<ul><li>PHARMACOLOGY </li></ul><ul><li>(ANTONIO B. CRUEL, RMT, RN, MSPH) </li></ul><ul><li>PHARMACODYNAMICS: </li></ul><ul...
<ul><li>ALLERGIC= drug: Ag </li></ul><ul><li>ANAPHYLAXIS= > allergic rxn: bronchial vc, LE causing airway obstruction </li...
<ul><li>DRUG INTERACTION=mod of drug effect: </li></ul><ul><li>ANTAGONISM= opposing 1 + (-1)=0 </li></ul><ul><li>SUMMATION...
<ul><ul><li>PHARMACOKINETICS= body does to drugs </li></ul></ul><ul><ul><li>ABSORPTION </li></ul></ul><ul><ul><li>=site of...
<ul><li>METABOLISM </li></ul><ul><li>=chemical events (in/activates drug) </li></ul><ul><li>*Biotransformation=using enz, ...
<ul><li>ELIMINATION/EXCRETION </li></ul><ul><li>=excreted via kidnys, intestines, bile duct, lungs, sweat, mammary glands ...
<ul><li>DRUG ADMINISTRATION </li></ul><ul><li>Principles: </li></ul><ul><li>1. 7 Rights: DR. CAT </li></ul><ul><ul><li>*DR...
<ul><li>2. Verify all new or questionable orders with physician or nurse. </li></ul><ul><li>3. Use meds in clearly labeled...
<ul><li>9. Stay with clients until meds taken </li></ul><ul><li>10. Report to Dr: client vomits </li></ul><ul><li>11. Reco...
<ul><li>COMMON DOSAGE FORMS: </li></ul><ul><li>CAPLET= solid for oral use, shaped like a capsule and coated for ease of sw...
<ul><li>GLYCERITE= soln of meds combined c glycerine(50%) for external use. </li></ul><ul><li>INTRAOCULAR DISK= small, fle...
<ul><li>PILL= solid form,1 or > meds, shaped into globules, ovoids, oblong </li></ul><ul><li>SOLUTION= liquid, used PO, IV...
<ul><li>TABLET= powder pressed into disk or cylinders, contains binders (adhesive), disintegrators (for tab dissolution), ...
<ul><li>ROUTES OF ADMINISTRATION </li></ul><ul><li>VIA MOUTH </li></ul><ul><li>1.ORAL </li></ul><ul><li>=take c 50-100 ml ...
<ul><li>When preparing solid meds: </li></ul><ul><li>Only scored tablets may be broken </li></ul><ul><li>Crush tab only wh...
<ul><li>Read amount at meniscus and at eye level </li></ul><ul><li>Wipe lip and neck of bottle before re-capping </li></ul...
<ul><li>BUCCAL </li></ul><ul><li>Place meds against mucous membranes of the cheek. </li></ul><ul><li>Also not swallow or t...
<ul><li>TOPICAL MEDICATIONS (SKIN, NOSE, EYE, EAR, VAGINA, RECTUM) </li></ul><ul><li>1. VIA SKIN </li></ul><ul><li>Use glo...
<ul><li>Powder: dusted lightly to cover affected area thinly </li></ul><ul><li>Transderm patches: remove backing and place...
<ul><li>Posterior pharynx: head tilted backward </li></ul><ul><li>Ethmoid & sphenoid sinus: head hyperextended, tilted ove...
<ul><li>Meds may produce unpleasant taste or coughing </li></ul><ul><li>CI: to decongestants (most common nasal meds): HPN...
<ul><li>For Eye Ointment </li></ul><ul><li>Squeeze thin stream along inner edge of lower conjunctiva from inner to outer c...
<ul><li>For irrigation: place towel under client’s head. Irrigate with 50 ml of fluid. </li></ul><ul><li>5. VIA VAGINA </l...
<ul><li>Store suppositories in ref to avoid melting </li></ul><ul><li>For creams, jelly, irrigating solutions (douche) </l...
<ul><li>INHALANT MEDS: METERED DOSE INHALERS </li></ul><ul><li>These clients depend on meds for adequate control of airway...
<ul><li>Place inhaler in mouth or 1-2 “ away if c spacer </li></ul><ul><li>Client inhales deeply, presses canister </li></...
<ul><li>Keep tip of needle under fluid to avoid aspirating bubbles. If aspirated do not expel air in ampule </li></ul><ul>...
<ul><li>Insert needle thru center of rubber seal. Keep tip below fluid level & allow pressure in vial to fill syringe </li...
<ul><li>Mixing Meds </li></ul><ul><li>2 vials=Inject air into vial A & withdraw needle (tip must not touch soln) </li></ul...
<ul><li>ADMINISTERING INJECTIONS </li></ul><ul><li>Select appropriate site avoiding bruised / tender areas & rotating site...
<ul><li>Airlock IM Tx: for interferon, DPT vaccine </li></ul><ul><li>Most common site of heparin injxn: abdomen </li></ul>
Z track IM: < irritation Hold like dart. Insert. Inject 10-20 sec G:21-23 L:1” (K) 1 1/2 “  (A) K:.5-1ml A:2-3 ml Gluteus,...
<ul><li>INTRAVENOUS ADMINISTRATION </li></ul><ul><li>Microtubing: 60 gtts/ml, rates >12 h </li></ul><ul><li>Macrotubing: a...
<ul><li>5. Use the most distal site in non-dominant arm </li></ul><ul><li>6. Dilate vein:close-open fist </li></ul><ul><li...
<ul><li>Types IV Admin: </li></ul><ul><li>1. IV push via hep lock </li></ul><ul><li>a. 2 ml saline: flush </li></ul><ul><l...
<ul><li>3.IV infusion </li></ul><ul><li>Inject meds thru port thru port in IV bag with rubber stopper not thru air vent or...
<ul><li>DOSAGE CALCULATION </li></ul><ul><li>A. DRUG DOSAGE= D  x Q </li></ul><ul><li>S </li></ul><ul><ul><li>eg: erythrom...
<ul><li>PEDIA DRUG DOSAGE </li></ul><ul><li>1. BSA (M2)=sq rt  WEIGHT (kg) x HT (cm)  </li></ul><ul><li>3600 </li></ul><ul...
<ul><li>Based on body weight </li></ul><ul><li>=  mg/kg/dose X wt (kg)  X  Q </li></ul><ul><li>S </li></ul><ul><li>eg: Par...
<ul><li>Young’s= (1-12 years) </li></ul><ul><li>Child’s Dose=  age in years   X AD </li></ul><ul><li>age in yrs + 12 </li>...
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7351039 Pharma Gapuz Intro

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7351039 Pharma Gapuz Intro

  1. 1. <ul><li>PHARMACOLOGY </li></ul><ul><li>(ANTONIO B. CRUEL, RMT, RN, MSPH) </li></ul><ul><li>PHARMACODYNAMICS: </li></ul><ul><li>what drugs do to the body </li></ul><ul><li>Drug Effects: </li></ul><ul><li>1. DESIRED =therapeutic effect </li></ul><ul><li>2.SIDE = unintended/predictable </li></ul><ul><li>3. ADVERSE = harmful/severe </li></ul><ul><li>4. TOXIC= pathologic/> 1 st drug </li></ul><ul><li>5. IDIOSYNCRATIC=unpredictable </li></ul><ul><li>6. CUMULATIVE=> response RT repeated dose,<metab,<excretion </li></ul>
  2. 2. <ul><li>ALLERGIC= drug: Ag </li></ul><ul><li>ANAPHYLAXIS= > allergic rxn: bronchial vc, LE causing airway obstruction </li></ul><ul><li>TOLERANCE= <effect RT rpt dose; reqr > </li></ul><ul><li>TACHYPHYLAXIS= rapid devt of tolerance to drug </li></ul><ul><li>DEPENDENCE=driving needs: drug use </li></ul><ul><li>*HABITUATION: PSYCH </li></ul><ul><li>*PHYSICAL: ADDICTION </li></ul><ul><li>ABUSE= inappropriate drug intake (un/prohibited) </li></ul>
  3. 3. <ul><li>DRUG INTERACTION=mod of drug effect: </li></ul><ul><li>ANTAGONISM= opposing 1 + (-1)=0 </li></ul><ul><li>SUMMATION= combined(=) 1 + 1= 2 </li></ul><ul><li>SYNERGISM= combined(>) 1 + 1= 3 </li></ul><ul><li>POTENTIATION= 1 drug enhanced by etc. </li></ul><ul><li>1 drug alone (0) </li></ul><ul><li> 1 + 1= 1x,2x,3x effect </li></ul>
  4. 4. <ul><ul><li>PHARMACOKINETICS= body does to drugs </li></ul></ul><ul><ul><li>ABSORPTION </li></ul></ul><ul><ul><li>=site of admin to bloodstream </li></ul></ul><ul><ul><li>>in: IV, >absorbing surface, liquid/lipid soluble form, good blood flow </li></ul></ul><ul><ul><li><in: PO (RT food, >GI motility, acid pH </li></ul></ul><ul><ul><li>2. DISTRIBUTION </li></ul></ul><ul><ul><li>=from site of absorption to action </li></ul></ul><ul><ul><li>>in: >BF, >PPB (drugs inactive if bound in albumin for transport), >volume of distribution (edema), > membrane perm. </li></ul></ul><ul><ul><li><in: <albuminemia(<PPB=>free drug), dehydr </li></ul></ul>
  5. 5. <ul><li>METABOLISM </li></ul><ul><li>=chemical events (in/activates drug) </li></ul><ul><li>*Biotransformation=using enz, drugs are made more H20-soluble (excreted in liver) </li></ul><ul><li>*1 st -pass effect= oral meds are metab in liver via portal circ before distributed </li></ul><ul><li>>in: Drug-drug interaction (>Cytochrome P450) </li></ul><ul><li><in: infants, elderly, disease (liver, malnut) </li></ul>
  6. 6. <ul><li>ELIMINATION/EXCRETION </li></ul><ul><li>=excreted via kidnys, intestines, bile duct, lungs, sweat, mammary glands </li></ul><ul><li>=affected by DD interaction, organ elim, blood% levels, renal status. </li></ul><ul><li>Renal excretion= filtration+secretion=reab </li></ul><ul><li><renal fxn=<excretion=>toxicity </li></ul><ul><li>Excretes only H20-sol,unbound metabolite </li></ul><ul><li>Modified by acid/alkalinizing urine </li></ul><ul><li>(carbonic anhydrase inh alkalizes urine > UA excretion) </li></ul>
  7. 7. <ul><li>DRUG ADMINISTRATION </li></ul><ul><li>Principles: </li></ul><ul><li>1. 7 Rights: DR. CAT </li></ul><ul><ul><li>*DRUG </li></ul></ul><ul><ul><li>*DOSE </li></ul></ul><ul><ul><li>*ROUTE </li></ul></ul><ul><ul><li>*RECORD </li></ul></ul><ul><ul><li>*CLIENT </li></ul></ul><ul><ul><li>*APPROACH </li></ul></ul><ul><ul><li>*TIME </li></ul></ul>
  8. 8. <ul><li>2. Verify all new or questionable orders with physician or nurse. </li></ul><ul><li>3. Use meds in clearly labeled containers, check it 3X (pharmacy/cabinet, before, after prep) </li></ul><ul><li>4. Check expiry date, changes:clarity,odor </li></ul><ul><li>5. Aseptic tx:wash hand,caps upside down </li></ul><ul><li>6. Meds id with correct client </li></ul><ul><li>7. Check for allergies: ANST </li></ul><ul><li>8. Inform client: meds, tx, purpose </li></ul>
  9. 9. <ul><li>9. Stay with clients until meds taken </li></ul><ul><li>10. Report to Dr: client vomits </li></ul><ul><li>11. Record admin of drug asap: chart any omission, initial, give rationale </li></ul><ul><li>12. For meds errors: report asap </li></ul><ul><li>13. For safety, give only meds YOU prep. </li></ul>
  10. 10. <ul><li>COMMON DOSAGE FORMS: </li></ul><ul><li>CAPLET= solid for oral use, shaped like a capsule and coated for ease of swallowing </li></ul><ul><li>CAPSULE=solid, meds in powder, liq, oil encased by gelatin shell </li></ul><ul><li>ELIXIR=clear fluid c water/ROH;PO; usually c sweetener </li></ul><ul><li>ENTERIC TAB= tablet coated with materials that dissolves in intestine </li></ul><ul><li>EXTRACT= concentrated form made by removing active portion of meds from its other components </li></ul>
  11. 11. <ul><li>GLYCERITE= soln of meds combined c glycerine(50%) for external use. </li></ul><ul><li>INTRAOCULAR DISK= small, flexible oval if moistened by ocular fluid, releases meds up to 1 week. </li></ul><ul><li>LINIMENT=prep c ROH, oil, soapy emolient applied to skin </li></ul><ul><li>LOTION= MEDS IN LIQUID SUSPENSION APPLIED EXT TO PROTECT SKIN </li></ul><ul><li>OINTMENT= semisolid, externally applied prep, c 1 or more meds </li></ul>
  12. 12. <ul><li>PILL= solid form,1 or > meds, shaped into globules, ovoids, oblong </li></ul><ul><li>SOLUTION= liquid, used PO, IV, externally, instilled c body </li></ul><ul><li>SUPPOSITORY= pellet-shaped solid c gellatin for insertion into body cavity </li></ul><ul><li>SUSPENSION= fine frugparticles dispersed in liq medium w/c settles on standing, shake </li></ul><ul><li>SYRUP=meds dissolved in concentrated sugar solution </li></ul>
  13. 13. <ul><li>TABLET= powder pressed into disk or cylinders, contains binders (adhesive), disintegrators (for tab dissolution), lubricants, fillers (for convenient tab size) </li></ul><ul><li>TINCTURE= ROH or H20 meds soln. </li></ul><ul><li>TRANSDERMAL PATCH= meds in semi-permeable membrane disk or patch absorbed thru skin </li></ul><ul><li>TROCHE/ LOZENGE= flat & round form, dissolves in mouth to release meds, contains mucilage, sugar and flavoring </li></ul>
  14. 14. <ul><li>ROUTES OF ADMINISTRATION </li></ul><ul><li>VIA MOUTH </li></ul><ul><li>1.ORAL </li></ul><ul><li>=take c 50-100 ml of cold fluid unless CI </li></ul><ul><li>CI: GI dysfxn (vomiting), unconscious or unable to swallow, NPO per/post-op </li></ul><ul><li>DisAdv: GI irritation, inactivation by gastric acid, unpleasant taste/odor, teeth discoloration. </li></ul><ul><li>Remember: Sit client upright to enhance swallowing </li></ul>
  15. 15. <ul><li>When preparing solid meds: </li></ul><ul><li>Only scored tablets may be broken </li></ul><ul><li>Crush tab only when appropriate (children,elderly,dysphagia) </li></ul><ul><li>For enteric-coated tabs:don’t crush, give c antacid,milk </li></ul><ul><li>When preparing liquid meds: </li></ul><ul><li>Shake suspensions and pour away from label to prevent dirtying it </li></ul>
  16. 16. <ul><li>Read amount at meniscus and at eye level </li></ul><ul><li>Wipe lip and neck of bottle before re-capping </li></ul><ul><li>Evaluate client’s response to meds after 30 min. If client vomits after taking meds, inform physician. Do not give again. </li></ul><ul><li>2. SUBLINGUAL </li></ul><ul><li>Place meds under tongue until it dissolves. Do not swallow or take with fluid. (gastric acid deactivate meds) </li></ul><ul><li>Fast absorption thru blood vessels under the tongue </li></ul>
  17. 17. <ul><li>BUCCAL </li></ul><ul><li>Place meds against mucous membranes of the cheek. </li></ul><ul><li>Also not swallow or taken with fluid </li></ul>
  18. 18. <ul><li>TOPICAL MEDICATIONS (SKIN, NOSE, EYE, EAR, VAGINA, RECTUM) </li></ul><ul><li>1. VIA SKIN </li></ul><ul><li>Use gloves, gauze or sterile applicator </li></ul><ul><li>Cleanse skin with soap & warm water to remove encrustation that blocks contact & absorption of new meds. </li></ul><ul><li>Remember: </li></ul><ul><li>Lotion & creams: applied gently, not rubbed </li></ul><ul><li>Liniment: rubbed into skin gently but firmly </li></ul>
  19. 19. <ul><li>Powder: dusted lightly to cover affected area thinly </li></ul><ul><li>Transderm patches: remove backing and place patch in area with little hair, use gloves to avoid drug absorption </li></ul><ul><li>NTG patch: take BP before & after application </li></ul><ul><li>2. VIA NOSE </li></ul><ul><li>Have client blow nose, lie supine and breathe thru mouth </li></ul><ul><li>Position head as follows for 5 min to ensure absorption </li></ul>
  20. 20. <ul><li>Posterior pharynx: head tilted backward </li></ul><ul><li>Ethmoid & sphenoid sinus: head hyperextended, tilted over HOB (Parkinson’s position) </li></ul><ul><li>Frontal & Maxillary sinus: Hyperextended & side wards (Proetz) </li></ul><ul><li>Place dropper 1 cm above nares & squeeze quickly, not to touch nose with applicator </li></ul><ul><li>Client may wipe but not blow nose </li></ul>
  21. 21. <ul><li>Meds may produce unpleasant taste or coughing </li></ul><ul><li>CI: to decongestants (most common nasal meds): HPN, heart disease </li></ul><ul><li>3. VIA EYE </li></ul><ul><li>Gently clean eyelid of crusts or discharge using gauze in saline. Wipe from inner-outer canthus. </li></ul><ul><li>For Eyedrops: Client looks up, use thumb/forefinger to pull down cheekbone & pull up lid exposing lower conjunctiva. </li></ul><ul><li>Drop prescribed meds & ask client to blink/close eys </li></ul>
  22. 22. <ul><li>For Eye Ointment </li></ul><ul><li>Squeeze thin stream along inner edge of lower conjunctiva from inner to outer canthus. Don’t touch eye with container, twist tube to break stream. </li></ul><ul><li>Client closes eyes, then lightly rub lid in circular motion. </li></ul><ul><li>4. VIA EAR </li></ul><ul><li>With client side-lying, straighten ear canal by pulling ear </li></ul><ul><li>Assess for eardrum perforation or DC. </li></ul><ul><li>Warm meds in hands (avoids vertigo). Hold dropper 1 cm above ear & instill meds, Maintain for 2-3 min. </li></ul>
  23. 23. <ul><li>For irrigation: place towel under client’s head. Irrigate with 50 ml of fluid. </li></ul><ul><li>5. VIA VAGINA </li></ul><ul><li>Privacy, void 1 st </li></ul><ul><li>Position: dorsal recumbent, over bedpan if for irrigation </li></ul><ul><li>Use gloves, then retract labia with non-dominant hand </li></ul><ul><li>For suppositories: With dominant hand, apply water-based lubricant on rounded end of suppository and insert 3-4 inches down. </li></ul>
  24. 24. <ul><li>Store suppositories in ref to avoid melting </li></ul><ul><li>For creams, jelly, irrigating solutions (douche) </li></ul><ul><li>Insert applicator 2-3 inches down & deposit meds. </li></ul><ul><li>Client remains in position for 15-20 min. </li></ul><ul><li>6. VIA RECTUM </li></ul><ul><li>Sim’s, breathe slowly thru mouth </li></ul><ul><li>Apply lubricant, insert tapered end past internal anal sphincter (kids: 2”) & hold buttocks togeter as client may expel suppository. </li></ul>
  25. 25. <ul><li>INHALANT MEDS: METERED DOSE INHALERS </li></ul><ul><li>These clients depend on meds for adequate control of airway obstruction & must learn self-admin. </li></ul><ul><li>Position:upright (sitting or standing) </li></ul><ul><li>Shake inhaler then have client inhale & exhale deeply </li></ul><ul><li>3-point/lateral hand position: client holds inhaler, thumb at bottom of mouthpiece & index & middle finger at the top. </li></ul>
  26. 26. <ul><li>Place inhaler in mouth or 1-2 “ away if c spacer </li></ul><ul><li>Client inhales deeply, presses canister </li></ul><ul><li>Hold breath for 10 sec then exhale thru pursed lips. </li></ul><ul><li>PARENTERAL MEDS (NEEDLE/INJXN) </li></ul><ul><li>AMPULE PREP: </li></ul><ul><li>Tap neck to move fluid down ampule then snap off neck towards self. Hold ampule upside down, quickly draw meds s needle touching rim </li></ul>
  27. 27. <ul><li>Keep tip of needle under fluid to avoid aspirating bubbles. If aspirated do not expel air in ampule </li></ul><ul><li>To expel bubbles, tap syringe to move bubbles up & draw back plunger slightly then push to expel air. </li></ul><ul><li>VIAL PREP (SOLUTION) </li></ul><ul><li>Multi-dose vials: Wipe off rubber stopper with ROH pledget </li></ul><ul><li>S contaminating plunger, draw up air in equal to amt of meds needed & inject air into vial. This prevents (-) pressure buildup </li></ul>
  28. 28. <ul><li>Insert needle thru center of rubber seal. Keep tip below fluid level & allow pressure in vial to fill syringe </li></ul><ul><li>Before injecting, change dulled needle </li></ul><ul><li>VIAL PREP (POWDER FOR RECON) </li></ul><ul><li>Prepare diluent & inject into vial. Remove needle & roll vial in palms. Don’t shake </li></ul><ul><li>Use filter needle when drawing up recon meds. </li></ul>
  29. 29. <ul><li>Mixing Meds </li></ul><ul><li>2 vials=Inject air into vial A & withdraw needle (tip must not touch soln) </li></ul><ul><li>Inject air into vial B & withdraw meds. Change needle. </li></ul><ul><li>Inject new needle into vial A and withdraw meds. </li></ul><ul><li>VIAL TO AMPULE: Draw meds from vial-ampule </li></ul>
  30. 30. <ul><li>ADMINISTERING INJECTIONS </li></ul><ul><li>Select appropriate site avoiding bruised / tender areas & rotating sites AMAP. </li></ul><ul><li>Clean site with ROH swab. Use gloves to prevent contact with client blood. </li></ul><ul><li>Insert needle quickly, bevel up, then release hold to < pain. </li></ul><ul><li>Aspirate for blood. Re-insert if with blood unless it IV </li></ul><ul><li>Inject slowly. Press swab over site before removing needle. </li></ul><ul><li>Massage area except Z track or heparin injxn </li></ul>
  31. 31. <ul><li>Airlock IM Tx: for interferon, DPT vaccine </li></ul><ul><li>Most common site of heparin injxn: abdomen </li></ul>
  32. 32. Z track IM: < irritation Hold like dart. Insert. Inject 10-20 sec G:21-23 L:1” (K) 1 1/2 “ (A) K:.5-1ml A:2-3 ml Gluteus, A&M thigh, deltoid IM Don’t aspirate or massage for heparin or insulin injxn Pinch skin to form fold, dart palm down. 45/90 G:25-27 L:3/8 5/8 1/2 K: 0.5-1ml A: 1-3ml LUA, anterior thigh, abdomen SQ Don’t massage Stretch skin, insert needle 10-15 2-3mm deep G: 26 L:3/8 5/8 0.1-1 ml Ventral upper arm, scapula, chest ID Remarks Method Needle Syringe Site
  33. 33. <ul><li>INTRAVENOUS ADMINISTRATION </li></ul><ul><li>Microtubing: 60 gtts/ml, rates >12 h </li></ul><ul><li>Macrotubing: all other rates </li></ul><ul><li>VENIPUNCTURE </li></ul><ul><li>1. Prepare infusion set. Place roller clamp 1-2 inches below drip chamber & move to off position. Insert spike into fluid bag. </li></ul><ul><li>2. Prime fill drip chamber & tubing (up to adapter) c solution. </li></ul><ul><li>3. Remove any air bubbles by tapping tubings </li></ul><ul><li>4. Apply tourniquet & select a vein </li></ul>
  34. 34. <ul><li>5. Use the most distal site in non-dominant arm </li></ul><ul><li>6. Dilate vein:close-open fist </li></ul><ul><li>7. Cleanse site then anchor vein using thumb & stretch skin opposite the direction of insertion </li></ul>
  35. 35. <ul><li>Types IV Admin: </li></ul><ul><li>1. IV push via hep lock </li></ul><ul><li>a. 2 ml saline: flush </li></ul><ul><li>b. admin meds </li></ul><ul><li>c. 2 ml saline: flush </li></ul><ul><li>d. 10-100 U heparin: flush </li></ul><ul><li>2. IV push via existing line </li></ul><ul><li>Occlude primary IV line by pinching tubing just above injxn port closest to pt, give meds & release tubing </li></ul>
  36. 36. <ul><li>3.IV infusion </li></ul><ul><li>Inject meds thru port thru port in IV bag with rubber stopper not thru air vent or port for IV tubing. </li></ul><ul><li>4. Piggyback/Add med solution bag to an existing line </li></ul><ul><li>*connect IV tubing to meds bag. Hang med bag higher than primary bag if piggyback </li></ul>
  37. 37. <ul><li>DOSAGE CALCULATION </li></ul><ul><li>A. DRUG DOSAGE= D x Q </li></ul><ul><li>S </li></ul><ul><ul><li>eg: erythromycin 250 mg PO, stock: 125mg/5ml </li></ul></ul><ul><ul><li>250mg/125 mg X 5 ml= 10 ml </li></ul></ul><ul><ul><li>For drugs that need dilution: </li></ul></ul><ul><ul><li>IM=2 cc </li></ul></ul><ul><ul><li>IV < 500= 5 cc </li></ul></ul><ul><ul><li>IV >500= 10 cc </li></ul></ul><ul><ul><li>Eg 5 FU 259 mg IV; stock: 500 mg vial </li></ul></ul><ul><ul><li>250 mg/500 mg X 5 cc dil=2.5 cc </li></ul></ul>
  38. 38. <ul><li>PEDIA DRUG DOSAGE </li></ul><ul><li>1. BSA (M2)=sq rt WEIGHT (kg) x HT (cm) </li></ul><ul><li>3600 </li></ul><ul><li>Child’s dose = child’s BSA X AD </li></ul><ul><li>Adult’s BSA (1.73 m2) </li></ul><ul><li>3 yo weighs 15 kg, ht of 92 cm is to be given Demerol; AD for Demerol is 100 mg/dose </li></ul>
  39. 39. <ul><li>Based on body weight </li></ul><ul><li>= mg/kg/dose X wt (kg) X Q </li></ul><ul><li>S </li></ul><ul><li>eg: Paracetamol 15 mkd for child weighing 20 kg. Stock: 250 mg/5 ml </li></ul><ul><li>Based on Age </li></ul><ul><li>Fried’s: birth-12 months </li></ul><ul><li>Infant’s dose= age in months X AD </li></ul><ul><li> 150 </li></ul>
  40. 40. <ul><li>Young’s= (1-12 years) </li></ul><ul><li>Child’s Dose= age in years X AD </li></ul><ul><li>age in yrs + 12 </li></ul><ul><li>Clark’s Rule= </li></ul><ul><li>Child’s Dose= wt of child in lbs X AD </li></ul><ul><li>150 lb </li></ul>

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