Acute Gastroenteritis

DRUG DOSE/PREP/DURATION DOSE/PREP/DURATION

Bacillus clausii  Dilute contents of 1 vial in
TID x 5 days
(Erceflora) sweetened juice or milk
Oral Rehydration Solution  Take as volume per volume
PRN
(Vivalyte/Pedialyte) replacement
 Drops OD x 2 weeks  Syrup OD x 2 weeks
Zinc Sulfate o <6 months: 1ml o <6 months: 2.5ml
o >6 months: 2ml o >6 months: 5ml

Acute Hypersensitivity Reaction

DRUG DOSE/PREP/DURATION DOSE/PREP/DURATION
 12.5mg/5ml
Diphenhydramine  Weight in kilograms x 1/IM or IV
o 5ml ODHS x 5 days
 Weight in kilograms x 5/IV
Hydrocortisone
o Max dose: 250mg/IV
Oxygen support  2 lpm via nasal cannula PRN
 5mg/5ml syrup ODHS x 5 Days
 2.5mg/5ml oral drops
o 1-2 years old: 1ml
Cetirizine o 6-12 months: 1ml
o 2-5 years old: 5ml
o 2-5 years old: 2ml
o 6-12 years old: 10ml
Acute Tonsillopharyngitis
DRUG DOSE/PREP/DURATION DOSE/PREP/DURATION
 10 mkd  every 4 hours PRN for
Paracetamol o 100mg/ml oral drops fever > 37.8C
o 250mg/5ml syrup
 < 3 months: 30 mkd q12 x 7 days
 > 3 months:  315.5mg/5ml
Co-Amoxiclav
o 20-40 mkd q8 x 7 days  457mg/5ml
o 25-45 mkd q 12 x 7 days
*when able
 Gargle 15 ml  TID x 7 days
Hexetidine Gargle

Benign Febrile Seizure

DRUG DOSE/PREP HOW LONG TO TAKE
DO NOT PUT ANYTHING ON THE MOUTH
 10 lpm while on active seizure
Oxygen support then decrease accordingly post-
seizure
 0.2-0.5 mkd/IV
Diazepam
 2.5mg/rectal gel (max: 10mg)
 10 mkd  Every 4 hours RTC for the
Paracetamol o 100mg/ml oral drops first 24 hours then PRN for
250mg/5ml syrup fever >37.8C
Carbuncle/Furuncle/Cellulitis
DRUG DOSE/PREP HOW LONG TO TAKE
 10 mkd  every 4 hours PRN for
Paracetamol o 100mg/ml oral drops fever > 37.8C
o 250mg/5ml syrup
 50-100mkd
Cloxacillin o 125mg/5ml oral suspension  Every 6 hours x 7 days
o 500mg/cap
 10-30mkd
o 75mg/5ml  Every 6 to 8 hours x 7
Clindamycin
o 150mg/cap days
o 300mg/cap
Mupirocin ointment  Apply to affected area  TID x 7 days
Fucidin cream/ointment  Apply to affected area  BID-TID x 7 days

Dyspepsia/GERD
DRUG DOSE/PREP HOW LONG TO TAKE
 40mg/cap 30mins before
Omeprazole 2 weeks
breakfast
 10ml every after meal and at
Maalox 5 days
bed time
Upper Respiratory Tract Infection
DRUG DOSE/PREP HOW LONG TO TAKE
 10 mkd  every 4 hours PRN for
Paracetamol o 100mg/ml oral drops fever > 37.8C
o 250mg/5ml syrup
Procaterol  5mcg/ml
 BID x 5 days
(Meptin) o Wt x .25
 30mg/5ml
Levodropropizine o 10-20kg BW: 3ml
 TID x 7 days
(Levopront) o 20-30kg BW: 5ml
o >2 years old: 1mkd
 200mg/sachet
*for 2 years and up
o Dissolve contents in ½ glass  BID x 5 days
N-Acetylcysteine
of water
 2mg/5ml syrup
*If with tight air entry o 2-6 years old: 2.5-5 ml  Every 6 to every 8 hours
Salbutamol syrup o 7-12 years old: 5ml for 5 days
o >12 years old: 5ml to 10 ml
Sodium Chloride Nasal
 1-2 sprays/drops each nostril  TID x 5 days
Spray/Drops
 6.25mg/ml drops: TID-QID x 5 d
 12.5mg/5ml syrup: TID-
o 1-3 months: ¼ ml
Phenylpropanolamine QID x 5 days
o 4-6 months: ½ ml
(Disudrin) o 2-6 years old: ½ tsp
o 7-12 months: ¾ ml
o 7-12 years old: 1 tsp
o 1-2 years old: 1 ml
Urinary Tract Infection
DRUG DOSE/PREP HOW LONG TO TAKE
 10 mkd  every 4 hours PRN for
Paracetamol o 100mg/ml oral drops fever > 37.8C
o 250mg/5ml syrup
 20-40mkd
o 250mg/5ml
Amoxicillin o 125mg/5ml  TID x 7days
o 250mg/cap
o 500mg/cap
 6-12mkd or 30-60mkd
TMP-SMX  BID x 7 days
o 40mg/200mg/5ml
 8mkd
Cefixime o 100mg/5ml oral susp  BID x 7 days
o 20mg/ml oral drops
PCAP
DRUG DOSE/PREP HOW LONG TO TAKE
 10 mkd  every 4 hours PRN for
Paracetamol o 100mg/ml oral drops fever > 37.8C
o 250mg/5ml syrup
 40-50mkd
o 250mg/5ml
Amoxicillin o 125mg/5ml  BID or TID x 7days
o 250mg/cap
o 500mg/cap
 10mkd
o 100mg/5ml
Azithromycin  OD x 3 days
o 250mg/tab
o 500mg/tab
 15mkd
o 125mg/5ml
Clarithromycin o 250mg/5ml  BID x 7 days
o 250mg/tab
o 500mg/tab
LIST OF PEDIATRIC DRUGS
DRUG DOSE PREPARATION
 IV: 30 mkD q8 x 7 – 10 days
 PO: 80 mkD QID x 5 days
 ADULT: 800 mg 5x/D for 7 days
200mg cap
Acyclovir  CHILDREN:
200mg/5ml
o > 6 YRS OLD: 800 mg
o 2 - 6 YRS OLD: 400 mg
o < 2 YRS OLD: 200 mg
30mg tablet
Ambroxol Hydrochloride 1.2-1.6 mkD
15mg/5ml
50mg/ml
Amikacin 15-22.5 mkD q8 125mg/ml
250mg/ml
 LD: 6 mkDose
Aminophylline
 MD: 2.5 mkDose q12
250mg cap
Amoxicillin 25-50 mkD q8 500mg cap
125/250mg/5ml
 <3 MONTHS: 30 mkD q12 TID: 125/31.25
Amoxicillin-Clavulanic 250/62.5mg
Acid  >3 MONTHS: 20-40mkD q8 or
(Co-amoxiclav) 25-45 mkD q12 BID: 200/28.5
 IV: 30 – 50 mkD q8 400/57mg
 DRUG DOSE PREPARATION
100-200 mkD q6
250mg vial
Ampicillin  MENINGITIC DOSE:
500mg vial
200-400 mkD q4-q6
375mg:
 IV-IM:
125mg sulbactam
o 100-200 mkD q6
Ampicillin-Sulbactam 250mg ampicillin
 MENINGITIC DOSE:
750mg: 250/500
O 200-400mkD q4-q6
1.5g: 500/1000
250mg tab
Azithromycin 10 mkD OD x 3 days 500mg tab
100mg/5ml
1 cc/k/d
Calcium gluconate  < 3 YRS OLD: 2-5 tsp
 4-12 YRS OLD: 2-3 tbsp
250mg cap
Cefaclor 500mg cap
20-40 mkD q8
(2nd Generation) 50mg/ml drops
125mg/5ml 250mg/5ml
500mg
Cefazolin 50-100 mkD q8
1g vial
100 mkD q12
Cefepime 500mg
(4th Generation)  MENINGITIC DOSE: 1g vial
150 mkD q8
 DRUG DOSE PREPARATION
Cefixime 8 mkD q12-24 20mg/ml
(3rd Generation)  TYPHOID: 20 mkD 100mg/5ml
250mg
Cefazidime 500mg
90-150 mkD q8
(3rd Generation) 1g
2g
Cefotaxime
50 - 100 mkD q12
(3rd Generation)
250mg
Ceftriaxone 50-75 mkD q12-24
500mg
(3rd Generation)  NEONATES: 20 - 50 mkD
1g vial
125mg/5ml
Cefuroxime  IV: 75-150 mkD q8 250mg/5ml
(2nd Generation)  PO: 20mkD q12 250mg
500mg
Cefalexin
25-100 mkD q6 125/250/5ml
(1st Generation)
 6 MONTHS - 2YRS OLD:
o 2.5mg OD 5mg tab
 1 – 5 YRS OLD: 10mg tab
Cetirizine
o 2-5mg OD/ 5 drops BID 5mg/5ml
 6 YRS OLD: 2.5mg/ml drops
o 5-10mg/ 10 drops BID
 DRUG DOSE PREPARATION
 IV: 50-75mkD q6
 MENINGITIC DOSE: 75-100 mkD
q6
125/5ml susp
Chlorampenicol  FULL TERM – 2 WEEKS
1g vial
o 20-50 mkd
 PRETERM – NEWBORN
o 25 mkd q6
Cimetidine 5 mkDose
100mg
 IV: 10-20 mkD q12
Ciprofloxacin 250mg
 PO: 20-30 mkD q12
500mg
Cisapride 0.1-0.3 mkD TID - QID for GERD
125mg/5ml
Clarithromycin 15 mkD q12 250mg/5ml
250mg tab 500mg tab
 IV/IM: 25-40 mkD q6-q8
Clindamycin 75mg/5ml
 PO: 10-30 mkD q6-8
Cloxacillin 50 - 100 mkD q6
 IV/PO: 80 TMP/400SMX
Co-trimoxazole o 8-10 mkD q12 based on 40/200/5ml
TMP
 DRUG DOSE PREPARATION
 BPD:
o 0.5 mkD x 3 days then 0.4, 0.3, 0.2 then
DC for a total of 15 days or 2 weeks
Dexamethasone  LARYNGEAL EDEMA:
o 0.3 mkD then 0.1 mkD or 0.5 - 1 mkD
q6 beginning 24h prior to extubation
continued for 4-6 doses
 IV: 0.2 -0.5 mkD 10mg/2ml amp
Diazepam
 PER RECTUM: 0.5 mkD 2.5mg rectal gel
12.5/5 ml
 IV: 1-2 mkD q6 25mg tab
Diphenhydramine
 PO: 3-5 mkD q6 50mg tab
50mg/ml amp
Domperidone 0.3 - 0.6 mkDose TID AC
 IV: 0.01 mg/kg
1:10,000 solution
Epinehrine
 ET: 0.1 mg/kg
1:1,000 solution
250/5ml
Erythromycin 30-50 mkD q6
500mg tab
40mg/5ml
 IV: 0.6 - 0.8 mkD q8-12
Famotidine 10mg, 20mg, 40mg
 PO: 1-1.2 mkD q8-12
 DRUG DOSE PREPARATION
30mg/5ml
Ferrous Sulfate 3-6 mkD OD-TID
15mg/ml drops
20mg/2ml
 IV: 0.5-2 mkD q6-12
Furosemide 20mg
 PO: 1-6 mkD q12-24
40mg
Gentamycin 7.5 mkD q8
 LD: 4-8 mkD 100mg
Hydrocortisone
 MD: 8 mkD q6 (MCU 5mkD) 250mg vial
10mg/5ml
10mg
Hydroxyzine 2 mkD q6-8
25mg
50mg
100mg/5ml
200mg/5mll
Hydroxyzine 2 mkD q6-8 40mg/ml
100mg tablet
200mg tablet
Ibuprofen 10 - 20 mkD q6 100 mg/5mL
Imipinem 15 mkDose q8 - q6
0.2 mkDose x 3 doses q8
PDA: Extended dose - 5 doses more OD or
Indomethacin
repeat the initial dose
0.1 mkD OD q6 days
 DRUG DOSE PREPARATION
Isoniazid 5-10 mkD OD
 12 YRS OLD: 1 tab OD, 10 mL OD
 2 - 12 YRS OLD: > 30 kg = 10 mL
Loratidine
o < 30 kg = 5 mL
 1 - 2 YRS OLD: 2.5 mL OD
0.2 cc/kg dose IV + equal amount of
DH2O
200 mg = 0.8 mmol/L
Magnesium in
200 mg/0.8 mmol = 250mg/X
pulmonary HPN
X = 1 mmol
1 mmol = 1 mL
DOSE: 0.2 mkDose q8
Mannitol 1 - 2 cc/k
50mg/ml
100mg q12 BID x 3 days
20mg/5ml
Mebendazole or
100mg tablet
500mg OD
500mg tablet
 3 MONTHS:
O 60 mkD q8
Meropenem 1g
 MENINGITIC DOSE:
O 120 mkD q8
 DRUG DOSE PREPARATION
Metoclopramide 0.1 - 0.3 mkD TID - QID for GERD
125mg/5ml
Metronidazole 35-50 mkD q8 x 10 days 250mg
500mg
Midazolam 0.1 - 0.3 mkDose
 2-5 YRS OLD: 4mg
Monteleukast  6-14 YRS OLD: 5mg
 >15 YRS OLD: 10mg
Mycostatin 50000 u/k/dose
Nalidixic acid  PO: 50 - 55 mkD q6
Naloxone 0.1 mkDose
Netilmycin 10 - 20 mkD q12 - q8
 PO: 50-100 mkD q6
Oxacillin/ Cloxacillin 500mg 125mg/5ml
 IM-IV: 100-200 mkD q4-6
Paracetamol  PO/IV: 10-20 mkD q4-6
Penicillin G  IM/IV: 100,000-400,000 1m units/vial
125mg/5ml
250mg/5ml
Penicillin V 25-50 mkD q6-8
250mg capsule
500mg capsule
 LD: 10 - 20 mg
Phenobarbital
 MD: 300 mg
 DRUG DOSE PREPARATION
 <6 MONTHS OLD:
O 150-300mkD q6-8 2g/250mg
Piperacillin-Tazobactam
 6MONTHS OLD: 4g/500mg
O 300-400mkD q6-8
 ASTHMA:
o 2 mkD q12-24
Prednisone
 ANTI-INFLAMMATORY:
O 0.5-2 mkD q12-24
Pyrazinamide 15 - 30 mkD OD - BID
 IV: 2-4 mkD q6-8 (MCU 1 mkD PO)
Ranitidine 15mg/ml
 PO: 2-4 mkD q12
Rifampicin 10 - 20 mkD OD
0.1 mkD 16-8
Salbutamol 2mg/5ml
1-2 puffs q4-6 PRN
100 mkDose q12
Reconstitute 2g/vial with 10 cc H2O for
single injection get desired mL form the
reconstituted solution. Dilute further with 10
Tazocin
cc DW to run for 30 min

VLBW: 50 mkDose q8
 DRUG DOSE PREPARATION
Terbutaline PO: 0.075 mkDose
Theophylline 2.5 mkDose q12
Tobramycin 5 - 8 mkD q12
15 mkD q6-8
Vancomycin 500mg
30 – 40 mkd
10-20mg/day 10mg/ml
Zinc Sulfate
10 mkd 20mg/5ml
 MKD COMPUTATION NOTES
EXAMPLE #1: Wt = 12kg Drug prep = Amoxicillin 250/5mL

12kg x 50mg/kg x . 5ml . = 12ml = 3ml/dose

day 250mg 3

EXAMPLE #2: 15kg child given 7mL of Paracetamol 250mg/5mL

250mg x 7ml = 350mg = 23mg/kg  Overdose

5ml 15kg

30-50 mkd  CMEAT (Co-amoxiclav, Metronidazole, Erythromycin,

Amoxicillin, Tetracycline)
All anti-TB drugs are bactericidal except Pyrazinamide

EMPERICAL DOSAGING (not used for antibiotic and regulated drugs)

AGE DOSE AGE DOSE
0-3 months 0.3ml 1-3 yrs old 2.5ml
4-6 months 0.6ml 4-6 yrs old 5ml
7-9months 0.9ml 7-10 yrs old 7.5ml
10-12 months 1.2ml >10 years old 10ml
 ANTHROPOMETRICS: ADULT
BMI = . Weight (kg) .
Height2 (m2)
BMI CLASSIFICATION BMI
UNDERWEIGHT < 18.5
NORMAL 18.5 – 22.9
OVERWEIGHT 23 – 24.9
OBESE 1 25 – 29.9
OBESE 2 30 – 32
OBESE 3 > 32
IBW (< 5 FEET) = Height (cm) – 100- 10% of (Height – 100)
IBW (MALE) = 106lbs for the first 5 feet + 6lbs for every inch more than 5 feet
IBW (FEMALE) = 100lbs for the first 5 feet + 5lbs for every inch more than 5 feet
CALORIC REQUIREMENT = IBW + Activity
ACTIVITY kcal/kg BW
BEDREST 20
SEDENTARY 30
LIGHT WORK 35
MODERATE 40
HEAVY 45
DM DIET = 65% CHO 15% CHON 20% FAT
NORMAL DIET = 50-60% CHO 10-15% CHON 20-25% FAT
 ANTHROPOMETRICS: WEIGHT
Average birth weight: 3000 g
< 6 months (in grams) Age in months x 600 + BW
6-12 months (in grams) Age in months x 500 + BW
2-6 years (in kilograms) (Age in years x 2) + 8
6-12 years (in kilograms) . (Age in years x 7) – 5 .
2
ANTHROPOMETRICS: WEIGHT
At 4-5 months 2 x BW
At 1 year 3 x BW
At 2 years 4 x BW
At 3 years 5 x BW
At 5 years 6 x BW
At 7 years 7 x BW
At 10 years 10 x BW
ANTHROPOMETRICS: LENGTH
Average birth length: 50 cm or 20 inches
From birth to 3 months 9 cm
From 3-6 months 8 cm
From 6-9 months 5 cm
From 9-12 months 3 cm
HEIGHT IN CENTIMETERS = age in years x 5 +80
HEIGHT IN INCHES = age in years x 2 +32
 ANTHROPOMETRICS: HEAD CIRCUMFERENCE
1st 4 months ½ inch/month  2 inches (5 cm)
Next 8 months ¼ inch/month  2 inches (5 cm)
2nd year 1 inch (2.5 cm)
3rd to 5th years ½ inch/yr  1.5 inches (3.8 cm)
6th to 28th years ½ inch/5 yrs  1.5 inches (3.8 cm)

CATCH-UP GROWTH
= . Calculated weight for age . x IBW for height
Actual body weight

WATERLOWE CLASSIFICATION
STUNTING WASTING
NORMAL >95% >90%
MILD 87.5% - 95% 80-90%
MODERATE 80% - 87.5% 70-80%
SEVERE <80% <70%
STUNTING = Actual height x 100
Ideal height
WASTING = Actual weight x 100
Ideal weight
 CLINICAL FEATURES OF DEHYDRATION
PARAMETERS NO SIGNS SOME SIGNS SEVERE
Condition Well, alert Restless, irritable Lethargic or unconscious
Eyes Normal sunken Very sunken and dry
Tears Present Absent Absent
Mouth/ tongue Moist Dry Very dry
Thirst Drinks normally, Thirsty, drinks eagerly Drinks poorly or not able
not thirsty to drink
Skin pinch Goes back Goes back slowly Goes back very slowly
quickly
Heart Rate Normal Slightly increased Rapid, Weak
Systolic BP Normal Normal to Orthostatic, Hypotension
>10mmHg change
Urine output Decreased Moderately decreased Marked decrease, Anuria
Anterior Fontanel Normal Normal to sunken Sunken
 PNEUMONIA MALARIA (high risk)
Severe - Any general danger sign Very Severe - Any general danger sign
pneumonia or - Chest indrawing Febrile Malaria - stiff neck
Very Severe - Stridor in calm child Malaria - Blood smear (+)
disease - If clood smear not done:
Pneumonia - Fast breathing  No runny nose
No Pneumonia - No signs of pneumonia OR  No measles
Coughs and Colds - Very severe disease  No other cause of fever
 No fast breathing/
pneumonia
DENGUE
MALARIA (low risk)
Severe Dengue - Bleeding nose, gums,
Very severe febrile - Any general danger sign
vomitus, stool
Malaria - stiff neck
- Petechiae in the skin
Malaria - No runny nose
- Signs of shock
- No measles
- Cold clammy extremities
- No other cause of fever
- Slow capillary refill
FEVER; Malria - Presence of:
- Persistent abdominal pain
unlikely  Runny nose
- Persistent vomiting
 Measles
- Tourniquet test positive
 Other causes of fever
FEVER: DHF - No signs of severe dengue
unlikely hemorrhagic fever
 MEASLES EAR INFECTION
Severe - Any general danger sign Mastoiditis - Tender swelling behind the
Complicated - Clouding of cornea ear
Measles - Deep extensive mouth Acute Ear - Pus is seen draining from
ulcer Infection the ear and discharge is
Measles w/ Eye or - Pus draining from the eye reported for less than 14
mouth - Mouth ulcer days
complication - Ear pain
Measles - Measles now or within the Chronic Ear - Pus is seen draining from
last 3 months Infection the ear and discharge is
reported for 14 days or
more
MALNUTRITION
No Ear Infection - No ear pain and No pus
Severe - Visible severe wasting
seen draining from the
Malnutrition - Edema of both feet
ear
Very LOW weight - Very low weight for age
NOT very low - Not very low weight for
weight age and no other signs or ANEMIA
malnutrition Severe Anemia - Severe palmar pallor
Anemia - Some palmar pallor
NO Anemia - No palmar pallor
WONG-BAKER FACES PAIN RATING SCALE
APGAR SCORE

0 1 2
APPEARANCE Blue Pink Completely Pink
PULSE RATE (-) <100 >100
GRIMACE (-) Grimace Cry,Cough
ACTIVITY Limp Some Flexion Active
RESPIRATION (-) Slow, irregular Good, Strong Cry
AT I MINUTE – Need for resuscitation
SCORE:
AT 5 MINUTES – adequacy of resuscitation
7-10 Good
CYANOTIC BABY: 4-6 Borderline
If CR < 80/min, do chest compressions, if still <80/min: intubate 0-3 High Risk
If still <80/min: Lidocaine, Atropine, Naloxone, Epinenphrine (LANE)

BALLARD SCORE

MATURITY RATING
SCORE WEEKS SCORE WEEKS SCORE WEEKS
-10 20 15 30 40 40
-5 22 20 32 45 42
0 24 25 34 50 44
5 26 30 36
10 28 35 38
 EXPANDED PROGRAM ON IMMUNIZATION
PHILIPPINES EPI VACCINES
1. BCG 5. OPV/IPV
2. Hepatitis B 6. Rotavirus
3. DPT 7. Measles/MMR
4. Hib

FULLY IMMUNIZED CHILD

Fully immunized child must have completed the following vaccinations before the child
is 12 months of age:
 BCG  1  Hepatitis B  3
 DPT  3  Measles  1
 OPV  3

BCG
ROUTE: ID (deltoid)
 After birth w/in first 2 months of life
 PPD is recommended:
o Suspected congenital TB
o Hx of close contact to known or suspected infectious cases of TB
o Clinical findings suggestive of TB and/or CXR suggestive of TB
 0.05ml <12 months and 0.1ml =/>12 months
 HEPATITIS B
ROUTE: IM (0.5ml)
 1st dose  within the first 12 hours of life.
 Subsequent doses are given at least 4 weeks apart, with the 3rd dose preferably not
given earlier than 24 weeks of age
 4th dose is needed for the following:
o Paientss using EPI schedule of birth, 6 and 14 wks
o Preterms <2kgs whose 1st dose was given at birth
 If mother HBsAg (+), administer HBV and HBIg (0.5ml) within 12 hours of life.

DIPHTHERIA AND TETANUS TOXOIDS AND ACELLULAR PERTUSSIS

ROUTE: IM (0.5ml)
 6 weeks with a minimum interval of 4 weeks
 4th dose may be given as early as 12 months provided there is minimum interval of 6
months from 3rd dose
 HAEMOPHILUS INFLUENZAE TYPE B CONJUGATES VACCINE
ROUTE: IM
 6 weeks (4 weeks interval)
 If 1st dose given 7-11wks, 2nd dose given at least 4 weeks later then the 3rd dose at
least 8 weeks from the 2nd dose
 BOOSTER DOSE – 12-15 months (interval of 6 months from 3rd dose)

POLIOVIRUS VACCINE
ROUTE: IPV (IM)/OPV (per orem)
 6 weeks (4 weeks interval)
 Final dose should be given on or after 4th birthday and at least 6 months after the
previous dose

MEASLES
ROUTE: SQ
 <12 months = should be given 2 additional doses (preferably MMR) beginning at 12-15
months (4 weeks interval)
 Given As early as 6 months of age in cases of outbreaks
 MMR
ROUTE: SQ
 12 months. 2nd dose 4-6 years or earlier (interval between 1st and 2nd dose of 4
weeks)
 <12 months, should be given additional 2 doses of MMR

ABSOLUTE CONTRAINDICATIONS
 Measles and OPV- most sensitive to heat (strictly maintained at -15-20 C)
 < 4 WEEKS INTERVAL Lessen Antibody Response
 > 4 WEEKS INTERVAL  Higher Antibody Levels
 Practice FEFO (First Expiry-First Out Rule)
 1 syringe – 1 needle – 1 child
NORMALVALUES OF BLOODPRESSURE, CARDIAC RATE & RESPIRATORY RATE BY AGE
AGE BP CR RR
Premature 55-75/35-45 120-170 40-70
0-3months 65-85/45-55 100-150 35-55
4-6months 70-90/50-65 90-120 30-40
7-11months 80-110/55-65 80-120 25-40
1-3 yrs old 90-105/55-70 70-110 20-30
4-6 yrs old 90-110/60-75 65-100 20-25
7-12 yrs old 100-120/60-75 60-95 17-22
13-15 yrs old 110-135/75-85 55-85 12-14
>18 yrs old 110-120/80-89 60-100 16-20
 FLUIDS & ELECTROLYTES
WEIGHT (kg) TFR = cc/k/d
0-3 75
3-10 100
10-20 75
20-30 60
30-40 50
>40 40
>50 30
<7y/o or <15kg >7 y/o or >15kg
INITIAL IVF 0.3 NaCl 0.9 NaCl
MAINTENANCE IMB NM

IVF RATE = volume x weight

24 hrs

NORMAL UO = 1 - 2cc/k/h
 FLUIDS DEXTROSITY

1g glc = 4cal 1g = 4 cal = Desired - available

100cc D50 - available

D50: = D12.5 - D5
1cc = 2 cal = 0.5g glc D50 - D5

D10: = 7.5
1cc = 0.4 cal = 0.1g glc 4

D12.5: = 0.1666 x 100

1cc = 0.5 cal
= 16.66
D5: (vol of D50W to be mixed with D5IMB or D5
1cc = 0.2 cal = 0.05g 0.3 NaCl)

MILK FORMULA
PT: 0.8 cal/ml 24/30cc
T: 0.6 cal/ml 20/30cc
 LUDAN’S
<2yo or <10kg >2yo or >10kg
Mild 50/8 30/8
Moderate 100/8 60/8
¼ PLR x 1 h ¼ PLR x 1h
¾ 0.3 x 7h ¾ 0.3 x 7h
Severe 150/8 90/8
1/3 PLR x 1h 1/3 PLR x 1h
2/3 0.3 x 7h 2/3 0.3 x 7h

DENGUE (Dr. Lim)

0-3 75 8 cc/k/h
3-10 100 7 cc/k/h
10-20 75 6 cc/k/h
20-30 60 5 cc/k/h
30-40 50 4 cc/k/h
>40 40 3 cc/k/h
1cc/k/h x 24 = 24cc/k
2 cc/k/h x 24 = 28 cc/k and so on…
 NEONATES
DAY Term PT SGA
1 70 80 80
2 80 90 90
3 90 100 120
4 110 110 150
5 130 120 180
6 140 160 210
7 160 180 240
8 160 200 270

1st day <1kg – D5W >1kg – D10W

>1kg – D10
2nd day <1kg – D5 0.3 or D5IMB
0.3 or D10IMB
 ELECTROLYTE COMPONENT
Dextrose Na (mEq) K (mEq) Cl (mEq) Lactate Other (mEq)
LRS 130 4 109 28 Ca -3
NSS 154 154
D5 IMB 50 25 20 22 23 Mg – 3;
PO4 - 3
D5 NM 50 40 13 40 16 Mg – 3;
Acetate - 26
D5 NR 50 140 5 98 50 Mg – 3;
Acetate – 26;
Gluconate - 23
D5 LRS 50 130 4 109 28 Ca - 3
D5 0.3% NaCl 50 51 - 51 -
D5 0.45% NaCl 50 77 - 77 -
D5 0.9% NaCl 50 154 - 154 -
CONTINUOUS FEVER –daily fluctuation exceed 1 C (<1.5 F)
REMITTENT FEVER – daily fluctuation exceed 2C (>1.5 F) but never touch normal
INTERMITTENT FEVER – temperature touching normal for a part of the day
 SHOCK
1. Consciousness 4. Temp 7. Pulse
2. Color 5. CRT 8. BP
3. Respiratory Effort 6. Heart rate 9. UO
NAPROXEN TEST  10mg/kg
(+) Fever = Infection
(-) Fever = Tumor

COMA Scale
COMA Scale
Birth – 6 months 9
6 – 12 months 11
1 – 2 years 12
2 – 5 years 13
> 5 years 14