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Edition/Revision: 1.0
Archived
Archived
Paediatric Prescribing - Archived
The following information is given as a rough guide for quick reference only. Further advice should be sought when prescribing for children in palliative care.[1-3]
Many of the following drugs, doses or indications are unlicensed in children.
Analgesics
| Drug | Route | 2-12 yr | 12-18 yr | Notes |
| Morphine | PO/PR | 0.15mg/kg | 10mg | 4-hourly starting doses |
| Diamorphine | CSCI | 0.3mg/kg/24h | 20mg | 24h starting dose |
| SC/IM | 0.05mg/kg | 5mg | 4-hourly as needed | |
| Naproxen | PO/PR | 5-10mg/kg | b.d. Maximum 1g/day | |
Antiemetics
| Drug | Route | 2-12 yr | 12-18 yr | Notes |
| Cyclizine | PO/IM | >5 years 25mg | 25-50mg | Up to t.d.s. as needed |
| Haloperidol | PO | 0.5-2mg | 1-3 times daily. Increased risk of extra-pyramidal side-effects in children. | |
| Chlorpromazine | PO | 5-15mg | 10-25mg | Repeat up to q.d.s. |
| Metoclopramide | PO/IM | 0.1mg/kg | <60kg 5mg >60kg 10mg |
2-3 times daily. Increased risk of extra-pyramidal side-effects in children. |
Sedatives
| Drug | Route | 2-12 yr | 12-18 yr | Notes |
| Diazepam | PO/PR | 0.25-0.5mg/kg | 5-10mg | Repeated as needed |
| Promethazine (Phenergan) |
PO | 10-25mg | 25-50mg | Repeated every 6h as needed. Also antiemetic (antihistamine. |
| Midazolam | CSCI | 0.3mg/kg/24h | ||
| SC | 0.7mg/kg | |||
Antisialogogue (for death rattle)
| Drug | Route | 2-18 yr | Notes |
| Hyoscine hydrobromide | SC | 0.01-0.02mg/kg | Repeat every 4h as needed |
| Glycopyrronium | SC | 4µg/kg | Repeat every 6-8h as needed. Doses for drooling much lower. |
Average weights
Average weights for healthy children:
| Age | Mean weight Kg |
% Adult dose |
| Newborn | 3.5 | 12.5 |
| 6 months | 8 | 22 |
| 1 year | 10 | 25 |
| 3 years | 15 | 33 |
| 5 years | 20 | 40 |
| 7 years | 25 | 50 |
| 12 years | 40 | 75 |
| Adult male | 70 | 100 |
| Adult female | 60 | 100 |
NB Wt. in stones x 6 ≈ wt. in Kg.
The percentage adult dose should only be used as a rough guide when paediatric doses in mg/kg are not available.
References
- Doyle D, Hanks GWC, MacDonald N. eds. Oxford textbook of palliative medicine. 2nd ed. Oxford: Oxford University Press, 1997
- Brady M. Treatment of common symptoms in paediatric palliative care. CME Bulletin Palliat Med 1999;1(3):63-68
- Royal College of Paediatrics and Child Health. Medicines in children. London: RCPCH, 1999
Edition/Revision: 1.0
Created 1 Aug 2001 - Archived
Validated 1 Aug 2001 by Ian Back
Validated 1 Aug 2001 by Ian Back
