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Anti-NMDA Receptor Encephalitis — Abortive Medication Management — Clinical Pathway: Inpatient

Anti-NMDA Receptor Encephalitis Clinical Pathway — Inpatient

Abortive Medication Management

These are initial dose recommendations and can be titrated based on child-specific response.

Pediatric doses should not exceed adult dosing recommendations (initial or maximum). Please contact pharmacy with questions or concerns.

Alpha2-Adrenergic Agonist

Medication Age Initial Dose Side Effects and Considerations
Clonidine Pediatric Enteral: 0.002-0.005 mg/kg/DOSE
Max: 0.05 mg
  • Hypotension
  • Bradycardia
  • Sedation
Adult
Dexmedetomidine
ICU only
Pediatric IV Bolus: 0.25-0.5 mcg/kg/DOSE
Max: 25 mcg
  • Bradycardia
  • Hypertension
  • Hypotension
  • Nausea/vomiting
Adult

Benzodiazepines

Medication Age Initial Dose Side Effects and Considerations
Diazepam Pediatric IV; Enteral: 0.04-0.1 mg/kg/DOSE
  • Sedation
  • Hypotension
  • CNS depression
  • Respiratory depression
Adult IV; Enteral: 2 mg
Lorazepam Pediatric IV; Enteral: 0.05 mg/kg/DOSE
Adult IV; Enteral: 1-2 mg
Midazolam Pediatric IV: 0.05 mg/kg/DOSE
Adult IV: 1-2 mg

Opioids

Medication Age Initial Dose Side Effects and Considerations
Morphine Pediatric IV: 0.05-0.1 mg/kg/DOSE
Enteral: 0.1-0.2 mg/kg/DOSE
  • Sedation
  • Hypotension
  • CNS depression
  • Respiratory depression
  • Constipation
  • Nausea/vomiting
  • Itching
Adult IV: 2-4 mg
Enteral: 5 mg
Oxycodone Pediatric Enteral: 0.1 mg/kg/DOSE
Adult Enteral: 5 mg

 

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