Pediatric Primary Care (139 page)

APPENDIX G

Asthma Management Plan

APPENDIX H

Pediatric Dosage Schedules

APPENDIX I

Pediatric Medications

ACYCLOVIR-ANTIVIRAL

Brand Name

Zovirax, Avirax

Uses

Antiviral, used to treat initial and recurrent episodes of mucocutaneous herpes simplex virus (HSV-1 and HSV-2) infections in immunocompromised patients; varicella (chickenpox) infections in immunocompromised patients; acute herpes zoster infection in immunocompetent patients; herpes simplex encephalitis.

Availability

Suspension: 200 mg/5 mL. Tablets: 400 mg, 800 mg. Capsules: 200 mg. Injection: 500 mg/vial, 1 g/vial. Cream, Ointment.

Indications/Routes/Dosage

Varicella infection in immunocompromised patients: Children age 12 years or older: 800 mg PO q4h (5 times/day while awake) for 5 days. Children age 2 years or older and weighing < 40 kg: 20 mg/kg (max: 800 mg/dose) PO qid for 5 days.

Acute herpes zoster: Children age 12 years or older: 800 mg PO q4h (5 times/day) for 7-10 days.

Genital herpes (initial episode): Adults: 200 mg q4h (5 times/day) for 10 days.

Genital herpes (recurrent episode): Adults: 200 mg q4h (5 times/day) for 5 days.

Usual topical dosage: Adults: 3-6 times/day for 7 days.

Labial herpes: Apply cream to affected area 4-6 times/day for 10 days; apply ointment q3h 6 times/day for 7 days–use glove or applicator stick to apply.

Adverse Reactions

Malaise, headache, encephalopathic changes, nausea, vomiting, diarrhea hematuria, acute renal failure, thrombocytopenia, leukopenia, rash, itching, urticaria, inflammation or phlebitis at injection site.

Implications

  May increase blood urea nitrogen (BUN) and creatinine levels. May decrease white blood count (WBC) and increase or decrease platelet count.

  Use cautiously in patients with neurologic problems, renal disease, or dehydration. Monitor renal function.

  Drink adequate fluids, do not touch lesions with fingers to prevent spreading infection to new site, use finger cot or rubber glove to apply topical ointment.

  Avoid sexual intercourse while lesions present to prevent spread to partner.

ALBUTEROL–BRONCHODILATOR

Brand Name

Ventolin, Proventil

Uses

Relaxes bronchial, uterine, and vascular smooth muscle, to prevent or treat bronchospasm.

Availability

Aerosol inhaler: 90 mcg/metered spray, 100 mcg/metered spray. Albuterol sulfate: Capsules for inhalation: 200 mcg. Solution for inhalation: 0.083% mg/mL, 0.5% mg/ mL, 0.63 mg/mL, 1.25 mg/3 mL. Syrup: 2 mg/5 mL. Tablets: 2 mg, 4 mg. Tablets, extended-release: 4 mg, 8 mg.

Indications/Routes/Dosage

Prevention/treatment of bronchospasm in patients with reversible obstructive airway disease: Aerosol inhalation: Children 4 years old or older: 1 or 2 inhalations q4-6h. Capsules for inhalation: Children 4 years old or older: 200 mcg inhaled q4-6h. Solution for inhalation: Children 12 years old or older: 2.5 mg tid or qid by nebulizer. Children 2 -12 years old: initially, 0.1-0.15 mg/kg by nebulizer, with subsequent dosing titrated to response, not to exceed 2.5 mg tid or qid by nebulization.

Syrup or oral tablets: Children 2-6 years: initially, 0.1 mg/kg PO tid. Starting dose should not exceed 2 mg (1 tsp) tid. Do not exceed 4 mg tid. Children 6-14 years: 2 mg PO tid or qid. Do not exceed 24 mg daily. Adults, children 14 years old or older: 2-4 mg PO tid or qid. Do not exceed 8 mg qid.

Extended-release tablets: Children 6-12 years old: 4 mg PO q12h. Adults, children older than 12 years: 4-8 mg PO q12h.

To prevent exercise-induced bronchospasm: 2 aerosol inhalations 15 -30 min before exercise.

Adverse Reactions

Nervousness, dizziness, headache, weakness, insomnia, nasal congestion, hoarseness, tachycardia, hypertension, nausea, vomiting, heartburn, increased appetite, hypokalemia, muscle cramps, bronchospasm, cough, increased sputum.

Implications

  Use caution in patients with diabetes mellitus, hypertension, or hyperthyroidism.

  Teach family how to use inhaler properly.