PALS Course

Chapter 8 : Pediatric Pharmacology

Drug	Adenosine
Indications	SVT
Side Effects	Facial flushing Shortness of breath Lightheadedness Nausea Hypotension Dyspnea Palpitations Angina Headache
Dosage	First dose: 0.1 mg/kg IV/IO rapid push (max 6 mg) Second dose: 0.2 mg/kg IV/IO rapid push (max 12 mg)

PALS By American HealthCare Academy Video:

Drug	Albuterol
Indications	Asthma Anaphylaxis Hyperkalemia
Side Effects	Anxiety Headache Cough Dyspnea Palpitations Tachycardia Hypertension Heartburn Nausea Diarrhea Flushing Hypotension
Dosage	4 to 8 puffs repeat 20 minutes PRN 2.5 mg/dose every 20 minutes for children <20 kg 5 mg/dose every 20 minutes for children >20 kg
Drug	Amiodarone
Indications	SVT VT Pulseless arrest
Side Effects	Headache Dizziness Pulmonary fibrosis ARDS Bradycardia Nausea Vomiting Rash Hyper or hypothyroidism CHF Abdominal pain
Dosage	SVT, VT: 5 mg/kg IV/IO load over 20 to 60 minutes max dose of 300 mg Pulseless arrest: 5 mg/kg IV/IO bolus max dose of 300 mg
Drug	Atropine
Indications	Symptomatic Bradycardia Toxins or overdose Rapid sequence intubation
Side Effects	Headache Dizziness Blurred vision Tachycardia Hypotension Nausea Vomiting Urinary retention Rash Dry skin
Dosage	0.02mg/kg. May repeat once. Minimum dose is 0.1 mg and max single dose is 0.5 mg. Bradycardia: 0.02 mg/kg IV/IO and can repeat one dose. Or 0.04 to 0.05 mg/kg ET Toxins or overdose: 0.02 to 0.05 mg/kg IV/IO initially and repeat every 20 to 30 minutes for children <12 years of age. Or 0.05 mg/kg IV/IO initially and then 1 to 2 mg repeat every 20 to 30 minutes for children >12 years of age RSI: 0.01 or 0.02 mg/kg IV/IO or 0.02 mg/kg IM

PALS Certification by American HealthCare Academy Video:

Drug	Epinephrine
Indications	Anaphylaxis Asthma Bradycardia Croup Pulseless arrest Shock –hypotensive Toxins/overdose
Side Effects	Tremors Anxiety Dyspnea Arrhythmias Palpitations Tachycardia Hypertension Nausea Vomiting Renal vascular ischemia Hyperglycemia
Dosage	Anaphylaxis: 0.01 mg/kg in thigh every 15 mins or 0.01 mg/kg every 3 to 5 minutes IV/IO Asthma: 0.01 mg/kg every 15 minutes Bradycardia: 0.01 mg/kg every 3 to 5 minutes IV/IO Croup: 0.25 mL racemic solution with 3 mL NS by inhaled nebulizer or 3 ml by inhaled nebulizer Pulseless Arrest: 0.01 mg/kg every 3 to 5 minutes IV/IO Hypotensive shock: 0.1 to 1 µg/kg per minute IV/IO infusion Toxins/overdose: 0.01 mg/kg IV/IO 0.3mg autoinjector
Drug	Ipratropium Bromide
Indications	Asthma
Side Effects	Anxiety Dizziness Blurred vision Cough Palpitations Nausea Vomiting Rash
Dosage	250 to 500 µg inhaled every 20 minutes x 3 doeses
Drug	Lidocaine
Indications	VF/pulseless VT Wide-complex tachycardia RSI
Side Effects	Seizures Headache Dizziness Tinnitus Blurred vision Hypotension Cardiac arrest Dyspnea Nausea Vomiting Rash Edema
Dosage	Pulseless VT/VF and complex Tachy: 1 mg/kg IV/IO loading bolus initial and 20 to 50 µg/kg per minute IV/IO infusion for maintenance RSI: 1 to 2 mg/kg IV/IO

PALS Course by American HealthCare Academy Video:

Drug	Magnesium Sulfate
Indications	Torsades de pointes Asthma Hypomagnesemia
Side Effects	Confusion Sedation Respiratory depression Hypotension Bradycardia Nausea Vomiting Cramps Flushing Sweating
Dosage	Asthma: 25 to 50 mg/kg IV/IO slower infusion 15 to 30 minutes Torsades: 25 to 50 mg/kg IV/IO bolus Hypomagnesemia: 25 to 50 mg/kg IV/IO over 10 to 20 minutes

Drug	Methylprednisolone
Indications	Asthma Anaphylactic shock
Side Effects	Depression Headache Hypertension Embolism Hemorrhage Diarrhea Nausea Fractures Hyperglycemia Ulcers
Dosage	Load 2mg/kg (max 60 mg)and maintenance of 0.5 mg/kg for 6 hours (max of 120 mg/d)

Drug	Nitroglycerine
Indications	Congestive heart failure Cardiogenic shock
Side Effects	Headache Dizziness Hypoxemia Tachycardia Cardiac arrest Syncope Flushing Pallor Sweating
Dosage	0.25 to 0.5 µg/kg per minute IV/IO infusion and can increase to 0.5 to 1 µg/kg per minute every 3 to 5 minutes PRN for max dose of 10 µg/kg per minute

Drug	Norepinephrine
Indications	Hypotensive shock
Side Effects	Headache Anxiety Respiratory distress Hypertension Tachycardia Renal failure Arrhythmias
Dosage	0.05 to 2mcg/kg/min
Drug	Oxygen
Indications	Hypoxia Respiratory distress/failure Shock Trauma Cardiopulmonary failure Cardiac arrest
Side Effects	Headache Dry mucous membranes Airway obstruction Gastric distention
Dosage	100% O2 initially via high flow O2 system
Drug	Sodium Nitroprusside
Indications	Cardiogenic shock Hypertension
Side Effects	Seizures Headache Nausea Hypothyroidism Cyanide toxicity
Dosage	0.3 to 2 mcg/kg/min (with max 8 mcg/kg/min prn)

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Course: PALS Course

Chapter 8 : Pediatric Pharmacology

Drug	Adenosine
Indications	SVT
Side Effects	Facial flushing Shortness of breath Lightheadedness Nausea Hypotension Dyspnea Palpitations Angina Headache
Dosage	First dose: 0.1 mg/kg IV/IO rapid push (max 6 mg) Second dose: 0.2 mg/kg IV/IO rapid push (max 12 mg)

PALS By American HealthCare Academy Video:

Drug	Albuterol
Indications	Asthma Anaphylaxis Hyperkalemia
Side Effects	Anxiety Headache Cough Dyspnea Palpitations Tachycardia Hypertension Heartburn Nausea Diarrhea Flushing Hypotension
Dosage	4 to 8 puffs repeat 20 minutes PRN 2.5 mg/dose every 20 minutes for children <20 kg 5 mg/dose every 20 minutes for children >20 kg
Drug	Amiodarone
Indications	SVT VT Pulseless arrest
Side Effects	Headache Dizziness Pulmonary fibrosis ARDS Bradycardia Nausea Vomiting Rash Hyper or hypothyroidism CHF Abdominal pain
Dosage	SVT, VT: 5 mg/kg IV/IO load over 20 to 60 minutes max dose of 300 mg Pulseless arrest: 5 mg/kg IV/IO bolus max dose of 300 mg
Drug	Atropine
Indications	Symptomatic Bradycardia Toxins or overdose Rapid sequence intubation
Side Effects	Headache Dizziness Blurred vision Tachycardia Hypotension Nausea Vomiting Urinary retention Rash Dry skin
Dosage	0.02mg/kg. May repeat once. Minimum dose is 0.1 mg and max single dose is 0.5 mg. Bradycardia: 0.02 mg/kg IV/IO and can repeat one dose. Or 0.04 to 0.05 mg/kg ET Toxins or overdose: 0.02 to 0.05 mg/kg IV/IO initially and repeat every 20 to 30 minutes for children <12 years of age. Or 0.05 mg/kg IV/IO initially and then 1 to 2 mg repeat every 20 to 30 minutes for children >12 years of age RSI: 0.01 or 0.02 mg/kg IV/IO or 0.02 mg/kg IM

PALS Certification by American HealthCare Academy Video:

Drug	Epinephrine
Indications	Anaphylaxis Asthma Bradycardia Croup Pulseless arrest Shock –hypotensive Toxins/overdose
Side Effects	Tremors Anxiety Dyspnea Arrhythmias Palpitations Tachycardia Hypertension Nausea Vomiting Renal vascular ischemia Hyperglycemia
Dosage	Anaphylaxis: 0.01 mg/kg in thigh every 15 mins or 0.01 mg/kg every 3 to 5 minutes IV/IO Asthma: 0.01 mg/kg every 15 minutes Bradycardia: 0.01 mg/kg every 3 to 5 minutes IV/IO Croup: 0.25 mL racemic solution with 3 mL NS by inhaled nebulizer or 3 ml by inhaled nebulizer Pulseless Arrest: 0.01 mg/kg every 3 to 5 minutes IV/IO Hypotensive shock: 0.1 to 1 µg/kg per minute IV/IO infusion Toxins/overdose: 0.01 mg/kg IV/IO 0.3mg autoinjector
Drug	Ipratropium Bromide
Indications	Asthma
Side Effects	Anxiety Dizziness Blurred vision Cough Palpitations Nausea Vomiting Rash
Dosage	250 to 500 µg inhaled every 20 minutes x 3 doeses
Drug	Lidocaine
Indications	VF/pulseless VT Wide-complex tachycardia RSI
Side Effects	Seizures Headache Dizziness Tinnitus Blurred vision Hypotension Cardiac arrest Dyspnea Nausea Vomiting Rash Edema
Dosage	Pulseless VT/VF and complex Tachy: 1 mg/kg IV/IO loading bolus initial and 20 to 50 µg/kg per minute IV/IO infusion for maintenance RSI: 1 to 2 mg/kg IV/IO

PALS Course by American HealthCare Academy Video:

Drug	Magnesium Sulfate
Indications	Torsades de pointes Asthma Hypomagnesemia
Side Effects	Confusion Sedation Respiratory depression Hypotension Bradycardia Nausea Vomiting Cramps Flushing Sweating
Dosage	Asthma: 25 to 50 mg/kg IV/IO slower infusion 15 to 30 minutes Torsades: 25 to 50 mg/kg IV/IO bolus Hypomagnesemia: 25 to 50 mg/kg IV/IO over 10 to 20 minutes

Drug	Methylprednisolone
Indications	Asthma Anaphylactic shock
Side Effects	Depression Headache Hypertension Embolism Hemorrhage Diarrhea Nausea Fractures Hyperglycemia Ulcers
Dosage	Load 2mg/kg (max 60 mg)and maintenance of 0.5 mg/kg for 6 hours (max of 120 mg/d)

Drug	Nitroglycerine
Indications	Congestive heart failure Cardiogenic shock
Side Effects	Headache Dizziness Hypoxemia Tachycardia Cardiac arrest Syncope Flushing Pallor Sweating
Dosage	0.25 to 0.5 µg/kg per minute IV/IO infusion and can increase to 0.5 to 1 µg/kg per minute every 3 to 5 minutes PRN for max dose of 10 µg/kg per minute

Drug	Norepinephrine
Indications	Hypotensive shock
Side Effects	Headache Anxiety Respiratory distress Hypertension Tachycardia Renal failure Arrhythmias
Dosage	0.05 to 2mcg/kg/min
Drug	Oxygen
Indications	Hypoxia Respiratory distress/failure Shock Trauma Cardiopulmonary failure Cardiac arrest
Side Effects	Headache Dry mucous membranes Airway obstruction Gastric distention
Dosage	100% O2 initially via high flow O2 system
Drug	Sodium Nitroprusside
Indications	Cardiogenic shock Hypertension
Side Effects	Seizures Headache Nausea Hypothyroidism Cyanide toxicity
Dosage	0.3 to 2 mcg/kg/min (with max 8 mcg/kg/min prn)