2: Pediatric Drug Management

Section 2:

Pediatric Drug Management

Martha Ann Keels, DDS, PhD and Erica Brecher, DMD, MS

1 | Analgesics Dosage

In order to alleviate pain in pediatric patients, systemic analgesics are indicated. Most commonly, acetaminophen or ibuprofen are utilized according to the dosing schedule below. For instances of moderate to severe pain, acetaminophen and ibuprofen can be alternated every three hours. The use of opioids for pain management in children is not recommended due to potential severe side effects.

Table 1. Pediatric Pain Medication


Sample Dosage



10-15 mg/kg/dose given at 4-to 6- hour intervals

Suspensions: 160 mg/5 mL

Chewable Tablets: 80 mg, 160 mg

Tablets: 325 mg, 500 mg


4-10 mg/kg/dose given at 6- to 8-hour intervals

Suspensions: 100 mg/5 mL

Chewable Tablets: 50 mg, 100 mg

Tablets: 100 mg, 200 mg,

(with prescription: 400, 600, and 800 mg)

2 | Anesthetic Dosage

To determine the local anesthetic dosage for a pediatric patient, one must determine the patient’s weight pre-operatively. The potential for toxic reactions increases when local anesthetics are being combined with sedative medications. Therefore, when sedating a child, the local anesthetic dose needs to be adjusted downward. Moore and Hersh developed “The Rule of 25” as a simplified method for calculating the most conservative local anesthetic dose (see Suggested Reading list). The Rule of 25 states that for a healthy patient, a dentist can safely use 1 cartridge of anesthetic for every 25 pounds of weight. For example, a patient weighing 25 pounds could receive 1 carpule of anesthetic and a patient weighing 50 pounds could receive 2 carpules of anesthetic.

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Feb 15, 2020 | Posted by in Dental Materials | Comments Off on 2: Pediatric Drug Management
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