Medical Aspects of Chemical Warfare (2008) - The Black Vault

Medical Management of Chemical Toxicity in PediatricsTable 21-10Example of a Pediatric-Specific Hospital Emergency Drug CacheTherapy orDrug Strength Dosage Form Pediatric Dosing Prophylaxis DiseaseAlbuterol MDI 17gm INH 2–4 puffs q4h respiratory distress Chemical exposurefrom chemicalagentsAmoxicillin 400 mg/5 mL Oral suspension 27 mg/kg q8h–up to 40kg Chemoprophylaxis Anthraxoral 100 ml > 40kg 500 mg q8hsuspensionAtropine 1 mg/mL Injection See dosing table Chemotherapy Nerve agentexposureCiprofloxacin 250 mg/5 mL Oral suspension 20–30 mg/kg/ day divided Chemoprophylaxis Anthrax, plagueoral 100 ml q12h for 60 dayssuspensionClindamycin 600 mg/NS IV 30 mg/kg/day q8h (max Chemotherapy Anthrax50 mL 4.8 g/day)Cyanide 1 kit kit see dosing table chemotherapy Cyanide poisoningantidotepackageDiazepam IV 5 mg/mL x 2 Injection See dosing table Seizures post Seizures postml chemical exposure chemical exposureDoxycycline 25 mg/5 mL Oral suspension 2.5 mg/kg q12h– up to 40 Chemoprophylaxis Anthrax, cholera,oral 60 ml kg, > 40 kg 100 mg q12h brucellosis,suspension for 60 days plagueOseltamivir 12 mg/mL Suspension For children ≥ 1–12 years Chemotherapy Avian influenzasuspension 25 ml old:≤ 15 kg: 2 mg/kg/dose(max 30 mg) BID x 5 days> 15–23kg: 45 mg/dosebiD x 5 days> 23–40 kg: 60 mg/dosebiD x 5 days> 40 kg 75 mg/dose BIDx 5 daysPotassium 65 mg Tablet For children 4–18 yrs: 65 mg; Chemotherapy Radiationiodide For children 1 m–3 yrs: emergency32.5 mg;For children < 1 mo:16.25 mgPralidoxime 1 gm/20 mL Powder for See dosing table Chemotherapy Nerve agentvial injection exposureRibavirin 40 mg/mL Solution LD 30 mg/kg followed by Chemotherapy Viral hemorrhagicsolution 100 mL 15 mg/kg/day BID x 10 feverdaysRifampin 20 mg/mL Compounded 10–20 mg/kg/day q12h Chemotherapy Anthrax,solution 100 mL solution (max daily dose 600 mg) brucellosisTriple 0.9 g Tube apply as needed chemotherapy Skin chemicalantibioticexposureointmentBID: bis in di´e (twice a day)INH: inhalerIV: intravenous solutionLD: loading doseNS: normal saline679