Dose calculation in Paediatric dentistry

practice:

Body Body
Age Weight
Surface
Area

• Young’s Rule • Clarke’s rule •Clark’s SA Rule

•Dilling’s Rule
•Brunton’s Rule
•Fried ‘s Rule In the calculation of dosages, weight has a more direct
•Cowling’s Rule bearing on the dose than any other factor, especially
•Starkenstein’s Rulein the calculation of pediatric doses. The rule
governing calculation of pediatric doses for newborns
and young infants with a normal lean body mass and
normal body development is Clark's Rule. For
toddlers use Fried’s Rule, and for older children
Young’s Rule is used.
AGE

Young’s rule (for 1 to 12 years):

Paediatric dose = Age (in years) x adult dose
age+12
Brunton’s Rule:
Paediatric dose = age x adult dose
25
Dilling’s rule:
Paediatric dose = age (in years) x adult dose
20
Fried's Rule (for Infants and Children up to 1 to 2 Years):
Paediatric dose = age (in months) x adult dose
150
Cowling’s rule:
Pediatric dose = age(at next birthday in years) x adult dose
24
Starkenstein’s Rule:
Paediatric dose = age x adult dose
18
 Clarke’s rule:
Body
Weight Paediatric dose = weight(in pounds) x adult dose
150

Body surface area (BSA) is determined from a west’s nomogram using the
child's height and weight.

Paediatric dose = child’s body surface area x adult dose

Body 1.7m2
surface Clark’s SA Rule:
area Paediatric dose = Surface area of child x adult dose
Surface area of adult
1) Drugs for infection control: Antimicrobial Agents

 An antibiotic is a chemical substance produced by various species of

micro organisms (bacteria, fungi, and actinomycets) that suppress the
growth of other microorganisms and may eventually destroy them.

May be :Synthetic drugs

Naturally obtained drugs

Choice of an antimicrobial agent depends upon

Patient Factors

Organism
related Drug factors
considerations
Antimicrobial Agents

Beta Lactem Antibiotics

Metronidazole

Tetracycline and chloramphenicol

AntiFungal Agents

AntiViral Agents
Antimicroba DOSAGE
l agent AVAILABILITY
ADULT
CHILDREN

AMOXICILLIN 0.5-2g 25-50mg/kg/ Amoxylin, 125mg/5ml dry 250,500

oral/i.m./i.v day Novamox, syrup mg/vial inj.
every 6 hrs Synamox
250, 500mg
capsule

AMPICILLIN Same as Same as amox Ampilin, 125,250 250,500 mg

Amox Roscillin, mg/5ml dry and 1 g per vial
Biocilin syr, inj
250,500 mg 100 mg/ml
cap pediatric drops

CLAVULANIC ACID 500mg 250mg Augmentin,

amoxicillin amoxicillin+12 Enhancin,
+ 125mg 5mg clavulanic Amonate
clavulanic acid TDS. 375mg, 625mg
acid. tab.
CEPHALEXIN 0.25-1g 6-8 25-100 cephaxin 125 mg/5 ml
hourly, mg/kg/day spoidex, dry syr.,
alcephalin 100mg/ml
250,500 mg pediatric drops
cap,
CEPHADROXI Dose: 0.5-1g 30 mg/kg : droxyl 0.5,1g 250mg/5ml
L BD /day tab, 250mg kid syrup,
tab 125mg/5ml
Cefadrox 0.5g syrup and.
cap,

ERYTHROMY 250-500 mg/ 30-60mg/kg/ Erysafe 125, 125mg/5ml

CIN 6 hourly (8 mg day 250, 500 mg and
max) tab,Althrocin 250mg/5ml
250, 500 mg dry syr.
tab, 125 mg 100mg/ml
kid tab ped. Drops.

METRONIDAZO 400- 800 mg, 30-50 Flagyl, 200mg/5ml 500mg/100 ml

LE mg/kg/day. metrogyl, susp., i.v. infusion.
aldezole 200,
400 mg tab,
 Antibiotic prophylactic regimens for certain dental procedures

SITUATION ANTIBIOTIC REGIMEN

Standard Amoxicillin Adults, 2.0 grams; children,50
Prophylaxis milligrams/kilogram
orally one hour before
procedure

Cannot Use Oral Ampicillin Adults, 2.0 g IM or IV;

Medications children, 50 mg/kg IM or
IV within 30 minutes
before procedure

Allergic to Penicillin Clindamycin Adults, 600 mg; children,

20 mg/kg orally one hour
before procedure
Cephalexin or cefadroxil Adults, 2.0 g; children,
50 mg/kg orally one hour
before procedure
Azithromycin or Adults, 500 mg; children,
clarithromycin 15 mg/kg orally one hour
before procedure
Allergic to Clindamycin Adults, 600 mg; children,
Penicillin and Unable 15 mg/kg IV one hour
to Take Oral before procedure
Medications
Cefazolin Adults, 1.0 g; children,
25 mg/kg IM or IV within
30 minutes before procedure
 Drugs for pain control

 Analgesic is a drug that relieves pain by acting in the central

nervous system or on peripheral pain mechanisms.

Widely prescribed for pain relief, especially after a dental surgical

procedures, pulpitis, gingival infections and periapical
infections,dental extractions and teething.

Non steroidal anti-inflammatory drugs

Classified as

Opioid analgesics
Non steroidal anti inflammatory drugs:
(non narcotic or aspirin like and antipyretic analgesic)

CLASSIFICATION
A. Nonselective COX inhibitors (conventional NSAIDS)
Salicylates
Aspirin
Pyrazolone derivatives
Phenylbutazone, oxyphenbutazone
Indole derivatives
Indomethacin
Propionic acid derivatives Ibuprofen,Naproxen, Ketoprofen,
Fenoprofen, Flurbiprofen.
Anthranilic acid derivative
Mephenamic acid
Aryl-acetic acid derivatives
Diclofenac
Oxicam derivatives
Piroxicam, Tenoxicam
Pyrrolo-pyrrole derivative
Ketorolac.
 B. Preferential COX-2 inhibitors :
Nimesulide, Meloxicam, Nabumetone

c. Selective COX-2 inhibitors :

Celecoxib, Rofecoxib, Valdecoxib, Etoricoxib

D. Analgesic - antipyretics with poor antiinflammatory:

Paraaminophenol Paracetamol (Acetaminophen)

derivative
Pyrazolone Metamizol (Dipyrone),
derivatives propiphenazone
Benzoxazocine
derivative Nefopam

• NSAIDS are weaker analgesics but they do not depress the central nervous
system and have no physical dependence.
Ibuprofen:
Dose&Availability:
Brufen, emflam, ibusynth, 200, 400, 600
mg tab
Brufamol kid DT 200mg
Ibugesic 100mg/5ml susp.

Paracetamol :
Dose: Infants 50 mg, children (1-3 years) 60-80 mg,
(4-8 years) 240-320 mg, (9-12 years) 300-600 mg
Availability: Crocin, Metacin, Paracin 500mg tab,
125mg/5ml syrup, 150 mg/ml paed. drops. Ultragin,
Pyrigesic 500 mg tab, 125 mg/5ml syrup. Neomal,
Fevastin febrinil 300mg/2ml inj.
Thank you