Pediatric Dosage Calculations General ‘Most drugs in children are dosed according to body weight (mo/ke) or body surface area (BSA) (ongim?). Care must be taken to properly convest body weight from pounds to kilograms (1 kg= 22 lp) before calculating doses based on body weight. Doses are often expressed as magiday ‘or mg/kg/éose, therefore orders writen “mg/kg/d,” which is confusing, require further clarification ‘rom the proscrbor. ‘Chemotherapeutic drugs are commonly dosed according to body surface area, which requires an extra verifcation step (BSA calculation) prior to dosing. Me¢ications are availaole in mutiple ‘concentrations, therefore orders written in “mL. rather than “mg” are not acceptatie and require further clarification, Dosing elso varies by indicaton, therefore diagnostic information is helpful when calculating ‘doses. The following examples are typically encounteree when dosing medication in children Example 1. Calculate the dose of amoxicilin suspensicn in mLs for otits media for a 1-yF-old child weighing 2 lb. The ose requrec is 40 mo/kg/day avided BID and te suspension comes in 2 ‘concentration of 400 mg/S mL. ‘Stop 1. Convert pounds to kg, 22 lb» 1 kg/2.2 b= 10 kg ‘Step 2. Calculate the dose in mg: 10 kg = 40 makaiday = 400 ma/cay ‘Step 3. Divide the dase by the fraquency:| 400 mgiday = 2 (BID) = 200 mg/dose BID ‘Step 4, Convert the mg dose to mL: | 200 mgidose + 400 mg/5 mL = 2.5 mL BID| Example 2. Calculate the dose of ceftriaxone in mLs for meningitis fora 5-yr-old weighing 18 kg, The dose required 1s 100 mg/kg/day alven Iv once dally and the crug comes preclluted in 2 concentration of 40 mg/m. ‘Stop 1. Calculate the dose in mg: 48 kg = 100 mg/kg/day = 1200 mg/day ‘Step 2. Divide the dase by the frequency:| 1800 mg/day 1 (daly) = 1800 mg/dose ‘Step 3. Convert the mg dose to mL: | 1800mg/dese = 40 mg/mL = 45 mL once daily Example 3. Calculate the dose of vincnstine in mis fora 4-y"-old with leukemia weighing 37 ib endis 97 cm tal. The dose required in 2 mgim? and the drug comes in 1 mg/mL concentration ‘Step 1. Convert pounds tokg [S71b™1 hg22Ib= 168 kg ‘Step 2. Calculate BSA: 1168 ka * 97 cm/3600 = 0.67 m? ‘Step 3. Gaiculate me dose in mg. [> mgim? » 0.57 m2 ‘Step 4, Calculate the dose in mL: | 124mg =1 mgimL=