2 mg/kg/day
Dose:
10mg/day 0 – 6 months
3-acute sever IDA packed RBC (but if IDA is chronic (the body compensate on low Hb) do not give blood until
Hb=5, instead give iron supplemet)
4-anemia of prematurity packed RBC ( not give blood even when Hb= 7 ,but if pnemonia+IDA+congenital
heart disease and Hb=11 give blood)
Dose:
17- plasma
Indications:
1-immuonodefecency
2-clotting disoreders
3-DIC
18- platelets
Indications:
2-platelets < 50000 with bleeding from vital organ ( intracrinal, GI)
20%
Dose:
21- ceftrixone
Indications:
(prolong use of antibiotic dirrhea (pseudomembrance colitis) we shold stop the medication )
23- Amoxicilin
Oral syrp: 125, 200, 250, 400 mg/5ml
Flagyl
Antipyrol
Plasil
Allermine
Buscopan
Ventolin
Zantac
Pentostam
Digoxin
Sodium bicarbonate
Cyklokapron
Vit K
Insulin
Glucagon