Pediatric Anesthesia Drug Dosages
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PEDIATRIC ANESTHESIA DRUG DOSAGES
General Drugs: Anzemet Atropine Benadryl Dantrolene Decadron Fosphenytoin
(Cerebryx)
0.35 mg/kg up to 12.5 mg IV 0.01 mg/kg IV; 0.02 mg/kg IM 0.5-1.0 mg/kg IV 2.5 mg/kg IV initially, up to 10 mg/kg 0.2-1.0 mg/kg IV 10-20 mg PE/kg IV
(at a rate no greater than 150 mg PE/min)
Heparin Ketorolac
(Toradol)
1-3 mg/kg IV; 100-300 U/kg (100 U=1mg) 0.5 mg/kg IV/IM 1 mg/kg IV 0.25-1.0 gm/kg IV 3-5 mg/kg slow IV 0.1 mg/kg IV 5-10 µ g/kg IV 10-15 mg/kg PO; 10-40 mg/kg PR
0.3-0.75 mg/kg PO up to 15 mg; 0.025-0.05 mg/kg IV
Lidocaine Mannitol Protamine Reglan Robinul Tylenol Versed Zofran Induction Agents: Ketamine Pentothal Propofol Narcotic Agents: Fentanyl Morphine Remifentanil
Resuscitation Agents: Atropine 0.02 mg/kg IV or ETT Epinephrine 5-10 µ g/kg IV/ETT gtt: 0.1-1.0 µ g/kg/min CaCl 20 mg/kg IVP Ca Gluconate 50 mg/kg IVP Lidocaine 1.0 mg/kg IV/ETT NaHCO3 1 mEq/kg IV Isuprel 0.1-1.0 µ g/kg/min Dopamine 3-10 µ g/kg/min Dobutamine 1-20 µ g/kg/min Calculation of Infusion Rates:
• for Dopamine and Dobutamine:
kg x 3 diluted to 50 ml. 1 ml/hr=1 µ g/kg/min
• for Epinephrine and Isuprel:
kg x 0.3 diluted to 50 ml. 1 ml/hr= 0.1 µ g/kg/min Caudal Blocks: Marcaine 0.1-0.25% with epi (1:200,000): 0.75-1.0 ml/kg Maximum Local Infiltration by Surgeon:
0.1-0.15 mg/kg to limit of 4 mg IV
2 mg/kg IV; 5-10 mg/kg IM 3-5 mg/kg IV; 25-40 mg/kg PR diluted to 5 ml 2-3 mg/kg IV; 50-200 µ g/kg/min IV infusion
• Marcaine 0.25% with epi (1:200,000): 1 ml/kg • Lidocaine 0.5% with epi (1:200,000): 1 ml/kg
Blood Volume and Maximum Allowable Blood Loss Calculation: Neonate 90 ml/kg Infant 80 ml/kg Child 75 ml/kg Maximum Allowable Blood Loss = ETT Size Estimates: Age NB 1-10 months 1 yr 2 yr 3 yr 4-5 yr 6 yr 7-8 yr 9-10 yr 11-12 yr LMA Sizes: Size 1 1 1/2 2 2 1/2 3 4
EBV x (Pt. Hct.-30) Pt. Hct.
2-10 µ g/kg IV (♥’s 50 µ g/kg) 0.05 - 0.1 mg/kg IV; 0.1 - 0.15 mg/kg IM 0.05-1.3 µ g/kg/min IV infusion
Neuromuscular Blocking Agents: Succinylcholine 2 mg/kg IV; 4 mg/kg IM Norcuron 0.1 mg/kg IV
(25% dose for maintenance)
Pavulon Tracrium Zemuron Reversal Agents: Neostigmine Edrophonium Enlon-Plus Narcan Flumazenil
(Romazicon)
0.1 mg/kg IV
(25% dose for maintenance)
0.3-0.5 mg/kg
(25% dose for maintenance)
0.3-0.6 mg/kg IV
0.05 mg/kg IV 1 mg/kg IV 0.05-0.1 cc/kg IV 0.01 mg/kg IV 0.01 mg/kg IV (up to 0.2 mg)
(can repeat up to 4 additional times up to a maximum total dose of 0.05 mg/kg or 1.0 mg, whichever is lower)
Size 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 6.0 cuff 6.5 cuff
Antibiotics: Ampicillin 50 mg/kg IV Cefazolin (Ancef) 25-40 mg/kg IV Cefoxitin (Mefoxin) 25-40 mg/kg IV Cefuroxime (Kefurox) 75 mg/kg IV Ceftriaxone (Rocephin)50-75 mg/kg IV Clindamycin 10 mg/kg IV Gentamicin 2-2.5 mg/kg IV Oxacillin 20 mg/kg IV Penicillin 50,000 U/kg IV Vancomycin 10 -15 mg/kg IV over 60 min.
Weight to 5 kg 5-10 kg 10-20 kg 20-30 kg >30 kg adult
Max. Cuff Volume up to 4 ml (Air) up to 7 ml up to 10 ml up to 14 ml up to 20 ml up to 30 ml
DELL CHILDREN’S MEDICAL CENTER ANESTHESIA DEPARTMENT
**Recommended that all highlighted drug doses be confirmed by another Anesthesia Practioner______
APROTININ: (Traysol) give 1ml test dose, then after 10min. give 100ml over 20 min. (600 ml/hr.) then continuous drip @ 25cc/hr. (100cc to be given in pump by perfusionist.) Pedi dosing: The maintenance dose after the loading dose is 1.0 mg/kg/hr (0.714 ml/kg/hr) during the entire case. EPINEPHRINE: Mix 4mg in 250ml D5W makes 16mcg/cc (0.016mg). Dose range 0.05 - 4.0 mcgs/kg/min. DOBUTAMINE: Mix 500mg(40ml) in 210cc D5W makes 2000mcg/cc (2mg/cc). Dose range 2.5 - 20 mcgs/kg/min DOPAMINE: Mix 400mg in 250ml D5W makes 1600mcgs/cu (1.6mg/ml). Dose range 5-20mcgs/kg/min. ISOPROTERENOL: Mix 1mg in 250ml D5W makes 4mcgs/ml (0.004mg/cc) Dose range 0.052.0mcgs/kg/min. PHENYLEPHRINE: Mix 10mg in 250cc D5W. Makes 40mcgs/cc. Dose range 0.05-2.0mcgs/kg/min. -ORPut 10mg in 100cc (0.1mg/cc) and draw up 32cc of 0.1mg/cc and add 8cc NS which will equal .08mg NITROGLYCERINE: Mix 100mg in 250ccD5W makes 400mcgs/cc. Dose range 0.5-5.0mcgs/kg/min NITROPRUSSIDE: Mix 100mg per. ,250ccD5W makes 400mcgs/cc. Dose range 0.05-5.0mcgs/kg/min ESMOLOL: BOLUS 0.5-1 mg/kg (using the 10mg/cc solution) INFUSION: Mix 2.5g in 240cc makes 10mg/cc range of 50-100mcgs/kg/min. MILRINONE (Primacor): BOLUS (using the 1mg/cc solution) 50mcgs/kg over ? minutes INFUSION: Mix 20mg in 80cc makes 0.2mg/cc range of 0.375-0.75mcgs/kg/min DILTIAZEM (Cardiazem): BOLUS 0.25mg/kg over 2 minutes INFUSION: Mix 1mg/cc conc. infuse 4-15 mg/hr. VASOPRESSIN (Pitressin): Mix 100 UNITS in 100ccD5W (1 UNIT/cc) Run @ 0.04 - 0.1 UNITS/min CARDENE (Nicardipine) 25mg in a 10ml ampule (2.5mg/ml) Dilute a 10ml amp of Cardene in 100ml of Normal Saline =0.25mg/ml concentration **Not compatible with Lactated Ringers or NaHCO3 RAPID BP CONTROL: initiate @ 5mg/hr. Increase by 2.5 mg/hr every 5 minutes up to 15mg/hr until desired BP attained then decrease to 3mg/hr. GRADUAL BP REDUCTION: initiate @ 5mg/hr – increase by 2.5mg/hr every 15 minutes, up to 15mg/hr until desired BP PRECEDEX (Dexmedetomidine) 100mcg/ml-2ml vial Dilute Precedex 2ml (200mcg) in 48 ml Normal Saline =0.004 mg/ml (4mcg/ml) Infusion rate 0.2 mcg/kg/HR-0.7mcg/kg/HR ** Note infusion pump is set per HOUR CYKLOKAPRON (tranexamic acid) Loading Dose: 10mg/kg IV -one dose over 30 minutes THEN Maintenance infusion of 1mg/kg/HR **** Note infusion pump is set per HOUR
General Drugs: Anzemet Atropine Benadryl Dantrolene Decadron Fosphenytoin
(Cerebryx)
0.35 mg/kg up to 12.5 mg IV 0.01 mg/kg IV; 0.02 mg/kg IM 0.5-1.0 mg/kg IV 2.5 mg/kg IV initially, up to 10 mg/kg 0.2-1.0 mg/kg IV 10-20 mg PE/kg IV
(at a rate no greater than 150 mg PE/min)
Heparin Ketorolac
(Toradol)
1-3 mg/kg IV; 100-300 U/kg (100 U=1mg) 0.5 mg/kg IV/IM 1 mg/kg IV 0.25-1.0 gm/kg IV 3-5 mg/kg slow IV 0.1 mg/kg IV 5-10 µ g/kg IV 10-15 mg/kg PO; 10-40 mg/kg PR
0.3-0.75 mg/kg PO up to 15 mg; 0.025-0.05 mg/kg IV
Lidocaine Mannitol Protamine Reglan Robinul Tylenol Versed Zofran Induction Agents: Ketamine Pentothal Propofol Narcotic Agents: Fentanyl Morphine Remifentanil
Resuscitation Agents: Atropine 0.02 mg/kg IV or ETT Epinephrine 5-10 µ g/kg IV/ETT gtt: 0.1-1.0 µ g/kg/min CaCl 20 mg/kg IVP Ca Gluconate 50 mg/kg IVP Lidocaine 1.0 mg/kg IV/ETT NaHCO3 1 mEq/kg IV Isuprel 0.1-1.0 µ g/kg/min Dopamine 3-10 µ g/kg/min Dobutamine 1-20 µ g/kg/min Calculation of Infusion Rates:
• for Dopamine and Dobutamine:
kg x 3 diluted to 50 ml. 1 ml/hr=1 µ g/kg/min
• for Epinephrine and Isuprel:
kg x 0.3 diluted to 50 ml. 1 ml/hr= 0.1 µ g/kg/min Caudal Blocks: Marcaine 0.1-0.25% with epi (1:200,000): 0.75-1.0 ml/kg Maximum Local Infiltration by Surgeon:
0.1-0.15 mg/kg to limit of 4 mg IV
2 mg/kg IV; 5-10 mg/kg IM 3-5 mg/kg IV; 25-40 mg/kg PR diluted to 5 ml 2-3 mg/kg IV; 50-200 µ g/kg/min IV infusion
• Marcaine 0.25% with epi (1:200,000): 1 ml/kg • Lidocaine 0.5% with epi (1:200,000): 1 ml/kg
Blood Volume and Maximum Allowable Blood Loss Calculation: Neonate 90 ml/kg Infant 80 ml/kg Child 75 ml/kg Maximum Allowable Blood Loss = ETT Size Estimates: Age NB 1-10 months 1 yr 2 yr 3 yr 4-5 yr 6 yr 7-8 yr 9-10 yr 11-12 yr LMA Sizes: Size 1 1 1/2 2 2 1/2 3 4
EBV x (Pt. Hct.-30) Pt. Hct.
2-10 µ g/kg IV (♥’s 50 µ g/kg) 0.05 - 0.1 mg/kg IV; 0.1 - 0.15 mg/kg IM 0.05-1.3 µ g/kg/min IV infusion
Neuromuscular Blocking Agents: Succinylcholine 2 mg/kg IV; 4 mg/kg IM Norcuron 0.1 mg/kg IV
(25% dose for maintenance)
Pavulon Tracrium Zemuron Reversal Agents: Neostigmine Edrophonium Enlon-Plus Narcan Flumazenil
(Romazicon)
0.1 mg/kg IV
(25% dose for maintenance)
0.3-0.5 mg/kg
(25% dose for maintenance)
0.3-0.6 mg/kg IV
0.05 mg/kg IV 1 mg/kg IV 0.05-0.1 cc/kg IV 0.01 mg/kg IV 0.01 mg/kg IV (up to 0.2 mg)
(can repeat up to 4 additional times up to a maximum total dose of 0.05 mg/kg or 1.0 mg, whichever is lower)
Size 3.0 3.5 4.0 4.5 5.0 5.5 6.0 6.5 6.0 cuff 6.5 cuff
Antibiotics: Ampicillin 50 mg/kg IV Cefazolin (Ancef) 25-40 mg/kg IV Cefoxitin (Mefoxin) 25-40 mg/kg IV Cefuroxime (Kefurox) 75 mg/kg IV Ceftriaxone (Rocephin)50-75 mg/kg IV Clindamycin 10 mg/kg IV Gentamicin 2-2.5 mg/kg IV Oxacillin 20 mg/kg IV Penicillin 50,000 U/kg IV Vancomycin 10 -15 mg/kg IV over 60 min.
Weight to 5 kg 5-10 kg 10-20 kg 20-30 kg >30 kg adult
Max. Cuff Volume up to 4 ml (Air) up to 7 ml up to 10 ml up to 14 ml up to 20 ml up to 30 ml
DELL CHILDREN’S MEDICAL CENTER ANESTHESIA DEPARTMENT
**Recommended that all highlighted drug doses be confirmed by another Anesthesia Practioner______
APROTININ: (Traysol) give 1ml test dose, then after 10min. give 100ml over 20 min. (600 ml/hr.) then continuous drip @ 25cc/hr. (100cc to be given in pump by perfusionist.) Pedi dosing: The maintenance dose after the loading dose is 1.0 mg/kg/hr (0.714 ml/kg/hr) during the entire case. EPINEPHRINE: Mix 4mg in 250ml D5W makes 16mcg/cc (0.016mg). Dose range 0.05 - 4.0 mcgs/kg/min. DOBUTAMINE: Mix 500mg(40ml) in 210cc D5W makes 2000mcg/cc (2mg/cc). Dose range 2.5 - 20 mcgs/kg/min DOPAMINE: Mix 400mg in 250ml D5W makes 1600mcgs/cu (1.6mg/ml). Dose range 5-20mcgs/kg/min. ISOPROTERENOL: Mix 1mg in 250ml D5W makes 4mcgs/ml (0.004mg/cc) Dose range 0.052.0mcgs/kg/min. PHENYLEPHRINE: Mix 10mg in 250cc D5W. Makes 40mcgs/cc. Dose range 0.05-2.0mcgs/kg/min. -ORPut 10mg in 100cc (0.1mg/cc) and draw up 32cc of 0.1mg/cc and add 8cc NS which will equal .08mg NITROGLYCERINE: Mix 100mg in 250ccD5W makes 400mcgs/cc. Dose range 0.5-5.0mcgs/kg/min NITROPRUSSIDE: Mix 100mg per. ,250ccD5W makes 400mcgs/cc. Dose range 0.05-5.0mcgs/kg/min ESMOLOL: BOLUS 0.5-1 mg/kg (using the 10mg/cc solution) INFUSION: Mix 2.5g in 240cc makes 10mg/cc range of 50-100mcgs/kg/min. MILRINONE (Primacor): BOLUS (using the 1mg/cc solution) 50mcgs/kg over ? minutes INFUSION: Mix 20mg in 80cc makes 0.2mg/cc range of 0.375-0.75mcgs/kg/min DILTIAZEM (Cardiazem): BOLUS 0.25mg/kg over 2 minutes INFUSION: Mix 1mg/cc conc. infuse 4-15 mg/hr. VASOPRESSIN (Pitressin): Mix 100 UNITS in 100ccD5W (1 UNIT/cc) Run @ 0.04 - 0.1 UNITS/min CARDENE (Nicardipine) 25mg in a 10ml ampule (2.5mg/ml) Dilute a 10ml amp of Cardene in 100ml of Normal Saline =0.25mg/ml concentration **Not compatible with Lactated Ringers or NaHCO3 RAPID BP CONTROL: initiate @ 5mg/hr. Increase by 2.5 mg/hr every 5 minutes up to 15mg/hr until desired BP attained then decrease to 3mg/hr. GRADUAL BP REDUCTION: initiate @ 5mg/hr – increase by 2.5mg/hr every 15 minutes, up to 15mg/hr until desired BP PRECEDEX (Dexmedetomidine) 100mcg/ml-2ml vial Dilute Precedex 2ml (200mcg) in 48 ml Normal Saline =0.004 mg/ml (4mcg/ml) Infusion rate 0.2 mcg/kg/HR-0.7mcg/kg/HR ** Note infusion pump is set per HOUR CYKLOKAPRON (tranexamic acid) Loading Dose: 10mg/kg IV -one dose over 30 minutes THEN Maintenance infusion of 1mg/kg/HR **** Note infusion pump is set per HOUR
