
Drug
Dosing
All
of the drugs included in this guide have been researched using
current prescribing references and guidelines. Several of the
guides varied in their dosing ranges and age limitations. Below
are the specific drug dosing recommendations, their sources,
and the range included in CODE BLUE. A few medications are
listed in both the rapid sequence and ACLS sections. The appropriate
doses vary depending on the indication. The specific ranges
for each indication are listed below. None of the safety profiles,
adverse reactions, drug interactions, or contraindications
are listed on this reference site, nor on the application:
CODE BLUE. The user is responsible for checking valid references
for this important information PRIOR to administering any medication
to a patient. CODE BLUE is intended only as a drug dose calculator,
not a drug reference.
If
you note any errors, concerns with our dosing regimen, please
email us at: clinical@em-innovations.com
- References
- A-Z:
Facts and Comparisons - A to Z Drug Facts 2001
- HL:
The Harriet Lane Handbook, Johns Hopkins Hospital 2001
- PDT:
Handbook of Pediatric Drug Therapy, Lippincott, Williams & Wilkins
2001
- qRx:
Epocrates qRx April 2002
-
Notes
- When
age specific dosing is not listed, the breakoff between
child and adult dosing is 8 yrs. When used, this cut-off
is noted below.
RAPID
SEQUENCE
-
LIDOCAINE
- Premedication
- blunts stress response, increased ICP associated
with ETI related trauma.
- Adults
- A-Z:
50-100 mg at rate of 25-50 mg/min; may
repeat, but do not exceed 200-300 mg/hr
- HL:
N/A
- PDT:
50-100 mg (1 to 1.5 mg/kg) by IV bolus
at 25-50 mg/min
- qRx:1-1.5
mg/kg IV bolus q 3-5 minutes., max dose
300 mg/hr
- Pediatric
- A-Z:
1 mg/kg q 5 to 10 minutes, max dose 5 mg/kg
- HL:
1 mg/kg, repeat in 10 to 15 minutes, max
dose 3-5 mg/kg in first hour.
- PDT:
0.5-1 mg/kg
- qRx:
N/A
-
CODE
BLUE
- 1 mg/kg for all ages and weights. The indication
of intubation premedication was listed, but not FDA
approved
- ATROPINE
- Utilized
to decrease oral secreations during and after intubation.
- Adult
- A-Z:
0.4-0.6 mg q 4-6 hours
- HL:
0.5 mg
- PDT:
0.4 mg IM/SC 30-60 min prior to anesthesia
- qRx:
0.4 mg IM/SC 30-60 min prior to anesthesia
- PEDIATRIC
- A-Z:
- Infant
< 5 kg: 0.04 mg/kg IV/SC/IM
- Infant
>5 kg: 0.03 mg/kg IV/SC/IM
- Children:
Lowest effective dose, start 0.01
mg/kg IV/SC/IM not to exceed 0.4
mg q 4-6 hours
- HL:
0.01 mg/kg, max dose 0.4 mg, minimum dose
0.1 mg IV
- PDT:
- Infant
= 3 kg: 0.1 mg IM 30-60 min prior
to anesthesia
- Infant
4-9 kg: 0.2 mg IM 30-60 min prior
to anesthesia
- Infant
10-20 kg: 0.3 mg IM 30-60 min prior
to anesthesia
- qRx:
- Infant
< 5 kg 0.02 mg/kg PO/IM/IV/SC q 4-6
hrs
- Infant/Child
> 5 kg 0.01-0.02 mg/kg PO/IM/IV/SC
q 4-6 hrs
-
CODE
BLUE
- Weight
< 10 kg: Minimum dose 0.1 mg IV
- Weight
>=10 kg and <40 kg: dose 0.01 mg/kg
IV
- Weight
>=40 kg: Maximum dose 0.4 mg IV
- PANCURONIUM
/ VECURONIUM
- Non
depolarizing paralytic, used in pre-medication phase
for defasciculation.
- Adult
- A-Z:
- Pancuronium:
defasciculating dose not listed
- Vecuronium:
0.04-0.06 mg/kg IV
- HL:
- Pancuronium:
defasciculating dose not listed
- PDT:
- Pancuronium:
defasciculating dose not listed
- Vecuronium:
defasciculating dose not listed
- qRx:
- Pancuronium:
0.04-0.1 mg/kg IV, defasciculating
dose not listed
- Vecuronium:
defasciculating dose not listed
- PEDIATRIC
- A-Z:
- Pancuronium:
defasciculating dose not listed
- Vecuronium:
0.04-0.06 mg/kg IV, slightly higher
for children <10 years, lower for
infants
- HL:
- Pancuronium:
0.02 mg/kg initial dose, defasciculating
dose not listed
- Vecuronium:
defasciculating dose not listed
- PDT:
- Pancuronium:
0.02 mg/kg initial dose, defasciculating
dose not listed
- Vecuronium:
defasciculating dose not listed
- qRx:
- Pancuronium:
0.04-0.1 mg/kg IV, defasciculating
dose not listed
- Vecuronium:
0.04-0.06 mg/kg, following succinylcholine
-
CODE
BLUE
- Defasciculating
doses not listed in these references
- Dose
taken from Johns Hopkins Children's
Center "Kids Kard"
©1997
- Dose
0.01 mg/kg for all ages, weights
- FENTANYL
- Narcotic
analgesic, sedative. Dosing regimen below is for pre-medicating,
not induction.
- Adult
- A-Z:
- 50-100
mcg as surgery adjunct
- HL:
- PDT:
- 2
mcg/kg IV - low dose regimen
- qRx:
- 2
mcg/kg for low dose
- 2-20
mcg/kg for moderate dose
- 20-50
mcg/kg for high dose
- PEDIATRIC
- A-Z:
- HL:
- 1-2
mcg/kg/dose q 30-60 minutes PRN
- PDT:
- 2-3
mcg/kg IV dosing 2-12 years old,
for induction and maintenance of
anesthesia
- qRx:
- 1-3
yrs: 2-3 mcg/kg IV, or alternatively
1-2 mcg/kg IV, then 0.5-1 mcg/kg/hr
infusion
- 3-12
yrs: 1-2 mcg/kg IV, or alternatively
1-2 mcg/kg IV, then 0.5-1 mcg/kg/hr
infusion
- >12
yrs: 0.5-1 mcg/kg IV, or alternatively
1-2 mcg/kg IV, then 0.5-1 mcg/kg/hr
infusion
-
CODE
BLUE
- Chose
lower dosing regimen as pre-medicating
dose
- 1-2
mcg/kg for all ages, weights
- ETOMIDATE
(Amidate)
- Hypnotic
Agent, used for induction. Minimal cardiac depressent
side effects, when compared with barbituates.
- Adult
- A-Z:
- HL:
- PDT:
- 0.2-0.6
mg/kg, usual dose 0.3 mg/kg IV over
30-60 seconds
- qRx:
- 0.2-0.6
mg/kg, usual dose 0.3 mg/kg IV over
30-60 seconds
- PEDIATRIC
- A-Z:
- HL:
- PDT:
- >
10 years: 0.2-0.6 mg/kg, usual dose
0.3 mg/kg IV over 30-60 seconds
- qRx:
-
- CODE
BLUE
- <10
years (34 kg): not recommended, N/A
- >=
10 years (34 kg): 0.2-0.3 mg/kg
- KETAMINE
(Ketalar)
- Dissociative
Sedative Analgesic. Used for induction. Avoid in head
injury patients.
- Adult
- A-Z:
- 1-4.5
mg/kg via slow IVP over 60 sec.
- HL:
- 1-4.5
mg/kg via slow IVP over 60 sec.
- PDT:
- 1-4.5
mg/kg via slow IVP over 60 sec.
- qRx:
- 1-4.5
mg/kg via slow IVP over 60 sec.
- PEDIATRIC
- A-Z:
- 1-4.5
mg/kg via slow IVP over 60 sec.
- HL:
- PDT:
- 1-4.5
mg/kg via slow IVP over 60 sec.
- qRx:
-
CODE
BLUE
- 1-2
mg/kg for all ages, weights
- MIDAZOLAM
(Versed)
- Sedative
hypnotic, benzodiazepine, used for induction.
- Adult
- A-Z:
- 0.15-0.35
mg/kg for pre-medicated adults
- HL:
- 0.5-2
mg dose, may repeat, usual dose 2.5-5
mg
- PDT:
- 1-2.5
mg dose, may repeat, usual dose 2.5-5
mg
- qRx:
- 1
mg q 2-3 min, max 5 mg.
- PEDIATRIC
- A-Z:
- 6
mo - 5 yrs: 0.05-0.1 mg/kg, don't
exceed 6 mg
- 6-12
yrs: 0.025-0.05 mg/kg, don't exceed
10 mg
- 12-16
yrs: Dose as adults, 0.15-0.35 mg/kg
- HL:
- Neonates:
(>32 wks) 1 mcg/kg/min, titrate
- Infants
& Children, Mech Vent Sedation:
0.05-0.15 mg/kg
- 6
mo-5 yrs: 0.05-0.1 mg/kg over 2-3
min, max dose 6 mg
- 6-12
yrs: 0.025-0.05 mg/kg, don't exceed
10 mg
- 12-16
yrs: Dose as adults, max 10 mg
- PDT:
- 6
mo-5 yrs: 0.05-0.1 mg/kg over 2-3
min, max dose 6 mg
- 6-12
yrs: 0.025-0.05 mg/kg, don't exceed
10 mg
- 12-16
yrs: Dose as adults, max 10 mg
- qRx:
- 6
mo-5 yrs: 0.05-0.1 mg/kg over 2-3
min, max dose 6 mg
- 6-12
yrs: 0.025-0.05 mg/kg, don't exceed
10 mg
-
CODE
BLUE
- Wide
theraputic ranges
- Newborn
(3.5 kg to 5 kg) : 1 mcg/kg/min IV
drip
- >= 2
months (5 kg): 0.05-0.1
mg/kg IV boluses, titrated
- Maximum
dose 10 mg. (only attained at 100
kg or greater weight)
- PROPOFOL
(Diprivan)
- Hypnotic
agent, used for induction. Does not provide analgesia.
- Adult
- A-Z:
- 2-2.5
mg/kg total dose, titrated 40 mg
q 10 sec.
- 1-1.5
mg/kg total dose, elderly, debilitated,
titrated 20 mg q 10 sec.
- HL:
- PDT:
- 2-2.5
mg/kg total dose, titrated 40 mg
q 10 sec.
- 1-1.5
mg/kg total dose, elderly, debilitated,
titrated 20 mg q 10 sec.
- qRx:
- 2-2.5
mg/kg total dose, titrated 40 mg
q 10 sec.
- 1-1.5
mg/kg total dose, elderly, debilitated,
titrated 20 mg q 10 sec.
- PEDIATRIC
- A-Z:
- >
3 years: 2.5-3.5 mg/kg over 20-30 sec
- HL:
- PDT:
- >
3 years: 2.5-3.5 mg/kg over 20-30 sec
- qRx:
- 2.5-3.5
mg/kg over 20-30 sec
-
CODE
BLUE
- Dosing
not appropriate for elderly, ASA
Class III/IV
- <
3 years: N/A
- >
3 years: 2-3 mg/kg
- SUCCINYLCHOLINE
(Anectine)
- Depolarizing
Paralytic
- Adult
- A-Z:
- HL:
- PDT:
- qRx:
- 0.6-1.5
mg/kg IV,
max 150 mg
- PEDIATRIC
- A-Z:
- HL:
- Infants
and Children: 1-2 mg/kg, max 150 mg
- PDT:
- Infants:
2 mg/kg IV
- Children
and Adolescents: 1 mg/kg IV, max 150 mg
- qRx:
-
CODE
BLUE
- <
3 years (15 kg): 2 mg/kg IV
- >
3 years (15 kg): 1-1.5 mg/kg IV
- Maximum
150 mg
- CISATRACURIUM
(Nimbex)
- Non-depolarizing
rapid onset, short acting, paralytic
- Adult
- PEDIATRIC
- A-Z:
- HL:
- PDT:
- Children
2-12 yrs: 0.1 mg/kg IV
- qRx:
- CODE
BLUE
- <
2 years (12.4 kg): N/A
- 2-12
years: 0.1 mg/kg IV
- >
12 years (43 kg): 0.15-0.2 mg/kg IV
- ROCURONIUM
(Zemuron) Version:roc
- Non-depolarizing
rapid onset, relatively short acting, paralytic
- Adult
- Sota
Omoigui's Anesthesia Drugs Handbook 3rd
Ed:
- HL:
- PDT:
- qRx:
- PEDIATRIC
- Sota
Omoigui's Anesthesia Drugs Handbook 3rd
Ed:
- HL:
- PDT:
- Children
>= 3 mo: 0.6-1.2 mg/kg
- qRx:
ACLS
- EPINEPHERINE
0.01 mg/kg
- Sympathomimetic,
vasopressor, inotrope
- Adult
- PEDIATRIC
- A-Z:
- HL:
- Neonate:
0.01-0.03 mg/kg
- Infants
and Children: 0.01 mg/kg - FIRST
DOSE
- Infants
and Children: 0.1 mg/kg - Subsequent
Doses
- PDT:
- Neonate:
0.01-0.03 mg/kg
- Infants
and Children: 0.01 mg/kg - FIRST
DOSE
- Infants
and Children: 0.1 mg/kg - Subsequent
Doses
- qRx:
- Neonate:
0.01-0.03 mg/kg
- Infants
and Children: 0.01 mg/kg - FIRST
DOSE
- Infants
and Children: 0.1 mg/kg - Subsequent
Dose
-
CODE
BLUE
- 0.01
mg/kg for all ages upto 1 mg, Max
1 mg
- EPINEPHERINE
0.1 mg/kg
- Sympathomimetic,
vasopressor, inotrope
- Adult
- PEDIATRIC
- A-Z:
- 0.1
mg/kg - Subsequent Doses
- HL:
- Neonate:
0.01-0.03 mg/kg
- Infants
and Children: 0.01 mg/kg - FIRST
DOSE
- Infants
and Children: 0.1 mg/kg - Subsequent
Doses
- PDT:
- Neonate:
0.01-0.03 mg/kg
- Infants
and Children: 0.01 mg/kg - FIRST
DOSE
- Infants
and Children: 0.1 mg/kg - Subsequent
Doses
- qRx:
- Neonate:
0.01-0.03 mg/kg
- Infants
and Children: 0.01 mg/kg - FIRST
DOSE
- Infants
and Children: 0.1 mg/kg - Subsequent
Doses
- CODE
BLUE
- 0.1
mg/kg for all ages, up to Max 1 mg dose
- ATROPINE
- Anti-cholinergic
- Adult
- A-Z:
- HL:
- 0.5-1
mg IV q 5 min, Max 2 mg
- PDT:
- 0.5-1
mg IV q 5 min, Max 2 mg
- qRx:
- 0.5-1
mg IV q 5 min, Max 2 mg
- PEDIATRIC
- A-Z:
- 0.01-0.03
mg/kg q 1-2 hrs
- HL:
- 0.02
mg/kg IV q 5 min x 2-3 doses.
- Max
single dose 0.5 mg in children, 1
mg total
- Max
single dose 1 mg in adolescents,
2 mg total
- PDT:
- Children:
0.02 mg/kg up to max 1 mg
- qRx:
- 0.02
mg/kg IV q 5 min x 2-3 doses.
- Max
single dose 0.5 mg in children, 1
mg total
- Max
single dose 1 mg in adolescents,
2 mg total
-
CODE
BLUE
- <
8 yrs (27 kg): 0.02 mg/kg
- >=
8 yrs: 0.5-1 mg IV - adult dosing
- LIDOCAINE
- Anti-arrhythmic
- Class 1B
- Adult
- A-Z:
- HL:
- PDT:
- 50-100
mg (1-1.5 mg/kg) IV bolus
- qRx:
- 1-1.5
mg/kg bolus q 3-5 min, max 300 mg/hr
- PEDIATRIC
- A-Z:
- 1
mg/kg q 5-10 min, max dose 5 mg/kg
- No
specific age range
- HL:
- 1
mg/kg IV, may repeat in 10-15 min,
max 3-5 mg/kg in first hour
- PDT:
- qRx:
- CODE
BLUE
- <
8 yrs (27 kg): 1 mg/kg
- >=
8 yrs: 1-1.5 mg/kg IV - adult dosing
- AMIODARONE
- Anti-arrhythmic
- Class III
- Adult
- A-Z:
- HL:
- 150
mg over 10 minutes (w/pulse)
- PDT:
- 150
mg over 10 minutes (w/pulse)
- qRx:
- 300
mg IV x 1, ACLS pulseless VT/VF
- PEDIATRIC
- A-Z:
- HL:
- PDT:
- qRx:
- 5
mg/kg IV over 5-60 minutes
- Avoid
in newborn, contains benzyl alcohol
- CODE
BLUE
- Newborn:
N/A
- >
5 kg and <= 60 kg: 5 mg/kg IV
- >
60 kg: 300 mg bolus for Pulseless VT/VF, Adult dose
- DOPAMINE
- Vasopressor,
inotrope
- Adult
- A-Z:
- Initial
dose 2-5 mcg/kg/min IV
- Most
pts maintained <=20 mcg/kg/min
IV
- HL:
- 2-5
mcg/kg/min IV - low dose
- 5-15
mcg/kg/min IV - intermediate dosing
- >20
mcg/kg/min IV - high dose, decreases
renal perfusion
- PDT:
- 1-5
mcg/kg/min to 20-50 mcg/kg/min IV
- qRx:
- PEDIATRIC
- A-Z:
- HL:
- 2-5
mcg/kg/min IV-
low dose
- 5-15 mcg/kg/min
IV- intermediate dosing
- >20
mcg/kg/min IV-
high dose, decreases renal perfusion
- PDT:
- Neonates:
0.5-20 mcg/kg/min
IV
- Infants
and children: 1-20 mcg/kg/min
IV
- qRx:
-
CODE
BLUE
- 2-20
mcg/kg/min for all ages, weight
- DOBUTAMINE
- Inotrope
- Adult
- A-Z:
- Initial
dose 2.5-10 mcg/kg/min IV
- Increased
HR > 20 mcg/kg/min IV
- 40
mcg/kg/min IV -Maximum dosing
- HL:
- 2.5-15
mcg/kg/min IV
- 40
mcg/kg/min IV -Maximum dosing
- PDT:
- 2.5-15
mcg/kg/min IV
- 40
mcg/kg/min IV -Maximum dosing
- qRx:
- 2-20
mcg/kg/min IV
- 40
mcg/kg/min IV -Maximum dosing
- PEDIATRIC
- A-Z:
- HL:
- 2.5-15
mcg/kg/min IV
- 40
mcg/kg/min IV -Maximum dosing
- PDT:
- Neonates:2-20 mcg/kg/min
IV
- Infants
and children: 2-20 mcg/kg/min
IV
- qRx:
- 2-20
mcg/kg/min IV
- 40
mcg/kg/min IV -Maximum dosing
-
CODE
BLUE
- 2-20
mcg/kg/min for all ages, weights
- NOREPINEPHERINE
- Vasopressor
- Adult
- A-Z:
- HL:
- 4
mcg/min to start
- 8-12
mcg/min, usual dosing range
- PDT:
- 2-12
mcg/min, then titrate to BP
- Maintenance
is usually 2-4 mcg/min
- qRx:
- 2-12
mcg/min IV
- 40
mcg/kg/min IV -Maximum dosing
- PEDIATRIC
- A-Z:
- HL:
- 0.05-0.1
mcg/kg/min IV
- Max
dose 2 mcg/kg/min
- PDT:
- Children:
2 mcg/min, titrated to BP
- Or
0.1 mcg/kg/min IV, titrated to BP
- qRx:
-
CODE
BLUE
- <
8 yrs: 0.05-0.3
mcg/kg/min - From DrugDex
- >=
8 yrs: 2-12 mcg/min - Fixed Adult
dosing
- PHENYLEPHRINE
- Vasopressor
- Adult
- A-Z:
- 100-180
mcg/min to start
- 40-60
mcg/min maintenance rate
- HL:
- 100-180
mcg/min to start
- 40-60
mcg/min maintenance rate
- PDT:
- qRx:
- 40-180
mcg/min IV
- Alt
50 mcg boluses IV
- PEDIATRIC
- A-Z:
- HL:
- 0.1-0.5
mcg/kg/min IV
- Titrate
to effect
- PDT:
- qRx:
-
CODE
BLUE
- <=
16 yrs (70 kg): 0.1-0.5
mcg/kg/min
- >16
yrs (70 kg): 40-180 mcg/min - Fixed
Adult dosing
- VASOPRESSIN
- Vasopressor
- Adult
- A-Z:
- Not
Listed for this indication
- HL:
- Not
Listed for this indication
- PDT:
- Not
Listed for this indication
- qRx:
- 40
U IV x 1 for pulseless VT/VF
- PEDIATRIC
- A-Z:
- Not
listed for this indication
- HL:
- Not
listed for this indication
- PDT:
- Not
listed for this indication
- qRx:
- Not
listed for this indication
-
CODE
BLUE
- <=
16 yrs (70 kg): N/A
- >16
yrs (70 kg): 40 units IV x 1- Fixed
Adult dosing
- MANNITOL
LOAD
- Osmotic
diuretic
- Adult
- A-Z:
- HL:
- 0.25-1
g/kg/dose IV over 20-30 minutes for
cerebral edema
- PDT:
- qRx:
- 0.25-2
g/kg/dose IV over 30-60 minutes for
cerebral edema
- PEDIATRIC
- A-Z:
- HL:
- 0.25-1
g/kg/dose IV over 20-30 minutes
- PDT:
- <
12 yrs: 2 g/kg as a 15% to 20% solution
over 30-60 minutes for increased
ICP
- >
12 yrs: 1.5-2 g/kg as a 15% to 25%
solution over 30-60 minutes for
increased ICP
- qRx:
-
CODE
BLUE
- 0.25-1
g/kg for all ages, weights
- Conservatively
listing the lower dose range from
Harriett Lane, clinicians should
adjust their dosing when appropriate
- FUROSEMIDE
(Lasix)
- Loop
diuretic
- Adult
- PEDIATRIC
- A-Z:
- HL:
- Neonates:
0.5-1 mg/kg
- Infants
and Children: 0.5-2 mg/kg
- PDT:
- 1
mg/kg IV, maximum 6 mg/kg
- qRx:
- Neonates:
1-2 mg/kg IV q 12-24 hrs
- Infants
and Children: 1-2 mg/kg IV q 6-12
hrs
-
CODE
BLUE
- <
5 kg (2 mo): 1-3 mg IV - from Drug
Dex
- >=5
kg (2 mo) and <=27 kg (8 yrs):
1 mg/kg IV
- >
27 kg: 0.5-1 mg/kg IV
- METHYLPREDNISILONE
(Solumedrol)
- Corticosteroid
- Adult
- A-Z:
- Not
Listed for this indication
- HL:
- 30
mg/kg IV over 15 minutes
- 5.4
mg/kg/hr for 23 hours
- PDT:
- 30
mg/kg IV over 15 minutes
- 5.4
mg/kg/hr for 23 hours
- qRx:
- 30
mg/kg IV over 15 minutes
- 5.4
mg/kg/hr for 23 hours
- PEDIATRIC
- A-Z:
- HL:
- 30
mg/kg IV over 15 minutes
- 5.4
mg/kg/hr for 23 hours
- PDT:
- Not
listed for this indication
- qRx:
- 30
mg/kg IV over 15 minutes
- 5.4
mg/kg/hr for 23 hours
-
CODE
BLUE
- 30
mg/kg IV over 15 minutes
- 5.4
mg/kg/hr for 23 hours
- DEXAMETHASONE
(Decadron)
- Corticosteroid
- Adult
- A-Z:
- 10
mg IV for
cerebral edema
- HL:
- Not
listed for this indication
- PDT:
- 10
mg IV for
cerebral edema
- qRx:
- Not
listed for this indication
- PEDIATRIC
- A-Z:
- Not
listed for this indication
- HL:
- 1-2
mg/kg/dose, Max dose 16 mg/24 hrs
- PDT:
- Not
listed for this indication
- qRx:
- 1-1.5
mg/kg IV qd, Max dose 16 mg/24 hrs
-
- CODE
BLUE
- <=10
kg: 1-1.5 mg/kg
- >
10 kg: 10 mg IV x 1
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