Pediatric Primary Care (148 page)

Uses

Treat anemia due to folate deficiency, nutritional supplement to prevent neural tube defects.

Availability

Tablets: 0.4 mg, 0.8 mg, 1.0 mg.

Indications/Routes/Dosage

Recommended daily intake for children: 6 months-3 years: 50 mcg (15 mcg/kg/day). 4-6 years: 75 mcg. 7-10 years: 100 mcg. 11-14 years: 150 mcg. Older than15 years: 200 mcg.

Dosage: Infants: 15 mcg/kg/daily. Children: 1 mg/day initial dosage. Maintenance dose, 1-10 years: 0.1-0.4 mg/day. Children older than 11 years, adults: 1 mg/day initial dose; maintenance dose 0.5 mg/day.

Adverse Reactions

Flushing, irritability, difficulty sleeping, malaise, rash, itching, GI upset, hypersensitivity reactions.

Implications

  Take everyday.

  Call provider if adverse reactions.

LACTULOSE–HYPEROSMOTIC LAXATIVE

Brand Name

Constilac, Constulose, Enulose

Uses

Treat constipation.

Availability

Syrup: 10 mg/15 mL. Packets: 10 g, 20 g.

Indications/Routes/Dosage

Children: 7.5 mL/day after breakfast. Adults: 15-30 mL/day up to 60 mL/day.

Adverse Reactions

Cramping, flatulence, increased thirst, abdominal discomfort, diarrhea indicates an overdose.

Implications

  Drink water, juice, milk with each dose.

  Evacuation occurs in 24-48 hours of initial dose.

  Patients should also be on a high-fiber diet and exercise to promote defecation.

LEVALBUTEROL–BRONCHODILATOR

Brand Name

Xopenex

Uses

Prevention of bronchospasm due to reversible obstructive airway disease.

Availability

Solution for nebulization: 0.63 mg OR 1.25 mg in 3-mL vials (no dilution necessary).

Indications/Routes/Dosage

Children older than12 years: 0.63-1.25 mg q6-8h (tid), with max of 1.25 mg tid.

Adverse Reactions

Tremors, nervousness, headache, throat dryness/irritation, palpitations, chest pain, extrasystole.

Implications

  Monitor rate, depth, rhythm, and type of respiration.

  Increase fluid intake.

  Rinse mouth with water after inhalation.

  Avoid caffeine.

LITHIUM CARBONATE–ANTIMANIC, ANTIDEPRESSANT

Brand Name

Eskalith, Dura-Lith

Uses

Prophylaxis, treatment of acute mania, manic phase of bipolar disorder.

Availability

Syrup: 300 mg/5 mL. Tablets: 300 mg. Tablets, slow-release: 300 mg, 450 mg. Capsules: 150 mg, 300 mg, 600 mg.

Indications/Routes/Dosage

Start at 25 mg/kg/day, gradually increase until serum level reaches therapeutic range of 0.9-1.1 mEq/L.

Adverse Reactions

Headache, drowsiness, dizziness, anorexia, nausea, vomiting, diarrhea, hypotension, dry mouth. May increase effects of antithyroid medication, iodinate glycerol, potassium iodide. Nonsteroidal anti-inflammatory drugs (NSAIDs) and diuretics may increase concentration, toxicity. May decrease absorption of phenothiazines.

Implications

  Give with meals, milk.

  Limit alcohol, caffeine.