Ok Ok Notes Pedia

 

  FLUIDS AND ELECTROLYTES  

Maintenance   Maintenance

MILD   MILD

50

30

D50.3NaCl   D50.3NaCl

 

15 kg. = D5NM  D5NM  

D50.3NaCl   D50.3NaCl

60

Weight

Fluid

D5LRS   D5LRS

(kgs)

requirement

SEVERE   SEVERE

( cc/kg/day)

PNSS   PNSS

40

40

IVF: D 50.3 NaCl 450 cc to run at 56

150

90

8 months old , 9 kgs.

9 kg patient

-57 ugtts/min for 8 hours then refer

9 kgs. x 100 = 900/24

for R/A

=37 to 38 uggts./min or Day

term

preterm

SGA

1 

70

60

60

IVF: D5IMB 500 cc to run at 37 – 38

2 

85

80

90

uggts/min

3 

100

100

120

4 

110

120

150

25 kgs patient  patient 

5 

130

140

180

25 x 60 = 1500 cc/ 24 hours

6 

140

160

210

= 62 – 63 uggts / min or 15 – 16

7 

160

180

240

8 

160

200

240

convert it to gtts divide by 4 = 9 -10 gtts/min

gtts/min IVF: D5NM I L to run at 15 -16

 

1ST day of LIFE use D10 Water

gtts/min

 

2nd day of LIFE use D10 IMB

FLUID RESUSCITATION

 

if patient is feeding with good

< 2 y/o  y/o 

>2 y/o  y/o 

< 10 kgs  kgs 

>10 kgs  kgs 

HGT may use D5IMB  

D10IMB dextroxity

 

  desired – actual

10 - 5 

* if px is feeding regulate IVF at 10

------------------------------ = ------

ugtts/min   ugtts/min

----

* if limit fluid intake by subtracting

= 0.11 0.11  

D highest –D lowest

50 - 5 

Day 1 of life, term, wt = 3kgs

240 cc from

TFR

= 750 – 240 = 510/3 = 170 cc  

Limit fluid intake to170 cc per

3kgs x 70 = 210

shift, pls. provide measuring

= 210/2 = 105

cup.

IVF : Hook to D10 water to release 105 cc/soluset to run at 8 – 9 ugtts

 

Day 2

= BSA x 400

½

urine output  output 

 /min for 12 hours hours x 2 doses

Eg. UO = 600 cc D2 of life , preterm wt.= 1.2 kgs

= 0.5 x 400 + 300

TFR = 80 cc/kg/day

= 500 cc to run at 20-21 ugtts/min

1.2 kgs x 80 = 96 cc COMPUTATION OF MEDICATIONS

IVF = D10 IMB D5IMB 85.5 cc

1. 

Ampicillin (100-200 MKD)  MKD) 

D5050 10.5 cc

 

7 days = q 12 hours  

------------

 

7 days = q 6 hours  

96 cc/soluset to run at 4 uggts/min for 24 hours  hours 

Eg. 3 kgs Px, 3 days term   3 x 100 = 300/2 = 150 mg q 12 hours  

RENAL/CARDIAC PATIENTS  

BSA = square root of wt x ht divided by 3600  3600 

 

Start ampicillin 150 mg q 12 hours  

Eg. Day 1

= BSA x 1500 cc cc  

2.  Pen G Na (100-300 thousand u/kg/D)

= 0.5 x 1500  1500 

100T = Renal/Cardiac

= 750 cc in 24 hours at 31-32

200T = Pneumonia

ugtts/min   ugtts/min

300 T = meningitic dose eg. 10 kg patient

 

  10 x 100,000 = 1,000,000 u/4 = 250 T units q 6 hours eg. Pen G Na 250,000 u q 6 hours hours in a 10 kg px 250,000 x 4 = 1,000,000

5. Amoxicillin (30-50 mkD)  mkD)  Prep: 60mg/0.6ml 100mg/ml 125mg/ml 250mg/ml

u/10 kg = 100,000 UKD

Eg. 10 kg Px

3. Paracetamol (10-20Mkd)  (10-20Mkd) 

dose = wt x TD x denominator/numerator/freq. denominator/num erator/freq. of

Prep:

giving

60mg/0.6 ml drop 100mg/ml

= 10x50x5ml/125mg /3 = 6.6 ml  

120mg/5ml 125mg/5ml

TD = ml given x frequency of giving

150mg/5ml

xnumerator/denominator/wt

250mg/5ml

= 6.6ml x 3 x 125mg/5mg/10

Eg. 5 mos., 6 kg 

= 49.5 mkD

Dose = wt x TD x 1/100 = 6 x 10 x 1/100

6. Cotrimoxazole (5-8 MKD)  MKD) 

= 0.6ml

Prep: 200mg/40mg/5ml

TD = ml given x numerator x

400mg/80mg/5ml susp

denominator/weight

400mg/80mg tab

= 0.6 x 100/1/6=

800mg/1680mg tab 

10 MKD  

EG Px is 10 kgs. 4. Diazepam (0.2 – 0.8 MKd) 

dose = dose  = wt x TD x 5/40/freq. 5/40/freq.

Prep: 10mg/2ml; 10 mg tab

ofgiving

Eg. Px is 10 kg

= 10 x 8 x 5/40/2

IV = 10 x 0.2 = 2 mg IM/IV

= 5 ml

Rectal = 10 x 0.5 = 5 mg / rectum

 

  TD = TD  = ml given x freq of giving x

 



500mg

40/5/wt = 5 x2 x 40 / 5 / 10

 

50MKD q12 PO < 30kgs

 

>30 kgs; adult dose

 

250mh/5ml; 375 mg;





PROCATEROL  

0.25 mg/kg/ dose

 

Eg. 8kgs.

•

•

8 x .25 = 2 ml BID AMIKACIN  

15mkd q8, q12, OD

 

250mg, 500mg/vial





AMINOPHYLLINE  



500mg=250mg; 750mg =

LD 8m/kg IV infusion x



750mg/tab AMOXICILLIN  

50MKD

 

100mg/ml, 125/5, 250/5;





500mg/cap AMOXICILLIN-CLAVULANIC ACID  



50MKd q 8-12 hours

30mins ASPIRIN

 

MD 3ml dose q8

 

25mg/ml amp



 

26.7 mg/5ml, 80mg/5ml



syr









ALLOPURINOL

 

100mkd QID

 

10-15 MKd q4-6 hours

 

30mg, 80mg, 100mg/tab

AZITHROMYCIN



10mkd; TID



10mkd x 3 days PO OD



300mg/tab

   



200/5, 250mg, 500mg/tab

 

10mkd on 1st day then 5

   



AMPICILLIN  

100mkd q6, q12

 

500mg, 1g/vial





mkd on D2-D5

BENZATHINE PEN G AMPICILLIN SULBACTAM 

 

50-100 mkd q6-q8 (IV)

 





 

600,000 u if 2yo: 5ml BID x 3 days



 

65%

6 x doses x wt /RR = mg



terbutaline in 100c 100c D5W @



____cc/hr



Running Rate (RR) = 2 cc/hr

 



RR x 24H = _____ml of

Use

terbu/day



 

PNSS, Fresh Plasma, FFP

 

  Vol of blood to Remove

plasma

ABG’S   ABG’S p H ↓ 

PCO 2 N

HCO 3 ↓ 

Compensate

N

↓ 

↓ 

d Uncompens ated

↓ 

↑ 

N

Compensate d Uncompens ated

N

↑ 

↑ 

↑ 

↓ 

N

Compensate d

N

↓ 

↓ 

vol to give  

Actual Hct – Desired HCT /



actual Hct x blood vol x wt PNEUMONIA PNEUMONIA  – Cough, PNEUMONIA

1. 

Uncompens ated

Metaboli c  Acidosis

Respirat ory  Acidosis

Tachypnea, rales  



DOC: Amoxicillin, CoTrimoxazole

 



Respirat ory  Alkalosis

Alternative: Co-Amoxiclav, Clarithromycin,

 



When to correct Metabolic

Roxithromycin Acidosis o  HCO# 10

 

o

Give the ½ if repeat

If not responding give

ABG still with

cefuroxime, ceftriaxone,

metabolic acidosis

azithromycin 3.  PNEUMONIA VERY SEVERE Pneumonia Severe + Cyanosis, failure to feed, seizure, malnutrition  malnutrition   





 

ET TTUBES  

ET Size = Age (years) +4 / 4

 

ET level – ET size x 3

 

Insertion Distance + Wt + 6







DOC: Chloramphenicol