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| SPECIALIST ANSWERS
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In managing a patient with kawasaki disease ,when is the best time to satrt the aspirin -is it after the IVIG dose or simultaneously .and when is the best time to reduce the dose of the aspirin and when to stop. 2) how to manage oculogyric crisis in pediatric age group.is benzhexol the drug of choice or benedryl will do
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The best time to start aspirin is with IVIG. Aspirin should be reduced to antiplatelet aggregating doses (i.e. 5mg/kg/day) once the active inflammation subsides. This can be monitored with WBC count, ESR and CRP. Aspirin in antithrombotic doses may be required for 6-8 weeks or even longer if the child has developed carotid aneurysms (sometimes even indefinitely).
For oculogyric crisis, the drug of choice is intravenous diphenhydramine (1-2mg/kg/dose).
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