Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ In addition to medications in this formulary chapter, the following categories of medications can be found in the identified chapters: Intubation Medications - see chapter 6 Code Medications - see chapter 7 Cardiovascular Medications - see chapter 14 Sedation/Analgesia/Neuromuscular Blockade - see chapter 15 Anti-infective Medications - see chapter 16 ++ Table Graphic Jump Location|Download (.pdf)|Print Respiratory Medication Dose Mechanism Comment Albuterol Intermittent 2.5 mg nebulization or ß2-agonist: bronchodilation via airway smooth muscle relaxation Frequent re-evaluation needed, especially if tachycardic Continuous nebulization from 5–20 mg/hr Side effects: tremor, tachycardia, agitation, hypokalemia Acetylcysteine Infants: 1–2 mL of 20% solution or 2–4 mL of 10% solution (undiluted); three to four times daily Exerts mucolytic action through its free sulfhydryl group, which opens up the disulfide bonds in the mucoproteins, thus lowering mucous viscosity Children and adolescents: 3–5 mL of 20% solution or 6–10 mL of 10% solution (undiluted); administer three to four times daily Ipratropium 125–500 mcg nebulization q6–8 hr Inhaled anticholinergic (inhibit cGMP) bronchodilator Systemic SEs rare due to poor absorption from lung Saline nebulization 0.9%, 3%, 7% 3% solution: 4 mL inhaled every 2 hr Pretreatment with a bronchodilator is recommended to prevent potential bronchospasm ≥6 years and adolescents: inhalation: 7% solution: 4 mL inhaled twice daily Terbutaline Load: 2–10 mcg/kg IV Systemic ß2-agonist SEs same as albuterol Infusion: 0.08–1 mcg/kg/min Stop infusion and obtain ECG for chest pain or ST changes SE: Side Effects Table Graphic Jump Location|Download (.pdf)|Print Neurologic Medication Route Dose Mechanism Midazolam IV bolus Loading dose: 0.15–0.2 mg/kg Enhances GABA activity IV infusion 0.06–0.5 mg/kg/hr Intramuscular 0.2 mg/kg/dose, may repeat every 10–15 min, maximum dose: 6 mg Buccal 0.2–0.5 mg/kg once; maximum dose: 10 mg Intranasal 0.2 mg/kg once; maximum dose: 10 mg Lorazepam IV bolus 0.1 mg/kg maximum: 4 mg, slow IV over 2–5 min; may repeat in 5–15 min Diazepam IV bolus 0.1–0.3 mg/kg/dose given over 3–5 min, every 5–10 min; maximum dose: 10 mg/dose Rectal 2–5 years: 0.5 mg/kg 6–11 years: 0.3 mg/kg ≥12 years and adolescents: 0.2 mg/kg Fosphenytoin IV bolus 15–20 mg PE/kg; maximum dose: 1500 mg PE Stabilizes voltage-gated sodium channels Administer at 1–3 mg PE/kg/min up to a maximum of 150 mg PE/min Levetiracetam IV bolus 20–60 mg/kg; dose should not exceed adult initial range: 1000–3000 mg Thought to have multiple sites of action, including calcium channels, glutamate receptors, and GABA modulation Pentobarbital IV bolus Loading dose: 5 mg/kg Enhances GABA activity IV infusion Initial: 0.5–1 mg/kg/hr Phenobarbital IV bolus 15–20 mg/kg; maximum dose: 1000 mg PE: Phenytoin equivalent; GABA: gamma-aminobutyric acid. Table Graphic Jump Location|Download (.pdf)|Print Miscellaneous Medication Dose Mechanism Comment Albumin 0.5–1 g/kg/dose IV Provides increase in intravascular oncotic pressure Administration rate: Use 5% in hypovolemic or intravascularly depleted patients 5% = 2–4 mL/min Use 25% in fluid/Na restricted patients 25% = 1 mL/min (after initial volume replacement) Diphenhydramine 0.5 mg/kg/dose IV/PO Maximum dose: ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.