# DOSAGE CALCULATIONS (ADULT AND PEDIATRICS

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Introduction y Three systems of measurement- metric, apothecary, and household-are used to measure drugs and solutions.

y Metric system  Is a decimal system based on the power of 10.  Basic units of measure are GRAM (g, gm, G, GM) for weight; LITER (L) for volume; and METER (m, M) for linear measurement or length.  KILO is the prefix used for larger units (e.g., kilometer) and milli, centi, micro, and nano are the prefixes used in smaller units (e.g., millimeter) y Apothecary system  Was the common system used by the most practitioners before the universal acceptance of the international metric system.  Uses roman numerals instead of Arabic numbers to express the quantity.  The unit of weight is the grain (gr), and the units of fluid volume is ounce (oz) y Household system  Not as accurate as the metric system because lack of standardization of spoons, cups, and glasses.  A teaspoon is considered to be equivalent to 5ml according to the official United States pharmacopeia.

Calculations of Oral Dosage Introduction    80% of all drugs consumed are given orally. Oral drugs are available in tablet, capsule, powder, and liquid form. Written abbreviation for the drug given orally is PO or P.O. (per mouth)

Calculation for Tablet, Capsule, and Liquid doses Examples: 1. Order: diltiazem (cardizem) 60 mg PO b.i.d. Available: diltiazem (cardizem) 30 mg Solution: Formula = D/S x Q or D -----x Q S 60mg ------- x 1 = 2 tablets 30mg

where: D= doctor¶s order (DOSE DESIRED) S= (DOSE ON HAND) stock dose Q= quantity

2. Order: clarithromycin (Biaxin) 100mg PO q6 Available: 125mg per 5ml

D -----x Q S

=

100mg ----------- x 5ml = 4ml 12mg

Example: Order: cyclophosphamide (cytoxan) 2mg/kg PO daily.2 to equal kilograms.25ml S 10. To convert. SUBCUTANEOUSLY (SQ into the fatty tissue). How much the client weights in kilograms? How many mg should the client receive? Solution: 143/ 2. Client weighs 143 lb. To use the body surface area (BSA) method. the person¶s weight and height and a nomogram is needed.000 units/ml in multiple dose vial (10ml) Solution: D 2500 units -----x Q = -----------.x 1 ml = 0.000 units Intramuscular injections Muscles have more blood vessels than fatty tissues and are absorbed more rapidly than those given by SQ injection. INTRAMUSCULARLY (IM within the muscle) and INTRAVENOUSLY (IV in the vein) y Injectible preparations are in appropriate container (vial or ampule) Interpreting Injectible Drug Labels Intradermal injections Usually used for skin testing to diagnose the cause of an allergy or to determine the presence of a microorganism Subcutaneous injections Drugs injected to the subcutaneous or fatty tissues are absorbed slowly because there are fewer blood vessels in the fatty tissue. To use the body weight method.2= 65 kg 2mg x 65kg= 130 mg of cyclophosphamide (cytoxan) Calculations of Injectible Dosages Introduction y When medication cannot be taken by mouth because: y An inability to swallow y A decreased level of LOC y An inactivation of the drug by gastric juices y A desire to increase the effectiveness of the drug y Parenteral route may be the route of choice. divide pounds by 2. y Parenteral medications are administered INTRADERMALLY (ID under the skin).Body Weight and Body Surface Area      Calculating the drug dosage for adults by body weight (BW) and body surface area used mostly when administering drugs to treat cancer (antineoplastic drugs) These two individualized methods are used frequently to calculate dosages for children. convert the person¶s weight in pounds to kilograms (kg). . Calculation Order: heparin 2500 units¶ subQ Available: heparin 10.

therefore manufacturers package these drugs in powdered form.x 2ml = 1.  The measuring device can be a small plastic.x 3ml = 1. Oral  Oral pediatric drug delivery usually occurs the use of a calibrated measuring device because most drugs for small children are in liquid form. which delays metabolism and elimination of many drugs. a measuring spoon.25ml S 80mg Certain drugs lose their potency in liquid form. q12 Available: 1g of cefotetan disodium (Cefotan) add 3ml of diluents D 0.8) Child¶s drug dosage: 20-40 mg/kg/day in three different doses Available: cefaclor (Ceclor) 125mg/5ml drug parameters: 20mg x 6.5ml S 1g Pediatric Drug Calculations Introduction  Pediatric dosages differ greatly from those for adults because of the physiologic differences between the two.  Neonates and infants have immature kidney and liver function.8kg= 272mg/day 50mg x 4 times= 200mg/day .8kg= 136mg/day 40mg x 6.d. child weighs 15lb or 6. Intramuscular  Intramuscular sites for drug administration are chosen on the basis of age and muscle development of the child. or an oral syringe. an oral dropper.5g -----x Q = ----------.5g IM.8 kg (15lb/2.  The purpose of learning how to calculate pediatric drug dosages is to ensure that children receive the correct dose within the approved therapeutic range. Pediatric dosage per body weight Example: Order: cefaclor (Ceclor) 50mg q. They are reconstituted using diluents (bacteriostatic water or saline) before administration.Example: Drug order: gentamycin (garamycin) 50mg IM Available: gentamycin 80mg/2 ml in a vial D 50mg -----x Q = ----------. Example: Order: cefotetan disodium (Cefotan) 0.2=6.i.

S 125mg Pediatric Dosage per Body Surface Area Directions: 1.D 50mg -----x Q = ----------. Example: Order: methotrexate (mexate) 50mg weekly. Where the line intersects on the BSA column is the body surface area.x 5ml = 2ml. Find weight 3. Draw a straight line that connects height and weight 4. give 2ml four times a day. Child¶s height is 54 inch and weighs is 90lb (41kg) Child¶s drug dosage: 25-75mg/m2/week Child¶s height and weight intersect at 1. Find height 2.3m2 (BSA) .

Intravenous Sets Various IV sets are marked by Abbott. determine the child¶s height and weight. Cutter. Child¶s height is 42 inches and weight is 60lb.5 mg pediatric dosage from adult dosage to calculate pediatric dosage from the adult dosage.=DROPS/ MINUTE (GTTS/MIN) HOURS TO MINUTES PER HOUR (60) ADMINISTER .3m2 = 97.9 m2. Where they intersect on the nomogram is the BSA in square meters. dextrose. The drop factor.5 mg 75mg x 1.73m2 Example: Order: erythromycin (E-Mycin) 125 mg PO qid. A set that delivers large drops per milliliter (10 to 20 gtts/min) is called macrodrip set. The adult dose is 1000mg/day 0. the number of drops per milliliter. Continuous Intravenous Administration The nurses calculate the IV flow rate according to the drop factor. and Travenol.73m2 Drug dosage: 520mg/ 4 times a day = 130mg/dose. Calculations of Intravenous Fluids Intravenous (IV) fluid is used to administer fluids that contain water.9m2 --------.3 m2. Child¶s height and weight intersect at 0.x adult dose = Pediatric dose 1. 25mg x 1. 1. by the maximum and minimum doses. and drugs.X --------------------------------------------. and one with small drops per milliliter (60gtts/min) is called microdrip set. the amount of fluids to be administered and time of period.x 1000mg/day = 520mg/day 1. McGaw. Calculating Intravenous Flow Rate AMOUNT OF FLUID DROP PER MILLILITER (IV SET) ---------------------------. is normally printed on the packaging cover of the IV set. Formula: Surface area (m2) ------------------------.Is the prescribed dose safe? Answer: Multiply the BSA. vitamins.3m2 = 32. electrolytes.

KRISTAL MANLAPAZ.DOSAGE CALCULATIONS ADULT AND PEDIATRIC IV CALCULATION ENDORSEMENT CATALA. MAYNARD BSN IV-E .

10.5 NSS and 10 mEq of KCL in 10hr How many milliliters of KCL should be injected into the bag How many drops per minute using the macroset? .5 NSS to infuse over 12h Available macroset with 10gtts/ml Calculate for the flow rate.500 units subQ Available: heparin 10.000 units/ml How many milliliters should the client receive? 5. q6 Available: 1g (diluted 3ml) How many milliliters should the client receive in one day? 6. IV volume is 750ml and should be infused at how many hours if the flow rate is 32gtts/min? 9. Order: heparin 7. Order: 1L of D5 0.5g IV q6 Available: 2g (diluted @ 10ml of sterile water) 7. Order: 1000ml of D5 0.25mg) per tab How many tablets should the nurse administer? 3. cefazolin 500mg IV. Order: cefadroxil (Duricef) 500mg PO bid Available: 250mg/5ml 4. Ceftazidine 1. Order: doxepin HCL (sinequan) 30mg PO @bedtime Available: doxepin HCL (sinequan) 10mg/ capsule How many capsules should the client receive? 2. daily Available: 250mcg (0. Ampicillin 500mg IV q6 Available: 2mg/5ml 8. Order: digoxin (lanoxin) 0.5mg PO. Order.Exercises: 1.