CF      cystic fibrosis 

Diet   : PO     (   if in distress   : NPO   

V/S: routine

1.  CBC diff

2. Electrolyte

3.  BNU & Creatinine

4. AST .ALT.AP. Albumin . Globulin   

5.  U/A. U/ C

6. S/E:   OB, OP. fat  

7.   ESR   . CRP

8. CXR

9. Sputum sample (   gram stain , culture    )

10. Sweat chloride test (   + CF mutation test   )

11. (   if suspected to influenza   ) : H1N1 PCR

12. Hydration N/S   : 20 cc/kg    ( up to 3 times )

13. IV Maintainance

14. Antibiotics   :

ceftazidime (    Amp 500 mg & 1g   )   : 50 mg / kg / dose TDS

 OR

imipnem 20 mg / kg / dose    QID   ,

OR 

meropnem 20 mg / kg / dose TDS    

+ 

 vancomycin 15 mg / kg / dose QID

+

  IF pseudomonas   

amikacin 7.5 mg / kg / dose TDS for 14 days

15.  (   if suspected to influenza   ) :

osetamivir ( tomiflu ) (   cap 75 mg   ) : 2 mg / kg / dose BID   5 days

16. Mucolytic :

Nebulized solution Acetyl cysteine 20% ( with   Nebulizer ):

infant : 1-2 cc ; child 3-5 cc + 3cc water QID    ( or EFF ACC : 200 & 600 QD – BD ) ;

or

SYR bromhexine  2.5-5 cc q 6 h ,

or

SYR guaifenesinc  2.5 – 5 cc q 6h

or

nebulizer  Hypertonic saline 5 % : BID-QID

17.   Bronchodilators  :

salbutamol  : (   Spray & Nebulizer & SYR 2 mg/5 ml & Tab 4 mg    )

:  nebulizer  ventoline : 2.5 mg q 20 min  * 3 doses   

or

Spray 2 puffs QID or SYR 2.5 -5 cc q 4-8 h

18. Hydrocortisone IV 

  five mg / kg / dose stat ; then 2 mg / kg / dose QID

or

prednisolone 1-2 mg / kg / d in div doses 

19. (    if     fungal )

Amphotericin 0.5 – 0.75- 1 mg / kg IV QD 

or

voriconozole 8 mg / kg / dose BID IV maintenance : then 9 mg / kg / dose BID oral maintenance    

20. malabsorption 

cap creon : 50 IU /KG / DOSE QID ( ??after meal 

infants (up to 12 months)

Creon should be administered to infants immediately prior to each feeding, using a dosage of 3,000 lipase units per 120 mL of formula or prior to breast-feeding 

children and Adults

Creon should be taken during meals or snacks, with sufficient fluid. Creon capsules and capsule contents should not be crushed or chewed. Capsules should be swallowed whole

21.

VIT A

(   Amp 50000 IU & Tab 25000, 50000 IU   ) 

PO

¼-1 Tab QD

IM

under 1 year    :

 amp ¼   = 12500 IU,

1-7 YEAR   :

½ amp  = 25000 IU  amp,

over 7 years :

50000 IU   IM  stat  

22. VIT     D   

 Amp 300 000 IU  IN 59 CC OLIVE OIL : 1 CC QD-BID 

23. VIT     E  

( Tab 200-400 mg ) 

¼ - 1 Tab QD

24. VIT    K  

( Amp 10 mg & Tab 10 mg ) :

نیم تا یک میلیگرم بر هر سال سن کودک حداکثر ده میلیگرم وریدی یا خورااکی روزانه 

25. ( if fever ) : Acetaminophen 15 mg / kg / dose Q 4-6 h

26. ( if PHT ) : sildenafil  ( viagra ) : 0.25-0.5 mg / kg / TDS

27. Chest physiotherapy & suction

OPD:

1. Tab ciprofloxacin (   250 & 500)   : 10-15 mg / kg / dose BID   14 days

Or Azithromycin   10 mg / kg / on day 1 , then 5 mg / kg *  4 days

: then   prophylaxis : ciorofioxacin  Or Azithromycin    : 2 days per weak

2. SYR bromhexine  2.5 – 5 cc    q 4-6 h (   or Tab bromhexine 8mg QID   )

OR EFF acetylcystein   (   ACC   )  QD –BD

 3.  Spray salbutamol 2 puffs QID   ; or salbutamol 2 puffs BID

4. Spray fluticasone    2 puffs BID –QID   , or Tab prednisolone