What is the recommended dose of salbutamol (SYP) for a 2.5-year-old child weighing 12 kg?

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Salbutamol Syrup Dosing for a 2.5-Year-Old Child (12 kg)

For this 12 kg child, administer salbutamol syrup 1.2 mL (2 mg) three times daily, which provides the standard pediatric dose of 0.1-0.2 mg/kg per dose.

Weight-Based Dosing Calculation

  • Standard pediatric dosing: 0.1-0.2 mg/kg per dose, given 3-4 times daily 1
  • For this 12 kg child:
    • Minimum dose: 1.2 mg per dose (0.1 mg/kg × 12 kg)
    • Maximum dose: 2.4 mg per dose (0.2 mg/kg × 12 kg)
    • Practical starting dose: 2 mg (1.2 mL) three times daily 1

Syrup Formulation Details

  • Standard concentration: Salbutamol syrup is typically available as 2 mg/5 mL 1
  • Volume calculation for 2 mg dose: 5 mL of syrup contains 2 mg, so administer 5 mL three times daily as the standard dose 1
  • Alternative calculation: If using 0.15 mg/kg (middle range), this equals 1.8 mg per dose, which is approximately 4.5 mL three times daily 1

Dosing Frequency and Timing

  • Standard frequency: Three to four times daily, spaced evenly throughout the day 1
  • Maximum daily dose: Do not exceed 0.6 mg/kg/day (7.2 mg total for this 12 kg child) 1
  • Administration: Can be given with or without food, though meals may improve gastrointestinal tolerability 1

Critical Safety Considerations

  • Start conservatively: Begin with 2 mg (5 mL) three times daily and assess response before increasing 1
  • Monitor for side effects: Watch for tachycardia, tremor, and palpitations, which are dose-related 2
  • Avoid excessive dosing: Doses above 0.2 mg/kg increase systemic absorption and side effects without proportional bronchodilator benefit 2

Common Pitfalls to Avoid

  • Concentration confusion: Always verify the syrup concentration (typically 2 mg/5 mL) before calculating volume 1
  • Overdosing: The 3 mg dose used in nebulizers is NOT equivalent to oral dosing—oral bioavailability is much higher 2
  • Ignoring weight: Never use age-based dosing alone; always calculate based on actual weight 1

When to Escalate Dose

  • If inadequate bronchodilation occurs with 2 mg (5 mL) three times daily, increase to 2.4 mg (6 mL) three times daily, but monitor closely for tremor and tachycardia 2
  • Maximum single dose should not exceed 4 mg (10 mL) in this age group 1

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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