MKD COMPUTATION Empirical dose

Weight x mkd x preparation = mL per dose

6 months ¼ tsp
6 mos – 2 y/o ½ tsp
Example: 12kg x 10mg x 5ml/120mg = 5mL per dose
2-6 y/o 1 tsp
* If per day, divided total (mL) by the number of divided doses 6-9 y/o 1½ tsp
9-12 y/o 2 tsp
Dose x preparation x frequency = mkd
weight
* mkd = mk dose
PARACETAMOL Drops = Wt move 1 dec. point to the left
* mkD = mk Day
Age Wt
1 10 kg * C = capsule
2 12 D = drops
3 14
4 16 N = nebule
5 18 S = syrup/suspension
6 20
T = tablet
1 drop = 1/20 ml V = vial
1 teaspoon = 5 ml
Sup = suppository
1 tablespoon = 15 ml
1 wineglass = 60 ml = 2 ounces Sac = sachet
1 glassful = 250 ml = 8 ounces
1 grain = 60 mg
1 pint = 500 ml
1 quart = 1000 ml
1 ounce = 30 ml
1 kg = 2.2lbs
1 lb = 0.45359 kg
 ANALGESIC & ANTI-PYRETIC Paracetamol 10-15 mkd Q4
Aspirin 60-80 mkD
D: 100mg/ml
T: 80mg, 100mg, 325mg st
RHD: 100 mkD (1 2 weeks) S: 120mg/5ml, 250mg/5ml
T: 80mg, 500mg
75 mkD (4 weeks)
V: 150mg/ml, 300mg/2ml
Anti-inflammatory: 60-90 mkD Sup: 125mg, 250mg
Kawasaki: 80-100 mkD Q6
Indomethacin 1-2 mkD x 3 (PDA)

C: 100mg
Ibuprofen 6-8 mkd Q6

D: 100mg/2.5ml
S: 100mg/5ml, 200mg/5ml
C: 200mg, 800mg
Mefenamic acid 6.5 mkd Q6

S: 50mg/5ml
C: 250mg, 500mg
Meperidine 6 mkD/ 0.5-1 mkD
Midazolam 0.2 mkd

T: 15mg
V: 1mg/ml, 5mg/ml
Morphine 0.1-0.2 mkd Q6 (max 15mg)

T: 10mg, 30mg, 60mg,

100mg
V: 10mg/ml
Nalbuphine 0.1-0.2 mkd IM/IV

V: 10mg/ml
Naproxen 5-7 mkD Q8-Q12 (>2 y/o)

T: 275mg, 550mg
 ANTI-HISTAMINES V: 10mg/ml 7-12y/o ½ tab TID
Cetirizine 6 mons-1y/o 1ml OD
Adult 1 tab TID or 2 tsp TID
D: 2.5mg/ml, 10mg/ml 1-2y/o 2.5mg BID
S: 1mg/ml, 5mg/5ml 1ml OD or BID IV/IM: 1ml OD
T: 10mg
Promethazine HCl 1mg/kg IM
2.5y/o ¼ tab BID or ½ tab OD
5ml OD or 2.5ml BID V: 25mg/ml
Fexofenadine 120mg OD
6-12y/o ½ tab BID
10ml OD or 5ml BID T: 120mg, 180mg

>12y/o 1 tab OD
Diphenhydramine 1-2mg/kg IV (max 100mg/dose)

S: 12.5mg/5ml 3-5 mkD PO

C: 25mg, 50mg
V: 50mg/ml
2-6y/o 2.5ml Q6/Q8
6-12y/o 5ml Q6/Q8
Hydroxyzine HCl 1-2 mkD Q12 PO

S: 2mg/ml Adult 25mg BID-QID

T: 10mg, 25mg
Loratadine 1-2y/o 2.5ml OD

S: 1mg/ml, 5mg/5ml 2-12y/o <30kg 5ml

T: 10mg >30kg 10ml

>12y/o 1 tab OD
Chlorphenamine <1y/o 2.5ml TID
maleate
1-3y/o 2.5-5ml TID
S: 2mg/5ml
T: 4mg >6y/o 5ml TID
 COUGH & COLDS Erdosteine 15-19kg 5ml TID
Chlorphenamine 0.2-0.3 mkD 20-30kg 5ml TID
maleate S: 175mg/5ml >30kg 10ml BID
>12y/o 5ml TID or 1 tab TID C: 300mg
S: 2mg/5ml Procaterol (Meptin) <5y/o 0.25 mkD BID-TID
T: 4mg
V: 10mg/ml S: 5mcg/ml >6y/o 5ml or 25mcg/tab OD-BID
Ambroxol T: 25mcg, 50mcg
Adult 20ml or 50mcg/tab OD-BID
30mg/tab 5-10y/o ½ tab TID Salbutamol + Guaifenesin 2-6y/o ½ - 1 tsp TID
>10y/o 1 tab TID
6-12y/o 1 tsp TID
Syrup (15mg/5ml) 2-5y/o 2.5ml BID
>5-10y/o 5ml BID-TID >12y/o 10ml TID, 1 cap BID-TID
>10y/o 10ml TID Acetylcysteine Children 100mg BID-QID

Infant drops (6mg/ml) <6mos 0.5ml BID Sach: 100mg, 200mg Adult 200mg BID-TID
6-12mos 1ml BID S: 100mg/5ml 600mg OD
>1-2y/o 1.25ml BID T(effervescent): 600mg
Carbocisteine Guaifenesin 6-12y/o 5ml TID-QID

Syrup (100mg/5ml) 2-3y/o 5ml TID S: 100mg/5ml Adult 5-10ml TID-QID

C: 200mg 1-2caps TID-QID
4-7y/o 10ml TID
8-12y/o 15ml TID Phenylpropanolamine

Syrup (250mg/5ml) 2-3y/o 2.5ml TID Drops (6.25mg/ml) 1-3mos0.25ml QID

4-7y/o 5ml TID 4-6mos0.5ml QID
8-12y/o 7.5ml TID 7-12mos 0.75ml QID
1-2y/o 1ml QID
Drops (50mg/ml) <2mos 0.3ml TID
3-6mos0.6ml TID Syrup (12.5mg/5ml) 2-6y/o 2.5ml QID
7-12mos 0.9ml TID 7-12y/o 5ml QID
13-24mos 1.2ml TID
 RESPIRATORY MEDS & BROCHODILATORS TERBUTALINE DRIP
Aminophylline 3-5 mkD (0.6-0.9 mk/hr)
N: 5mg/ml (0.1-0.4 g) x weight x 60 x 8
Loading dose: 3-6mg/kg x 20-30mins 500g/ml
Example:
Maintenance dose: 2 mkd Q8 Terbutaline = ____ D5W = ____
80cc or 100cc x 10 gtts/min (8hrs)
MD: 1-9y/o 0.8 1-1.2hr
9-12y/o 0.7 0.9hr BRICANYL DRIP
12-16y/o 0.6 Q6-Q8 Dose: 30-40g

*Example: Weight x Dose = ____ cc

20kg = (Wt x dose) / prep 500
(20 x 5) / 5 = 20cc SIVP as LD Example:
(20 x 2) / 2 = 8cc SIVP Q8 as MD Bricanyl = ____ D5W = ____
Hydrocortisone 10 mkd LD, 4-9 mkd MD 120cc x 24 hrs
or 10-20 mkD LD
V: 100mg, 200mg, 250mg or 3-5 mkd IV
AMINOPHYLLINE DRIP
Dose: 0.2-0.4
Asthma: 5-6 mkD Q8 MD
Salbutamol 0.15-0.30 mkD Q6
Weight x Dose = ____ cc
2
S: 2mg/5ml
Example:
T: 2mg
Terbutaline 0.075 mkd Q6 PO (3kg x 0.4) / 2 = 0.6cc
0.01 mkd (max 0.5cc)
S: 1.5mg/5ml Aminophylline (0.6cc) + D5W (99.4cc)
N: 5mg/2ml = 100cc or 80cc to run for 12 hrs at 8-9 gtts/min
 AMINOPHYLLINE PUSH CEPHALOSPORINS
V: 25mg/ml Dilute 25 mg/ml vial + 4cc PNSS = 25 Cefalexin 1st Gen 25-50 mkD Q6 (max 4g/D)
mg/ml concentration
Then get 1cc to have 5mg/ml D: 100mg/ml
concentration S: 125mg/5ml, 250mg/5ml
C: 250mg, 500mg, 1gm
Neonates LD: 4-6 Cefazolin 1st Gen 20-50 mkD Q6-8
MD: 1.5-3 mkd Q8-Q12
V: 500mg, 1gm Severe infection: 100 mkD
Order: Give 2.4cc of Amino as LD + Cefaclor 2nd Gen 20-40 mkD Q8
EAD then after 12 hours give 1.2cc IV
D: 50mg/ml
Q8
S: 125mg/5ml, 250mg/5ml
C: 250mg, 500mg
- OR – Cefuroxime 2nd Gen 20-40 mkD Q12
50-100 mkD Q8 IV
3-5 mkD (0-6-0.9 mk/hr) S: 125mg/5ml, 250mg/5ml
LD: 3-6 mg/kg x 20-30mins T: 250mg, 500mg
MD: 2 mkd Q8 V: 750mg, 1.5gm
MD: 1-9 y/o 0.8 to 1-1.2hr Cefoxitin 2nd Gen 80-160 mkD Q4-6 (max 12g/D)
9-12 y/o 0.7-0.9hr 20-40 mkD (infants)
12-16 y/o 0.5hr V: 500mg, 1gm
Q6-8 (5mg/ml) Ceftazidime 3rd Gen 100-150 mkD Q8 IV

Example: For a 20kg patient V: 250mg, 500mg, 1gm,

2gm
Wt x dose = 20 x 5 = 20cc SIVP as LD Ceftriaxone 3rd Gen 50-100 mkD OD IV
Prep 5 8cc SIVP Q8
V: 250mg, 500mg, 1gm,
2gm
Cefotaxime 3rd Gen 100-200 mkD Q4-6

V: 250mg, 500mg, 1gm

Cefixime 3rd Gen 3-8 mkD Q12 Amoxicillin 30-50 mkD Q8

D: 20mg/ml D: 100mg/ml
S: 100mg/ml S: 125mg/5ml, 250mg/5ml
C: 100mg, 200mg C: 250mg, 500mg
Cefepime 4th Gen 50 mkD Q8-12 x 10 days V: 1gm
500mg-1000mg Q12 (>12y/o) Amoxicillin- 30-50 mkD Q8 PO
V: 500mg, 1gm, 2gm Clavulanic Acid 50-100 mkD Q8 IV
(Co-Amoxiclav)
BETALACTAMS
S: 156.25/5ml, 228.5/5ml,
Penicillin 50-100 mkD Q6 312.5/5ml, 457/5ml
Pen G Crystalline 100,000-200,000 ukD Q12 T: 375mg, 625mg
50,000-100,000 ukD Q8/Q12 (<7days) V: 600mg (500), 1.2gm
75,000-150,000 ukD Q6-Q12 (>7days) (1000)
Benzathine Penicillin Early syphilis: 500,000 u/K single dose Piperacillin- 200-300 mkD Q6
Tazobactam
Syphilis: 50,000 u/K max dose 2.4M 6mons 150-300 mkD Q8
u/dose V: 4gm/500mg,
2gm/250mg
Sumapen 50 mkD Q6
Phenoxymethyl penicillin Aztreonam Children 50 mkD Q6-Q8
125/5 – 200,000 u/5ml
250/5 – 400,000 u/5ml V: 1gm 1wk-2y/o 30 mkD Q6-Q8
Ampicillin Neonates 50-100 mkD Q6/Q8 Meropenem Septic: 20 mkD Q12
100-200 mkD Q4/Q6
D: 125mg/1.25ml Meningitis: 100-150 mkD Q8-Q12 V: 500mg, 1gm Meningtis: 40 mkD Q12
S: 125mg/5ml, 250mg/5ml 200-400 mkD Q4/Q6 Imipenem 15 mkD (max 2gm/D)
C: 250mg, 500mg
50 mkD/1-2gm Q6-Q8 (max 5gm/D)
V: 125mg, 250mg, 500mg,
V: 500mg
1gm
Ampicillin-Sulbactam 100-200 mkD Q8 IV
Sultamicillin (Unasyn) 1.5-12gm/day IV
50 mkD Q12 (<30kg)
S: 250mg/5ml 2.25gm (single dose, gonorrhea)
C: 375mg. 750mg
V: 750mg, 1.5gm
 TETRACYCLINE FLUOROQUINOLONES
Tetracycline 25-50 mkD Ciprofloxacin 7.5-15 mkD

C: 250mg, 500mg T: 250mg, 500mg

Doxycycline 4.4 mkD V: 2mg/ml infusion
2.2 mkD Levofloxacin 8 mkD Q12 (max 250mg)
C: 100mg
T: 250mg, 500mg
V: 5mg/ml infusion
MACROLIDES
Erythromycin 30-50 mkD Q8-Q12 (max 1gm)

D: 100mg/2.5ml
S: 200mg/5ml, 400mg/5ml
Clarithromycin 15 mkD Q12 (max 1gm/D)

S: 125mg/5ml, 250mg/5ml
T: 250mg, 500mg
V: 50mg/ml
Azithromycin 10 mkD x 3 days
10 mkD 1st day, 2 mkD 2nd-5th day
S: 200mg/5ml
C: 250mg, 500mg
V: 500mg

AMINOGLYCOSIDES
Amikacin LD: 15 mkD
MD: 10 mkD Q12
V: 50mg/ml, 125mg/5ml,
250mg/ml
Gentamycin 5-8 mkD Q8-Q12

V: 40mg/ml, 80mg/2ml
Neltilmicin 6-8 mkD OD
V: 50mg/ml, 75 mg/ml
Chloramphenicol 50-100 mkD Q6-Q8 PO ANTIFUNGAL
50- mkD Q6 IV Fluconazole LD: 12 mkD
S: 125mg/5ml 25 mkD Q6 (neonates) MD: 6 mkD
C: 250mg, 500mg T: 50mg, 100mg, 150mg,
V: 1gm 200mg
Co-trimoxazole 5-8 mkD Q12 V: 2mg/ml
Ketoconazole <15kg 5 mkD OD
S: 40mg/ml (200), 80mg/5ml >20kg 100 mkD OD
(400), 160mg/5ml (800) T: 200mg >30kg 200 mkD OD
T: 400mg/80mg,
Griseofulvin 10 mkD
800mg/160mg
Clindamycin Newborn 5 mkD Q8-12 PO
T: 125mg, 500mg
Amphotericin B MD: 0.5-1 mkD OD
S: 75mg/5ml granules Infant/Child 15-25 mkD Q6 IV
C: 150mg, 300mg 20-30 mkD Q6 PO
V: 150mg/ml SIVP in 30mins V: 5mg/ml, 50mg/10ml

Vancomycin <1,200g (0-4wks) 15 mkd OD

Amphotericin B
V: 500mg >1,200g (0-1wk) 20 mkd OD Prep: 50mg/vial
Dose: 0.1 mkD, max 30-35mk in 3 weeks
1-4wks 30 mkd OD Should be properly covered

Infant/Child: Dilute 50mg vial + 10cc D5W to make a concentration of 5mg/10ml

20mkd Q8 PO - then aspirate 1cc + 4cc D5W = 5mg/ml
60 mkD Q8 1-3hr infusion - then aspirate from the solution 1cc + 9cc D5W = 1mg/ml
Metronidazole 30-50 mkD Q8-Q12 PO - then aspirate from the solution 1cc to make 0.1mg/ml
15 mkD LD, 7.5 mkD Q8
S: 125mg/5ml Wt 1kg
T: 500mg Test does: 0.1 mkd
V: 5mg/ml 1cc of solution + 19cc D5W x 30mins
Day1 0.25mk: 2.5cc + 17.5cc D5W x 4hrs
Day2 0.5mk: 5cc + 15cc D5W x 4hrs
Day3 0.75mk: 7.5cc + 12.5cc D%W x 4hrs
Day4 1mk: 10cc + 10cc D5W x 4hrs then OD
 ANTI-VIRALS
Acyclovir 10-20 mkD Q6 ANTI=PARASITIC
Pyrantel Pamoate 11 mkD x 3 doses OD
S: 200mg/5ml Adult, children >2 y/o 200mg 5x daily
T: 200mg, 400mg, 800mg S: 125mg/5ml
V: 250mg T: 125mg
Children <2 y/o ½ adult dose
Amantadine <8 y/o 5-9 mkD Q12 Mebendazole 200-500 mkD OD single dose

T: 100mg, 250mg S: 20mg/ml, 50mg/ml

>8 y/o 100-200mg
V: 500mg T: 100mg, 500mg
Methisoprinosol 50 mkD Q6-Q8
STEROIDS
S: 250mg/5ml Betamethasone 0.0178-0.25 mkD Q6-Q8 (max 9mg/D)
T: 500mg
T: 500mcg
ANTI-TUBERCULOSIS V: 1ml, 2ml
Rifampicin (R) 10-20 mkD OD AC Dexamethasone ICP: 0.5-1 mkD

D: 100mg/5ml T: 500mcg, 750mcg, 4mg Cerebral edema: 1 mkD Q4-Q6

S: 200mg/5ml V: 2mg/ml, 4mg/ml,
C: 150mg, 300mg, 450mg 5mg/ml
Bacterial meningitis: 0.2-0.5 mkd
Isoniazid (H) 10-20 mkD OD AC
Adult dose 5-10mg IV Q6
S: 200mg/5ml Hydrocortisone Asthma: 10-15 mkD LD,
C: 75mg, 100mg, 200mg,
4-6 mkD Q6-Q8 MD
300mg, 400mg
T: 20mg
Pyrazinamide (Z) 15-30 mkD OD PC V: 100mg, 200mg, 250mg, Dengue: 3-4 mkD
400mg, 500mg
S: 250mg/5ml Prednisone 1-2 mkD Q12
C: 400mg, 500mg
Ethambutol (E) 15 mkD OD S: 10mg/5ml Nephrotic: BSA x 60 mkD
T: 5mg, 20mg
C: 275mg, 400mg, 800mg <2mons 5-25 mkD
Streptomycin (S) 10 mkD OD Q48 or EOD
V: 1gm
 ANTI-SEIZURE NEUROLEPTICS & ANTI-CONVULSANTS
1st line 2nd line Diazepam 0.2-0.3 mkD
Tonic-Clonic Valproic Acid Lamotrigine Max dose: <5y/o 5mg
Carbamazepine Oxycarbazepine T: 5mg, 10mg >5y/o 10mg
Phenytoin V: 5mg/ml, 10mg/ml
Absence Valproic Acid Exthosuzimide Drip: 50mg (10cc) + 250cc 0.9 NSS to run at
Lamotrigine 1cc/kg/hr
Myoclonic Na Valproate Lamotrigine Carbamazepine MD: 10-20 mk
Partial Carbamazepine Lamotrigene <4y/o 20-60mg/day  by 20-60mg OD
Phenytoin Oxacarbazepine
Undentifiable Valproic Acid Na valproate 4y/o 100mg/day  100mg weekly
Lamotrigine Mannitol 20% 2.5-5cc/kg Q6-Q8
Phenobarbital LD: 10-20 mkd
ANTI-SEIZURE DRUGS MD: 5 mkD Q12
Carbamazepine 10-30 mkd BID-TID 20mg/ml;
Clonazepam 0.1-0.3 mkd TID-QID Grain 1 = 60mg Max: 1-2gms (300mg)
T: 15mg, 30mg,
Ethosuximide 15-40 mkd TID-QID
60mg, 90mg
Phenobarbital 2-5 mkd BID-TID V: 130mg/ml
Phenytoin 5-8 mkd BID, TID Phenytoin LD: 10-20 mkd
Valproic acid 30-80 mkd OD, BID, TID, QID MD: 5 mkD Q12
Gabapentin 15-45 mkd TID S: 30mg/5ml,
Lamotrigine 5-15 mkd BID, TID 125mg/5ml Max: 1gm
Topiramate 5-9 mkd BID V: 50mg/ml
Leviteracitam 20-40 mkd BID Valproic Acid LD: 15 mkD OD/BID
Oxcarbazepine 8-10 mkd BID MD: 20 mkD Q8
S: 250mg/5ml
V: 100mg/ml
 G-CSF (Granulocyte-Colony Stimulating Factor)
Filgrastim
Prep: 300mcg/ml
Dose: 5mcg/kg/day OD IV/SQ

To boost imuune system

Stimualte the production of WBC

IVIG transfusion
Prep: 2.5gm, 5gm, 2,500mg/50ml
Dose: 2gm/kg single dose
Pre-meds: Diphen & Hydrocort

Example: Wt 10kg
Wt x dose = # vials x 50ml = ___ml in 12hrs
Prep
Test dose: Wt x 0.01 x 30mins

RH Immunoglobulin: WinRho
Dengue Dose: 50g/kg/dose
Prep: 300g/vial
1 vial x 9-10mins

Dilute to complete 8.5cc to run for

10mins/vial
Use D5W to dilute
Kawasaki Dose: 75g/kg single dose
Contraindication: Hct <100, Rh+

Request CBC w/ PC OD after 24hrs x 3days

 GASTRO MEDS Omeprazole 0.6-0.7 mkD OD
Al Mg (OH)3 2-4 tabs 20mins pre meal and HS
Al Mg (OH)3 + 2-4 tsp or tab QID C: 20mg, 40mg
Dimethicone V: 40mg

Bisacodyl 6-12y/o 5-10mg Nitrofuroxide <6mos 1tsp BID

T: 5mg S: 218gm/5ml >6mos 1tsp TID

>12y/o 10-15mg
Sup: 5mg (pedia), C: 200mg
10mg(adult) Prozinc <6mos 10mg
Hyoscine-N- 12y/o 1-2 tabs 3-5x/day
butylbromide (Max: 100mg/day) D: 0.5-1ml OD >6mos 20mg
(1ml=10mg elemental zinc)
T: 10mg Infants 0.3-0.6 mkD S: 2.5-5ml OD
V: 20mg & children (5ml=20mg elemental zinc)
Cimetidine LD: 5 mkD Q6 Racecadotril <9kg 10mg/sachet TID
MD: 5-10 mkD Q6
T: 200mg, 400mg 9-13kg 10mg/2sachet TID
V: 100mg/ml, 150mg/ml
Ranitidine 1 mkD Q8
13-27kg 30mg/sachet TID
T: 75mg, 150mg, 300mg Adult 150mg BID or
V: 25mg/ml
>27kg 30mg/2sachet TID
300mg OD
Dicycloverine 6mons-2y/o 0.5-1ml QID Adult 100mg/cap TID

D: 5mg/ml 2-5y/o 2.5-5ml QID

S: 10mg/5ml
T: 10mg 6-12y/o 5ml QID
Domperidone 0.2ml kg/dose Q8

D: 5mg/ml
S: 1mg/ml, 5mg/5ml
T: 10mg
Erceflora 1 vial BID x 5 days
Lactulose 2ml/kg/dose Q6
 CREATININE CLEARANCE
Creatinine clearance ml/min
For urine vol >1L = TV ml x Ucr mg% x 1.73 m2
1440 min x Crea mg% x BSA
TOTAL PROTEIN SPILLAGE
UTP  BSA – gm/day
(1000 x UTP)  BSA x 24hr mg/m2/day
N = <4mg/m2/hr or 100mg/m2/day

For urine vol <1L = Wt kg x (140-age) x 0.85 Nephrotics: if >40mg/m2/hr or 4gm/day,

72 x serum crea mg% x BSA start PRED at 60mg/m2

Creatinine clearance 24-hour URINE PROTEIN

= K x height (in cm) Urine protein = 1.12
Plasma crea (mmol/L) 100mg/g x urine protein
Age K BSA x 24 hours
<2.5kg 29
0-18mos 40 Example: 100 x 1.12 = 6.86 (normal)
2-13y/o boys 49 0.68 x 24
2-16y/o girls 49
13-16y/o boys 62 URINE CONCENTRATING ABILITY
Osmolality
Normal 80-120 Urine osmolality: more precise than USG
Renal impairment 50-80 Urine osmolality = (USG – 1.000) x 40,000
Renal insufficiency 20-50
Renal failure 5-20 Normal = 400 – 600 mOsm/L
Uremia <5
Serum osmolality
To get % = creatinine clearance  120 = 2Na + (Glucose in mg/dl  18) + (BUN in mg/dl  2.8)
Creatinine  88.4; K in decimal point (0.29)
Normal = 230 – 300 mOsm
* If >3 = Renal failure
Urine Specific Gravity
Each 15 mmol/l (2.7g) Glucose:  USG by 0.001
Each 4g/l protein:  USG by 0.001
 ANION GAP
Normal = 20 NEPHROTIC SYNDROME
Na – (HCO3 + Cl) Remission: protein free/edema free for 3-4 months
Relapse: recurrence of edema and/or proteinuria
ALBUMIN TRANSFUSION Steroid responsive: (-) protein after 4-6 weeks
Prep: 12.5gm/50ml (25%) or 10gm/50ml (20%) Steroid resistant: (+) protein after 4-6 weeks of continuous
Dose: 0.5-1gm/day daily divided doses of PRED (60mkd); use methyl prednisolone
1ml = 0.25gm to run for 2-4hrs as Q12 or OD Steroid dependent:
- if you withdraw the tx, proteinuria will recur
Example: Wt 0.81 - 2 consecutive relapses occurring during therapy or
Wt x 50 = 3.2ml within 14 days of completing steroid therapy
12.5 Frequent relapse
- responds to corticosteroid treatment but experiences 2
ACUTE GLOMERULONEPHRITIS relapses within 6 mos after the initial response
Typical course - has 4 relapses within 1 yr
Latent: Few days – 3 wks
Oliguric: 7-10 days Prednisone
Diuretic: 7-10 days >40mg/kg/day, Hypoalbuminemia <2.5mg/dl
Convalescent: 7-10 days 60mg/kg/day x 4-6 weeks then
40mg/kg/day (am) x 2-3 mos alternate day dose
Normalization of urine sediment
Gross hematuria: 2-3 wks *If steroid resistant: +2 protein Q8 weeks
Complement level: 6-8 wks Steroid dependent: relapse within 28 days
Proteinuria: 3-6 mos Frequent relapse: relapse >12x/month
Micro-hematuria: 6-12 mos
Cyclophosphamide
Bladder capacity: age (y/o) x 2oz x 30 2-3 mk/24hrs single dose 8-12 wks
500mk/kg/m2/day x 3-5 days (max: 1g/day x 3days)
Normal bladder residual <5cc or 10% of bladder capacity means
greater risk for UTI Methylpred
Clean catch: >100,000/ml 30 mkD x 3-5 days (max: 1gm)
Catheter: >100/ml
Suprapubic: 1 col/ml
 RENAL FAILURE STAGES CALCIUM
Diminished renal reserve 100-300 mg/kg/day
- GFR 50-80 Prep: 100mg/ml
- may still be asymptomatic
Example: 2.6kg
Chronic renal insufficiency 2.6 x 100 x 1 = 0.9cc in IVF for 8 hrs
- GFR 30-50 100
- hypocalcemia, decrease tolerance to stress
0.9ml of 10% Ca Gluconate + in 100ml
Chronic renal failure
- GFR 10-30 Calcium Carbonate (TUMS)
- anemia, hypertension, bon problem, metab disorder Prep: 500mg/tab
- for dialysis Dose: 50 mkD

End-stage renal disease (ESRD) Calcium Gluconate

- GFR <10 Prep: 10cc/vial
- kidneys are small and contracted Max 10cc vial + EAD Q8 SIVP in 30mins
- for dialysis, kidney transplant
Alkalka
SODIUM BICARBONATE Prep: 10mg/tab = 10mEqs
Base excess x Wt x 0.3 (half correction) Dose: 1-2 mkD
Base excess x Wt x 0.6 (full correction) Max: give 2 tabs Q8
K: 0.2-0.5kg/hr, increase to 0.5 if symptoms noted
To be given as 50% SIVP
50% incorporate in IVF to run for 6-8hrs
1-2 mEqs/kg if deficit is too large

CHLORIDE: 5 mEqs/100ml
 POTASSIUM SODIUM
Nephro Desired – Actual x Wt x 0.6 = deficit
0.2-0.3 mEq/kg/hr Wt x 2-3mEqs= maintenance

Example: Wt = 10kg Deficit + Maintenance = Total infusion

0.2 x Wt (10) = 2 mEqs x 24hrs = 48 mEqs (deficit) Give 50%: 1st 8 hrs
2 x Wt (10) = 20 mEqs (maintenance) 25%: next 8 hrs
68 mEqs 25%: next 8 hrs
Prep: 2 mEq/ml
Normal: 135-145 mEq/l
Intensivist Significant hyponatremia: 120 mEq/l
Wt x 50 x transcellular K = ____ / 3 MD: 2-3 mEq/kg/24hr

Transcellular K = 50 mmol/kg Prep: 2.5 mEq/ml/amp

2.5-3 0.05 (5%) Fast correction: values <120 mEq
2-2.5 0.10 (10%) 4ml/kg of 2.5 mEq/ml prep
1.5-2 0.20 (20%) (For every ml of NaCl = 4cc sterile water)

Cardio
Desired – Actual x Wt x 0.3 = deficit
Wt x 2 mEq/kg/day = maintenance

Deficit + Maintenance = Total infusion Q8

3

40 mEqs/day/L = maximum, excess will cause arrhythmia

 MAGNESIUM SULFATE Lanoxin TDD: 0.035 x Wt
Prep: 250mg/ml
LD: 100-200mg/kg/dose over 30mins LD: ¼ TDD x 4 doses Q6
MD: 20-30mg/kg/day MD: 1/10 TDD x 2 doses Q12

Example: Wt = 3.2kg Or

LD: Wt x 200 Wt x 0.004 x 2

= 3.2kg x 200 = 640mg / 250 0.05 (elixir)
= 2.56cc + EAD in 30mins
* should not exceed Wt of px Elixir: 0.05mg/ml
MD: Wt x 30 0.04/kg loading divide by 4 doses T: 0.25mg/tab
= 3.2lg x 30 = 96mg x 24hrs 0.04 maintenance/dose IV 0.025mg/ml
= 2304mg / 250 (max: 0.5/day) or 0.5mg/2cc
= 9.2ml in 24 hrs
DESFERAL
Order: MgSO4 9.2ml + D5W 14.8ml to make 24cc to run at Dose: 20-45/kg/dose
1cc/hr for 24hrs
250mg/ml Infuse in 100cc PNSS then give before and after BT run for 6hrs
5cc/kg PRBC x 2hrs x 4 doses Q8 or as ordered

PHLEBOTOMY
LIDOCAINE DRIP FFP transfusion:
Dose: 2-10 mkd or 0.5-1.0mkd Q10mins (max: 5mg/kg) - Wt x EBV (70-80) x 0.15 (0.10-0.15)
Bolus: 1-2 mkd - Give ½ 30mins-1hr before phlebo, then remaining
during phlebotomy
Wt x 60 x dose = running rate
4000 PNSS can be also be used
Example: 1 mEq/kg NAHCO3 if with hypoxic spells
Lidocaine 10cc
D5W 40cc
50cc x ____gtts