小兒科常用藥物
Cough
Robitussin 0.25cc /kg qid
Medicon 1# /40Kg qid
Brocin 0.25cc /kg qid
Throat swelling
Varidase 1#/40kg qid
Danzen 1# qid
Mucolytics
Mucosolvon 0.25cc /kg qid
Fluimucil 1p /40kg qid
Anti-histamine
Mintapp 0.25cc /kg qid
Periactin 1# /40kg qid
Clarityne 1# /40kg bid
Vena 1mg/kg IVD prn
Decongestant
Suffin 1# /40kg qid
Bronchodilator
Berotec 0.25cc /kg qid
Ventolin 1# /40kg qid
Aminophyllin 1# /40kg qid
Meptin 1# /40kg bid
Steroid
Prednisolone 1~2 mg/kg/day
Solu-cortef 10mg /kg iv loading
And then 5mg /kg iv q6h
Anti-pyretics
Panadol 0.5cc /kg prn
Voltaren supp 1#/12kg prn
Voren 1# /40kg prn
Mac-safe 0.5cc /kg prn
Peptic ulcer
Nacid 1# /40kg qid
SMP 1# /40kg qid
Fanta 0.25~0.5cc/kg qid
Zantac 1#/40kg tid
0.8 mg/kg (IVD) q8h
GI medication
Biofermin 1# /10kg qid
Gascon 1# /40kg qid
Abdominal pain
Strocain 1# /40kg qid
Buscopan 1# /40kg qid
1amp/40kg prn
Diarrhea
Kaopectin 0.25~0.5cc/kg qid
Questran 1p /40kg qid
Laxatics
MgO 1# /40kg qid
Ducolax 1# prn
Vomiting
Cisapride 1# /40kg qid
Primperan 1# /40kg qid
1amp/40kg prn
Oral antibiotics
Ulex 0.5cc /kg q6h
Amoxil 0.5cc /kg q8h
Erythromycin 0.25cc/kg q6h
Cefspan 1p /12kg q12h
Keflor 0.5cc /kg q8h
Augmentin 0.3cc/ /kg q8h
IV antibiotics
Keflin 25mg/kg q6h
Gentamicin (IVD) 2.5mg/kg q8h
Unasyn 40mg/kg q8h
Aq-penicillin 0.1MU/kg q6h
Rocephin 25mg/kg q12h
(meningitis 50mg/kg q12h)
Augmentin 25mg/kg q8h
Ampicillin 25mg/kg q6h
Fortum 50mg/kg q8h
Vancomycin (IVD) 10mg/kg q6h
Amikin (IVD) 5mg/kg q8h
Ointment
Antifungal cream (Antifungus)
ZnO ointment (Diaper rash)
Canesten (Antifungus)
Elomet (Steroid ointment)
Corti-S (Steroid ointment)
Kenalog in orabase (oral ulcer)
Difflam spray (oral ulcer)
範例三:AGE with 10% dehydration
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx :AGE with moderate dehydration, R/O Salmonella infection
z BW: 10 Kg
z On 4C ward routine : I/O qd, BW qd, BP tid
z Record 大便次數
z Stool isolation
z On soft diet and/or lactose-free formula as tolerance
z IVF with (T2 + 1amp D50W) run 100 cc/hr for 8hrs, then 70 cc/hr for
16 hrs, then 45 cc/hr
(10% dehydration == 10kg x 1000 x 10% =1000 cc, maintenance
= 10 x 100 = 1000 cc)
z Lab. Exam. :
1. CBC/DC, B/C, BUN/Cre, Na, K, Cl, Glucose, CRP (急診已做)
2. Check stool routine, culture and Rotavirus antigen, U/A
3. 換 IV 時, check CBC/DC and CRP, e-
z Oral medication :
1.. Kaopectin 5 cc qid & st
2. Gascon 1/4 # qid & st
3. Biofermin 1# qid & st
4. Rowapraxin 1/4 # qid & st
5. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆMac-safe 5 cc q6hprn
如果符合給抗生素的情況
z Rocephin 250 mg iv q12h & st (50 mg/kg/day)
範例四:Acute bronchiolitis
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : Acute bronchiolitis
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z On O2 tent
z chest care q4h & sputum suction prn
z Lab. Exam. :
1. CBC/DC, B/C, Na, K, Cl, CRP (急診已做), micro blood gas
2. Chest x-rays (PA or AP view)
3. Nasopharyngeal aspiration for RSV rapid antigen test st
4. Nasopharyngeal aspiration for viral isolation
z Oral medication :
1. Brocin 3cc qid & st
2. Mintapp 3cc qid & st
3. Berotec 2cc qid & st
4. Fluimucil 1/4 # qid & st
5. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 3/4 # supp q6hprn
範例七:Acute purulent tonsillitis
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : Acute purulent tonsilitis
z BW: 20 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 65 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, Na, K, Cl, CRP (急診已做)
2. Throat swab for bacterial and viral cultures
z Oral medication :
1. Robitussin 5cc qid & st
2. Periactin 1/2 # qid & st
3. Varidase 1/2 # qid & st
4. Fluimucil 1/2 # qid & st
5. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 10 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
如果符合給抗生素的情況
z Keflin 500 mg iv q6h & st (100 mg/kg/day)
範例二:Croup
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : croup
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP (急診已做)
2. Throat swab for viral cultures
3. neck X-ray (PA & lateral view) (急診已做)
z On O2 tent
z Bosmin 1/2amp + N/S 1cc inh q6hr & st
z Oral medication :
1. Robitussin 3cc qid & st
2. Periactin 1/4 # qid & st
3. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
範例一:RML pneumonia
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : RML pneumonia
z BW: 20 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T2 + 1amp D50W) run 60 cc/hr
z chest care q4h & suction prn
z Lab. Exam. :
1. CBC/DC, B/C, CRP (急診已做)
2. Chest x-rays (PA and lateral view)
3. sputum routine and for bacterial culture
z urine pneumococcus Ag rapid test (自費)
z Oral medication :
5. Brocin 5cc qid & st
6. Mintapp 5cc qid & st
7. Fluimucil 1/2 # qid & st
8. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 10 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
如果符合給抗生素的情況
z Aq-PCN 2MU ivd q6h & st (10-400,000U/kg/day)
or unasyn 750 mg iv q6h & st (150 mg/kg/day)
範例六:leg cellulitis
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : leg cellulitis
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with T1 run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP, ESR (急診已做)
2. pus smear and bacterial culture
z wound CD qd
z fucidin cream 1 tube topical use for wound care
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
z keflin 250 mg iv q6h & st (100 mg/kg/day)
範例五:Neck lymphadenitis
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : neck lymphadenitis
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP, ESR (急診已做)
2. needle aspiration for smear and bacterial culture
z neck echo
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
z keflin 250 mg iv q6h & st (100 mg/kg/day)
GM 25mg ivd qd & st (5mg/kg/day)
範例八:Neutropenia fever
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : PNET with neutropenic fever
z BW: 20 Kg
z On 4C ward routine : I/O qd, BW qW1,4, BP q8h (如果 toxic 就 q4h)
z Admitted to isolation room if available
z On full diet as tolerance
z IVF with 2.5% G/S run 65 cc/hr
z Dobell’s solution for oral hygiene use
z 5cc B-Iodine in 500cc N/S for perianal use
z Lab. Exam. :
1. CBC/DC, B/C (如果有 port-A 要兩套), BUN/Cre, Na, K, Cl, Ca, P,
GOT, GPT, ALP, LDH, CRP, PT, APTT st (急診已做)
2. U/A, U/C st, S/A, S/C st if diarrhea (+)
3. CxR st (急診已做)
4. F/U CBC/DC, CRP, qd x 3 days if port-A (+) (沒有 Port-A 的病人
或許 QOD 即可)
5. F/U BUN/Cre, Na, K, Cl, Ca, P, GOT, GPT, ALP, LDH, PT, APTT
QW1, W4 (或是換 IV時)
z Medication :
1. G-CSF 250 ug sc qd & st
2. Hold 所有化學藥物
3. 看症狀給藥 (MgO if hard stool, ……..)
4. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 10 cc po q6hprn
> 39 CÆ Voren 1/2# + Nacid 1/2# aa po q6hprn
z 抗生素特殊處方
1. Keflin 500 mg iv q6h & st (100mg/kg/day)
2. Piperacillin (Pipril) 1000 mg iv q6h & st (200~300 mg/kg/day)
3. Amikacin 100 mg ivdrip q8h & st (15 mg/kg/day)
4. Baktar 1/2 # bid QW1, W3, W5
5. Mycostatin 1/2 # qid & st
6. Mycostatin 3cc qid & st (if oral ulcer (+))
範例十一:Young infant fever
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : young infant fever
z BW: 5 Kg
z On level II ward routine
z On 14% RF q4hr as tolerance
z IVF with (T1 + 1amp D50W)
z IV + PO = (120~200ml/kg/day) q8hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP, Glucose (急診已做)
2. U/A and U/C (suprapubic puncture)
3. CSF/R and CSF/C
4. sign lumbar puncture permit
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 3 cc q6hprn
> 39C CÆ warm bath
z Ampicillin 125mg iv q6h & st (100mg/kg/day)
GM 12.5mg ivd q12h & st (5mg/kg/day)
範例十二:pyruia R/O acute pyelonephritis
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : UTI R/O APN
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP (急診已做)
2. Urine routine & culture (註明 urine bag or suprapubic puncture)
z Renal echo
z DMSA renal scan (加蓋急做印章)
z 留一管CBC, 生化for Dr周信旭/VS 邱元佑
z 每天留一管 U/A 冰冰箱下層 for VS 邱元佑
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
z keflin 250 mg iv q6h & st (100 mg/kg/day)
GM 25mg ivd q12h & st (5mg/kg/day)
範例十五:prolonged fever R/O Kawasaki disease
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : R/O Kawasaki disease
z BW: 20 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 60 ml/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP, ESR, GOT, GPT (急診已做)
2. U/A, U/C st
3. Arrange cardioecho before IVIG
4. Arrange DMSA—若確立或高度懷疑為Kawasaki disease時
5. 請預留一管生化及urine for Dr.王玠能 before IVIG
6. Please inform CV fellow Dr.葉政南/姚志達
z IVIG 1 g/kg/d ivd for 12 hrs qd * 2 days (1st day先以0.5g ivd for 30
min作為testing dose)
z Aspirin 50-60 mg/kg/d qid
z Nacid 1/2# po qid with Aspirin
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 1/2# po q6h prn
> 39C CÆ Voren 1/2# + Nacid 1/2# po q6h
prn
若infections無法完全排除時,則可給予empiric A/B:
z Keflin 25mg/kg/dose iv q6h
GM 2.5mg/kg/dose ivd q8h
範例十:ALL for HD-MTX chemotherapy
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : ALL in consolidation week 3 of TPOG-ALL-2002-HR
z BW: 20 Kg
z On 4C ward routine : I/O qd, BW qW1, W4, BP q8h
z On full diet as tolerance
z IVF with (2.5% G/S+ 1/2 amp Jusonin) run 90 cc/hr (1.5 X
maintenance)
z Check urine pH q8h, if pH < 7.0 add 1/2 amp Jusonin in 500cc IVF
z Lab. Exam. :
1. CBC/DC, BUN/Cre, Na, K, Cl, Ca, P, GOT, GPT, ALP, LDH, PT,
APTT st and QW1, W4
2. 24 hr Ccr st and QW
z Medication :
1. MgO if hard stool
2. 看症狀給藥
3. 化學藥物特殊處方請參考工作手冊
範例九:Thrombocytopenia R/O ITP
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : thrombocytopenia R/O ITP
z BW: 20 Kg
z On 4C ward routine : I/O qd, BW qW1, W4, BP q8h
z On full diet as tolerance
z IVF with 2.5% G/S run 65 cc/hr
z Lab. Exam. :
1. CBC/DC, reticulocyte, BUN/Cre, Na, K, Cl, Ca, P, GOT, GPT, ALP,
LDH, PT, APTT, fibrinogen st
2. C3, C4, ANA (& dsDNA if lupus highly suspected) [年齡 < 5 y/o
不必做]
3. Coombs' test (direct & indirect) --- if anemia present (for Evan's
syndrome)
4. EBV IgG & IgM, CMV IgG & IgM, Anti-HCV, Anti-HBs, HBsAg,
Rub IgM
5. 留 3 cc 生化血給陳醫師
6. U/A
7. BM aspiration st
8. NPO 4hrs before BM exam
9. Propofol 1amp for sedation during BM exam (自費)
z Medication :
1. 看症狀給藥
2. BMA 顯示 leukemiaÆ 依照 leukemia work-up
3. BMA 正常,病人沒有 infection signÆ Solumedrol 600 mg ivdrip
1hr qd x 3 days (30 mg/kg/day, max 1000mg)
4. if 病人有 infection signÆ IVIG 20g ivdrip 12 hr qd x 2 days
5. 治療結束隔天 F/U CBC
6. If PLT > 20,000 就出院,出院給一張CBC單門診檢驗
範例十四:Large VSD for cardiac cath exam.
< Pre-cath. Order >
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : Large VSD for catheterization
z BW: 20 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with T1 run 60 cc/hr
z Lab. Exam. :
1. CBC/DC (若要做PDA coil embolization,則需check PT/PTT)
2. Chest x-rays (PA view), complete EKG (若3個月內曾做過則不需
repeat)
z Pre-medication :
1. 備Propofol 1 amp帶至Cath. Room (自費)
2. Keflin 25 mg/kg/dose iv q6h * 4 doses, 1st dose 30 min before
cath.
z Send p’t to cath. room on call with CXR, chart, sand bag and 急救箱
z Keep Hct around 55% in cyanotic CHD, and 40-50% in non-cyanotic
CHD
z Compress the puncture site for 6 hrs (artery) or 2 hrs (vein) with sand
bag
z May try soft diet or milk feeding if consciousness clear
z Palpate pedis dorsalis a. or post. tibial a. of the punctured limb; please
inform CV fellow if suspect a. obstruction
z Resident or Intern doctor and nurse should accompany the transport of
TOF p’t
範例十三:Recurrent abdominal pain for endoscopy exam.
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : recurrent abdominal pain for panendoscopy
z BW: 20 Kg
z On 4C ward routine
z NPO since midnight
z IVF with (T2 + 1amp D50W) run 60 cc/hr while NPO
z Lab. Exam. :
CBC/DC
z Pre-medication :
1. Demoral 40mg (2mg/kg, max 50mg)
2. Buscopan 10mg (0.5mg/kg, max 20mg)
Mixed IM 30mins before send patient to endoscopy room
z 備Propofol & Dormicum 1 amp 帶至 endoscopy Room
z take pulse oximeter & Ambu-bag & mask for appropriate size to
endoscopy room ( 請務必 check)
z Send p’t to endoscopy room on call with X-ray film & chart
請確實檢查申請單已開出,並以電話聯絡內視鏡室 (2680, 2681) 確定
時間
範例十六:hematuria for renal biopsy
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : Hematuria for renal biopsy
z BW: 20 Kg
z On 4C ward routine
z On full diet as tolerance ( NPO 4-6 hrs before biopsy)
z IVF with (2.5%G/S + 1amp D50W) run 60 cc/hr
z Lab. Exam. : CBC/DC, PT/APTT, bleeding time (check之前在OPD
是否已測過)
z 開病理檢驗單及報告單 (檢體欄勾腎臟切片)
z Explain the procedure to patient and obtain written permission
z Premeditate before biopsy with:
1. 能配合的病人: Demerol 1mg/kg (max: 50 mg) IM or IVD 30 min
before biopsy
2. 不能配合的病人: Dormicum (15mg/3ml/amp) 0.03-0.04cc/kg, 3
mins before biopsy
3. 另備 propofol 1amp
4. < 3 m/o 僅需 chloral hydrate 0.5-1 ml/kg PO or PR
<< Post Biopsy Order >>
z Apply a firm dressing to biopsy site
z Keep supine flat position with a rolled sheet or bags under the biopsy
site
z Absolute bed rest for 24 hrs
z Check BP with BP monitor and vital signs q15min for 2 times -> q30
min for 2 times -> q1hr for 2 times -> q4hr for 12 hr
z Check U/A, CBC at 4 and 24 hours after the procedure and prn
z Observe all samples of urine for hematuria and clots
z Resume previous diet and medication, if conscious clear
z F/U renal echo 48 hr later before discharge
z If BP>140/90 or < 90/50 or not void by 12 hours follow biopsy ->
inform Dr (BP 需考慮各年齡層差異)
z Explain to family: 數日內避免過度運動, 便祕及咳嗽等
範例十九:Asthma attack
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : Asthma
z BW: 20 Kg
z On 4C ward routine, on oximeter if needed
z On full diet as tolerance
z O2 mask use if needed ( keep SaO2 > 95% )
z IVF with (T2 + 1amp D50W) run 60 cc/hr
z Aminophylline 1 Amp (250mg) in D5W 250ml run 20ml/hr (一次taper
半量, 在24hr內DC)
z Bricanyl 1ml in N/S 2ml inh. q4~6h & st.
z Solu-cortef 200mg loading (10mg/kg) st, then 100mg (5mg/kg) iv q6h
z Lab. Exam. :
1. CBC/DC, blood gas, Na, K, Cl, Glucose, CRP (急診已做)
2. CxR
z Oral medication :
1 Ventolin 1/2# qid & st.
2. Periactin 1/2# qid & st.
3. Aminophylline 1/2# qid & st. (iv form DC後, 改口服)
4. Prednisolone 1# qid & st. (iv form DC後, 改口服)
5. Fluimucil 1/2pk qid & st.
範例二十:HFM disease R/O CNS involvement
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : HFMD R/O CNS involvement
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP, glucose (急診已做)
2. throat/ rectal swab for viral isolation
3. CSF/R, CSF/C and viral isolation
4. 預留生化血 3cc
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
範例二十三:Hyperbilirubinemia for phototherapy
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : hyperbilirubinemia for P/T
z BW: 3 Kg
z On level II ward routine
z On 14% RF q4hr as tolerance
z IVF with (T1 + 1amp D50W)
z IV + PO = (100~150ml/kg/day + 25ml x lamp No./kg/day) q8hr
z Lab. Exam. :
1. CBC/DC, reticulocyte count, RBC morphology, Coombs’ test, HDN
test
2. Bil (T/D), GOT/GPT, G-6-PD test
3. SB level q12h
z On phototherapy x (I~II)
範例十八:Surgical Scarlet fever
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : surgical scarlet fever
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, GOT/GPT, BUN/Cr, CRP
2. pus smear and bacterial culture
z fucidin cream 1 tube topical use for wound care
z On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
z keflin 250 mg iv q6h & st (100 mg/kg/day)
GM 25mg ivd q12h & st (5mg/kg/day)
範例十七:HS purpura
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : HSP
z BW: 20 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T2 + 1amp D50W) run 60 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, ESR, Na, K, Cl, CRP (急診已做)
2. S/A, U/A st.
z Oral medication :
1. Panadol 1/2# qid for arthralgia
2. Prednisolone(1-2mg/kg/day) 1# qid & st
3. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 1/2# q6hprn
> 39 CÆ Voren 1/2# & nacid 1/2# q6hprn
範例二十二:Bronchopneumonia
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : bronchopneumonia
z BW: 10 Kg
z On 4C ward routine
z On full diet as tolerance
z IVF with (T1 + 1amp D50W) run 40 cc/hr
z Lab. Exam. :
1. CBC/DC, B/C, CRP
2. CxR (PA or AP view)
z Nasopharyngeal aspiration for viral isolation
z Chest care q6h & suction prn
z Oral medication :
1. Brocin 3cc qid & st
2. Mintapp 3cc qid & st
3. Fluimucil 1/4 # qid & st
4. On fever routine: > 38 CÆ ice pillow
> 38.5 CÆ Panadol 5 cc q6hprn
> 39 CÆ Voltaren 1# supp q6hprn
如果符合給抗生素的情況
z unasyn 375 mg iv q6h & st (150 mg/kg/day)
範例二十一:Nephrotic syndrome
z On the service of VS x x x /R4 x x x /Ri x x x
z Dx : Nephrotic syndrome (relapse)
z BW: 10 Kg
z On 4C ward routine, record I/O, check BW, 腹圍 qd
z Diet: low sodium diet
z IVF with (T1 + 1amp D50W) keep line or on IV lock
z Lab. Exam. :
1. CBC/DC, BUN/Cr, Albumin, Ca/P, Na/K/Cl (if fever 加 CRP, B/C)
2. Urine routine & 24 hr Ccr & daily protein loss
3. 若第一次發生: check TG/Chol, IgG, A, E, HbsAg, ASLO, C3/C4,
serum IgG & transferring, urine IgG & transferring 及 Renal echo
z Albumin 40 ml IVD 2 hrs qd x 3 days
z Lasix 10 mg iv after albumin x 3 days
z Prednisolone 1# po qid (2mg/kg/day, max 60mg/day)
z 若為 relapse case 注意病人之前在OPD 服用的藥物 (e.g.
cyclosporin, Endoxan, Decaris…等) 需繼續服用
z 留2管CBC 各3 ml for VS 邱元佑
z Empiric A/B with Keflin + GM if fever or infection sign present