**6.4.22 Heparin**

*Uses:* Preventing blood clots, the risk of their formation is increased, e.g. after surgical procedures in acute myocardial infarction. Heparin is also used to treat blood clots in the legs and lungs in congestion of the arteries. The use of heparin also gives good results in the treatment of frostbite and burns (Young & Mangum, 2010). Prevention of peripheral and central catheters from congestion. Its use in renal vein thrombosis is still a matter of discussion (Kanmaz, 2010).

*Dose:* IV for each ml of liquid 0.5-1 Unit

For thrombosis treatment 70 Unit/kg bolus in 10 minutes, 28 Unit/kg/hour continuous infusion (Young & Mangum, 2010). 75 units/kg bolus over 19 minutes.

*Adverse Effects:* Side effects in the form of bleeding occurs in approximately 10% of patients. >1/100 Bleeding. A decline in platelet count. Changes in the functions of the liver. <1/1000 Allergic reactions, allergic shock. Disturbances in the function of the adrenal cortex. Hair loss (Young & Mangum, 2010).

*Preparation:* Added onto the solution as half of the total.

*Miscible Serums:* SF, 5% DX, 10% DX

*Drugs to be confronted at the end point:* Dex/Amino acid mixture, Acyclovir, Amphotericin B, Ampicillin, Calcium gluconate, Cefazolin, Cefepime, Cefotaxime, Ceftazidime, Ceftriaxone,

The Administration and Dose of Most Frequently Used Drugs in Pediatrics 327

*Adverse Effects:* The most common side effects are nausea, vomiting, diarrhea, stomach discomfort, heartburn, rash, headache, dizziness and drowsiness (Young & Mangum, 2010).

*Uses:* Restricted to treatment of no-CNS infections caused by bacteria, primarily Enterobacteriaceae and anaerobes, resistant to other antibiotics (Kanmaz, 2010; Young &

*Adverse Effects:* Seizures occur frequently in patients with meningitis, preexisting CNS pathology, and severe renal dysfunction. Local reaction at the infection and increased platelet counts are the most frequent adverse effects. Other including eosinophilia, elevated hepatic transaminases, and diarrhea also occur in more than 5% of patients (Young & Mangum, 2010). *Incompatible Drugs:* Amicasin, Fluconazole, Gentamycin, Clonazepam, Sodium bicarbonate,

*Pharmacology:* It ensures intracellular glucose transmission. It converts glucose into glycogen, ensures amino acid intake and transmission of K into muscle tissue and cell. It increases fat synthesis. It inhibits lipolysis and the conversion of protein to glucose. It is

Age at 1st dose 1st 2nd 3rd <48 0.2 0.1 0.1 2 to 7 d 0.2 0.2 0.2 >7 d 0.2 0.25 0.25

*Dose:* 20 to 25 mg/kg per dose Q12 hours IV infusion over 30 minutes

*Indication:* For adjuvant treatment in hypoglycemia and hyperpotassemia.

decomposed in liver and kidneys. Serum half-life is 9 minutes for adults.

Only regular insulin can be given IV. The dose is adjusted according to blood sugar.

*Side effects:* Hypoglycemia and increase in insulin resistance. It can cause normoglycemic

*Monitor:* Blood sugar should be monitored at 15-30 min. intervals after infusion and dose

*Administration and Storage Conditions:* A solution of 1 U/ml concentration should be prepared by diluting with sterile water or SF. Should wait for 20 minutes to give time for connection of plastic to IV catheters before continuous infusion. It should be stored in

*Incompatible Drugs:* Aminophylline, Dopamine, Phenytoin, Phenobarbital, Pentobarbital

*Dose:* Intermittent dose: 0.1-0.2 U/kg, every 6-12 hours SC

Continuous infusion: 0.01-0.1 U/kg/hour

hyperinsulinemia and metabolic acidosis.

*Dose:*(mg/kg)

**6.4.26 Imipenem** 

Mangum, 2010).

**6.4.27 Insulin** 

adjustment.

refrigerator.

(Kanmaz, 2010).

Tobramycin (Kanmaz, 2010).

Dekort, Dobutamine, Dopamine, Fentanyl, Fluconazole, Furosemide, Insulin, Meropenem, Midazolom, Penicillin G, Potassium chloride, Sodium bicarbonate, Bactrim (Young & Mangum, 2010).

*Incompatible Drugs:* Amicasin (if concentration is intense), Diazem, Gentamicin (if concentration is intense), Phenytoin, Vancomycin (Kanmaz, 2010).

*Storage Conditions:* It should be stored at room temperature under 25°C in its package (Young & Mangum, 2010).
