Table 3

 Drugs commonly used in childhood illnesses

Drug nameIndicationsContraindicationsDose
Known allergy to any of the drugs or constituents is a contraindication in all cases.
Adrenaline (epinephrine)Anaphylaxis associated with wheeze or respiratory distress (including cyanosis) unrelieved by salbutamol OR stridor OR clinical signs of shock (systolic BP<90 mm Hg)None6–11 years: 250 μg (0.25 ml of 1:1000) IM.
6 months–5 years: 120 μg (0.12 ml of 1:1000) IM.
<6 months: 50 μg (0.05 ml of 1:1000) IM.
All ages: repeat after five minutes if necessary.
Adrenaline (epinephrine)Croup associated with severe respiratory distressNone5 ml 1:1000 via nebuliser once only while definitive care arranged
BenzylpenicillinMeningococcal septicaemia (also see cefotaxime)Confirmed penicillin allergyFor IV/IO use, dilute 600 mg in 10 ml. For IM, dilute 600 mg in 2 ml.
Less than 1 year 300 mg (5 ml IV/IO or 1 ml IM)
1–9 years 600 mg (10 ml IV/IO or 2 ml IM)
>9 years and adult 1.2 g (20 ml IV/IO or 4 ml IM)
BudesonideCroupLess than 3 months old2 mg via nebuliser, once only
CefotaximeMeningococcal septicaemiaAllergy80 mg/kg
Dexamethasone syrupCroupNone0.15 mg/kg IO
Dextrose 10%HypoglycaemiaNone5 ml/kg IV/IO, titrated to blood sugar
DiazepamContinuous or recurrent fitsNoneRectal: 0 to 1 years 2.5 mg; 1 to 3 years 5 mg; 4 to 12 years 10 mg.
IV: 250 to 400 μg/kg
All ages: repeat if required after 5 minutes.
HydrocortisoneAnaphylaxis; asthmaNone4 mg/kg IV
IbuprofenFever and mild to moderate painKnown sensitivity10 mg/kg up to thrice daily
Ipratropium bromideAsthma/bronchiolitisNoneUp to 7 years, 125 μg
>7 years 250 μg via nebuliser
MorphineModerate to severe painKnown sensitivity to opioids0.1 mg/kg, repeated at 5 min intervals to a maximum dose of 0.2 mg/kg. Use half dose in children less than 1 year old
Respiratory depression, hypotension, or reduced GCS (<12)
NaloxoneReversal of opioid overdoseNone10 μg/kg followed by 100 μg/kg titrated to effect
Paracetamol suspension or soluble tabletsFever and mild to moderate painUnder 2 months15 mg/kg (maximum single dose 1 g) PO 4–6 hourly
Prednisolone soluble tabletsExacerbations of asthmaNone1 mg/kg (maximum single dose 60 mg) PO, twice daily for 5 days
SalbutamolAsthma/bronchiolitisNone<1 year 2.5 mg (if ineffective do not repeat).
1 to 5 years 2.5 mg repeated at 15 min intervals, titrated to effect
>5 years 5 mg repeated at 15 min intervals, titrated to effect
Fucidic acid eye dropsEye infection—for prophylaxis or treatmentAllergyTwice daily