Table 3

Drugs commonly used in childhood illnesses

Drug name	Indications	Contraindications	Dose
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)	None	6–11 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 distress	None	5 ml 1:1000 via nebuliser once only while definitive care arranged

Benzylpenicillin	Meningococcal septicaemia (also see cefotaxime)	Confirmed penicillin allergy	For 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)

Budesonide	Croup	Less than 3 months old	2 mg via nebuliser, once only

Cefotaxime	Meningococcal septicaemia	Allergy	80 mg/kg

Dexamethasone syrup	Croup	None	0.15 mg/kg IO

Dextrose 10%	Hypoglycaemia	None	5 ml/kg IV/IO, titrated to blood sugar

Diazepam	Continuous or recurrent fits	None	Rectal: 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.

Hydrocortisone	Anaphylaxis; asthma	None	4 mg/kg IV
Ibuprofen	Fever and mild to moderate pain	Known sensitivity	10 mg/kg up to thrice daily
Ibuprofen	Fever and mild to moderate pain	Asthma	10 mg/kg up to thrice daily

Ipratropium bromide	Asthma/bronchiolitis	None	Up to 7 years, 125 μg
Ipratropium bromide	Asthma/bronchiolitis	None	>7 years 250 μg via nebuliser

Morphine	Moderate to severe pain	Known sensitivity to opioids	0.1 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
Morphine	Moderate to severe pain	Respiratory depression, hypotension, or reduced GCS (<12)

Naloxone	Reversal of opioid overdose	None	10 μg/kg followed by 100 μg/kg titrated to effect

Paracetamol suspension or soluble tablets	Fever and mild to moderate pain	Under 2 months	15 mg/kg (maximum single dose 1 g) PO 4–6 hourly

Prednisolone soluble tablets	Exacerbations of asthma	None	1 mg/kg (maximum single dose 60 mg) PO, twice daily for 5 days

Salbutamol	Asthma/bronchiolitis	None	<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 drops	Eye infection—for prophylaxis or treatment	Allergy	Twice daily