Short notes on ped. Drugs م. الخولى على/ وترتيب جمع الكوم بشبين الجامعة بمستشفى عامة باطنة ط

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

1) Abs : 1- penicillins :a) neutral penicillins : mainly for gm+ve , but not anti-staph--penicillin G : R/ penicillin G vial (1 million unit ) 50,000-100,000 unit/kg/d IV/IM divided in 4 doses Rarely used nowadays--penicillin V : R/ ospen susp/ tab rarely used nowadays--benzathine penicillin : R/ durapen-s / retarpen / pencitard LA vialb) broad spectrum penicillins :--ampicillin ( 50-100 mg/kg/d ) : R/ ampicillin 250/500/1gm vial -- 250 susp May cause some diarrhea ( most doctors prefer amoxicillin )--amoxicillin (50-100 mg/kg/d) : R/ amoxil- Emox 250/500/1gm vial – 250 susp--ampicillin sulbactam (50-150mg/kg/d) : R/ unictam-unasyn-sulbin 375/750/1000/1500 vial Measure dose according to ampicillin dose which is 250/500/750/1000 Susp form is not very effective--amoxicillin clavulinic : ( 50-100 mg/kg/d ) R/ hibiotic-N 230/460 susp ( amoxicillin dose is 200-400) R/ emoxclav – augmentic - curam 156/312 susp ( amox. Dose is 125/250 R/ deltaclav 228/457 susp ( not very good )--amoxicillin flucluxacillin : ( 50-100 mg/kg/d ) R/ flummox 500/1gm vial – 250 susp2- cephalosporins : a) 1st G : mainly for gm+ve ( 50-100 mg/kg/d ) R/ velosef 250/500 vial R/ duricef 250/500 susp ( the only susp form with 500 mg dose ) R/ ibidroxil—biodroxil 250 suspb) 2nd G : broad spectrum but expensive ( 50-100 mg/kg/d ) R/ zinnat 750 vial R/ bacticlor 250 suspc) 3rd G : mainly for gm-ve ( 50 mg/kg/d) R/ cefotax 250/500/1gm vial ( every 12 hrs ) R/ ceftriaxone 500/1gm vial ( every 24 hrs ) R/ suprax 100 susp ( 10mg/kg/d single daily dose) very expensive3- macrolides : mainly for gm +ve and some gm-vea) erythromycin : (50mg/kg/d) : R/ erythrocin 200 susp ( every 8 hrs )b) clarithromycin : ( 15mg/kg/d ) R/ klacid 250 susp (20 LE ) ( every 12 hrs )c) azithromycin : (10mg/kg/d) R/ zithrokan-zisrocin-zithromax 100/200 susp (every 24 hrs )

اليوم فى واحدة مرة ساعة 1/2ب االكل او الرضاعة قبل الريق على الجرعة **most commonly used : R/ amoxil susp/vial – R/ unictam vial – R/ hibiotic susp – R/ flummox vialR/ velosef vial – R/ duricef susp – R/ cefotax – ceftriaxone vialR/ zithrokan – zisrocin susp** some additional notes :--all Abs in susp form are 250mg except Duricef 250 and 500 susp--all Abs in ped are given 50-100mg/kg/d except Ampicillin sulbactam 100-150 mg/kg/d 3rd G cephalosporins 50 only/kg/d Clarithromycin 15 mg/kg/d Azithromycin 10mg/kg/d--all Abs are in ped. The daily dose is devided twice daily except Erythromycin 3-4 times Azithromycin single daily dose Ceftriaxone vial single daily dose

**how to measure dose :-- Each AB is named according to dose in the whole vial and the dose in 5cm of suspe.g. flummox 500 vial → the whole vial contains 500 mg amoxil 250 susp → each 5cm contains 250 mgexcept penicillin combinations as previous. -- the dose is measured according to wt of the pt e.g. 50mg/kg/d : if pt is 10 kg so the dose is 50*10= 500mg/d e.g. amoxil 250 susp for apt 10 kg1- 50*10=500 i.e. 500 mg / day2- amoxil 250 means 5cm = 250 mg 3- I need 500 mg / d so I need 10 cm / d4- if the dose is devided as here so I will give the child 5cm each 12 hrsAnd so on……………..For easy measuring : most Abs are 50 mg/kg/d so 5 kg needs : 250 mg/kg/d 10 kg needs : 50015 kg needs : 75020 kg needs : 1000

1000-800 ياخد كيلو 18و 600-500 ياخد كيلو 12 يعنى منها القريبة الجرعة اديلها االخرى واالوزان

The wt in kg = age in yrs * 2 + 8 السنة فوق لالطفال ودى e.g. 3 yrs child is 3*2 = 6 , 6+8=14 kg 5 yrs is 5*2=10 , 10+8 = 18 kg

متنساش عشان تقريبا االوزانBirth 3-3.5 kg اقل ليكون تسال الزم بس

3 mo 4.5-5 kg6mo 6-7 kg8mo 8kh10mo 9-9.5kg1yr 10-11kg2yrs 12kg3yrs 14kg4yrs 16kg5yrs 18kg6yrs 20kg

2) Antivirals وهى جدا بسيطة حاالت فى اال هتحتاجها مش ودى

Herpes simplex genral infection, herpes zoster, viral gingivostomatitis *acyclovir ( 20mg/kg/d) 1 or 2 dosesR/ lovir 400 tab ( 10 LE ) مرتين او واحدة مرة ويعطى عصير او ماء كوب 1/2ى فى ق½ اغو ق يذاب

الوزن حسب اليوم فى R/ zovirax 200 susp ( 40 LE)R/ zovirax 200-400 tab ( 30 LE )

3) Antifungals : a) local : R/ oracure– miconaz – micoban oral gel for oral candidiasis and aphthous ulcers

يوميا مرات 3 واللسان واللثة للفم دهان R/ miconaz – candistan cream يوميا مرات 3 للجلد دهانb) systemic : ( 5mg/kg/d ) rarely used in severe systemic fungal infection R/ diflucan 50 syrup/ 50 cap R/ fungican 150 cap ( 5mg/kg/d single oral dose )

4) Antiprotozoal : for amoeba and giardia ( 50 mg/kg/d) devided in 3 dosesR/ flagyl 125/200 susp ايام 10 لمدة مرات 3 االكل بعد الجرعةR/ flagyl 250/500 tab 1*3*10R/ fladazole 500 tab ( single oral dose ) 4 الغداء بعد واحدة مرة بالفم ق

5) Antihelminths : R/ bendax 100 susp 5 اخرى ايام 3 لمدة ايام 10 بعد ويكرر ايام 3 لمدة والعشا الفطار بعد سمR/ bendax 200 tab ايام 10 بعد ويكرر ايام 3 لمدة والعشا الفطار بعد ق

البلهارسيا ماعدا الديان انواع لمعظم ينفع ودهR/ epiquantel 600 susp ( 40 mg/kg/d ) single oral doseR/ betricide 600 tab ( 40 mg/kg/d ) single oral dose

6) Antipyretics anti-inflammatories : a) paracetamo : ( 15 mg/kg/dose 3-4 times daily )i.e. ( 50 mg/kg/d) R/ cetal 100 drops ( 2drops/kg/dose 3-4 times daily ) R/ cetal 125 supp R/ paramol 125 syrup

R/ cetal 250 syrup R/ cetal 500 tab R/ perfalgan vial ( 10mg/1ml i.e. 50mg/5ml ) vial = 100 ml i.e. 1000mg/vial Given only IV infusion with IV fluids or very slowly IV injection Dose for children < 10 kg is 7.5 mg/kg/dose 3 doses/d ( max 60mg/kg/d) Dose for children > 10 kg is 15 mg/kg/dose 3 doses/d (max 690mg/kg/d)b) ibuprofen : ( 50mg/kjg/d ) R/ brufen 100 syrup – 200/400/600 tabc) combination of paracetamol and ibuprofen : R/ cetafen – megafen susp ( 100 brufen+ 160 paracetamol ) R/ cetafen – megafen tab ( 200 brufen + 325 paracetamo )d) diclofenac/ketoprofen : 1mg/kg/dose 2-3 times daily ( better to be avoided in children < 1 yr ) R/ dolphin-k drops ( 2 drops/kg/dose) R/ dolphin 12.5 supp ( 1-3 yrs) 25 supp ( 3-5yrs ) 50 supp ( 5-10 yrs) K ( 75 ) ( ≥ 10 yrs ) R/ dolphin-k – cataflam – ketofan - ketolac 50 tab R/ dolphin-k – ketofan - ketolac ampe) nimesulide : 2mg/kg/dose 2-3 times daily R/ sulide 50 susp R/ sulide 100 tabf) meloxicam : 0.5mg/kg/dose 1-2 doses daily R/ anticox ∏ 7.5 cap/ 15 tab ** most commonly used :Cetal- paramol – paracetamol – pyral ( very safe and good drugs )( given for any age )Dolphin supp ( very effective but better avoided before 1 yr age )Ketofan – ketolac amp ( for older children ≥ 10 yrs )

7) Resp. sys. Drugs : a) nasal decongestants : -- nasal drops : ايام 5-3 لمدة اليوم فى مرات 3 دقايق 10ب الرضاعة قبل انف كل فى نقطتين فقطNot given > 5 ds as it will cause dryness and inf of the noseR/ otrivin – balkis NDR/ otrivin baby ND (it’s just saline for nasal washing i.e. not decongestant)-- oral : not used if with bronchitis as it ↑ dryness of bronchi and coughR/ rhinostop OD 1drop/kg/dose 3 times daily R/ sine-up – balkis – congestal suryp ( 1ml/kg/d) 3 times dailyN.B. congestal not given before 1 yr ageR/ congestal 500 tab

b) cough suppressants : for dry non productive cough as severe bronchitis and early pneumoniaR/ cyrinol – cough cut syrup ( 1 ml/kg/d ) 3 times dailyR/ selgon drops ( 1drop/kg/d) النوم قبل واحدة جرعةR/ selgon ing supp النوم قبل واحدة لبوسة**selgon is used only in severe cases non responsive to syrup forms as it acts on brain centerc) mucolytic expectorants : for productive cough الصدر على بلغمR/ toplexil – bronchophane – bisolvon – muco surup ( 1ml/kg/d ) 3 times dailyR/ bisolvon tab – bisolvon ampd) bronchodilators : for asthma and bronchiloitis--salbutamol : ( not effective before 1.5 yrs ) ( short time of action 4-5 hrs )R/ salbovent – farcolin syrup ( 1ml/kg/d ) 3 times dailyR/ farcolin nebulizer solu ( for nebulizer )--theophylline : very effective for any age, long time of action 12 hrs but dangerous if overdose it may cause arrhythmia ( 20 mg/kg/d) ( max 600 mg/d)R/ minophyllin-N 125 ampR/ minophylline 300/500 amp ( with IV fluids or very slow IV inj. Over 10-15 min)R/ etaphylline 100 syrup ( 1ml/kg/d) 3 times daily R/ etaphylline – minophylline ped. Supp ( 100 mg) يوميا النوم قبل لبوسةR/ etaphylline – minophylline 500 adult supp R/ quibron-T SR tab ½ والعشا الفطار بعد قR/ foradil diskus ( formeterol : long acting β2 agonist ) for older children with asthmae) combinations :R/ allvent syrup ( terbutaline + expectorant ) الحاالت لمعظم تكتبه وممكن ممتازR/ farcosolvin ( theophylline + expectorant ) قوى وحش طعمه بس معقول يعنى** all syrup forms dose is 1 ml/kg/d ** most commonly used : R/ otrivin ped – balkis ND/syrup – congestal syurp/tabR/ cyrinol – bronchophane – etaphylline – allvent syrupR/ selgon supp – etaphylline supp

8) Digestive sys.: a) antiacids :R/ mucogel – farcogel – epicogel susp اللزوم عند او مرات 3 االكل قبل ملعقةR/ zantac – ranitidine 150/300 tab والعشا الفطار قبل قR/ rani eff اللزوم عند او والعغشا الفطار قبل ماء كوب½ على فوار كيسb) antiemetics :--metoclopramide : ( 0.5mg/kg/d) oral,rectral,IV,IMOverdosage : torticollis, eye rolling, facial spasms ووجهه احولت وعنيه اتعوجت رقبته الواد هتالقى بيرعشAntidote for overdose : R/ phenergan syrup ( 0.5 ml/kg single dose and stup metoclop.R/ primperan amp ( 10mg/2ml) i.e. 0.1 ml/kg/day i.e. 1ml/10kgR/ primperan tab (10mg/tab)

R/ primperan ing supp ( 10mg/supp)R/ primperan adult supp (20mg/ supp)R/ primperan syrup (5mg/5ml) i.e. 0.5ml/kg/d 2-3 times dailyR/ primperan drops ( 1drop/kg/dose) 2-3 times daily--vit. B6 :R/ cortigen B6 50 amp ( for children < 10 yrs) اللزوم عند او ساعة 12 كل عضل حقنةR/ cortigen B6 100 amp ( if > 10 yrs )** very safe , very good , and with no SE-- domperidone :R/ motileum – motinorm susp (1ml/kg/d) 3 times dailyR/ motileum – motinorm tab ساعة 12 كل ق--chlorpromazine:only in severe cases not responsive to previous as it acts on brain centersUsed for adults and older children only > 10 yrsSE : sedation, disturbed consciousnessR/ neurazine 25 amp اللزوم عند عضل حقنةR/ neurazine 25 tab يوميا النوم قبل قc) spasmolytics : R/ sapsmotal drops ( 2drops/kg/dose) 3 times daily ( ≤ 1 yr )R/ spasmin in supp ( 1-5 yrs)R/ buscopan – visceralgin ( 0.5 mg/kg/d) Syrup (5mg/5ml) Tab (10mg/tab) Amp(20mg/1ml)d) antidiarrheal :R/ kapect – smechta – diax – streptoquin susp 3-5 الحالة حسب على يوميا مرات 3-2 سمR/ diax – streptoquin – enteroquin – entocid tab ومساء صباحا ق R/ aquaream-Z syrup ( zinc) 5 االسهال انتهاء بعد ايام 10 لمدة يوميا الفطار بعد سم WHO : zinc supplement for 10 ds after diarrhea to replenish body storese) laxatives :R/ lactulose – laxolac syrup 0.5ml/kg/d 2-3 times dailyR/ picolax drops ( 1drop/kg/single daily dose) يوميا النوم قبلR/ glycerine inf/adult supp اللزوم عند او دقايق 10ب الحمام قبل لبوسةR/ bisadyl inf/adult suppR/ enemax enema

**most commonly used :R/mucogel susp – R/ rani effR/cortigen – primperanR/ buscopan – spasminR/ diax – kapectR/ picolax – glycerine

9) Antihistaminics : all them 0.5ml/kg/d

**better avoided before 2 yrs except fenistil can be given for severe casesa) highly sedatives : R/phenergan syrup (0.5ml/kg/d) 3 times dailyb) moderately sedatives : R/ fenistil syrup (0.5ml/kg/d) 2 times daily

R/ fenistil oral drops (2drops/kg/d) 2 times dailyc) non sedatives : R/ histaminal syrup/tab 2 times daily

R/ histazine-1 syrup/tab 1 time daily يويما النةم قبل الجرعة R/ evastine syrup/tab 1 time daily

10) vitamins and iron: a) iron : --prophylactic dose : 15mg/day for 1 mo.--therapeutic dose : 6mg/kg/d for 1mo.--in ttt of anemis give therapeutic dose for 1mo. Then prophylactic dose for 2mo.R/ fer-in sol drops (dropper = 15 mg) مج 15 تاخد تتملر لما القطارةR/ sytron syrup (27.5mg/5ml)R/ ferose syrup (50mg/5ml)R/ ferose tab (100mg/tab)R/ haemoton – haemacaps cap ( 350mg/cap)

شهرين لمدة يوميا الفطار مع الجرعة نصف ثم شهر لمدة يوميا واحدة مرة الفطار مع الجرعة تعطى التحليل تعيد ثم

b) vit D & Ca:R/ decal B12 – pedical – hical – calcical syrup (400 IU vit D + 50 mg Ca)R/ devarol amp ( for shock therapy of rickets شهور 3 لمدة شهر كل عضل حقنة (--prophylactic dose : 5 اليوم فى واحدة مرة الفطار بعد سم--therapeutic dose in rickets : 20-30 (3 االكل بعد سم10-5) اليوم فى سم مرات c) multivit. :R/ bebe-vit drops رضعة اول بعد يوم كل القطارةR/ fruital syrup 5 يويما الفطار بعد سمR/ chewa vit tab يوميا الغدا بعد يمضغ قR/ supravit tabR/ vitamount males/females/pregnant/stress cap يوميا الفطار بعد ك

11) topical drugs : a) soothing agents :**for napkin dermatitis:R/ zinc oxide 10% ointR/ babay cream **for pruritis and rashes:R/ calamine lotion الهدوم بيبقع انه عيبهR/ bringo lotion الهدوم ومبيبعقشى ممتازb) antimicrobials :--fuscidic acid is best antistaph : R/ fusiderm oint--gentamycin is commonest used : R/ garamycin cream/oint--terramycin is not used before 8 yrs : R/ terramycin topical oint

c) antifungals :R/ daktarin – miconaz – candistan topical creamsd) antiparasitics : ( anti scabies )scabies ttt : hot bath + brushing body with soft brush then put lotion allover the body except head and neck , then put lotion in 2nd day without bathing , then put it again in 3rd day without bathing, then in the 4th day morning hot bath and soft brush.R/ benzanil 25% lotionR/ scabine 1% lotionR/ prioderm 0.5% lotion

12) topical steroids : indications : severe allergic & inflammatory conditions e.g. severe napkin dermatitis, severe itching, infantile eczema.Contraindic : viral infection e.g. chicken pox, herpes simplex, & TB or syphilis**creams are used for acute wet lesions, oint. For chronic dry lesions**use steroids as short as possible R/ hydrocortisone cream ( weak but safe )R/ kenacort – betaderm ( strong but ↑ SE )Combinations : steroids + antimicrobial +/- antifungalR/ polyderm – triderm – mixderm for monilial inf, severe napkin dermatitisR/ kenacombR/ fusicort

13) ear preparations : R/ otocalm ( for ear pain ) used in otitis media or externaR/ otosept ( antiseptic ) for externaR/ otophenicol – cipro ED ( AB for inf )R/ remowax ( wax softner )

14) eye prep : R/ ocuphenicol – cipro – tabrin ED ( AB ) for inf e.g. conjunctivitisR/ boric acid lotion 2% للعين غسول R/ terramycin – garamycin eye oint. R/ tobradex ED ( tobrin + dexamethasone ) for allergic conjunctivitisR/ prisoline ED ( decongestant + antihistaminic ) for allergy or allergic conjunctivitis

تعديل او نصيحة او استفسار واى دعائكم صالح من تنسونى ال

Alyelkholy87@yahoo.comFacebook : Aly mohammed