BCPPS flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Mosteller body surface area

BSA in square meters equals the square root of (height in cm times weight in kg divided by 3600); used for chemotherapy and other narrow-therapeutic-index drugs.

Neonatal total body water

Total body water is about 80-90% of body weight in preterm neonates versus 60% in adults, increasing the volume of distribution for hydrophilic drugs such as aminoglycosides.

Neonatal glomerular filtration

GFR is roughly 30-40 mL/min/1.73 m2 at term birth and reaches adult values by 6-12 months, so renally cleared drugs need longer dosing intervals in neonates.

Caffeine citrate apnea dosing

Loading dose 20-40 mg/kg IV or orally, then 5-10 mg/kg once daily; used for apnea of prematurity and reduces the need for mechanical ventilation.

Indomethacin for PDA closure

Typical regimen 0.1-0.2 mg/kg IV every 12-24 hours for up to three doses; contraindicated with necrotizing enterocolitis, renal failure, or significant bleeding.

Neonatal HSV acyclovir dose

20 mg/kg IV every 8 hours for 21 days for disseminated or CNS disease, and for 14 days for skin-eye-mouth disease; a higher dose than older regimens.

High-dose amoxicillin otitis media

80-90 mg/kg/day divided twice daily for acute otitis media, chosen to overcome penicillin-nonsusceptible Streptococcus pneumoniae; maximum 4 g per day.

MMR vaccine schedule

First dose at 12-15 months and second at 4-6 years; both are live vaccines and are contraindicated in significant immunocompromise and in pregnancy.

Rotavirus vaccine age limits

First dose by 14 weeks 6 days of age and all doses completed by 8 months 0 days; RV1 is two doses and RV5 is three doses.

Acute asthma albuterol dosing

Nebulized albuterol 0.15 mg/kg (minimum 2.5 mg) every 20 minutes for three doses; metered-dose inhaler alternative is 4-8 puffs with a spacer.

Croup dexamethasone dose

Single dose of 0.15-0.6 mg/kg orally, IM, or IV (maximum 10 mg) for croup; nebulized epinephrine is added for moderate to severe stridor at rest.

PALS epinephrine arrest dose

0.01 mg/kg IV/IO of 1:10,000 epinephrine (0.1 mL/kg), maximum 1 mg, repeated every 3-5 minutes during pediatric cardiac arrest.

Adenosine SVT dosing

0.1 mg/kg rapid IV push (maximum 6 mg), then 0.2 mg/kg (maximum 12 mg) if needed; flush rapidly because the half-life is only seconds.

PEG 3350 constipation dose

Maintenance dosing is 0.4-0.8 g/kg/day; disimpaction uses 1-1.5 g/kg/day for up to 6 days, often mixed in fluids; preferred osmotic laxative in children.

Ondansetron gastroenteritis dose

0.15 mg/kg IV or 2 mg orally for children 8-15 kg, 4 mg for 15-30 kg, and 8 mg above 30 kg; monitor for QT prolongation.

Holliday-Segar maintenance fluids

100 mL/kg/day for the first 10 kg, plus 50 mL/kg/day for the next 10 kg, plus 20 mL/kg/day for each kilogram above 20.

4-2-1 rule hourly fluids

4 mL/kg/hour for the first 10 kg, 2 mL/kg/hour for the next 10 kg, and 1 mL/kg/hour for each kilogram above 20.

Hyperkalemia calcium gluconate

10% calcium gluconate 100 mg/kg (0.1-0.2 mL/kg) IV over 5-10 minutes with cardiac monitoring; it stabilizes the myocardium but does not lower serum potassium.

Status epilepticus lorazepam

0.1 mg/kg IV (maximum 4 mg) as first-line therapy, which may be repeated once; if seizures persist, use fosphenytoin, levetiracetam, or valproate.

Valproate hepatotoxicity risk

Highest risk in children under 2 years, especially with polytherapy or metabolic disease; contraindicated in urea cycle disorders and avoided with suspected mitochondrial disease.

DKA insulin infusion

Start regular insulin at 0.05-0.1 unit/kg/hour without a bolus in children; add dextrose when glucose falls below about 250-300 mg/dL.

Congenital hypothyroidism levothyroxine

Start levothyroxine 10-15 mcg/kg/day as soon as possible, ideally before 2 weeks of age, to prevent irreversible neurodevelopmental impairment.

Enuresis desmopressin dose

Oral desmopressin 0.2-0.6 mg at bedtime for nocturnal enuresis in children over 6 years; restrict fluids to avoid hyponatremia.

Nephrotic syndrome prednisone

Initial prednisone 60 mg/m2/day (maximum 60 mg) for 6 weeks, then 40 mg/m2 every other day for 6 weeks for a first episode of idiopathic nephrotic syndrome.

Anaphylaxis epinephrine IM

Epinephrine 1:1000 at 0.01 mg/kg intramuscularly, maximum 0.3 mg in children or 0.5 mg in adolescents, into the lateral thigh; repeat every 5-15 minutes as needed.

Sickle cell penicillin prophylaxis

Penicillin V potassium 125 mg twice daily until age 3 years and 250 mg twice daily from 3 to 5 years to prevent pneumococcal sepsis.

Methotrexate leucovorin rescue

Leucovorin (folinic acid) rescues normal cells after high-dose methotrexate; the dose is guided by serum methotrexate levels and given until levels fall below threshold.

Acetaminophen overdose acetylcysteine

N-acetylcysteine is given as 150 mg/kg over 1 hour, 50 mg/kg over 4 hours, then 100 mg/kg over 16 hours; risk is assessed with the Rumack-Matthew nomogram.

Naloxone opioid reversal dose

0.1 mg/kg IV/IM (maximum 2 mg) for respiratory depression from opioids, repeated every 2-3 minutes; the duration is shorter than many opioids.

Septic shock fluid bolus

20 mL/kg isotonic crystalloid over 5-20 minutes, repeated up to 40-60 mL/kg, reassessing for hepatomegaly, rales, and worsening perfusion.

Magnesium sulfate severe asthma

25-50 mg/kg IV (maximum 2 g) over 20 minutes for severe asthma exacerbation not responding to bronchodilators and corticosteroids; monitor blood pressure.

DKA cerebral edema treatment

Mannitol 0.5-1 g/kg IV over 10-15 minutes or 3% hypertonic saline 5-10 mL/kg; slow the insulin and fluid rates and obtain emergent imaging.