**6.4.24 Ibuprofen**

It is a non-steroidal anti-inflammatory agent with analgesic and antipyretic effect. As an analgesic and antipyretic it is administered at a dose of 10-15 mg/kg/dose every 4-6 hours by PO route and 40-60 mg/kg/day at maximum (Dökmeci, 2000).

*Uses:* Rheumatic Diseases. Menstrual pain. Pain of different origins.

Dose:

3-6 months > 5 kg 50 mg 3-4 times a day

6-12 months 50 mg 3 times a day

1-4 ages 100 mg 3-4 times a day

The maximum dose for children and newborns is:

3 months– 4 age 30 mkg 3-4 times a day (Pursell, 2010).

*Adverse Effects:* >1/100 Abdominal pain, burning sensation in the throat, nausea, diarrhea. Fatigue.

Headache. Rash. 1/1000 Allergic reactions. Symptoms of allergy may be asthma, rhinitis, and rash. Bleeding from the gastrointestinal tract. Gastric ulcer. Blurred vision. The deterioration of hearing. Anxiety. Insomnia (Young & Mangum, 2010).

#### **6.4.25 Indomethacin**

Uses: Closure of ducts arteriosus. Prevention of intraventricular hemorrhage.


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

#### **6.4.26 Imipenem**

326 Complementary Pediatrics

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

*Incompatible Drugs:* Amicasin (if concentration is intense), Diazem, Gentamicin (if

*Storage Conditions:* It should be stored at room temperature under 25°C in its package

Dose: IV: 0.05 to 0.15 mg/kg over at least 5 minutes. Repeat as required, usually Q2 to 4 hours. May also be given IM. Dosage requirements are decreased by incurrent use of

Adverse Effects: Pediatric patients: desaturation 4.6%, apnea 2.8%, hypotension 2.7%, paradoxical reactions 2.0%, hiccough 1.2%, seizure like activity 1.1% and nystagmus 1.1%. The majority of airway-related events occurred in patients receiving other CNS depressing medications and in patients where midazolam was not used as a single sedating agent

It is a non-steroidal anti-inflammatory agent with analgesic and antipyretic effect. As an analgesic and antipyretic it is administered at a dose of 10-15 mg/kg/dose every 4-6 hours

*Adverse Effects:* >1/100 Abdominal pain, burning sensation in the throat, nausea, diarrhea.

Headache. Rash. 1/1000 Allergic reactions. Symptoms of allergy may be asthma, rhinitis, and rash. Bleeding from the gastrointestinal tract. Gastric ulcer. Blurred vision. The

Uses: Sedative/hypnotic. Anesthesia induction. Treatment of refractory seizures.

concentration is intense), Phenytoin, Vancomycin (Kanmaz, 2010).

by PO route and 40-60 mg/kg/day at maximum (Dökmeci, 2000). *Uses:* Rheumatic Diseases. Menstrual pain. Pain of different origins.

Mangum, 2010).

narcotics.

(Young & Mangum, 2010).

(Young & Mangum, 2010).

3-6 months > 5 kg 50 mg 3-4 times a day

The maximum dose for children and newborns is:

3 months– 4 age 30 mkg 3-4 times a day (Pursell, 2010).

deterioration of hearing. Anxiety. Insomnia (Young & Mangum, 2010).

Uses: Closure of ducts arteriosus. Prevention of intraventricular hemorrhage.

6-12 months 50 mg 3 times a day 1-4 ages 100 mg 3-4 times a day

**6.4.24 Ibuprofen** 

Dose:

Fatigue.

**6.4.25 Indomethacin** 

**6.4.23 Hydroxyzine hydrochloride** 

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

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

*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, Tobramycin (Kanmaz, 2010).

#### **6.4.27 Insulin**

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

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

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

Continuous infusion: 0.01-0.1 U/kg/hour

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 hyperinsulinemia and metabolic acidosis.

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

*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 refrigerator.

*Incompatible Drugs:* Aminophylline, Dopamine, Phenytoin, Phenobarbital, Pentobarbital (Kanmaz, 2010).

The Administration and Dose of Most Frequently Used Drugs in Pediatrics 329

*Adverse Effects:* Prolonged over treatment can produce premature craniosynostosis and

*Warning:* Injection should not be administered in renal failure. Injections should be done

*Uses:* Limited to treatment of pneumococcal meningitis and other serious infections caused by susceptible gram-negative organisms resistant to other antibiotics, especially extended-

Less than 32 weeks GA, less than or equal to 14 days PNA: administered Q12 hours; after 14 days PNA: administered Q8 hours. 32 weeks and older GA, less than or equal to 7 days PNA: administered Q12 hours; after 7 days PNA: administered Q8 hours. Meningitis and infections caused by Pseudomonas species, all ages: 40mg/kg per dose Q8 hours. Give as an IV infusion over 30 minutes. Longer infusion times (up to 4 hours) may be associated with

*Adverse Effects:* Diarrhea (4%), nausea/vomiting (1%) and rash (2%). May cause inflammation at the injection site. The use of carbapenem antibiotics can result in the development of cephalosporin resistance in *Enterobacter, Pseudomonas, Serration, Proteus, Citrobacter,* and *Acinetobacte*r species. The risk of pseudomembranous colitis and fungal

*Preparation:* 500 mg meropenem is diluted with 10 ml proper solution. 50 mg/ml

*Drugs to be confronted at the end point:* Dex/Amino acid, Lipid solution, Acyclovir, Aminophylline, Dopamine, Dobutamine, Fluconazole, Gentamicin, Heparin, Sodium

*Incompatibility:* Amphotericin B, Metronidazole, Acyclovir, Calcium gluconate, Diazepam,

*Storage Conditions:* Diluted with sterile distilled water it can be stored for 2 hours under room temperature, 12 hours in refrigerator; diluted with SF for 2 hours under room

spectrum beta-lactamase producing *Klebsiella pneumonia* (Young & Mangum, 2010).

slowly by controlling the breath of the patient (Young & Mangum, 2010).

**6.4.31 Levothyroxine** 

**6.4.32 Magnesium sulfate** 

*Dose:* 20 mg/kg per dose IV

**6.4.33 Meropenem** 

*Uses:* Treatment of hypothyroidism

*Uses:* Postpartum eclampsia. Tetanus.

*Dose:* PO: 10 to 14 mcg/kg. IV 5 to 8 mcg/kg

acceleration of bone age (Young & Mangum, 2010).

improved therapeutic efficacy (Young & Mangum, 2010).

infections are also increased (Young & Mangum, 2010).

*Administration:* IV 30 min. infusion

Miscible Serums: 5% Dex, 10% Dex, SF

concentration is obtained.

bicarbonate, Vancomycin.

Zidovudine.
