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Dose refers to the quantity of a drug, therapeutic agent, The average BSA for an adult has been given as
or other remedy that is taken or applied all at one time 1 .73 m2.

or in fractionalamounts within a given period. Here are

some methods on how dose is computed. For lndividual's Dose:
. When the dose of a drug is stated in amount of
For Children: drug/m2 BSA:
lndividual's dose = Amount of drug/m2 x BSA (m2)
Dosage is commonly based on a fraction of the adult
dose, measured either according to age or weight, . When dose of a drug is stated in mg/kg body
and the "surface area". weight:
lndividual's dose = mg/kg x body weight (kg)
. Clark's Rule is the method generally used, which
employs weight in determining the dose.
CALCULATION OF IV
Child's dose = Weight in pounds x Adult dose FLOW RATES
150
. Calculation of cc/hr is essential in most lV
Example: What is the dose of a drug for a 45-lb therapy.
child if the average adult dose of the medication
is 15 mg? Volume = cc/hr
# of hrs
Child's dose = 45 x 15 mg = 4.5 mg
150 E.g. 1 LoverShrs =125cclhr
50 cc over 20 minutes = 150 cc/hr
. Fried's Rule (for infants up to 2 years old)
Calculation of gtUmin (Long Method)
Child's dose = Age in months x Adult dose
150 Steps:
1. Need to know cc/hr to calculate

Example: What is the dose for a 9-month old infant 2. Gtt factor = gtUmL
if the average adult dose is 35 mg? :
gtt factors macrodrip 10, 15, 20 gtts/ml
microdrip 60 gtUmL
Child's dose = _9_ x 35 mg = 2.1 mg
Example: Long Method
150
:
Doctors Order Run 1L DsW over I hours
o Yourg's Rule (for children 2 years and older)
Microdrip - 1000 mL + 8 hours = 125 cc/hr
(yr) x Adult dose 125 cc x 60 gtUml = 125 gtU
Child's dose = Age
60 min 1 mL
Age (yr) + 12

Example: The adult dose of a drug is 7 grains (gr).

10 gtUmL set 125 cc x 10 gtUml = 20-21
What is the dose for a 3-yearold child?
60 min 1 gtVmin

15 gtUml set 125 cc x 15 gtUmL = 31 gtUmin

Child'sdose = 3 x 7gr = 1.49r 60 min
g.12 1

20 gtUml set 125 cc x 20 gtUmL = 41-42

. Surface Area Method requires finding the surface 60 min 1 gtUmin
area in square meters (m2) of each individua! child. Short Method
Body surface area (BSA) can be obtained in charts
available. e
cc/hr + 6 for 10 gtUmin
cc/hr + 4 tor 15 gtUmin
Chitd's dose = BSA of chitd (m2) x Adult dose cc/hr + 3 for 20 gtUmin
(aooroxi
(approx) 1.73 m2 cc/hr = gtUmin for microdrip set
Dosage Calculation
3. Proportion:
CALCULATION OF IV Ex. For 50 kg
TNFUSTONS (DRTPS) 0.5 mcg/kg/min = 25 mcg/min

Steps: 25 mcg/min x 60 mcgtUmin or 7-B cc/hr

1. Know the concentration on drug
lsoket
2. Dose desired
3. Set proportion 1. Add 10 mg in 100 cc DuW - 0.1 mg/mL
4. Solve/find the flow rate 2. Dosage: 1 mg/hr

Examples:
3. Proportion: 1 mg/hr
0.1 mg/ml
l. Xylocaine Drip 4. Solve = 10 mL

Piggyback lnsulin
Xylocaine 2o/o = 20 mg/ml = 1 Gm/100 mg
1. Bolus: 0.2"U"lkg
1. Add 1 Gm ,000 mg) Lidocaine in 250 mL
(1 2. lnsulin Drip: 0.1 "U"lkglhr
DuW = 4 mg/ml a.) Add 100'U'lnsulin in 1000 mL ol 0.45==
2. Dosaga =2-4 mg/min NaCl
3. Proportion: 2 mg/min b.) Dose: 0.2"U"lkglhr
= 60 ugtts/mL 4 mg/mL Ex.5kilo=1"U"/hr
4. Solve = 30 ugtts/min c.) Solve:
1 "U'7hr = 10 cc/hr
ll. Docard(lntropions) 1 "U'7mL

Docard = 40 mglmU200 mg/S mL

CALCULATION OF IV ADDITIVES
1 Add roo:nJ:r1?:l..rd in 250 mL Duw
TO ENTIRE INFUSION
= 800 mcg/mL
e.g. Doctors order reads: 1 L DsW with 20 rnec ..1
2. Dosage = 2-10 mcg/kg/min
over I hrs.
Ex. For 50 kg patient
meq/cc =
5 mcg/kg/min = 250 mcg/min meq/hr =
3. Proportion: meq/500 cc =
250 mcg/min x 60 ugtts/ml meq/750 cc =
800 mcg/mL meq/1000 cc =
4' solve: equivalent of 20 meq in cc =
= 1g-1g ugtts/min
e.g. Doctors order reads: 1 L DsW with 1 Grn n
Dopamine Dose (mcg/kg/min) nophylline making 1.1 L. Give at 55 mg\
aminophylline/mL =
Given: 400 mg Dopamine is added in 250 mL DuW. 55 mg/ml =
The !V is regulated to run for 23 cc/hr. The cc/hr =
patients weight is 60 kg. gtUmin on microdrip =

Solve:
1. 1,600 mcg/mL PREPARING A SOLUTION
2. 1.600 mcg/mL = 26.6 mcg/kg mL
60 kg Formula:
3. 26.6 mcg/kg/mL x 23 cc = 10 mcg/kg/min desired strength x total Q of solution
60 min strength on hand

Have only D5W. Need 0.22Yo Nacl 500 cc. 'er"r

lll. Nipride (Nitroprusside)
20% NaCl on hand

1 Add so m3 mL Duw Solve: 0.22% x 500 = 5.5 mL

t1l'#o 20Yo
200 mcg/ml
Dosage = 0.5 mcg - 8 mcg/kg/min Add 5.5 mL of 20o/o NaCl to get 0.22o/o NaO
I)rip Rates

Controlling the infusion rate of lV fluids is a simple, yet an important calculation. Calculating the drip rate
depends on the type of tubing that is being used. There are two types of tubing -macrodrip and microdrip.
Macrodrip tubing (standard adult tubing 0 has a drip factor of either 10 gtts/ml or 15 gtts/mL. Microdrip tubing
fns a drip factor of 60 pgtts/ml. lt is used for pediatric patients because it helps to maintain a closer watch on
fluid volumes so as not to overload them. lt is also used for precise infusion rates of drip medications.

Drip Rate Formula

grtts/min = Volume to be infused in one hour x gtts/ml for drip factor

infusion time (60 minutes)

Example

1. An lV is initiated to a patient, the doctor want to set a TKVO (to keep vein open) rate, about 30 mL per hour.
Using a macrodrip tubing with a drip factor of 15 gtts/mL. What is the drip rate?

Drip rate (gtts/minute) = 30 mL x 15 gtts/ml

60 min

= 7.5 gtts/min - 8 gtts/min

2. An lV fluidis given to a child, and a physician gives an order to run the lV at 50 mUhr. Using the microdrip
tubing with a drip factor of 60 pgtts/ml, what's the drip rate?

Drip rate (pgtts/minute) = 50 mL I=60Igtts/mL

60 min

= 50 Pgtts/min

3. The physician orders lV fluids to hydrate a client. The order is written as "DSNS 4 Liters over 24 hours."
Looking at the package indicates the drip factor of the tubing is 15 gtts/mL. What is the drip rate?

convert first the time, from hour to minutes:

24 (hr) x 60 (minutes) = 1440 minutes

Drip rate (gtts/minute) = 4000 mL x 15 gtts/ml

1440 mins

= 41.66 gtts/min - 42 gtts/min

Source: 2001 lntravenous therapy CME Package, York Region Base Hospital Program Markham
Stouftuille Hospital