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Pediatric Drug calculation

This document discusses pediatric drug dose calculations. These include formulas to calculate Sedative, Narcotic and Inotropes infusion calculations.The purposes, rights, and approaches to drug administration in pediatrics are also summarized.

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Pediatric Drug calculation

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  1. PEDIATRIC DRUG CALCULATION SHINI CHERIAN, CNS-PEDIATRIC, NURSING EDUCATION AND TRAINING DIVISION

  2. Objectives

  3. 10 RIGHTS OF MEDICATION RIGHT 5: RIGHT ROUTE RIGHT 6: RIGHT TIME AND FREQUENCY RIGHT 1-RIGHT PATIENT(FULL NAME +RIGHT MEDICAL RECORD NUMBER) RIGHT 3 RIGHT MEDICATION RIGHT 2-RIGHT HISTORY AND ASSESSMENT RIGHT 4: RIGHT DOSE

  4. 10 RIGHTS OF MEDICATION RIGHT 10: RIGHT DOCUMENTATION RIGHT 7: RIGHT EDUCATION RIGHT 9: RIGHT EVALUATION RIGHT 8:RIGHT TO REFUSE

  5. Antidotes • WARFARIN(COUMADIN) VITAMIN K (phytonadione) • OPIOIDS NALAXONE • BENZODIAZIPINES FLUMAZENIL

  6. 1. Tablet form

  7. Example The doctor ordered 500 mg Panadol. ‘Panadol’ tablets containing 1g per tablet are available. How many tablets will you give? Step1 -Desired dose=500 mg Step 2-Dose on hand/strength=1g Step3-Check the units=different unit=1g X 1000= 1000 mg Step 4 Perform math's Desired dose = 500 = 0.5 tablet = half tablet Dose on hand 1000

  8. 2. For Intravenous , Intramuscularand Syrup form

  9. Example The doctor ordered 250 mg Paracetamol syrup, TID. ‘Paracetamol’ syrup containing 120 mg per 5 ml are available. How many ml syrup will you give? Step1 -Desired dose=250 mg Step 2-Dose on hand/strength=120 mg Volume = 5 ml Step3-Check the units=same unit= No convertion Step 4 Perform math's Desired dose × Volume= 250 mg × 5ml = 10.5 ml Dose on hand 120 mg

  10. 3. Calculating IV infusion rates

  11. Calculating dose in mL/hr. Example: Ordered 1 gram Vancomycin to be given over 2 hrs, pharmacy preparation label showing 10mg/mL, total bag volume 100 mL, determine what the correct rate per hour if using infusion pump? Total Bag Volume: 100 mL. Desired Time: 2 hours. = = 50 mL/hr.

  12. Calculating the hours for infusion

  13. 4. Drop Factor calculation (GTT)

  14. EXAMPLE-1 Order: 500ml over 4 hours Drop factor : Macro drip = 20 gtt/mt Solve gtts/mt? Gtts/mt = Volume × drop factor (20) Time (Hrs) × minute (60) = 500×20 4×60 =41.66 = 41.7 gtts/ mt

  15. EXAMPLE-2 Order: 500ml over 4 hours Drop factor : Micro drip = 60 gtt/mt Solve gtts/mt? Gtts/mt = Volume × drop factor (60) Time (Hrs) × minute (60) = 500×60 4×60 = 125 gtts/ mt

  16. 5. Medication Concentration

  17. 6. Weight Based Calculation Formula-1

  18. Example-1 Doctor ordered to start Dopamine infusion by 5 mcg/kg/mt to a 5 kg child to improve blood pressure, note that dopamine concentration 400mg/250 ml . So, how many ml/hr you will start? 1.Drug concentration = =400 mg 250 ml = 1.6 mg/ml 2. Convert to mcg = 1.6 mg×1000= 1600 mcg/ ml 3. Implement the formula= = 5mcg/kg/mt×5kg×60mt 1600mcg/ml =0.9ml/hr

  19. Example-2 Doctor ordered to start Midazolam infusion by 3 mcg/kg/mt to a 2.2 kg child to improve blood pressure, note that dopamine concentration 15mg/30 ml . So, how many ml/hr you will start? 1.Drug concentration = =15 mg 30 ml = 0.5 mg/ml 2. Convert to mcg = 0.5 mg×1000= 500 mcg/ ml 3. Implement the formula= = 3mcg/kg/mt×2.2kg×60mt 500mcg/ml =0.792=0.8ml/hr

  20. 6. Weight Based Calculation Formula-2

  21. Formula 2 Rate of infusion Doctors order(mcg)×BW× Diluted volume(ml) ×60 min Total strength (drug Concentration) ×1000 mcg Example : Dose ordered – 3 mcg/kg/min, wt-2.2 kg , drug concentration- 15mg in 30 ml Ml/Hr =3mcg×2.2kg×30ml×60min 15mg× 1000 =0.792 ml/hr=0.8 ml/hr

  22. Example Rate of infusion Doctors order(mcg)×BW× Diluted volume(ml) ×60 min Total strength (drug Concentration) ×1000 mcg Example : Norepinephrine- Dose ordered – 0.5mcg/kg/min, wt-1.24 kg , drug concentration- 2mg in 50 ml D5W Ml/Hr =0.5mcg×1.24kg×50ml×60min 2mg× 1000 =0.9 ml/hr

  23. 7. Calculating mcg/kg/ mt Formula for mcg/kg/mt=drug concentration x Dose ÷weight ÷mt

  24. Example-1 Doctor ordered to start Dopamine infusion by 0.9ml/hr to a 5 kg child to improve blood pressure, note that dopamine concentration 400mg/250 ml . So, how many mcg/kg/mt is ongoing? 1.Drug concentration = =400 mg 250 ml = 1.6 mg/ml 2. Convert to mcg = 1.6 mg×1000= 1600 mcg/ ml 3. Implement the formula= mcg/kg/mt = 1600 mcg/ml×0.9 ml/hr ÷5kg÷60mt = 4.8 4.8mcg/kg/min

  25. Practice Dopamine dose= 20 mcg/kg/min Weight=3.61 kg Strength= 240 mg in 50 ml Determine how many ml/hr you will give? 0.9025 ml/hr.

  26. Practice Midazolam dose= 110 mcg/kg/hr Weight=3.61 kg Strength= 15 mg in 30 ml Determine how many ml/hr you will give? • Doctors order(mcg)×BW× Diluted volume(ml) • Total strength (drug Concentration) ×1000 mcg 0.79=0.8 ml/hr.

  27. Practice Morphine dose= 0.1 ml/hr ongoing Weight=3.61 kg Strength= 10 mg in 50 ml Determine how many mcg/hr of morphine patient is receiving? Formula for mcg/hr=drug concentration x Dose 20 mcg/hr.

  28. Practice Epinephrine (1:1000/ml) dose= 0.2 ml/hr ongoing Weight=3.61 kg Strength= 10 mg in 10 ml Determine how many mcg/kg/min of Epinephrine patient is receiving? Formula for mcg/kg/min=drug concentration x Dose ÷weight ÷min 0.9mcg/kg/mt.

  29. ANY QUESTIONS???

  30. THANK YOU

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