Children infusion

Vitex negundo var heterophylia French Rehd. Verbenaceae Chi, Pak twigs convulsions in children infusion 35... 

For children, heparin sodium is administered by intermittent IV infusion in a range of 60 to 80 units/kg of body weight every four hour. For a 57-lb child, calculate the range, in mL, of a heparin sodium injection containing 5000 units/mL to be administered daily. 

An intravenous infusion for a child weighing 55 lb is to contain 17.5 mg of vancomycin HC1 per kg of body weight in 200 mL of NaCl injection. Using a 7.5 mL vial containing 500 mg of dry vancomycin HC1 powder, explain how you would obtain the amount needed in preparing the infusion. 

An underweight 4-year-old boy presents semi-comatose in the emergency room at 10 a.m. Plasma glucose, urea, and glutamine are abnormally low acetoacetate is elevated and lactate is normal. He Is admitted to the ICU, where an increase in blood glucose was achieved by controlled infusion of glucagon or alanine. Which metabolic pathway is most likely deficient in this child ... 

A child with acute myelogenous leukeamia and unresponsive to conventional therapies was treated with 500 mpk i.v. infusion of butyric acid... 

Unlabeled uses In pediatric patients with cardiac arrest, less than 10% develop ventricular fibrillation, and others develop ventricular tachycardia the hemodynamically compromised child may develop ventricular couplets or frequent premature ventricular beats. In these cases, administer 1 mg/kg lidocaine by the IV, intraosseous, or endotracheal route. A second 1 mg/kg dose may be given in 10 to 15 minutes. Start a lidocaine infusion if the second dose is required a third bolus may be needed in 10 to 15 minutes to maintain therapeutic levels. 

Even if a medication is available in multiple formulations and dosage forms, the prescriber must consider the absorption and distribution differences between adult and pediatric patients. Blood supply at injection or infusion site, available blood supply for unit muscle mass, and skeletal muscle mass relative to body mass vary with patient age and size, causing drug absorption to vary, as well. A rapid intravenous bolus in a pediatric patient might result in acute toxicity a slow intravenous infusion, often required in neonates, can cause erratic, unreliable drug delivery in an older child. In addition, the volume of fluid tolerated for intravenous delivery varies significantly with the age and size of the patient. The blood supply and blood flow to and from the injection site are of prime importance since a gradual decrease in blood supply per unit muscle mass is seen with maturation. In addition, the skeletal muscle mass relative to... 

There is no way of treating Tay-Sachs disease. Enzyme replacement is not considered a likely therapy because infused enzyme cannot penetrate the blood-brain barrier. However, the incidence of the disease has been dramatically decreased by prenatal diagnosis. Tay-Sachs disease is an autosomal recessive disease and so can arise only if both parents are carriers, i.e., if each parent carries a single defective gene for the hexosaminidase A enzyme. In that case there is a 25% chance that a child of these parents will have the disease. 

Beckman RA, Siden R, Yanik GA, Levine JE. Continuous octreotide infusion for the treatment of secretory diarrhea caused by acute intestinal graft-versus-host disease in a child. J Pediatr Hematol Oncol 2000 22(4) 344—50. 

Severe lactic acidosis occurred in a 7-year-old child with osteogenesis imperfecta during short-term (150 minutes) propofol infusion anesthesia (mean infusion rate 13.5 mg/kg/hour) (949). The peak arterial lactate concentration occurred 160 minutes after withdrawal of propofol (lactate 9.2 mmol/1, bicarbonate 16 mmol/1, base deficit 8.3 mmol/1). The hyperlactatemia settled within 18 hours. 

Propofol infusion syndrome might be precipitated by a combination of prolonged propofol infusion and carbohydrate intake insufficient to suppress fat metabolism. Support for this hypothesis has come from a case report of a child with catastrophic epilepsy who developed fatal propofol infusion syndrome after a ketogenic diet was introduced in an attempt to control severe intractable epilepsy (962). 

A 10-year-old child had status epilepticus controlled with a combination of valproate, oxcarbazepine, and 48 hours of propofol infusion in a dose of 5.5 mg/kg/ hour. After weaning from propofol, a classic ketogenic diet was instituted in an attempt to provide long-term control of the seizures. A day later status epilepticus recurred and propofol was restarted at a rate of 6-9 mg/ kg/hour to suppress seizure activity (the diet, valproate, and oxcarbazepine were also continued). Shortly thereafter, he developed the classical constellation of malignant ventricular arrhythmias, hyperlipidemia, rhabdomyolysis, lactic acidosis, and biventricular cardiac failure. He did not survive. 

Lactic acidosis and rhabdomyolysis have been reported in a child receiving an infusion of propofol for sedation in an intensive care unit (965). 

Kill C, Leonhardt A, Wulf H. Lactic acidosis after short-term infusion of propofol for anaesthesia in a child with osteogenesis imperfecta. Paediatr Anaesth 2003 13 823-6. 

Freedman MH, Grisaru D, Olivieri N, etal. Pulmonary syndrome in patients with thalassemia major receiving intravenous deferoxamine infusions. Am J Dis Child 1990 144 565-569. 

Acute lead toxicity produces appetite loss and vomiting. Chronic toxicity leads to renal malfunction, anemia, gout, and nervous system disorders, including brain damage in children. (Lead inhibits development in fetal and child brains.) The effects are more serious for a patient deficient in calcium, zinc, or iron (see Figure 2). Available Pb + affects the structure and function of the bone marrow, where it inhibits several enzymes involved in heme synthesis. It also affects mitochondrial functions in diverse ways. It has proven difficult, however, to specify critical interactions in lead toxicity. Pb + is not particularly carcinogenic but quite toxic. Acute toxicity is dealt with by infusion of Ca +-EDTA,... 

Raised blood pressure and proteinuria (preeclampsia) complicates 2-8% of pregnancies and may proceed to fitting (eclampsia), a major cause of mortality in mother and child. Magnesium sulphate halves the risk of progress to eclampsia (tj/pically 4 g i.v. over 5-10 min followed by 1 g/hour by i.v. infusion for 24 hours after the last seizure). Additionally, if a woman has one fit (treat with diazepam), then the magnesium regimen is superior to diazepam or phenytoin in preventing further fits. ... 

A 33-year-old woman with spasticity caused by a myelopathy after numerous operations on her spine received a single bolus dose of baclofen 50 pg via a lumbar puncture, which resulted in complete resolution of her spasticity for almost 24 hours. However, her temperature increased to 39.0 C within 2 hours after the injection, and she had flu-like sjmptoms. Influenza was assumed to be the most likely explanation, as a child in her house had influenza at that time. Subsequently, an intrathecal catheter was placed and a baclofen pump implanted. However, her temperature rose again after baclofen administration had been started and the pump was halted. Subsequently, several attempts were made to restart the infusion, followed each time by spikes of fever. In the end, continuous intrathecal baclofen therapy had to be abandoned, and the fever did not recur. Several investigations to identify other causes of fever were mostly negative. However, based on bilateral hilar adenopathy on the... 

Douchain F, Hode E, Paul JC, Bakhache P, Pautard JC. Priapisme aigu apres une perfusion d emulsion lipidique a 10 p. 100 chez un enfant mucoviscidosique. [Acute priapism after infusion of 10% fat emulsion in a child with cystic fibrosis.] Presse Med 1990 19(9) 429. 

An effective carboplatin desensitization protocol has been reported in a child with hypersensitivity, allowing additional months of carboplatin treatment (248). After premedication with diphenhydramine, ranitidine, and methylprednisolone, eight dilutions of carboplatin (0.01-50.0 mg) were given intravenously at 15-minute intervals at a rate of 1 mg/minute. Subsequently, carboplatin 600 mg was given as a continuous infusion over 3 hours without adverse effects. Whether desensitization is generally suitable for overcoming allergic adverse events should be tested prospectively (249). 

Bass NE, Wyllie E, Cohen B, Joseph SA. Pyridoxine-depen-dent epilepsy the need for repeated pyridoxine trials and the risk of severe electrocerebral suppression with intravenous pyridoxine infusion. J Child Neurol 1996 11(5) 422. ... 

Ekblad H, Kero P, Takala J. Slow sodium acetate infusion in the correction of metabolic acidosis in premature infants. Am ] Dis Child 1985 139(7) 708-710. 

Kasik J W, Vafai J, Goodrich P. Sodium acetate infusion to correct acidosis in premature infants. Am J Dis Child 1986 140(1) 9—10. 

Jackson JK, Derleth DP. Effects of various arterial infusion solutions on red blood cells in the newborn. Arch Dis Child Fetal Neonatal Ed 2000 83(2) F130-F134. 

Recently it was described that an 11-year-old boy who developed status epilepticus after a prolonged right-side simple partial motor seizure, which was unresponsive to long-term aggressive treatment with several AEDs [51]. The control of seizures was achieved at a plasma valproic acid level of 108 pg/ml, but electrical status epilepticus persisted, and the child remained comatose. On day 37, a treatment with verapamil (a calcium L-channel blocker) was started, and 1.5 h after the initiation of the infusion, the patient regained consciousness, breathed spontaneously, and the electrical status promptly disappeared. The authors suggested that verapamil, a... 

Therapy 20 mL/kg lactated Ringer s IV over 10-15 min Unlikely to need blood cell replacement even if hemorrhagic loss Lactated Ringer s IV as rapidly as possible until response in adult, then decrease rate of infusion 20 mL/kg lactated Ringer s IV in child (repeat quickly if minimal response) likely to need blood cell replacement and surgery if hemorrhagic... 

Koul RL, Aithala GR, Chacko A, et al. Continuous midazolam infusion as treatment of status epilepticus. Arch Dis Child 1997 76 445 48. 

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