Jeffrey L. Segar, MD and Sarah B. Tierney, PharmD
Peer Review Status: Internally Peer Reviewed 12/19/12

  Agent Dose Toxicity Remarks
β-agonists Albuterol
(One MDI actuation delivers 100 mcg (0.1mg))
Acute: 0.1 mg/kg via nebulization/MDI every 1-4 hours as needed. Can increase to 0.5 mg/kg.
Chronic: 0.1 mg/kg every 12 hours
Increased heart rate, agitation  
(One MDI actuation delivers
90 mcg/18 mcg)
1-2 puffs BID   Added anticholinergic effect. The combination of ipratropium with a beta-agonist produces more bronchodilation than either drug individually.
(0.63 mg)
1-2 puffs BID   (R)-enantiomer of racemic albuterol and associated with less tachycardia
Methylxanthines 1Theophylline LD: 5-6 mg/kg IV/PO followed by
MD: 2 mg/kg IV/PO every 8 hours
Increased heart rate, irritability, arrhythmia, seizures. Metabolism varies with age. Therapeutic levels (peak): 10-20 mg/L. Consider changing to a Q6h schedule if unable to achieve adequate levels after 4 weeks on therapy.


  • Monitoring serum levels is required.  See “Use of Drug Monitoring Levels in the NICU” for more information. 


  • Lexi-Comp, Inc. Pediatric Drug Information.  Accessed online.  Updated annually.
  • Thomas Reuters.  Neofax.  24th Edition. 2011.