PEDI DOSAGE CALCULATION CONCEPTS

SAFE DRUG DOSAGES

The nurse administering a drug to a pediatric patient shares responsibility with the
physician in verifying that a drug dose is a safe amount. There are several formulas for
determining that a drug dose is within a safe range. The formula described below is
recommended. Consult your drug text for dosage information.

Example:
Ordered: Cleocin 75 mg IV Q 6 hrs

Drug text states dosage is 15-40 mg/kg/day IV Q 6 hrs.

Child’s weight = 10 kgs
Safe dose range: 15 mg X 10 kg = 150 mg/day
or
40 mg X 10 ks = 400 mg/day

Therefore a safe dose would be anywhere between 150 mg to 400 mg in one day.
Compare the dose ordered to the safe dose.

Dose ordered: Cleocin 75 mg X 4 doses (Q 6 hrs) = 300

Is 300 mgs within the safe range? Yes
Practice problem
Ordered: Cleocin 500 mg IV Q 6 hrs.
Child’s weight: 6.2 kgs
Is this a safe dose?

Example
1. Check the doctor’s order for the medication

Example: Ampicillin 1500 mg q 8 hr. IV for osteomyelitis

2. Check for the child’s weight

Example: 16.89 kg
3. Check reference for recommended dosage. This will usually be expressed in
mg/kg/day. To read this formula, mg = dosage of medication, kg = child’s
weight, day = 24 hours.

Example: Recommend dosage for Ampicillin is 50-100 mg/kg/day for mild

infections and 200-400 mg/kg/day for severe infections.
4. Calculate the 24 hour total.

Example: Ampicillin 1500 mg q 8 hr = 1500mg X 3 does

Therefore the 24 hour total = 4500 mg
5. Calculate the recommended safe dosage.

Osteomyelitis is a serious infection.

Example: 200 mg X 16.89 kg = 3378 mg/day (24 hours)
400 mg X 16.89 kg = 6756 mg/day (24 hours)
Safe range for this patient is between 3378 mg – 6756 mg in 24 hrs
Patient is receiving 4500 mg which is within the range.
This is a safe dose.

6. Calculate the recommended dilution for administration.

Example: Ampicillin 100 mg/ml

100mg. : 1ml : : 1500mg : x ml
x = ml (recommended dilution)
x = 15 mL
7. Determine rate of infusion.

Example: Ampicillin 5-30 minutes

8. Calculate the IV rate and determine the number of ml’s per hour. This value
(ml’s hr) is necessary in order to program the pump.

Example: Minimum dilution X 60 = ml/hr.

Rate of infusion (minutes)
15 ml (dilution ) X 60 = 30 ml/hr
30 (minutes)
CALCULATION OF FLUID REQUIREMENT
Maintenance fluid requirement formula: (Holliday – Segar method of Calculation)

Used to calculate daily fluid requirement when there are no abnormal fluid losses.

100 ml/kg per 1st 10 kgs body weight

plus 50 ml/kg per 2nd 10 kgs body weight

plus 20 ml/kg for remainder of weight

Example
Child weights 12 kgs or 10 kgs + 2 kgs
100 ml X 10 kgs = 1000 mls
+
50 ml X 2 kgs = 100 ml
1100 ml fluid/ 24 hours

The above formula is used to calculate fluid required to maintain a steady state. Increases
or replacement fluids are often indicated for conditions such as diarrhea.

Practice problem
Calculate the fluids requirement for a child who weighs 16 kgs.

Answer: 1300 mls