**6.4.5 Albuterol**

Albuterol is used as a bronchodilator in the treatment of bronchospasm developed in children with reversible respiratory tract disease. It affects the smooth muscles (Kavakl et al, 1998).

*The dose, route of administration, duration and discharge of drug:* 

The age-appropriate daily dose of albuterol:

2-6 age → 0.1-0.2 mg/kg/dose 3 times a day, 4 mg 3 times a day (the highest applicable dose)

6-12 age → 2 mg/dose 3 times a day, 24 mg/day (the highest applicable dose)

12 ages and older → 2-4 mg/dose 3-4 times a day, 8 mg 4 times a day (the highest applicable dose).

The drug is administered every 4-6 hours as 0.5% solution 0.01-0.05 ml/kg by inhalation via nebulizer. It can be administered more frequently on children with need.

Aerosol inhalation is administered on children above 12 at 90 µ/sprey and the drug reaches the highest level in blood after ½- 2 hours. It is metabolized in liver and discharged from body via urinary system (Kavakl et al, 1998).

*Side effects of the drug:* Tachycardia, peripheral vasodilatation, tremor, nervousness, hyperactivity, hypokalemia, irritation in oropharynx are potential side effects (Kavakl et al, 1998).

*The things to be considered by nurse applying the drug:* The drug should be well shaken before inhaler application. Mouth should be washed with water after each application in order to avoid mouth and throat dryness.

It should be administered with precaution in children with hyperthyroidism, diabetes, mellitus and heart disease. Addictiveness may develop in prolonged therapy and the usual dose may not be enough.

It has more effect when used with drugs decreasing congestion.

The Administration and Dose of Most Frequently Used Drugs in Pediatrics 319

The drug should be stored in refrigerator. Suppository forms should be stored either outside or in refrigerator according to the recommendation of the manufacturer (Kavakl et al, 1998).

As an antipyretic and analgesic it is administered 4-6 times a day at a dose of 30-65

Reversal of severe sinus Bradycardia, particularly when parasympathetic influences on the heart predominate. Also used to reduce the muscarinic effects if neostigmine when

*Dose:* IV: 0.01 to 0.03 mg/kg per dose IV over 1 minute, or IM. Dose can be repeated Q10 to 15 minutes to achieve desired effect, with a maximum total dose of 0.04 mg/kg (Young &

*Endotracheal:* The same dose can be administered from ET tube. Right after ET tube, 1 ml SF

*Adverse Effects:* Cardiac arrhythmias can occurs, particularly during the first 2 minutes following IV administration; usually a simple A-V dissociation more often caused by smaller rather than larger doses. Fever, especially in brain-damaged infants. Abdominal distention with decreased bowel activity. Esophageal reflux. Mydriasis and cyclopedia

*Uses:* Treatment and prevention of hypocalcaemia, usually defined as a serum ionized calcium concentration less than approximately 4 mg/dL. Treatment of asymptotic infants is

*Dose:* Symptomatic hypocalcaemia – acute treatment: 100 to 200 mg/kg per dose.

*The things to be considered by nurse applying the drug:* The drug should be administered by IV route in a way not to exceed 0.5 ml per minute. Besides, 1000 ml serum, prepared in physiologic, can be administered every 12-24 hours. The temperature of solution should be close to the body temperature. The fast delivery of calcium to heart at higher concentrations may result in fatal cardiac arrest. So the drug should be administered very slowly when parenteral route is used. The heart rate should be checked and monitored. When the drug is administered by non-diluted IV route paresthesias, peripheral vasodilatation and hypotension can be observed. If the child is observed with any symptom drug administration should be ceased and the child should be ensured to rest for half an hour or one hour. It can cause extravasation (the process of exuding or passing out of a vessel into surrounding tissues) tissue irritation and necrosis. Nurse should closely monitor the

Maintenance treatment: 200 to 800 mg/kg per day (Young & Mangum, 2010).

should be given and PPV should be applied for homogenous distribution.

*Oral:* 0.02 mg-0.09 mg/kg/dose every 4-6 hours (Kanmaz, 2010).

mg/kg/day via PO route in infants and children (Dökmeci, 2000).

**6.4.7 Acetylsalicylic acid** 

reversing neuromuscular blockade.

**6.4.8 Atropine** 

Mangum, 2010).

(Young & Mangum, 2010).

controversial.

injection area.

**6.4.9 Calcium gluconate 10%** 

The serum potassium level, heart rate, respiration rate, blood gases of children should be closely monitored when the drug is administered (Kavakl et al, 1998).
