Anaphylaxis Treatment and Phenothiazine Overdose

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Questions and Answers

What is the maximum daily dose for an adult taking phenothiazine for anaphylaxis?

600 mg

300 mg

400 mg (correct)

200 mg

At what age should caution be taken when administering Cetirizine dihydrochloride?

Below 5 years

Below 2 years

Below 6 months (correct)

Below 1 year

What is the adult dose range for Cetirizine dihydrochloride?

5-10 mg daily

30-40 mg daily

20-30 mg daily

10-20 mg daily (correct)

Which condition is NOT a contraindication for the use of phenothiazines?

High blood pressure Signup and view all the answers

What is the initial loading dose of Voriconazole for children over 2 years old?

6 mg/kg q 12 hours Signup and view all the answers

What is the maximum daily dose of ceftriaxone sodium for severe infections in adults?

4 gm Signup and view all the answers

Ceftazidime is specifically indicated for which organism?

Pseudomonas aeruginosa Signup and view all the answers

What dose should be administered for meningitis treatment with ceftriaxone sodium?

100 mg/kg/day Signup and view all the answers

What is a contraindication for using ceftriaxone sodium?

Pencillin hypersensitivity Signup and view all the answers

How often should Ceftazidime be dosed for meningitis?

Every 8 hours Signup and view all the answers

What is the usual adult dosage range for Ceftazidime?

2-6 gm daily Signup and view all the answers

What form of administration is used most commonly for Cefotaxime?

Intravenous Signup and view all the answers

What is the recommended dosing frequency for Cefotaxime?

Every 6-8 hours Signup and view all the answers

What is the loading dose for Phenytoin sodium administered intravenously?

15-20 mg/kg Signup and view all the answers

Which of the following is a contraindication for the use of Phenytoin sodium?

Heart block Signup and view all the answers

What is the therapeutic level range for Phenytoin sodium in the blood?

10-20 mg/L Signup and view all the answers

What is the recommended dose of Midazolam for sedation during mechanical ventilation in neonates?

0.05-0.15 mg/kg/dose Signup and view all the answers

Which side effect is associated with Phenytoin sodium therapy?

Gingival hypertrophy Signup and view all the answers

What is the IV bolus dose of Midazolam for acute seizure control?

0.2 mg/kg Signup and view all the answers

At what rate should the loading dose of Phenytoin sodium be administered?

1 mg/kg/min Signup and view all the answers

Which of the following statements is correct regarding Phenytoin sodium administration?

It should be diluted in normal saline. Signup and view all the answers

What should be done if a sibling receives IPV by mistake?

The sibling should remain away from the index child for at least 2 weeks. Signup and view all the answers

Which vaccine is encouraged for an unimmunized sibling who has not had chicken-pox?

Varicella vaccine Signup and view all the answers

What should parents do if they develop a varicella vaccine induced rash?

Isolate from the index child until all lesions crust. Signup and view all the answers

What is the recommended action after transferring an infant to NICU to reduce the risk of gastritis?

Perform a stomach wash with normal saline Signup and view all the answers

What is a significant toxicity of Etoposide?

Nausea and vomiting Signup and view all the answers

Why is suctioning of the ET tube itself not recommended?

It can cause airway trauma Signup and view all the answers

In which type of cancer is Etoposide commonly used?

Gastric cancer Signup and view all the answers

What is the typical dose of Etoposide for testicular cancer?

100 mg/m2 IV on days 1–5 Signup and view all the answers

How many times might an infant be intubated to ensure all meconium is removed?

What is indicated by a period of inactivity longer than one hour during fetal movement monitoring?

Potential fetal compromise Signup and view all the answers

What type of patient should refrain from changing diapers of a vaccinated infant post-Rotavirus vaccination?

Immunocompromised contact Signup and view all the answers

How does Etoposide work as an anti-cancer drug?

By stabilizing the topoisomerase II-DNA complex and preventing DNA unwinding. Signup and view all the answers

In a non-stress test (NST), what is considered a normal heart rate for a fetus?

110 to 160 bpm Signup and view all the answers

What is a sign of a positive contraction stress test (CST)?

Late decelerations with uterine contractions Signup and view all the answers

What parameter does the biophysical profile combine with NST for fetal assessment?

Amniotic fluid volume Signup and view all the answers

Continuous electronic fetal monitoring during labor assesses which of the following?

Baseline heart rate and beat-to-beat variability Signup and view all the answers

Study Notes

Anaphylaxis and Phenothiazine Overdose Treatment

Administer 1-2 mg/kg IV slowly for anaphylaxis or phenothiazine overdose.
Adult dosage ranges from 10-50 mg per dose, with a maximum of 400 mg per day.
Contraindications include use with MAOIs, asthma, narrow-angle glaucoma, and urinary retention.
Common formulations: Dimiril 25 mg tab, Benadryl caps 25 mg and 50 mg, syrup version available with 12.5 mg per 5 ml, and injectable Benadryl in either 50 mg/ml ampoules or 10 mg/ml vials.

Cetirizine Dihydrochloride Dosage

Dosage for children:
- 6 months to 2 years: 2.5 mg once daily.
- 2 to 6 years: 2.5 mg twice daily or 5 mg once daily.
- Above 6 years: 5-10 mg orally once daily.
Adults typically take 10-20 mg daily, administered every 12-24 hours.
Caution advised for those under 6 months; formulations include various branded options.

Voriconazole Administration

Pediatric dosing: 6 mg/kg loading dose every 12 hours followed by 4 mg/kg every 12 hours for children over 2 years.
Adult dosage is 200 mg (max 600 mg/day) divided into twice daily doses for patients over 40 kg; for patients under 40 kg, 100 mg (max 300 mg/day) twice daily.
Indicated for conditions such as infantile spasms and partial seizures.

Phenytoin Sodium Treatment

Loading dose: 15-20 mg/kg IV slowly at 1 mg/kg/min with cardiac monitoring.
Maintenance dose: 5-8 mg/kg/day every 8-12 hours or as a single oral dose.
Therapeutic level range is 10-20 mg/L, with an adult range from 150-300 mg daily, adjustable up to 200-400 mg/day.
Contraindications: Prophyria, heart block; side effects can include gingival hypertrophy, hirsutism, and ataxia.

Midazolam for Status Epilepticus

Dosing: 0.2 mg/kg IV or IM as a bolus; follow with 0.1-0.2 mg/kg/hour.
For mechanical ventilation sedation: 0.05-0.15 mg/kg every 1-2 hours or continuous infusion based on age.
Effective intranasally or buccally at 0.3 mg/kg for acute seizures until IV access is available.

Ceftriaxone Sodium Administration

Pediatric dosage: 50-75 mg/kg/day IV or for meningitis: 100 mg/kg/day in divided doses.
Adult dosage typically 1 gm daily, increasing to 2-4 gm daily for severe infections.
Contraindications: Hypersensitivity to penicillin or cephalosporins.

Ceftazidime Use

Dosing schedule for children is 100-150 mg/kg/day IV every 8 hours; for meningitis, increase to 150 mg/kg/day every 8 hours.
Adult dose ranges from 2-6 gm daily in 2-3 divided doses, maximum 6 gm/day.
Indicated specifically for infections caused by Pseudomonas aeruginosa.

Cefotaxime Administration

Typical pediatric dosing is 100-150 mg/kg/day every 6-8 hours and should be adjusted based on specific needs.
Ongoing considerations for vaccination status and precautions regarding possible infections among siblings and care for immunocompromised contacts.

Etoposide Overview

Extracted from Podophyllum peltatum, a plant alkaloid, targeting the late S- and G2-phases of the cell cycle by inhibiting topoisomerase II.
Common toxicities include myelosuppression, nausea, vomiting, hepatic enzyme elevations, alopecia, and mucositis.
Indicated for a variety of cancers, dosages vary by specific cancer type and regimen.

Fetal Wellbeing Assessment Techniques

Fetal Movement Monitoring: Normal active period is 30-40 min; less than 10 movements per day raises concern for fetal distress.
Non-Stress Test (NST): Measures heart rate variability and acceleration; normal HR is 110-160 bpm with appropriate variable patterns.
Contraction Stress Test (CST): Used as a confirmatory test when NST is non-reactive; positive CST indicates potential fetal compromise.
Biophysical Profile: Combines NST with ultrasound parameters, assessing amniotic fluid and fetal activity for a comprehensive view.

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Description

This quiz focuses on the treatment protocols for anaphylaxis and phenothiazine overdose, including dosages, contraindications, and specific medications. Test your knowledge on adult dosages and the use of various antihistamines in emergency situations.