Pediatric Primary Care (141 page)

Implications

  Use cautiously with liver impairment.

  Give oral suspension 1 hour before or 2 hours after meals.

  Do not give with antacids.

BENZOCAINE–TOPICAL OTIC ANALGESIC

Brand Name

Auralgan Otic Solution

Uses

Topical analgesic to reduce pain associated with acute otitis media.

Availability

10-mL bottle.

Indications/Routes/Dosage

Instill drops until ear canal is full, put wick into ear canal. May repeat every 1-2 hours as needed.

Adverse Reactions

Irritation of ear canal.

Implications

  Do not let dropper touch ear canal, do not rinse ear dropper after use, keep out of the reach of children.

  Have child lay on side and tilt the affected ear upward, pull ear lobe up and instill medication, have child lay on side for 5 minutes then insert wick.

  Do not use on perforated eardrum.

BUDESONIDE–INHALATION CORTICOSTEROID ANTI-INFLAMMATORY

Brand Name

Entocort EC, Pulmicort, Rhinocort

Uses

Manage symptoms of seasonal or perennial allergic rhinitis.

Availability

Nasal inhaler: 32 mcg/metered spray (Rhinocort AQ). Nasal spray: 50 mcg/dose (Pulmicort). Powder for inhalation: 200 mcg/inhalation (Pulmicort Turbuhaler). Suspension for oral inhalation: 0.25 mg/2 mL, 0.5 mg/2 mL (Pulmicort Respules).

Indications/Routes/Dosage

Intranasal: Children older than 6 years, adults: Rhinocort: 2 sprays each nostril 2 times/ day or 4 sprays to each nostril in morning. Rhinocort Aqua: 1 spray to each nostril once daily. Children younger than 12 years: 4 sprays/day. Children older than 12 years: 8 sprays/day.

Nebulization: Children 1-8 years: 0.25-1 mg/day titrated to lowest effective dosage.

Inhalation: Children older than 6 years, adults: initially 200-400 mcg 2 times/day to max 400 mcg 2 times/day.

Rhinitis: Nasal inhalation: Children older than 6 years: initial, 2 sprays/nostril twice daily. Adult: initial 2 sprays/nostril bid or 4 sprays/nostril in the morning. Max 4 sprays/ nostril per day. Nasal spray: Children older than 6 years: initial, 1 spray/nostril once a day. Max dose 4 sprays/nostril/day. Children younger than 12 years: 2 sprays/nostril once a day. Not recommended for children younger than 6 years. Children older than 12 years: 4 sprays/nostril, once a day. Nasal spray: initial, 1 spray/nostril once daily, max 4 sprays/nostril once a day.

Adverse Reactions

Mild nasopharyngeal irritation, burning stinging, headache, throat irritation, epistaxis, Cushing's syndrome, cataract, adrenal suppression, glaucoma.

Implications

  Use caution in patients with cataracts, diabetes mellitus, exposure to viral infections, glaucoma, liver cirrhosis, peptic ulcer.

  Do not consume grapefruit juice during oral treatment.

  Reduce dose for hepatic insufficiency.

  May take 3-7 days for full effect.

CEFDINIR–THIRD-GENERATION CEPHALOSPORIN ANTIBIOTIC

Brand Name

Omnicef

Uses

Treat susceptible infections due to
Streptococcus pyogenes, S. pneumoniae, Haemophilus influenzae, H. parainfluenzae, Moraxella catarrhalis
, acute maxillary sinusitis, chronic bronchitis, community-acquired pneumonia, otitis media, pharyngitis/tonsillitis, skin infections.

Availability

Suspension: 125 mg/5 mL; 250 mg/5mL; Capsule: 300 mg.

Indications/Routes/Dosage

Children older than 6 mos: 7 mg/kg PO q12h for 10 days or 14 mg/kg PO once a day for 10 days, max 600 mg/day.

Children: 20 kg: 2.5 mL (0.5tsp) q12h or 5 mL (1 tsp) q24h. 20-40 lbs: 5 mL (1 tsp) q12h or 10 mL (2 tsp) q24h. 41-60 lbs: 7.5 mL (1.5 tsp) q12h or 15 mL (3 tsp) q24h. 61-80 lbs: 10 mL (2 tsp) q12h or 20 mL (4 tsp) q24h. 81-85 lbs: 12 mL (2.5 tsp) q12h or 24 mL (5 tsp) q24h.