Pediatric Acetaminophen

Transcription

1 Pediatric Acetaminophen Infants Tylenol Grape Flavor New Formulation 160 mg/5 ml Old Formulation 80 mg/ 0.8 ml Source:

2 Pediatric Acetaminophen Current directions for use: Repeat dose every 4 hours Max 5 times/24 hours Weight (lb) Age (yr) Dose (ml) Under 24 Under 2 years Ask a doctor years 5 ml mg/kg

3 Tylenol Products Infants Tylenol Oral Suspension 160 mg/5 ml (grape) Children s Tylenol Oral Suspension 160 mg/5 ml (grape, cherry blast) Children s Tylenol Meltaways Chewable Tablets 80 mg/tablet (bubble gum burst, grape punch) Jr. Tylenol Meltaways Chewable Tablets 160 mg/tablet (bubble gum burst, grape punch)

4 Acetaminophen Case Study How much acetaminophen would you recommend for a child weighing 44 pounds?

5 Acetaminophen Case Study How much acetaminophen would you recommend for a child weighing 44 pounds? 44 pounds = 20 kg Dose = 10 mg/kg x 20 kg = 200 mg

6 Acetaminophen Case Study How much liquid acetaminophen would the parent measure? Dose = 200 mg Volume = 5 ml/160 mg x 200 mg = 6.25 ml Note same volume whether infant drops or children s liquid

7 Pediatric Ibuprofen 5-10 mg/kg Infants Advil Ibuprofen 50 mg/1.25 ml Every 6-8 hours Max 4 times/24 hours Weight (lb) Age (mos) Dose (ml) Under 6 mos Ask a Doctor lb 6-11 mos 1.25 ml lb mos mlini Source: childrens.advil.com

8 Pediatric Ibuprofen Children s Advil 100 mg/5 ml Every 6-8 hours Max 4 times/24 hours Source: childrens.advil.com

9 Advil Products Infants Advil Drops 50 mg/1.25 ml Children s Advil Suspension 100 mg/5 ml Junior Strength Advil Chewables 100 mg/tablet Junior Strength Advil Tablets 100 mg/tablet

10 Ibuprofen Case Study How much ibuprofen would you recommend for a child weighing 44 pounds?

11 Ibuprofen Case Study How much ibuprofen would you recommend for a child weighing 44 pounds? Per the Children s Advil label: Weight (lb) Age (yr) Dose (tsp) Under 24 lb Under 2 yr Ask a doctor lb 2-3 yr 1 tsp lb 4-5 yr 1 ½ tsp lb 6-8 yr 2 tsp lb 9-10 yr 2 ½ tsp lb 11 yr 3 tsp

12 Ibuprofen Case Study How much ibuprofen would you recommend for a child weighing 44 pounds? Per the Children s Advil label: 1 ½ tsp 150 mg Based on weight: 5 mg/kg x 20 kg = 100 mg 10 mg/kg x 20 kg = 200 mg

13 New Labeling Cough and Cold FDA has advised that cough and cold medications not be used in children under 2 years of age Manufacturers have voluntarily updated cough and cold product labels, and they current state do not use in children under 4 years of age

14 Decongestants Sinus and nasal congestion Adrenergic agonists (sympathomimetics) Adverse reactions: CNS stimulation Cardiovascular stimulation

15 Decongestants Phenylephrine (q 4 hours) 4-5 years old: 2.5 mg 6-11 years old: 5 mg Adults: 10 mg Pseudoephedrine (q 4-6 hours) 4-5 years old: 15 mg 6-11 years old: 30 mg Adults: 60 mg

16 Antihistamines Allergic rhinitis Two classifications: First-generation Sedating Nonselective Second-generation Nonsedating Selective

17 Antihistamines First-generation Highly Sedating (> 6 years old) Clemastine Diphenhydramine Doxylamine

18 Antihistamines First-generation Moderately Sedating (>6 years old) Brompheniramine Chlorpheniramine Dexbrompheniramine Dexchlorpheniramine Pheniramine

19 Antihistamines First-generation Weak CNS effects; increased GI effects (>6 years old) Pyrilamine

20 Antihistamines Second-generation Minimally to moderately sedating Cetirizine (>2 years old) Hydroxyzine (Rx) Levocetirizine (Rx)

21 Antihistamines Second-generation Nonsedating (> 2 years old) Fexofenadine Loratadine

22 Nonpharmacologic Therapy All patients: Fluid intake Rest Nutritious diet Humidifier, vaporizer or steamy shower Infants: Saline drops or spray Upright position Adults: Neti-pot

23 Case Study Cold and Allergy (Child) Patient with a runny nose, sneezing, nasal congestion, itchy watery eyes Symptoms have been present for 2 days No medications NKDA Patient: What if patient is 8 years old? What if patient is 3 years old?

24 Case Study Cold and Allergy (Adult) Patient with a runny nose, mild congestion, headache and itchy eyes Symptoms have been present for 2 days when arrived at friend s house for a visit 42 year old female Medications: Multivitamin daily Oral contraceptive NKDA

25 Case Study Cold and Allergy (Adult) Runny nose and itchy eyes: antihistamine Mild congestion: decongestant Headache: analgesic Questions: What at her friend s house is causing the symptoms? What adverse reactions should we avoid?

26 Cough Antitussives Dextromethorphan (>4 years old) Diphenhydramine (>6 years old) Expectorant Guaifenesin (>4 years old)

27 Nonpharmacologic Therapy Lozenges Humidifier or vaporizer Hydration

28 Case Study Nonproductive Cough (Child) Chesty cough without mucus Wakes her up at night No other symptoms. 6 years old NKDA No medications

29 Case Study Nonproductive Cough Dry hacking cough (Adult) Wakes her up at night and interrupts work. Cold last week, but most of symptoms have resolved. Still has nasal congestion with a sensation of something tickling her throat. 25 years old NKDA Oral contraceptive

30 Case Study Productive Cough (Child) Productive cough with some clear mucus for 3 days. Cough wakes her up at night and interrupts work. Symptoms started 3 days ago with nasal congestion, headache, cough and sore throat. 25 years old NKDA Oral contraceptive

31 Case Study Productive Cough (Adult) Productive cough with some clear mucus for 3 days. Cough wakes her up at night and interrupts work. Symptoms started 3 days ago with nasal congestion, headache, cough and sore throat. 25 years old NKDA Oral contraceptive