1397/06/15 23:09:16
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
