1.
P E D I A T R I C S
EMERGENCY & MEDICATIONS DOSES
2nd
Edition
BY:
DR. ESSAM S. YAQOOB
DUHOK - KURDISTAN REGION - IRAQ
APRIL 2022

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Amoxil Syrup
30-50mg/kg/day ÷3
125mg/5ml → 1-2cc/kg/day ÷3
200mg/5ml → 0.75-1.25cc/kg/day ÷3
250mg/5ml → 0.5-1cc/kg/day ÷3
400mg/5ml → 0.35-0.65cc/kg/day ÷3
Augmentin Syrup
30-50mg/kg/day ÷3
← (125/31.25mg)/5ml
← (200mg/28.5mg)/5ml
← (250mg/62.5mg)/5ml
← (400mg/57mg)/5ml
Acyclovir Syrup 200mg/5ml
<12 years → 20mg/kg/dose x4
0.5cc/kg/dose x4
>12 years → 800mg/dose x5
20cc/dose x5
(5 days)
Suprax (Cefixime) Syrup
8mg/kg/day x1
100mg/5ml → 2cc/5kg x1 or ÷2
200mg/5ml → 1cc/5kg x1 or ÷2
Erythromycin Syrup
30-50mg/kg/day ÷3
125mg/5ml →1-2cc/kg/day ÷3
200mg/5ml →0.75-1.25cc/kg/day ÷3
250mg/5ml →0.5-1cc/kg/day ÷3
400mg/5ml →0.35-0.65cc/kg/day ÷3
Flagyl (Metronidazole) Syrup
30mg/kg/day ÷3
125mg/5ml →1cc/kg/day ÷3
200mg/5ml →0.75cc/kg/day ÷3
250mg/5ml →0.6cc/kg/day ÷3
Trimethoprim Syrup
(40mg/200mg)/5ml
>2 months → 8-12mg/kg/day ÷2
1cc/kg/day ÷2
Clarithromycin Syrup
>6 months → 15mg/kg/day ÷2
125mg/5ml → 0.6cc/kg/day ÷2
250mg/5ml → 0.3cc/kg/day ÷2
Nystatin Oral Drops
<1 year → 2cc x4
>1 year → 4-6cc x4
Azithromycin Syrup
10mg/kg/day x1
100mg/5ml → 0.5cc/kg/dose x1
200mg/5ml → 0.25cc/kg/dose x1
Nalidixic Acid Syrup
250mg/5ml, 300mg/5ml
55mg/kg/day ÷4
1cc/kg/day ÷4
Albendazole Syrup
100mg/5ml, 200mg/5ml
<2 years → 200mg once
>2 years → 400mg once
Keflex (Cephalexin) Syrup
25-50mg/kg/day ÷3 or ÷4
125mg/5ml → 1-2cc/kg/day ÷3 or ÷4
250mg/5ml → 0.5-1cc/kg/day ÷3 or ÷4
Cefdinir Syrup
>6months → 7mg/kg/dose x2
125mg/5ml → 0.3cc/kg/dose x2
250mg/5ml → 0.15cc/kg/dose x2
Mebendazole Syrup
>2 years
100mg/5ml → 100mg/dose x2
(3 days)
500mg/5ml → 500mg/dose once.
Pediatric Syrup Doses
* All Doses are Age and Condition and Severity Dependent.

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Parol Syrup
10-15mg/kg/dose x3 or x4
120mg/5ml→ 0.5cc/kg/dose x3 or x4
250mg/5ml→ 0.2-0.3cc/kg/dose x 3 or x4
Adol Oral Drops 100mg/ml
2-3 drops/kg/dose x3 or x4
ParAzar Flu Syrup (Colden)
(125mg/1mg)/5ml
1-2 years→ 2.5-5cc x3
1-6 years→ 5-10cc x3
6-12 years→ 10-15cc x3
Profen Syrup 100mg/5ml
>6 months → 5-10mg/kg/dose x3
0.5cc/kg/dose x3 (Max. 40mg/kg/day)
Depakin Syrup 200mg/ml
B:10-15mg/kg/day ÷1 ÷2 ÷3
M: 30-60mg/kg/day ÷1 ÷2 ÷3
Ketotifen Syrup 1mg/5ml
0.025mg/kg/dose x2
0.25cc/10kg/dose x2
Fenistil (Dimethindene) Oral
Drops
3 drops/kg/day ÷3
Loratadine Syrup 5mg/5ml
>2-6 years→ 5cc/day x1 at night
>6 years→ 10cc/day x1 at night
Allermine (Chlorpheniramine) Syrup
2mg/5ml
0.35mg/kg/day ÷3 or ÷4
0.85cc/kg/day ÷3 or ÷4
Diphenhydramine Syrup
12.5mg/5ml
5mg/kg/day ÷3 or ÷4
0.5cc/kg/day ÷3 or ÷4
Desloratadine Syrup 0.5mg/ml
1-6 years→ 2.5cc/day x1 at night
6-12 years→ 5cc/day x1 at night
>12 years→ 10cc/day x1 at night
Actifed Syrup (30mg/1.25mg)/5ml
>2 years → 4mg/kg/day ÷3 or ÷4
0.7cc/kg/day ÷3 or ÷4
Dexon Syrup 0.5mg/5ml
0.15-0.3mg/kg/day ÷3
1-3cc/kg/day ÷3
(Max. 16mg/day) (5 days)
Prednisolone Syrup (5 days)
1-2mg/kg/day ÷2
5mg/5ml → 1-2cc/kg/day ÷2
15mg/5ml → 0.35-0.7cc/kg/day ÷2
Exidil (Bronquium) Syrup
2-6 years→ 5cc x2 or x3
6-12 years→ 10cc x2 or x3
>12 years→ 15cc x2 or x3
Solvodin Syrup 4mg/5ml
2-6 years→ 2.5cc x3
6-12 years→ 5cc x3
>12 years→ 10cc x3
DryCough Syrup 15mg/5ml
4-6 years → 2.5cc x3
6-12 years → 5cc x3
>12 years → 10cc x3
Samillin Syrup
1-5 years → 2.5cc x3
6-12 years → 5cc x3
>12 years → 10cc x3
Tussilet Syrup
<1 year → 2.5cc x3
1-6 years → 5cc x3
6-12 years → 10cc x3
Ventolin (Butadin) Syrup
2mg/5ml
>2 years → 0.1mg/kg/dose x3
0.25cc/kg/dose x3

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De-vomit (Zofran) Syrup 4mg/5ml
2mg/10kg/dose x3
2cc/10kg/dose x3
Motilium (Domperidone) Syrup 5mg/5ml
0.2-0.4mg/kg/dose x3
1-2cc/5kg/dose
Biolact Sachet
6 months-2 years x1
>2 years x2
Bonnisan Syrup
<1 month→ 2.5cc x3
1-6months→ 5cc x3
6 months-3 years→ 10cc x3
Colic EZ (Simethicone) Oral Drops
<6 months→ 0.5cc x4
6 months-1 year→ 0.75cc x4
>1 year→ 1cc x4
Zinc Syrup 20mg/5ml
(14 days)
<1 year→ 10mg (2.5cc) x1
>1 year→ 20mg (5cc) x1
Buscopan (Spasmodain) Syrup
5mg/5ml
<6 months → 1-4cc x3
6 months-6 years→ 5cc x3
6-12 years→ 10cc x3
Ferrous Fumerate Syrup 140mg/5ml
1-2mg/kg/day ÷3 Prophylaxis
3-4mg/kg/day ÷3 Mild →0.15cc/kg/day ÷3
4-6mg/kg/day ÷3 Severe IDA
Periactin Syrup 2mg/5ml
2-6 years → 5cc x2 or x3
>6 years → 10cc x2 or x3
Multivitamins Oral Drops
<1 year → 0.3cc (6 drops) x1
1-5 years→ 0.6cc (12 drops) x1
>5 years → 1cc (20 drops) x1
Vitamin D3 Oral Drops 10,000IU/ml
Prophylaxis: 400IU/day (10mcg) x1
Treatment: <6 months → 3,000IU/day x1
(6 drops)
>6 months → 6,000IU/day x1 (12 drops)
Vitamin B6 (Pyridoxine)
Syrup 20mg/5ml
Convulsion: 50-100mg PNG
Deficiency: 2.5-10mg/day
NaCl Nasal Drops x4 or x6 Lactulose Syrup 667mg/ml
0.5cc/kg/dose x2 or x3
B.T. Enema 65ml Once.
Voltaren Suppository
12.5mg, 25mg, 50mg, 100mg
1mg/kg x2 or x3
Paracetamol Suppository
125 mg, 250 mg
15mg/kg x2 or x3
Bisacodyl Suppository 10mg
<6 years→ 5mg x1
>6 years→ 10mg x1
Oral Rehydration Solution ORS
Add 1 Sachet to 1 L of water for 24hr and give as following (or more if child wants more accordingly):
Mild dehydration: 10cc/kg after each diarrheal stool.
Moderate dehydration: 20cc/kg/hr. (Reassess after 4hrs accordingly).
Severe dehydration: 20cc/kg/hr. PO/PNG with IV Fluids. (Hospital admission).

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Oframax 1gm / Claforan 1gm
Vial [Avoid R.L.] (Max. 4g/day)
50-100mg/kg/day ÷2
(Or weight in kg/day ÷2 in cc
(Neonates) (10cc dilution))
Clindamycin Amp.
300mg/2ml, 600mg/4ml
20-40mg/kg/day ÷3 or ÷4
Ampicillin 500mg / Amoxicillin 500mg Vial
50-100mg/kg/day ÷2
(Or weight in kg/day ÷2 in cc (Neonates)
(5cc dilution))
(Max. 500mg/dose)
Meropenem Vial 250mg, 500mg,
1g
20-40mg/kg/dose x3
Imipenem/Cilastatin Vial
250mg/250mg, 500mg/500mg
20-40mg/kg/dose x3
Vancomycin Vial 250mg, 500mg, 1g
15-20mg/kg/dose in 1hr x3 or x4
Gentamicin Amp.
20mg, 40mg, 60mg, 80mg
5-7mg/kg/day ÷2
Amikacin Vial 250mg,
500mg
15mg/kg/day ÷2
Flagyl Bottle 500mg/100ml
30mg/kg/day ÷3
2cc/kg/dose x3
Penicillin G Procaine Vial IM
25.000-50.000 units/kg/day
Flucloxacillin Vial 500mg,1g
25-50mg/kg/dose x3 or x4
Acyclovir Vial 250mg, 500mg, 1gm
10-20mg/kg/dose x3 (5-10 days)
Zofran (De-vomit) Amp 4mg/2ml
0.1mg/kg/dose x3 (Max. 4mg)
2cc + 3cc N.S. → 1cc/10kg x3
(Max. 5cc)
Parol Bottle 1gm/100ml
10-15mg/kg/dose x3 or x4
1-1.5cc/kg/dose x3 or x4
(Max. 4g/day)
Aminophylline Amp. 250mg/10ml
(1cc+9cc N.S.)
Bolus: 4-5mg/kg → 2cc/kg
Maintenance: 3-6mg/kg → 1cc/kg/dose x3
Decadron Amp. 8mg/2ml
Croup: 0.6mg/kg/day once
Others: 0.2-0.6mg/kg/day ÷2
Voltaren Amp. IM 75mg/3ml
<12 years→2mg/kg/dose
>12 years→ x1 or x2
Cyklokapron Amp. 100mg/ml
10mg/kg/dose x3 infusion
Hydrocortisone Vial 100mg
1-5mg/kg/day ÷2 or ÷3
Allergic Reaction: 4-5mg/kg/dose
Diphenhydramine Amp.
10mg/ml, 50mg/ml
5mg/kg/day ÷4
Allarmine (Chlorpheniramine) Amp.
10mg/1ml
0.25mg/kg/dose
Omeprazole Vial 20mg or 40mg
1mg/kg/day x1 infusion
Buscopan Amp. 20mg/ml
0.3-0.5mg/kg/dose x3
Tagamet (Cimetidine) Amp. 200mg/2ml
25mg/kg/day ÷4
Morphine Amp. IM/SC 10mg/ml
0.05-0.2mg/kg/dose
Lasix Amp. 20mg/2ml
1mg/kg/dose
Hydralazine Amp. 20mg/ml
0.1-0.2mg/kg/dose. Can repeat after 20 min.
Pediatric IV/IM Doses

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Magnesium Sulphate MgSO4 Vial
50% 5g/10ml
10% 1g/10ml
25-50mg/kg/dose x3
IM or Infusion
Potassium Chloride KCl Amp.
15%= 2mEq/ml = 2mmol/ml = 150mg/ml
7.5%= 1mEq/ml = 1mmol/ml = 75mg/ml
0.5-1mEq/kg/dose
Over 3-4 hrs (Max. 40mEq/dose)
Calcium Gluconate 10%
1gm/10ml Amp.
0.5-1cc/kg/dose in 30min x2
or x3
(Max. 20cc/dose)
Albumin Bottle 20%
20g/100ml, 10g/50ml
20% = 200mg/ml
0.5-1g/kg/dose x2 or x3
2.5-5cc/kg/dose x2 or x3
Over 1-2hr infusion
Mannitol Bottle
Bolus: 0.25-1g/kg
Maintenance: 0.25-0.5g/kg x2 or x3
20% = 200mg/ml
B:5cc/kg, M:2.5cc/kg x2 or x3 infusion
10% = 100mg/ml
B:10cc/kg, M:5cc/kg x2 or x3
Sodium Bicarbonate
NaHCO3 Vial 8.4%
50mEq/50ml
8.4% = 1mEq/ml = 84mg/ml
1mEq/kg/dose in 15-30min
infusion
1cc/kg/dose in 30min
Caffeine Amp. 10mg/ml, 20mg/ml
Bolus: 10-20mg/kg
Maintenance: 5-10mg/kg/day
Vitamin B6 (Pyridoxine) Amp.
100mg/2ml, 100mg/ml
Convulsion: 70mg/kg over 10 min.
Deficiency: 10-20mg/day for 3 weeks
Vitamin K Amp. 1mg/0.5ml
Prophylaxis IM: term 1mg
or preterm 0.5mg
Treatment SC: 1mg
Hypertonic G.W. D10% = 100mg/ml
<5 year
Bolus: 0.25-0.5g/kg → 2-5cc/kg
2cc G.W50%+ 8cc D.W = G.W.10%
1cc GW50%+9cc GW5% ≈GW10%
Maintenance: 5-8mg/kg/min.
Hypertonic G.W. D25% = 250mg/ml
<12 years
0.25-0.5g/kg → 1-2cc/kg
5cc G.W50% + 5cc D.W = G.W.10%
4cc GW50% + 6cc GW5% ≈ GW10%
Hypertonic G.W. 25g/50ml
D50% = 500mg/ml
>12 years
0.25-0.5g/kg → 0.5-1cc/kg
(Diluted)
Whole Blood 500ml/pint
10-15cc/kg/over 3-4hr (NEED ABO,
Rh Compatibility)
PRBC 350ml/pint
10–15cc/kg/over 3-4hr (NEED ABO, Rh
Compatibility)
FFP 200-300ml/pint
10-15cc/kg in 20min (JUST
ABO Compatibility)
Platelets 200-300ml/pint
5-10cc/kg in 20min (NEED ABO,
Better Rh Compatibility too)
Cryoprecipitate 10-20ml/pint
1-2pints/10kg (Preferred ABO
Compatibility)
* All Doses are Age and Condition and Severity Dependent.

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Adrenaline Amp. 1mg/1ml (1:1000)
<30kg→0.1mg/kg/dose
>30kg → 0.3-0.5mg/kg/dose
1cc + 9cc N.S. → 0.1cc/kg/dose
Repeat if needed after 3-10min
Atropine Amp. 0.6mg/1ml
0.03mg/kg/dose
1cc + 4cc N.S. → 0.2cc/kg/dose
Propranolol Amp. 1mg/ml
0.1mg/kg/dose in 15 min
Noradrenaline Amp.
0.05-0.1mcg/kg/min.
(Max. 1-2mcg/kg/min)
4cc + 46cc D5% =
4mg/4ml → 0.04-0.08cc/kg/hr.
(Max. 0.08-0.15cc/kg/hr.)
8mg/4ml → 0.02-0.06cc/kg/hr.
(Max. 0.04-0.07cc/kg/hr.)
Dopamine Amp.
200mg/5ml, 400mg/10ml
1-5mcg/kg/min.
Then 5-20mcg/kg/min.
(Max. 50mcg/kg/min.)
5cc + 45 D5% →
0.15-0.08cc/kg/hr.
Then 0.08-0.3cc/kg/hr.
(Max.0.75cc/kg/hr.)
Dobutamine Amp. 250mg/20ml
0.5mcg-1mcg/kg/min.
Then 2-20mcg/kg/min.
(Max. 40mcg/kg/min.)
20cc + 30cc D5% →
0.006-0.012cc/kg/hr.
Then 0.024-0.24cc/kg/hr.
(Max. 0.5cc/kg/hr.)
Amiodarone Amp. 150mg/3ml
Cardiac Arrest: 5mg/kg (Max. 300mg)
3cc + 12cc D5% → 0.5cc/kg.
May repeat up to 2 times.
Fentanyl Amp. 50mcg/ml
Bolus: 0.5-2mcg/kg
Maintenance: 0.5-2mcg/kg/hr.
2cc + 10cc N.S. →0.1cc/kg
Propofol Amp. 1% 10mg/ml
Bolus: 2.5-3.5mg/kg
Maintenance: 0.125-0.3mg/kg/min
0.1cc/kg (Pure)
Adenosine Amp. 6mg/2ml, 12mg/4ml
0.1mg/kg
(2cc + 4cc N.S.) → 0.1cc/kg/dose
2 syringes: 1st
for adenosine, 2nd
for
>5cc N.S. → To be pushed together at
same time in 3 sec. rapid flush.
Repeat if needed after 1-2 min.
Isoptin Amp 5mg/2ml, 10mg/4ml
>1 year → 0.1-0.3mg/kg in 2 min.
(Max. 5mg)
2cc + 3cc N.S. →
0.1-0.3cc/kg/dose in 2 min. (Max.
5cc)
Repeat if needed after 30 min.
Lidocaine Amp.
1% = 10mg/ml
2% = 20mg/ml
VT/VF/Local Anesthesia
Bolus: 0.5-1mg/kg
(Max. 4.5mg/kg)
Maintenance: 1.2-3mg/kg/hr.
Ventolin (Salbutamol) Neb. 5mg/2.5ml
>2 years→ 0.1mg/kg x4
(Max. 2.5mg/dose) (2-4cc N.S. dilution)
Pulmicort Neb. 0.25mg/ml
>1 year→ 1-2cc x2
(2-4cc N.S. dilution)
Adrenaline amp Neb. 1mg/ml
0.5-1cc/dose
(2-4cc N.S. dilution)

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IV Fluids Therapy Maintenance for Neonates:
First 2 days is G.W. D10% then change to G.S. (5%-1/5)
If on Phototherapy: add 30cc/kg/24hr. (IV Fluid)
If on Feeding: 10-15cc/kg/day every 2-3hrs (i.e. ÷12 or ÷8)
then Subtract this amount from the total maintenance.
Mature or >1kg Premature or <1kg
1st
day:60-70cc/kg/24hr
2nd
day: 80cc/kg/24hr
3rd
day: 100cc/kg/24hr
4th
day: 120cc/kg/24hr
5th
day: 140cc/kg/24hr
Others: 150cc/kg/24hr
1st
day: 80cc/kg/24hr
2nd
day: 95cc/kg/24hr
3rd
day: 110cc/kg/24hr
4th
day: 125cc/kg/24hr
5th
day: 140cc/kg/24hr
Others: 150cc/kg/24hr
Bolus (Shoot) → N.S. or R.L. 20cc/kg in
20min-1hr up to 3 times
Maintenance for Older Children: G.S.
<10kg (1st
10kg) 100cc/kg/24hr
10-20kg (2nd
10kg) (1000cc + 50cc/kg for
every Kg >10)/24hr
>20kg (3rd
10kg) (1500cc + 20cc/kg for
every Kg >20)/24hr
Deficit for Older Children: G.S.
Mild dehydration 30-50cc/kg
Moderate dehydration 60-100cc/kg
Severe dehydration 90-150cc/kg
• Inform The Police for a Police Paper for cases of Poisoning, Inhalation and Ingestion of
Foreign Body or Animal or Ticks Bites and Scorpion Sting or Any Abuse or Suspicious case.
• Any case Death on Arrival, inform the police and refer to Forensics.
• Any new case being referred or admitted to the floor (wards) from the emergency department
that needs follow-up medications and vitally, like DKA or convulsion etc, the JHOs in ER
should inform the JHO on call in the floors (wards).
23hr Fluid for Older Children = Maintenance + Deficit – Bolus
½ amount in first 8hr.
½ amount in other 15hr.

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Sliding Scale for Sub-Cutaneous Soluble Insulin Injection in Diabetic Patients:
Pediatric DKA Management:
1. ABC and Double Cannula
2. Foley’s catheter
3. Bolus of N.S. 20cc/kg in 1hr then in the 2nd
hr start the below:
a) Fluid Per Hour for 23hr Equation:
[ (Maintenance + Deficit 85cc/kg) – Bolus ] all divided by 23hr
If RBS >250mg/dl then use N.S.
If RBS <250mg/dl then use G.S.
b) Soluble Insulin Infusion Per Hour: 0.1 unit/kg/hr.
Calculate the dose for 6hrs, dilute it with 30cc N.S., to be infused in 6hrs with Syringe Pump.
c) Antibiotics and Analgesics: Oframax Vial and Parol Bottle etc.
d) KCl Amp.: 1cc/kg/24hr infusion in the fluid or 1cc for each 100cc of the fluid. (1cc=2mEq).
RBS Every 6hr Amount of S.C. Soluble Insulin (Actrapid, Humulin R)
0-150 mg/dl Nothing
150-200 mg/dl 0.1 unit/kg
200-300 mg/dl 0.2 unit/kg
300-400 mg/dl 0.3 unit/kg
400-500 mg/dl 0.4 unit/kg
>500 mg/dl 0.5 unit/kg

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Neonatal Convulsion
IV cannula
Vital signs
including
RBS, if
hypoglycemic
treat with
G.W. D10%
→2cc/kg.
Luminal (Phenobarbital)
Amp. 200mg/ml
Bolus: 15-20mg/kg
1cc + 9cc N.S. →1cc/kg in
20 min.
If no response give 2nd
dose.
If response put on
maintenace after 12hr.
Maintenance:
3-5mg/kg/day ÷2
1cc + 9cc N.S.
→20 units/kg/day ÷2 in
20min.
If no response:
Phenytoin Amp.
250mg/5ml
(50mg/ml)
Bolus:15-20mg/kg
5cc + 10cc N.S.
→1cc/kg in 20
min.
Maintenance:
4-8mg/kg/day ÷2
5cc + 10cc N.S.
→50 units/kg/day
÷2 in 30min only
by N.S.
If no response: *
Midazolam Amp.
15mg/3ml (5mg/ml)
Bolus: 0.05-0.4mg/kg
1cc + 4cc N.S. →
0.1-0.2cc/kg in 3 min.
Maintenance:
0.03-0.2mg/kg/hr
• Calculated as [(0.1mg
× Kg × 24)mg
changed to cc of the
corresponding
original amp. cc + X
cc G.W.] = 24cc then
1cc/hr infusion.
Diazepam Amp. 10mg/2ml
IV: 0.2-0.5mg/kg
2cc + 3cc N.S. → 1cc/10kg
PR: 0.2-0.5mg/kg or 0.25cc/kg
Use NG tube or Foley’s
catheter or small syringe.
(Up to 3 doses)
If no response:
Luminal
(Phenobarbital)
Amp. 200mg/ml
Dosing as above.
If no response:
Phenytoin Amp.
250mg/5ml
(50mg/ml)
Dosing as above.
If no response: *
Midazolam
Amp. 15mg/3ml
(5mg/ml)
Dosing as above.
Older Children Convulsion
* If still no response in the last step, then consider Calcium Gluconate IV and Magnesium Sulphate IV and Pyridoxine PNG (neonate) or IV/IM.

11.
10 | P r e p a r e d B y D r . E s s a m S i d q i - D u h o k - K u r d i s t a n R e g i o n - I r a q - A p r i l 2 0 2 2
References:
➢ https://www.medscape.com/
➢ https://www.medicines.org.uk/emc/
➢ https://www.uptodate.com/
➢ https://bestpractice.bmj.com/
➢ https://www.drugs.com/
➢ https://www.rxlist.com/
➢ https://globalrph.com/
➢ https://www.webmd.com/
➢ BNF 81