Wed24November0743AM 10

Which of the following drugs when accidentally given intravenously to a 5-year-old boy would give rise to the most clinical concern?

(Please select 1 option)

400 mg paracetamol

2 mg ondansetron

400 mg cefuroxime

20 mg codeine Correct

40 mg gentamicin

Explanation

One first has to calculate the approximate weight of the child. There are a number of formulae that can be used. The advanced paediatric life support formula is acceptable:

Weight = (age + 4) × 2

A 5-year-old child will weigh approximately 18 kg.

Appropriate doses of the drugs given above are as follows:

Ondansetron - 0.1 mg/kg, but a maximum of 4 mg as a single dose = 1.8 mg

Gentamicin (once daily) - 5-7 mg/kg = 90-126 mg and subsequent dose adjusted according to plasma concentration

Codeine should be given orally at a dose of 1 mg/kg and not intravenously as the latter route can give rise to 'dangerous' hypotension, thought to be due to histamine release

Paracetamol - 15 mg/kg = 270 mg orally or intravenously (sometimes a loading dose of 20 mg/kg is suggested, that is, 360 mg, which is not far short of the dose given in the options above)

Cefuroxime - depending upon the indication, the minimum starting intravenous dose is 20 mg/kg = 360 mg (again, similar to the dose given in the answer options above).

Answer Statistics

1

27%

2

5%

3

3%

4

60%

5

8%

Times answered: 267