**6.2.1 Acyclovir**

Acyclovir is one of the most commonly used antiviral drugs (Kavakl et al, 1998). Treatment of neonatal herpes simplex infections varicella zoster infections with CNS and pulmonary involvement, and herpes simplex encephalitis (Kavakl et al, 1998; Young & Mangum, 2010).

It can be used for the treatment of herpes simplex virus infections of newborn, varicella infections of children taking immunosuppressive and of immunodeficient children (Kavakl et al, 1998).

*Dose:* 20 mg/kg per dose Q8 hours IV by syringe pump over 1 hour. Prolong the dosing interval in prematures infant <34 weeks PMA, or in patients with significant renal impairment or hepatic failure. Treat localized herpes simplex infections for 14 days,

The Administration and Dose of Most Frequently Used Drugs in Pediatrics 315

*Uses:* Treatment of systemic fungal infections resistant to conventional amphotericin B therapy or in patients with renal or hepatic dysfunction (Young & Mangum, 2010).Dose: 5 to 7 mg/kg dose Q24 hours IV infusion by syringe pump over 2 hours (Young & Mangum,

It is administered by IV route every 2-6 hours in a 5% dextrose solution. It is started with 0.25 mg/kg/day and increased by 0.25 mg/kg/day in 1-2 days and can be advanced up to

*Side Effects:* Anemia, thrombocytopenia, hypokalemia, nausea/vomiting, and fever/chills

It is active against oropharynx, esophagus, urinary and systemic candidiasis. It is orally well- absorbed. It interacts with Warfarin, Phenytoin, Cyclosporine and Rifampin (Eroğlu,

It is used in skin and mucosal candidiasis infections (Apak, 1996; Kanmaz, 2010). It resembles to Amphotericin B as structure. It cannot be absorbed via gastrointestinal channels, skin and mucosae. It may have fungicidal or fungistatic effect (Kanmaz, 2010).

*Dose:* Topical: cream or ointment can be used on the affected area every 6 hours. Therapy

PO: from 100.000 U/ml solution 2 ml for term infants, 1 ml for preterm ones every 6 hours for each side of mouth. Therapy should be maintained even after symptoms disappear

*Administration Properties:* Oral suspension must be shaken well before use. This suspension

It is a drug whose analgesic and antipyretic effect is almost equal to aspirin. However it does not resemble to aspirin in terms of gastric mucosa destruction and bleeding. It has no antirheumatic effect being only active against mild and moderate fever. It is used in cases of nuisance, muscle and joint pain, neuralgia and fever. It is also advised in situations where

should be maintained even after symptoms disappear (Kanmaz, 2010).

*Side effects*: Cream or ointment related rash (Kanmaz, 2010).

includes <1% alcohol, saccharin, 50% sucrose (Kanmaz, 2010).

aspirin is contraindicated or not tolerated (Kavakl et al, 1998). *The dose, route of administration, duration and discharge of drug:* 

Oral: loading dose 24 mg/kg, maintenance dose 12 mg/kg/dose Rectal: loading dose 30 mg/kg, maintenance dose 20 mg/kg

1-1.5 mg/kg/day (Apak, 1996; Dökmeci, 2001; Eroğlu, 2002).

2010).

2002).

(Young & Mangum, 2010).

**6.3.2 Fluconazole** 

**6.3.3 Nystatin** 

(Kanmaz, 2010).

**6.4 Other drugs** 

**6.4.1 Acetaminophen** 

Maintenance dose intervals Preterm ≤32 weeks: 12 hours

disseminated or CNS infections for 21 days (Young & Mangum, 2010).As this drug's intestinal absorption is not that good it should be taken by oral route at high doses. The drug reaches its peak after 1.5-2 hours following being administered by oral route. Almost 30-90% of it is discharged by urinary system (Kavakl et al, 1998).

*Adverse Effects:* The most common side effects are nausea, vomiting, diarrhea and headache. Other reported side effects include agitation, confusion, rash, anemia, and muscle pain. Hypersensitivity reactions, seizures, agitation, confusion, anemia, hepatitis, and muscle pain have also been reported (Apak, 1996; Kavakl et al, 1998; Young & Mangum, 2010).

*The things to be considered by nurse applying the drug:* In application by IV route a vial of 500 mg is diluted with 10 ml sterile water. The vial is shaken until the drug is fully dissolved. The desired dose is taken into syringe. In order to decrease concentration a single dose should be administered every 1 hour with infusion solution and if possible with infusion pump. Fast application may result in phlebitis and kidney destruction. The infusion area should be changed in order to avoid thrombophlebitis. The prepared solution should be used within 12 hours.

As the drug gets discharged from urinary system the child should be provided with adequate hydration pre-application and during application. The nephrotoxicity risk decreases after 2 hours following infusion application.

Nurse should attentively observe the observable side effects of the drug and should notify doctor if any is observed. If necessary, drug use should be ceased at once (Kavakl et al, 1998).
