PAEDIATRICS

Common Treatment Practice

By
Dr. Sarwar Jahan (Tomal)
MBBS
Dhaka Medical College (K-66)

Edited by
Dr. Md. Jobaer Chowdhury (Eshan)
MBBS
Dhaka Medical College (K-67)
 Index
Topic Page
Measurement of weight from age 4
Measurement of BSA from weight 4
Fluid requirement 4
Choice of fluid according to age of the baby 5
Choice of fluid according to clinical condition 5
Preparation of baby saline/Dextrose baby saline 5
Infusion/Transfusion flow rate calculator 6
Blood Transfusion 6
Calorie requirement 7
NG tube for children 7
Feeding number through NG tube 7
Nebulization 7
Nebulization dose 7

Paediatric doses
see the index next page
Topic page Topic page
Antibiotic drugs Anti-ulcerant drugs
Ceftriaxone 8 Ranitidine 19
Ceftazidime 8 Antacid 19
Cefuroxime 8 Anti-spasmodic drugs
Cefuroxime + Clavulanic acid 8 Dicycloverine 19
Cefotaxime 8 Tiemonium methyl sulphate 19
Cefepime 9 Hyoscine-n-butyl bromide 19
Cefexime 9 Anti-constipant drugs
Cephradine 9 Lactulose 20
Amoxicillin 9 Nitroglycerine 20
Co-amoxiclav 9 Milk of magnesia 20
Flucoxacillin 10 Anti-flatulent drugs
Ampicillin 10 Simethicone 20
Phenoxymethyl penicillin 10 Anti-emetic drugs
Ciprofloxacin 10 Domperidone 21
Levofloxacin 10 Ondansetron 21
Metronidazole 11 Anti-asthmatic (Bronchodilator)/anti-apneic drugs
Nitazoxanide 11 Salbutamol 21
Azithromycin 11 Levosalbutamol 21
Clarithromycin 11 Ipratropium bromide 22
Erythromycin 11 Theophylline 22
Gentimicin 12 Aminophylline 22
Amikacin 12 Cough suppressant drugs
Vancomycin 12 Ambroxol 23
Meropenem 12 Butamirate 23
Colistin 12 Herbal product 23
Netilmicin 12 Dextromethorphan 23
Antiviral drugs Bromhexin 23
Acyclovir 13 Anti-convulsant drugs
Anti-helminthic drugs Diazepam 24
Albendazole 13 Phenobarbitone 24
Mebendazole 13 Diuretics
Pyrental pamoate 13 Frusemide 24
Levamisole 13 Mannitol 24
Anti-fungal drugs Steroids
Fluconazole 14 Hydrocortisone 25
Nystatin 14 Prednisolone 25
Amphotericin-B 14 Dexamethasone 25
Anti-malarial drugs Vitamin & minerals
Quinine 14 Zinc 25
Chlorquine 14 Folic acid 25
Primaquine 15 Vitamin-A 25
Mefloquine 15 KCl (KT) 26
Anti- Kala azar drugs Vitamin-B complex 26
Sodium stibogluconate 15 Vitamin-K 26
Anti-parasitic Iron 26
Permethrin 15 Multivitamin 26
Ivermectin 15 Others
Analgesics & Anti-pyretic drugs Adrenaline 27
Paracetamol 16 Oxymetazoline 27
Ibuprofen 16 Zn oxide 27
Diclofenac 16 MgSO4 27
Aspirin 16 NaHCO3 27
Pethidine 16 Ca-gluconate 27
Anti-histamin & anti-allergic drugs
Chlorpheniramine 17
Loratadine 17
Pheniramine 17
Promethazine 17
Cetirizine 18
Desloratadine 18
Ketotifen 18
Montelukast 18
Dr. Sarwar Jahan (Tomal) 4

Measurement of weight from age (Approximately):

1. Age 3-12 months (< 1 year):
= weight in Kg

2. Age 1-6 years (up to 10 year may be applicable):

(Age in year × 2)+8 = weight in Kg
Or, (Age in year + 4) × 2 = weight in Kg

3. Age 7-12 years:

( × )
= weight in Kg

Measurement of Body surface area from weight:

( × )
BSA (in m2) =

Fluid requirement: Daily maintenance requirement of fluid

Age Requirement
D1 60 ml/Kg/day
D2 80 ml/Kg/day
D3 100 ml/Kg/day
D4 120 ml/Kg/day
D5- 9 months 150 ml/Kg/day
After 9 months For Body weight up to 10 Kg: 100 ml/Kg/day
For next 10 Kg: 50 ml/Kg/day
For next each Kg: 20 ml/Kg/day
Dr. Sarwar Jahan (Tomal) 5

Choice of Fluid according to age of the baby

In Paediatric Medicine
Age Fluid
D1 10% DA (If BWt. ≥ 1.2 Kg) Or, 5% DA (If BWt. < 1.2 Kg)
D2- 3 years 10% DBS (10% DA+ 0.225% NaCl) [e.g. Electrodex-10, APN]
Or, 5% DBS (5% DA+ 0.225% NaCl) [e.g. Baby Saline, Dextrosal baby]
3-6 years Junior Saline (5% DA + 0.45% NaCl) [e.g. Libott-s junior, Dextrosal mini]
> 6 years 5% DNS

In Paediatric Surgery
 For Neonates & children up to 1 year (Infants): 10% DBS or, 10% baby saline (10%
DA+0.225% NaCl) [e.g. Electodex-10, APN]
 For Children > 1 year up to 6 years: 5% DBS or, Baby saline (5% DA + 0.225% NaCl)
[Baby saline, Dextrosal baby]
 For Children > 6 years to 14 years: Junior Saline (5% DA +0.45% NaCl) [e.g. Libott-s
junior, Dextrosal mini]

Choice of fluid according to clinical condition:

Disease Fluid Comment
Diarrhoea Cholera saline No dehydration: 50 ml/Kg/day
Some dehydration: 75 ml/Kg within 4 hours
Severe dehydration: 100 ml/Kg/day
Gastroenteritis 5% DNS or, Amount: 100 ml/Kg/day
Cholera saline
Acute gastritis Neosol (<3 years) or,
Neosol-DS (3-6 years)
Or, 5% DNS (> 6 years)
Or, Cholera saline
Acute enteritis Choler saline
Hypovolemic Normal saline Amount: 10-20 ml/Kg/day I/V stat in a
shock bollus dose (running)

Preparation of baby saline/Dextrose baby saline

Requirement (কিনতে হবে): 25% DA, Baby saline (5% DA + 0.225% NaCl)
For DBS preparation From 25% DA From Baby saline
7.5% DBS (7.5% DA + 0.225% NaCl) 12.5 ml 87.5 ml
10% DBS (10% DA + 0.225% NaCl) 25 ml 75 ml
12.5% DBS (12.5 ml + 0.225% NaCl) 37.5 ml 62.5 ml
Note: 10% DBS বানােত য পিরমান 25% DA লােগ, তার সােথ 12.5 ml যাগ কের (12.5 %
DBS তরীেত) বা 12.5 ml িবেয়াগ কের ( 7.5% DBS তরীেত) বািক fluid baby saline (5%
DA + 0.225% NaCl) িমিলেয় িদেলই 100ml 12.5% বা 7.5% DBS হেয় যােব।
Dr. Sarwar Jahan (Tomal) 6

Infusion/Transfusion flow rate calculation:

( )
Flow rate (in drops/min):
× ( )
( )
Flow rate (in µd/min)=
( )
Note:
- যত ml fluid যত ঘ ায় যােব, তােদর ratio করেলই µd/min এ flow rate (fluid infusion rate) পাব।
- যত শ’ত ml fluid িদেন যােব, তত drop/min এ flow rate িদেত হেব।
Suppose: 1000 ml পােব িদেন (24 hours), তাহেল 1000 ml= 10 শত ml
So, flow rate= 10 drops/min over 24 hours
যিদ 1000 ml অথাৎ 10শত ml fluid 8 hours এ যায় তাহেল, 24 hours এর থেক 3 times faster flow
rate হেব অথাৎ flow rate = 10 × 3 = 30 drops/min
1 drop = 4 micro drops (µd)
16 drops = 1 ml = 60 µd
1 TSF= 5 ml
1 glass= 250 ml (~200 ml)

Blood transfusion:
- Requirement of whole blood (WB) in children: (10-20) ml/Kg; [Avg: 15ml/Kg]
- Requirement of packed red cell (concentrate RBC): (10-15) ml/Kg [Avg: 10 ml/Kg]
- Requirement of FFP: 20 ml/Kg
- 2 unit WB =1 unit FFP (that means 1 unit FFP produced from 2 unit WB)
- 4 unit WB = 1 unit packed cell (that means 1 unit packed cell is produced from 4 unit WB)
- In adult, if you transfuse 1 unit WB, then approximately 1gm/dl Hb% will be increased.
- If you transfuse 4 ml/Kg packed cell, then, 1 gm/dl Hb% will be increased.
- If you transfuse 6 ml/Kg WB, then 1 gm/dl Hb% will be increased.

So, For correction of 1 gm/dl Hb% we need-

WB: 6 ml/Kg
Packed cell (PCV): 4 ml/Kg

- Deficit of Hb% is calculated as following-

Deficit = 10-measured Hb%
So, Correction = Weight in Kg × Deficit × (WB or PCV)
E.g. If Hb% = 3 gm/dl, BWt. = 9 Kg, then
Correction = Weight in Kg × Deficit × (WB or PCV)
= 9×(10-3)×6 [WB] Or, 9×(10-3)×4 [PCV]
= 378 ml WB or, 252 ml PCV
- 1 bag blood (450 ml) contains 63 ml anti-coagulant [total volume: 513 ml]
- For mobile blood transfusion (MBT):
WB required 20 ml/Kg & for each 20 ml WB we need 3 ml anti-coagulant
- Blood volume required for exchange transfusion = weight in Kg × 2 × 85 ml (or 80 ml)
Dr. Sarwar Jahan (Tomal) 7

Calorie requirement:

Calorie requirement per day: Normal = 1390 Kcal/Kg/day

In PEM = 100-110/ Kcal/Kg/day
Note:
- 1 TSF (5 ml) [1 scoop] milk [protein] = 20 Kcal
- 1 TSF (5 ml) soybean oil [lipid] = 45 Kcal
So, 15 drops = 1 ml = Kcal = 9 Kcal

- 1 TSF sugar (CHO) = 20 Kcal

- For dilution of 1 TSF [1 scoop] milk we need 30 ml water (6 TSF)

NG tube (for children)

Age Size
< 1 year 5 Fr/ 6 Fr
1 year- 3 years 6 Fr/ 8 Fr
3 years- 5 years 9 Fr/ 10 Fr
> 5 years 12 Fr

Feeding Number through NG tube:

Age Number of feeding
< 1 month 20 feeds/day (1 hourly)
> 1 month 10 feeds/day (2 hourly)

Nebulization
Age Solution
< 2 months Ipratropium bromide
2 months – 4 months Salbutamol + Ipratropium (windel plus solution)
> 4 months Salbutamol ± Ipratropium

Nebulization dose
Ipratropium: 0.1 -0.3 ml/Kg/dose
But not more than 2 ml (should be mixed with Normal saline)
Salbutamol: 0.3 ml/Kg/dose
But not more than 2 ml (should be mixed with Normal saline)
Dr. Sarwar Jahan (Tomal) 8

Paediatric Doses
Antibiotic drugs
Ceftriaxone:
Inj. 125 mg / 1.25 ml; 250mg / 2.5 ml; 500 mg / 5 ml; 1gm / 10 ml; 2gm / 20 ml Vial
Dose: 30-100 mg/Kg/day single dose daily I/V
But clinically we use 100 mg/Kg/day single dose,
If we require > 10 ml per day then divided in to 2 doses may be given
Shortcut: 1 ml/Kg/day I/V

Ceftazidime:
Inj. 250mg / 2.5 ml; 500 mg / 5 ml; 1gm / 10 ml; Vial
Dose: 50-100 mg/Kg/day in 2-3 divided doses I/V
But clinically we use 100 mg/Kg/day or
50 mg/Kg/day, If age ≤ 7 days 2 doses daily;
If age > 7 days 3 doses daily
Shortcut: 0.5 ml/Kg/day I/V

Cefuroxime:
Inj. 125 mg / 2.5 ml; 250mg / 5 ml; 750 mg / 10 ml; 1.5 gm / 20 ml; Vial
Syp. 125 mg/ 5 ml
Tab. 125 mg, 250 mg, 500 mg
Dose:
Oral: 20 mg/Kg/day (20-30 mg/Kg/day) in 2 divided doses
I/V: 40-100 mg/Kg/day in 3 divided doses
But clinically we use 20 mg/Kg/day I/V BD/TDS
Shortcut: 20 mg/Kg/day Oral (BD) or I/V (TDS)

Cefuroxime + Clavulanic acid:

Same as cefuroxime (see previous one)

Cefotaxime:
Inj. 250mg / 2.5 ml; 500 mg / 5 ml; 1gm / 10 ml; Vial
Dose: 50 mg/Kg/day I/V BD in children < 7 days
TDS in children > 7 days
Meningitic dose: 200 mg/Kg/day (or, 50 mg/Kg/day) I/V QDS
Shortcut: 0.5 ml/Kg/dose I/V BD ≤ 7 days
TDS > 7 days
QDS in meningitis
Dr. Sarwar Jahan (Tomal) 9

Cefepime:
Inj. 250mg / 2.5 ml; 500 mg / 5 ml; 1gm / 10 ml; 2gm / 20 ml Vial
Dose: 100-150 mg/Kg/day I/V BD < 1 month
TDS > 1 month
Or, 50 mg/Kg/day
Shortcut: 0.5 ml/Kg/dose I/V BD < 1month
TDS > 2 months

Cefixime:
Tab./Cap. 200 mg, 400 mg
Syp. 100 mg/ 5 ml, 200 mg/ 5 ml
Dose: 8-10 mg/Kg/day in 2 divided doses orally
But clinically we use 10 mg/Kg/day BD oral
In enteric fever: 20 mg/Kg/day BD oral

Cephradine:
Inj. 250mg / 5 ml; 500 mg / 10 ml; 1gm / 20 ml; Vial
Drop. 100 mg/ 1 ml (15 drops)
Syp. 125 mg/ 5 ml
Cap. 250 mg, 500 mg
Dose: 50-100 mg/Kg/day I/V or Oral QDS
Or, 12.5-25 mg/Kg/dose
Shortcut: 1-2 ml/Kg/day QDS I/V

Amoxicillin:
Inj. 250mg / 5 ml; 500 mg / 10 ml; 1gm / 20 ml Vial
Drop. 100 mg/ 1 ml (15 drops) or, 125 mg/ 1.25 ml (20 drops)
Syp. 125 mg/ 5 ml, 250 mg/ 5 ml
Cap. 250 mg, 500 mg, 875 mg
Dose: 50-100 mg/Kg/day I/V or oral BD ≤ 1 month
TDS > 1 month
Shortcut: 1-2 ml/Kg/day BD < 1 month
TDS > 1 month I/V

Co-amoxiclav:
Inj. 600 mg, 1.2 gm Vial
Syp. 125 mg/ 5ml
Tab. 375 mg, 625 mg
Dose: Same as amoxicillin (see the previous one)
Dr. Sarwar Jahan (Tomal) 10

Flucloxacillin:
Inj. 250mg / 5 ml; 500 mg / 10 ml; 1gm / 20 ml; Vial
Syp. 125 mg/ 5ml
Cap. 250 mg, 500 mg
Dose: 50-100 mg/Kg/day I/V or Oral QDS
Or, 12.5-25 mg/Kg/dose
But clinically we use 100 mg/Kg/day single dose (or, 25 mg/Kg/dose)
Shortcut: 0.5-1 ml/Kg/day I/V QDS

Nice to know:
Dose of Ampicillin/Cephradin/Flucloxacillin/Cloxacillin are same: 50-100 mg/Kg/day QDS
Amoxicillin is also same: 50-100 mg/Kg/day But TDS

Ampicillin:
Inj. 250mg / 5 ml; 500 mg / 10 ml Vial
Syp. 125 mg/ 5ml
Drop. 100 mg/ 1 ml (15 drops)
Cap. 250 mg, 500 mg
Dose: 50-100 mg/Kg/day I/V or Oral BD in neonate; QDS in children > 1 month
Or, 1-2 mg/Kg/dose I/V QDS
Meningitic dose/septicemic dose: 200-400 mg/Kg/day I/V QDS

Phenoxymethyl penicillin:
Syp. 125 mg/ 5ml
Tab. 250 mg, 500 mg
Dose: 15-30 mg/Kg/day oral QDS/BD

Ciprofloxacin:
Inj. 200 mg/ 100 ml bottle
Syp. 250 mg/ 5 ml
Tab. 250 mg, 500 mg, 750 mg
Dose: 15-20 mg/Kg/day oral BD
10 mg/Kg/day I/V BD
(Or 5 ml/Kg/dose I/V BD)
Shortcut: 5 ml/Kg/dose I/V BD

Levofloxacin:
Inj. 500 mg/ 100 ml bottle
Tab. 250 mg, 500 mg, 750 mg
Dose: 5-10 mg/Kg/ day single dose I/V or oral daily
Or, 1-2 ml/Kg/day I/V single dose daily
Shortcut: 1-2 ml/Kg/day I/V OD
Dr. Sarwar Jahan (Tomal) 11

Metronidazole:
Inj. 500mg/ 100 ml bottle
Syp. 200 mg/ 5 ml
Tab. 200 mg, 400 mg, 500 mg
Dose: 7.5 mg/Kg/dose I/V TDS
Or, 1.5 ml/Kg/dose I/V TDS
& 10 mg/Kg/dose oral TDS
Or, 30 mg/Kg/day TDS oral
Shortcut: 1.5-2 ml/Kg/dose I/V TDS

Nitazoxanide:
Syp. 100 mg/ 5 ml
Tab. 500 mg
Dose:
< 1 year: ½ TSF BD - 3 days
1-4 years: 1 TSF BD- 3 days
4-11 years: 2 TSF BD- 3 days
≥ 12 years: 1 tab (500 mg) BD – 3 days

Azithromycin:
Syp. 200 mg/ 5 ml
Cap. 250 mg
Tab. 250 mg, 500 mg
Dose:
Usual dose: 10-15 mg/Kg/day oral BD/TDS
[clinically we use 10 mg/Kg/day OD/BD]
In enteric fever: 20 mg/Kg/day oral OD/BD
Shortcut: 0.25 ml/Kg/day orally OD/BD
In enteric fever: 0.5 ml/Kg/day OD/BD

Clarithromycin:
Inj. 500 mg/ 5 ml Vial
Syp. 125 mg/ 5 ml
Tab. 250 mg, 500 mg
Dose: 15 mg/Kg/day I/V or oral BD
(Or, 7.5 mg/Kg/dose oral or I/V BD)

Erythromycin:
Tab. 250 mg, 500 mg
Syp. 125 mg/ 5 ml
Dose: 20-40 mg/Kg/day oral QDS
Dr. Sarwar Jahan (Tomal) 12

Gentamicin
Inj. 20 mg/ 2 ml, 80 mg/ 2ml amp
Dose: 5-6 mg/Kg/day- I/V BD in neonate; BD/TDS in older children
In Severe acute malnutrition (SAM): 7.5 mg/Kg/day I/V OD
Shortcut: Inj. Gentamicin (80 mg/2 ml)
+ 6 ml D/W (80 mg/ 8 ml)
So, 10 mg/ 1 ml,
then give 5 mg/Kg/day I/V BD/TDS
(Or, 0.5 mg/Kg/day I/V BD/TDS)

Amikacin:
Inj. 100 mg/ 2ml; 500 mg/ 2ml amp
Dose: 15 mg/Kg/day I/V BD
(Or, 7.5 mg/Kg/dose I/V BD)
Shortcut: Inj. Amikacin (500 mg/2 ml)
+
500 mg/ 10 ml
So, 50 mg/ 1 ml
Then, Give 0.15 ml/Kg/dose I/V BD

Vanocomycin:
Inj. 500 mg/ 10 ml, 1 gm/ 20 ml vial
Dose: 15 mg/Kg/dose I/V BD ≤ 7 days; TDS > 7 days

Meropenem:
Inj. 500 mg/ 10 ml, 1gm/20 ml vial
Dose: 10-20 mg/Kg/dose I/V BD ≤ 7 days ; TDS > 7 days
Meningitic dose: 40-50 mg/Kg/dose I/V TDS

Colistin:
Inj. 10 lac IU / 10 ml Vial
Dose: 25000 IU/Kg/dose with I/VF- BD ≤ 7 days; TDS > 7 days
.
Shortcut: ml + 10 ml I/VF in each dose BD ≤ 7 days; TDS > 7 days

Neticimin:
Inj. 50 mg/ 2ml amp
Dose: 3 mg/Kg/dose I/V BD in neonate < 7 days; TDS in children > 7 days
Dr. Sarwar Jahan (Tomal) 13

Anti-viral drugs
Acyclovir:
Inj. 250 mg/10 ml, 500mg/ 20 ml vial
Syp. 200 mg/ 5 ml
Tab. 200 mg, 400 mg
Dose: 10 mg/Kg/dose (+20 ml I/VF) over 30 mins-1 hour- I/V QDS
& 10-20 mg/Kg/dose – TDS (oral)

Anti-helminthics drugs
Albendazole:
Tab. 200 mg, 400 mg
Syp. 200 mg/ 5 ml
Dose:
1-2 year age: 1 TSF (200 mg) stat single dose oral
> 2 years age: 2 TSF (400 mg) stat single dose oral
Or, 1 tab (400 mg) stat single dose, If necessary repeat the stat dose 7-14 days later

Mebendazole:
Tab. 100 mg, 500 mg
Syp. 100 mg/ 5 ml
Dose:
> 2 years age: 100 mg BD oral for 3 days

Pyrantal pamoate:
Tab. 125 mg
Syp. 250 mg/ 5 ml
Dose: 10-11 mg/Kg/dose oral single dose If necessary repeat after 7-14 days
Shortcut:
5 months- 4 years: ½ TSF stat oral
5-10 years: 1 TSF stat oral
11-15 years: 1½ TSF stat oral

Levamisole:
Tab. 40 mg
Syp. 40 mg/ 5 ml
Dose: 2.5-3 mg/Kg/dose single dose oral
Dr. Sarwar Jahan (Tomal) 14

Anti-fungal drugs
Fluconazole:
Cap. 50 mg, 150 mg, 200 mg
Syp. 50 mg/ 5 ml
Dose: 6-12 mg/Kg/day oral OD

Nystatin
Tab. 5 lac IU
Syp. 1 lac IU/ ml (15 drops)
Dose:
Neonate: 1 lac IU (15 drops) – QDS local
Infant: 2 lac IU (30 drops)- QDS local
Older children: 4-6 lac IU – QDS local

Amphotericin-B
Inj
Dose:
Loading dose (LD): 0.1-0.25 mg/Kg/dose stat I/V
Maintenance dose (MD): 0.5-1 mg/Kg/day I/V over 4-6 daily

Anti-malarial drugs
Quinine:
Inj. 300 mg/ 5 ml amp.
Tab. 300 mg
Dose:
Loading dose (LD):
20 mg/Kg/dose stat + 10 ml/Kg 10% Baby saline I/V @ 25 µd/min over 4 hours
After 12 hours of LD: Maintenance dose (MD)
10 mg/Kg/dose + 10 ml/Kg 10% Baby saline over 4hours – 8 hourly I/V
Then after regain consciousness of the patient MD-
10 mg/Kg/dose 8 hourly oral

Chloroquine:
Tab. 250 mg
Syp. 300 mg/ 5 ml
Dose:
1st day: 10 mg/Kg/day – OD oral
2nd day: 10 mg/Kg/day – OD oral
3rd day: 7.5 mg/Kg/day – OD oral
Dr. Sarwar Jahan (Tomal) 15

Primaquine:
Tab. 15 mg
Dose: 0.3 mg (base)/Kg/day – OD oral (maximum daily dose 15 mg)

Mefloquine:
Tab. 250 mg
Dose: 15 mg/Kg/dose oral stat (maximum- 750 mg)
Followed by 10 mg/Kg/dose – 6 hours later stat oral
For prophylaxis: 5 mg/Kg/dose once weekly oral

Anti-Kala azar drugs

Sodium stibogluconate:
Inj. 100 mg/ 1 ml in 10 ml (1000 mg) bottle
Dose: 20 mg/Kg/dose I/V OD (but not more than 8.5 ml/day)

Anti-parasitic drugs
Permethrin:
Cream. 5%
Topical use only for scabies

Ivermectin:
Tab. 3 mg, 6 mg
Dose: 200 µg/Kg/dose stat oral (single dose), If necessary repeat 7 days later
Dr. Sarwar Jahan (Tomal) 16

Analgesic & anti-pyretic drugs

Paracetamol:
Tab. 500 mg
Syp. 120 mg/ 5 ml
Drop. 80 mg/ 1 ml (15 drops)
Suppository. 60 mg, 125 mg, 250 mg, 500 mg
Dose: 10-20 mg/Kg/dose (Avg. 15 mg/Kg/dose) oral or PR TDS/QDS
Shortcut:
For each 8 Kg BWt. 1 TSF (120 mg)/dose TDS/QDS
For each 4 Kg BWt. ½ TSF (60 mg)/dose TDS/QDS

Ibuprofen:
Syp. 100 mg/ 5 ml
Tab. 200 mg, 300 mg, 400 mg, 600 mg
Dose: 5-10 mg/Kg/dose oral TDS/BD
Shortcut:
1-2 years: ½ TSF TDS/BD
3-7 years: 1 TSF TDS/BD
8-12 years: 2 TSF TDS or 1 Tab (200 mg) TDS
> 12 years: 1 tab (400 mg) TDS

Diclofenac:
Inj. 75 mg/ 3 ml
Tab. 25 mg, 50 mg, 100 mg
Suppository. 12.5 mg, 25 mg, 50 mg
Dose: 1-3 mg/Kg/day I/M or I/V or Oral or PR (Avg. 2 mg/Kg/day)
But clinically we use 1 mg/Kg/dose BD/TDS/QDS I/M or I/V or Oral or PR

Aspirin:
Tab. 75 mg, 300 mg
Dose: 30-60 mg/Kg/day (Avg. 50 mg/Kg/day) TDS or QDS oral
& in JIA: 60-100 mg/Kg/day (Avg. 100 mg/Kg/day) QDS oral

Pethidine:
Inj. 100 mg/ 2 ml
Dose: 1-2 mg/Kg/dose (Avg. 1.5 mg/Kg/dose) TDS/QDS I/M or I/V
Dr. Sarwar Jahan (Tomal) 17

Anti-histamine & anti-allergic drugs

Chlorpheniramine:
Tab. 4 mg
Syp. 2 mg / 5 ml
Dose: 0.35 mg/Kg/day oral BD /TDS
Shortcut:
< 1 year : ½ TSF BD oral
1-5 years: 1 TSF BD/TDS oral
> 5 years: 1-2 TSF BD/TDS oral

Loratadine:
Tab. 10 mg
Syp. 5 mg/ 5 ml
Dose:
2-10 years: 1 TSF OD oral
> 10 years: 2 TSF OD or 1 tab (10 mg) OD oral

Pheniramine (e.g Avil):

Tab. 22.5 mg
Syp. 15 mg/ 5 ml
Inj. 45.5 mg/ 2ml amp
Dose:
1 – 6 years: - th amp OD/BD I/M
> 6 years: 1 amp OD/BD I/M
&
< 1 year: ½ TSF BD oral
1-5 years: 1 TSF BD/TDS oral
5-11 years: 1-2 TSF BD/TDS or 1 tab BD/TDS oral

Promethazine:
Inj. 50 mg/ 2 ml amp
Tab. 10 mg, 25 mg
Syp. 5 mg/ 5ml
Dose:
6 months – 1 year: 5-10 mg/day OD/BD I/M or Oral
1 year – 5 years: 5-15 mg/ day OD/BD I/M or Oral
Or,
1 year – 6 years: 2-3 TSF OD oral
> 6 years: 2-3 TSF OD/BD Oral
Dr. Sarwar Jahan (Tomal) 18

Cetirizine:
Tab. 10 mg
Syp. 5 mg/ 5 ml
Dose:
6 months – 1 year: ½ TSF OD
2 years – 6 years: 1 TSF OD
> 6 years: 2 TSF OD

Desloratadine:
Tab. 5 mg
Syp. 2.5 mg/ 5 ml
Dose:
2-5 years: ½ TSF OD oral
> 5 years: 1 TSF OD oral

Ketotifen:
Tab. 1 mg
Syp. 1 mg/ 5ml
Dose:
6 months – 3 years: 0.5 mg BD or 1 mg OD oral
> 3 years: 1 mg BD oral

Montelukast:
Tab. 4 mg granules, 5 mg, 10 mg
Dose:
2-5 years: 4 mg daily at evening
6-14 years: 5 mg daily at evening
> 14 years: 10 mg daily at evening
Dr. Sarwar Jahan (Tomal) 19

Anti-ulcerant drugs:
Ranitidine:
Inj. 50 mg/ 2ml
Syp. 75 mg/ 5ml
Tab. 150 mg, 300 mg
Dose: 3-6 mg/Kg/day (Avg. 5 mg/Kg/day) I/V-TDS or Oral-BD
Or, 0.2-0.24 ml/Kg/day (or, 0.08 ml/Kg/dose) I/V TDS

Antacid:
Tab/Syp.
Dose:
2-5 years: ½ -1 TSF TDS/QDS
6-11 years: 1-2 TSF TDS/QDS
> 12 years: 2-3 TSF TDS/QDS or 1-2 tab TDS/QDS oral

Anti-spasmodic drugs
Dicycloverine
Tab. 10 mg
Syp. 10 mg/ 5 ml
Dose:

Tiemonium methyl sulphate

Inj. 5 mg/ 2 ml amp
Syp. 5 mg/ 5 ml
Tab. 50 mg
Dose: 2-6 mg/Kg/day (or, 1-2 mg/Kg/dose) oral TDS/BD
Shortcut: 6-12 years: 2 TSF TDS/BD oral & - th amp I/V or I/M TDS/BD

Hyoscine-n-butyl bromide:
Inj. 20 mg/ 2ml
Tab. 10 mg, 20 mg
Dose: 6-12 years: 10 mg/day TDS/BD oral & - th amp I/V or I/M TDS/BD
Dr. Sarwar Jahan (Tomal) 20

Anti-constipant drugs
Lactulose:
Syp. 3.4 mg/ 5ml
Dose:
< 1 year: ½ TSF BD/TDS
1-5 years: 1 TSF BD/TDS
6-12 years: 2 TSF BD/TDS
> 12 years: 2-6 TSF BD/TDS Oral

Nitroglycerine
Suppository. 1.15 mg, 2.30 mg
Dose:
< 12 years: 2-4 (1.15 mg) stick PR SOS
> 12 years: 3-6 (2.30 mg) stick PR SOS

Milk of magnesia:
Syp.
Dose:
< 1 year: ½ - 1 TSF BD/TDS
1-5 years: 1-2 TSF BD/TDS
6-12 years: 2-4 TSF BD/TDS
> 12 years: 4-6 TSF BD/TDS Oral

Anti-flatulent drugs
Simethicone:
Tab. 40 mg
Drop. 67 mg/ 1 ml (15 drops)
Dose:
< 2 years: 20 mg (0.3 ml) = 5 drops QDS/TDS
2-12 years: 40 mg (0.6 ml) = 10 drops QDS/TDS
> 12 years: 1-2 tab QDS/TDS
Dr. Sarwar Jahan (Tomal) 21

Anti-emetic drugs
Domperidone:
Tab. 10 mg
Drop. 5 mg/ 1 ml (15 drops)
Syp. 5 mg/ 5 ml
Dose: 0.2-0.4 mg/Kg/dose Oral TDS/QDS
Shortcut: 1 drop/Kg/dose oral TDS/QDS in case of paediatric drop
But usually we use as followings-
Neonate (≤ 1 month): 5 drops TDS/QDS oral
Children: 10-15 drops/10 kg oral QDS/TDS
Or, 2-4 ml/10 Kg oral TDS/QDS
> 12 years: 1-2 tab TDS/QDS oral
For induction of lactation in lactating mother: 1-2 tab oral TDS/QDS (1-4 weeks duration)

Ondansetron:
Inj. 8 mg/ 4 ml
Tab. 4 mg, 8 mg
Syp. 4 mg/ 5 ml
Dose:
6 months – 4 years (or, 8-15 Kg BWt.): 2 mg TDS/QDS oral
4 years – 11 years (or, 15-30 Kg BWt.): 4 mg TDS/QDS oral
> 12 years (or, > 30 Kg): 8 mg TDS/QDS oral
& 0.15 mg/Kg/dose TDS/BD I/V or Oral

Anti-asthmatic (Bronchodilator)/ Anti-apneic drugs

Salbutamol:
Tab. 2 mg, 4 mg If Weight = 9 Kg, then,
Syp. 2mg/ 5ml Dose of Syp. will be-
Inhaler. 5 mg/ml Syp. Salbutamol (2mg/ 5ml)
Dose: 0.2-0.4 mg (Avg. 0.3 mg)/Kg/day Oral TDS/BD 3 ml + 3 ml + 3 ml
& 0.05-0.25 mg/Kg/dose TDS/QDS for nebulization (=9 ml/day)
Shortcut:
1ml/Kg/day oral divided into TDS/BD in case of syrup & 0.03 ml/Kg/dose for nebulization.

Levosalbutamol:
Tab. 1 mg, 2 mg If Weight = 9 Kg, then,
Syp. 1 mg/ 5 ml Dose of Syp. will be-
Dose: ½ of the dose of salbutamol, that means Syp. levosalbutamol (1mg/ 5ml)
0.1-0.2 mg/Kg/day Oral TDS/BD 1.5 ml + 1.5 ml + 1.5 ml
Shortcut: (=4.5 ml/day)
0.5 ml/Kg/day oral divided into TDS/BD in case of Syrup
Dr. Sarwar Jahan (Tomal) 22

Ipratropium bromide
Inhaler. 20 µg/puff
Nebulization solution. 250 µg/1 ml
Dose: 0.02-0.03 ml/Kg/dose TDS/QDS for nebulization
Shortcut:
- 0.03 ml/Kg/dose for nebulization or as followings-
o Neonate (≤ 1 month): 0.02-0.3 ml (Avg. 0.25 ml)/ dose TDS/QDS
o 1 month- 6 months: 0.4 ml/dose TDS/QDS
o 6 months- 2 years: 0.5 ml/dose TDS/QDS
o > 2 years: 0.5-1 ml/dose TDS/QDS for nebulization

Theophylline:
Tab. 200 mg, 300 mg, 400 mg, 600 mg
Syp. 125 mg/ 5 ml
Dose: 10-20 mg/Kg/day oral TDS/BD

Aminophylline:
Inj. 125 mg/ 5 ml amp
Tab. 100 mg, 200 mg
Dose: 12 mg/Kg/dose BD/TDS oral
& in case of I/V as following-
Loading dose (LD): 5 mg/Kg/dose or 0.2 ml/Kg/dose stat I/V & then
Maintenance dose (MD): 2.5 mg/Kg/dose or, 0.1 ml/Kg/dose TDS/BD
LD & MD should be diluted with equal amount of D/W or N/S respectively
Shortcut:
0.2 ml/Kg/dose I/V stat LD & then
0.1 ml/Kg/dose I/V TDS/BD in case of apnoea
Dr. Sarwar Jahan (Tomal) 23

Cough suppressant drugs

Ambroxol.
Syp./Tab. (Tab. 75 mg)
Dose:
2-5 years: ½ TSF BD/TDS
5-10 years: 1 TSF BD/TDS
> 10 years: 2 TSF TDS

Butamirate:
Syp./Tab. (Tab. 50 mg)
Dose:
2-5 years: ½ TSF BD/TDS
5-10 years: 1 TSF BD/TDS
> 10 years: 2 TSF TDS & 1 tab (50 mg) TDS/BD

Herbal product (Basok, Adovas, Devas):

Syp.
Dose:
2-5 years: ½ TSF BD/TDS
5-10 years: 1 TSF BD/TDS
> 10 years: 2 TSF TDS

Dextromethorphan:
Syp.
Dose:
2-5 years: ½ TSF BD/TDS
5-10 years: 1 TSF BD/TDS
> 10 years: 2 TSF TDS

Bromhexin:
Syp.
Dose:
2-5 years: ½ TSF BD/TDS
5-10 years: 1 TSF BD/TDS
> 10 years: 2 TSF TDS
Dr. Sarwar Jahan (Tomal) 24

Anti-convulsant drugs
Diazepam
Inj. 10 mg/ 2ml
Tab. 5 mg
Suppository. 10 mg
Dose:
Per rectal: 0.2-0.3 (Avg. 0.35 mg) mg/Kg/dose stat & SOS but not more than 10 mg/day
Oral: 0.3 (0.35 mg) mg/Kg/dose BD/TDS maximum daily dose 10 mg
I/V/I/M: 0.2-0.3 mg/Kg/dose
Shortcut:
I/V/PR dose calculation: 0.1 ml/Kg/dose (diluted with same amount of D/W)
But never 2ml (10 mg)/day

Phenobarbitone:
Inj. 200 mg/ 1 ml amp
Syp. 20 mg/ 5 ml
Tab. 30 mg, 60 mg
Dose: 3-6 mg/Kg/day oral BD/TDS
But clinically we use 5 mg/Kg/day oral BD/TDS
& LD1 = 20 mg/Kg/dose I/V stat
LD2 & LD3 = 10 mg/Kg/dose I/V stat

MD = = = 2.5 mg/Kg/dose I/V BD

Diuretics
Frusemide:
Inj. 20 mg/ 2 ml
Syp. 20 mg/ 5 ml
Tab. 40 mg
Dose: 1-2 mg/Kg/dose BD/OD/TDS I/V or Oral
Shortcut: 0.1 ml/Kg/dose I/V OD/BD/TDS

Mannitol:
Inf. 20% solution
Dose: 10 ml/Kg/day or 2.5-5 ml/Kg/dose I/V TDS/QDS over 30 minutes-1 hour
Shortcut: 5 ml/Kg I/V stat & then 2.5 ml/Kg I/V TDS over 30 minutes-1 hour
Dr. Sarwar Jahan (Tomal) 25

Steroids
Hydrocortisone:
Inj. 100 mg/ 2 ml vial
Dose: 2.5-5 mg/Kg/dose I/V QDS/TDS (or, 10-20 mg/Kg/day I/V)
In shock (hypovolemic/anaphylactic): 50 mg/Kg/dose I/V
Shortcut: 0.1 ml/Kg/dose I/V QDS/TDS

Prednisolone:
Tab. 5 mg, 10 mg, 20 mg
Syp. 5 mg/ 5 ml, 15 mg/ 5ml
Dose: 1-2 mg/Kg/day or 60 mg/m2 BSA OD/BD/TDS oral
But clinically we use 0.5-1 mg/Kg/day oral OD/BD/TDS

Dexamethasone:
Tab. 0.5 mg
Inj. 5 mg/1 ml amp
Dose: 0.15-0.5 mg/Kg/dose TDS I/V
But usually we use 0.15 mg/Kg/dose I/V TDS
Shortcut: 0.03 ml/Kg/dose I/V TDS or 0.1-0.12 ml/Kg/day I/V TDS

Vitamins & Minerals

Zinc:
Tab. 20 mg
Syp. 10 mg/ 5 ml
Dose: 1-2 mg/Kg/day oral BD/OD
Shortcut:
Wt. < 10 Kg (or Age < 6 months): ½ TSF BD
Wt. > 10 Kg (or Age > 6 months): 1 TSF BD Oral

Folic acid:
Tab. 5 mg
Dose: 0.2-0.3 mg/Kg/day oral OD (Avg. 0.25 mg/Kg/day)
Clinically we use 1 tab (5 mg) stat oral & then tab or tab oral OD-from 15 day of
age to 3 months of age.

Vitamin-A:
Cap. 50,000 IU & 2,00,000 IU
Dose:
< 6 months: 50,000 IU (1 cap)
6 months – 1 year: 1,00,000 IU (2 cap)
> 1 year: 2,00,000 IU (4 cap)
On the D1, D2, D14
Dr. Sarwar Jahan (Tomal) 26

KCl (KT)
Syp. 6.7 mmol/ 5 ml
Inj.
Dose: 2-4 mmol/Kg/day oral OD/BD/TDS
But clinically we use 2 mmol/Kg/day- OD/BD oral
Shortcut:
Age < 6 months (or BWt. < 10 Kg): ½ TSF BD oral
Age > 6 months (or BWt. > 10 Kg): 1 TSF BD oral

Vitamin-B complex
Syp./Tab./Cap./Inj.
Dose:
BWt. < 10 Kg : 1 TSF OD
BWt. 10-30 Kg: 1 TSF TDS/BD
BWt. > 30 Kg : 2 TSF TDS/BD

Vitamin-K
Inj. 2 mg/0.2 ml, 10 mg/ 1 ml
Dose: 0.2 mg/Kg/dose I/V OD on 3 days
[ ½ amp I/V given at 4 hour, 4 days & 4 weeks of age]

Iron
Dose:
Neonate: 8-15 drops (0.5-1ml)
< 2 years: 2.5 ml Syp. OD ( ½ TSF OD)
2-6 years: 5 ml Syp. OD/BD (1TSF OD/BD)
6-12 year: 5-10 ml Syp. OD/BD (1-2 TSF OD/BD)

Multivitamin:
Dose:
1-3 months: 5 drops BD
3-6 months: 10 drops BD
6 months -1 year: 1 TSF BD
1 – 4 years: 1-2 TSF BD
4 – 12 years: 2-3 TSF BD
> 12 years: 3-4 TSF BD
Dr. Sarwar Jahan (Tomal) 27

Others
Adrenalin:
Inj. 1 mg/ 1ml amp [1 mg = 1:1000]
Dose:
I/V (Or, S/C): at first dilute 1 amp (1 mg/ 1ml) with 10 ml D/W &
then give 0.1 ml/Kg/dose I/V (or S/C) stat & sos

Oxymetazoline (0.025%)/Xylometazoline (0.05%):

Dose: 2-3 drops 2-4 times daily in each nostril

Zn Oxide:
apply on affected area

MgSO4:
Dose: 0.1 ml/Kg/dose

NaHCO 3 (7.5%):
Dose: 1 ml/Kg/dose diluted with equal amount of D/W

Ca-gluconate:
Dose: 1 ml/Kg/dose diluted with equal amount of D/W- I/V TDS/QDS