Levosalbutamol neb pediatric dose for 14 kg child
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levosalbutamol levalbuterol nebulization pediatric dose weight based mg/kg
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levosalbutamol nebulizer dose 0.025 mg/kg pediatric acute asthma India
Here is a complete dosing summary for levosalbutamol (levalbuterol) nebulization in a 14 kg child:
Levosalbutamol (Levalbuterol) Nebulization - 14 kg Child
Key Principle
Levosalbutamol is the R-enantiomer of salbutamol. The dose is half that of racemic salbutamol because it is the active enantiomer only (i.e., it is 2x more potent on a mg-for-mg basis).
Dose Calculation for 14 kg
Weight-based approach (Indian/South Asian guidelines):
- Levosalbutamol: 0.025-0.075 mg/kg/dose
- For 14 kg: 0.35 mg to 1.05 mg/dose
- Practical dose: 0.31 mg (standard unit dose vial) - appropriate for this weight
Fixed-dose approach (FDA-approved, age-based):
| Age group | Dose | Frequency |
|---|---|---|
| < 6 years (including ~14 kg) | 0.31 mg to 1.25 mg | Every 4-6 hours (maintenance) |
| 6-11 years | 0.31 mg | Three times daily |
| Acute exacerbation (infants/children) | 1.25 mg | Every 20 min x 3 doses, then every 1-4 hours |
For a 14 kg child (typically 1-4 years old):
- Mild/maintenance: 0.31 mg nebulized every 4-6 hours as needed
- Acute asthma attack: 1.25 mg every 20 minutes for 3 doses, then 1.25 mg every 1-4 hours as needed
Available Formulations
- 0.31 mg/3 mL unit-dose vial
- 0.63 mg/3 mL unit-dose vial
- 1.25 mg/3 mL unit-dose vial (or 1.25 mg/0.5 mL concentrated)
For a 14 kg child in acute bronchospasm, the 0.63 mg vial (or 1.25 mg vial for severe attacks) is typically used. Dilute to 3 mL with NS if needed.
Comparison with Racemic Salbutamol
Levosalbutamol 0.63 mg is roughly equivalent to salbutamol 1.25 mg; levosalbutamol 1.25 mg is equivalent to salbutamol 2.5 mg. Note: Tintinalli's Emergency Medicine notes that levosalbutamol "is not any more effective or safer than salbutamol and is much more expensive" - standard salbutamol (albuterol) 2.5 mg remains the recommended first-line agent for this age/weight.
Clinical Notes
- Administer via jet nebulizer with face mask
- Driven by oxygen (6-8 L/min) during acute exacerbations to prevent hypoxia
- Monitor heart rate and SpO2 during nebulization
- Can combine with ipratropium 250 mcg nebulization for moderate-severe attacks
Disclaimer: Always verify doses against your institution's formulary and current local guidelines before administering. This is a reference summary, not a prescription.
Budecort
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Budecort budesonide nebulizer pediatric dose 14 kg child asthma
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Here is a complete reference for Budecort (Budesonide) Respules in a 14 kg child:
Budecort (Budesonide) Respules - 14 kg Child
Generic: Budesonide inhalation suspension
Brand: Budecort, Pulmicort Respules
Available strengths: 0.25 mg/2 mL, 0.5 mg/2 mL, 1 mg/2 mL
Dose for a 14 kg Child (typically ~1-4 years)
| Indication | Dose | Frequency |
|---|---|---|
| Initiation / Severe asthma | 0.5-1 mg | Twice daily |
| Maintenance (mild-moderate) | 0.25-0.5 mg | Twice daily (or once daily if well-controlled) |
| Once-daily maintenance | 0.25-0.5 mg | Once daily (morning or evening) |
For a 14 kg child - practical recommendation:
- Start: 0.5 mg (1 respule of 0.5 mg/2 mL) twice daily
- Maintenance once controlled: 0.25 mg twice daily or 0.5 mg once daily
- Maximum: 1 mg twice daily (only for severe asthma, short periods)
Available Formulations (Budecort)
| Respule | Strength | Use in this child |
|---|---|---|
| Budecort 0.25 | 0.25 mg/2 mL | Maintenance dose |
| Budecort 0.5 | 0.5 mg/2 mL | Standard starting dose |
| Budecort 1.0 | 1 mg/2 mL | Severe/initiation only |
Administration
- Use a jet nebulizer with face mask (recommended for children <6 years)
- Air flow rate: 6-8 L/min through device
- Fill volume: 2-4 mL (dilute with NS if needed to reach 2-4 mL total)
- Rinse mouth and face after each treatment to prevent oral candidiasis and skin irritation
- Do not mix with other medications in the nebulizer unless confirmed compatible (compatible with salbutamol, ipratropium, and terbutaline nebulizer solutions)
Key Clinical Points
- Onset of effect: a few hours after first dose; full therapeutic effect takes days to weeks
- Used as controller/preventer therapy - not for acute bronchospasm relief
- Can be used from 3 months of age
- Taper dose to the lowest effective dose once asthma is controlled
- If switching from oral steroids, overlap and taper oral dose gradually
- Monitor growth velocity in children on long-term ICS
Typical Step-Up Protocol (for 14 kg child)
- Mild persistent asthma: 0.25 mg twice daily
- Moderate persistent: 0.5 mg twice daily
- Severe/initiation: 1 mg twice daily (short-term, then step down)
- Review every 4-6 weeks and step down if controlled
Disclaimer: Doses should be confirmed against your institution's current formulary and guidelines. This is a clinical reference summary, not a prescription.
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