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## Pediatric Dosage Calculation

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**Pediatric Dosage Calculation**Hello Class!!!!!!! Good luck in college. Our mom is nice. From Logan Shaffer and Jordan Shaffer**How is Pediatric Dosage Calculation Different than Adults?**• There is no standard dose • All doses are based on a recommended dosage based on: Body weight in kilograms (for this dosage test) Body Surface Area**Begin by Converting to Kilograms**• All MD orders will be ordered as a dose per kg • Convert the patient’s weight in lbs to kg by dividing the weight in lbs by 2.2 • Example: 50 lbs divide by 2.2 = 22.7272727272727 Round to tenths place = 22.7 kg**Now you try!**1. Patients weight 48 lbs How many kg does the patient weigh? Patient weight 13.9 lbs How many kg does the patient weigh?**The MD order**The MD order can be written in several ways: • In a daily total to be divided in equal doses Ex: 30mg/kg/day equally divided in three doses or • Per dose Ex: 30mg/kg TID**Lets Try it!**Patients weight: 45 lbs 2. Give 30mg/kg/day equally divided in three doses How many mg per dose? How much is the 24 hr drug total? 3. Give 30mg/kg TID How many mg per dose? How much is the 24 hr drug total?**Is the dose safe?**• All pediatric dosages have a recommended range in the drug guide • These ranges are typically based on a 24 hour total amount of a dosage in mg, mcg, gm, etc. • Remember how to convert mcg to mg, gram to mg etc.**Is the order safe?**• A statement from the drug guide will be provided on the dosage test Ex: The drug guide states the recommended safe dosage is 3-5 mg/kg/day to be given in 2 divided doses**Lets try it!**4. MD order Sporanox (itraconazole) 40 mg bid Patients weight 47 lbs Drug guide recommends 3-5mg/kg/day q12 hrs Is the dose safe?**Supply**• Pediatric medication is typically supplied in liquid form • Some children can swallow pills or the medication may only come in tablet form • Most of the dosage assessment questions will consist of medication in liquid form, few questions will be in tablet form**Remember….**• Supply is expressed as a dosage amount per a commonly used quantity • Example 250mg/5ml 100mg/ml 50mcg/1ml • This is different from the total amount of drug dosage in the bottle**Calculate Liquid Medication**Dose desired Dose on hand X quantity in ml = volume to be administered**Lets try it!**5. MD order is to give 75 mg Supply is 250mg/5ml Calculate the amount to administer**Some dosage questions will require you to read a drug label**Read a label**Lets try it!**6. Using the medication label supplied, how many milliliters should be administered per dose if the MD order is 100 mg po qd?**Ok, so how do you round?**Look at it this way… • If the calculated answer is <1 ml then round to the hundredths place as this amount could be easily administered in a 1 ml syringe Example: If the answer was 0.75 ml, where would you draw the solution to in this syringe?**What is the Answer is > 1 ml?**• If the calculated dose is greater than 1 ml then you round to the tenths place • Example- if the dose was 2.75 ml, using a 3 ml syringe you would need to round to 2.8ml, as 2.75ml can not be precisely administered**Intravenous**• Nothing new here…. Volume in ml x drop factor = gtt/min Time in min**You are Ready!!! Lets put it all together**7. The physician orders Kantrex (kanamycin) oral suspension po 150 mg/kg/day in 2 divided doses. Supply Kantrex 500mg/5ml. Patients weight: 28 lbs How many milliliters should be administered per dose?**8. The physician orders Prostigmin (neostigmine bromide) 8**mg q 4 hrs The drug guide recommended dosage is 2-4 mg/kg/day in divided doses Patients weight: 21 lbs Is the physicians order safe?**Careful…some may have patients weight in kg already!**9. The physician orders Primacor (milrinone lactate) 50 mcg IM stat. Supply: 0.2mg/ml Patients weight: 12 kg. How many milliliters should be administered per dose?**10. The physician orders Sustiva (efavirenz) 20mg/kg po q 12**hrs. Supply: Sustiva 50 mg tablets Patients weight: 11 lbs How many tablets are to be administered per dose?**11. The physician orders IV fluids as follows: Infuse 1000ml**of 0. 45% normal saline solution in 10 hours IV. • Calculate the flow rate when the drop factor is 10 drops per milliliters