Dosage And Solutions

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Dosage And Solutions

  1. 1. Dosage and Solutions
  2. 2. Definition of Terms <ul><li>Dosage: accurate and proper way of giving medicines in prescribed doses. </li></ul><ul><li>Dose: exact amount of medicine to be given or taken by the patient at one time or at stated intervals </li></ul>
  3. 3. Administration of Drugs <ul><li>Oral Administration </li></ul><ul><li>Parenteral Administration </li></ul><ul><ul><li>Intramuscular </li></ul></ul><ul><ul><li>Intravenous </li></ul></ul><ul><ul><li>Subcutaneous </li></ul></ul>
  4. 4. Common Abbreviations <ul><li>BY ROUTE </li></ul><ul><li>IM, IV, SC, SL, ID, p.o., p.r. </li></ul><ul><li>FREQUENCY </li></ul><ul><li>od, bid, tid, qid, qh (q4h), ac/pc, prn, qd </li></ul>
  5. 5. Drug Order <ul><li>The drug order consists of seven parts: </li></ul><ul><li>Name of the patient </li></ul><ul><li>Name of the drug </li></ul><ul><li>Dosage strength and form of the drug </li></ul><ul><li>Route by which the drug is to be administered </li></ul><ul><li>Frequency , time and special instructions related to administration </li></ul><ul><li>Date and time when the order was written </li></ul><ul><li>Signature of the person writing the order </li></ul><ul><li>Example: Naproxen 250mg/tab 1 tab p.o. b.i.d. </li></ul>
  6. 6. Parenteral Administration <ul><li>The maximum dosage volume to be administered per IM injection site for an average 150 lb adult is 3mL, for children ages 6-12 years is 2mL, and children birth to age 5 years is 1mL. Parenteral drugs are in the form of ampules or vials. </li></ul>
  7. 7. Oral and Parenteral Dosage Administration <ul><li>To Solve Use: </li></ul><ul><ul><li>Factor-Label Method </li></ul></ul><ul><ul><li>Ratio and Proportion </li></ul></ul><ul><ul><li>Formula </li></ul></ul><ul><ul><li>x = D (desired dosage) x Q (quantity) </li></ul></ul><ul><ul><li> S (stock available) </li></ul></ul>
  8. 8. Exercises <ul><li>1. Order: Furosemide, 160 mg, od </li></ul><ul><li>Available: 40 mg tablets </li></ul><ul><li>How many tablet/s should the patient receive? </li></ul><ul><li> D/S = 160mg/40mg </li></ul><ul><li> = 4 tablets </li></ul><ul><li>2. Trisilate 1500mg, q12h for 5 days </li></ul><ul><li>Available: Trisilate liquid, 500mg/15mL </li></ul><ul><li>a. How many mL should the patient receive? </li></ul><ul><li>D/S = 1500mg ÷ 500mg/15mL </li></ul><ul><li>= 45 mL </li></ul><ul><li>b. How many mL is consumed all in all </li></ul><ul><li>45 mL x (2x a day) x 5 days = 450 mL </li></ul>
  9. 9. Exercises <ul><li>3. Order: Phenobarbital grss, PO, qid </li></ul><ul><li>Available: Phenobarbital 15 mg tablet </li></ul><ul><li>a. How many tablet/s per dose? </li></ul><ul><li>D/S = (1/2gr x 60mg/1gr) ÷ 15 mg </li></ul><ul><li>= 2 tablets </li></ul><ul><li>b. How many tablets per day? </li></ul><ul><li>2 tablets/day x 4 times a day = 8 tablets/day </li></ul><ul><li>4. Order: Dicloxacillin 100mg, PO, q8h, for 7 days </li></ul><ul><li>Available: Dicloxacillin 62.5mg/5mL </li></ul><ul><li>a. How many mL should the client receive? </li></ul><ul><li>D/S = 100mg ÷ (62.5mg/5mL) </li></ul><ul><li>= 8mL </li></ul><ul><li>b. How many mL was actually consumed? </li></ul><ul><li>8 mL x 3 times a day x 7 days = 168mL </li></ul>
  10. 10. Exercises <ul><li>5. Order: Atropine sulfate gr 1/200, SC </li></ul><ul><li>Available: Atropine sulfate 0.4mg/mL </li></ul><ul><li>How many mL should the patient receive? </li></ul><ul><li>D/S = (1/200gr x 60mg/1gr) ÷ 0.4mg/mL </li></ul><ul><li>= 0.75 mL </li></ul><ul><li>6. Order: Aspirin grx, STAT </li></ul><ul><li>Available: Aspirin 325mg tablet </li></ul><ul><li>How many tablets should the patient receive? </li></ul><ul><li>D/S = (10gr x 60mg/1gr) ÷ 325mg </li></ul><ul><li>= 2 tablets (1.8) </li></ul>
  11. 11. Exercises <ul><li>7. Order: Scopolamine 0.3mg, SC </li></ul><ul><li>Available: Scopolamine ampule in gr 1/200 per mL </li></ul><ul><li>How many mL should the patient receive? </li></ul><ul><li>D/S = 0.3 mg ÷ (1/200 gr/mL x 60mg/1gr) </li></ul><ul><li>= 1 mL </li></ul><ul><li>8. Order: Cephalexin 40mg/kg/day, PO, q6h, 33 lb child </li></ul><ul><li>Available: Cephalexin 250mg/5mL </li></ul><ul><li>a. How many mg should the child receive per day? </li></ul><ul><li>33 lb = 15kg x 40mg </li></ul><ul><li>= 600mg/day </li></ul><ul><li>b. How many mL per dose? </li></ul><ul><li>D/S = 600mg ÷ (250mg/5mL) ÷ 4 </li></ul><ul><li>= 3mL/dose </li></ul>
  12. 12. Exercises <ul><li>9. Order: Allopurinol 450mg, PO, qid </li></ul><ul><li>Available: Allopurinol 300mg tablet </li></ul><ul><li>How many tablets should the patient receive? </li></ul><ul><li>D/S = 450mg ÷ 300mg </li></ul><ul><li> = 1.5 tablets per dose/ 6 tablets per day </li></ul><ul><li>10. Order: Sulfisoxazole 50mg/kg/day, PO, q6h, 44 lb child </li></ul><ul><li>a. How many mg per day? </li></ul><ul><li>44 lb = 20kg x 50mg/kg/day </li></ul><ul><li>= 1,000 mg/day </li></ul><ul><li>b. How many mg per dose? </li></ul><ul><li> 1000mg/day ÷ 4 doses/day </li></ul><ul><li>= 250mg/dose </li></ul>
  13. 13. Pediatric Dosages – Based on Age <ul><li>Fried’s Rule – newborn to 2 y/o </li></ul><ul><ul><li>Age in months x normal adult dose </li></ul></ul><ul><ul><li>150 </li></ul></ul><ul><li>Example: The physician prescribed Dolanex elixir for a 15-month old. The </li></ul><ul><li>normal adult dose is 325 mg q4h to q6h. Dolanex elixir is available as </li></ul><ul><li>325mg/5mL. </li></ul><ul><li>Young’s Rule – ages 1 to 12 y/o </li></ul><ul><ul><li> Age in years___ x normal adult dose </li></ul></ul><ul><ul><li>age in years + 12 </li></ul></ul><ul><li>Example: The physician prescribed Milk of Magnesia for an 8 year </li></ul><ul><li>old patient. The normal adult dose is 30mL. </li></ul>
  14. 14. Pediatric Dosages – Based on Weight <ul><li>Clark’s Rule – 2 y/o and older children </li></ul><ul><li>weight in pounds x normal adult dose </li></ul><ul><li>150 </li></ul><ul><li>Example: The physician prescribed Dolanex elixir for a 4-yr old who weighs about 30 lbs. The normal adult dose is 325 mg q4h to q6h. Dolanex elixir is available as 325 mg/5mL </li></ul>
  15. 15. Insulin Administration <ul><li>Formula: ____ Desired____ </li></ul><ul><li>Stock / 16 minims </li></ul><ul><li>Sample Problem: </li></ul><ul><li>The patient needs 30U of insulin but the available stock is 80U. </li></ul><ul><li>How much of the 80U will be given? </li></ul><ul><li>If the stock is 100U, how much should be given to meet the patient’s needs? </li></ul>
  16. 16. Intravenous Infusion <ul><li>Calculating mL/hour </li></ul><ul><li>Total volume to be infused (mL) </li></ul><ul><li>Total time (hours) </li></ul><ul><li>Sample Problem </li></ul><ul><li>A patient is to receive 1 liter of Ringer’s solution over a 6-hour period. The patient would receive ____mL/hour </li></ul>
  17. 17. Intravenous Infusion <ul><li>Calculating mL/min </li></ul><ul><li>Total volume to be infused (mL) </li></ul><ul><li>Total time (in minutes) </li></ul><ul><li>Sample Problem </li></ul><ul><li>A patient is to receive 500mL of NSS over a period of 4 hours. The patient would receive ____mL/min. </li></ul>
  18. 18. Intravenous Infusion <ul><li>Calculating gtt/min </li></ul><ul><li>Total volume to be infused (mL) x SDF (15) </li></ul><ul><li>Total time (in minutes) </li></ul><ul><li>Sample Problem </li></ul><ul><li>Administer 1 liter of D5W over 8 hours. Calculate the gtt/min. </li></ul>
  19. 19. Exercises <ul><li>The physician prescribed 800mL of RL to infuse over 12 hrs. You would give ___ mL/h. </li></ul><ul><ul><li> = 800mL </li></ul></ul><ul><ul><li>12 hours </li></ul></ul><ul><ul><li> = 67 mL/hr </li></ul></ul><ul><li>The physician prescribed an IV of 100mL of D 5 W to run at 100mL/h. The drop factor is 10. Set the flow rate at ___gtt/min </li></ul><ul><ul><ul><ul><ul><li> = _____ 100 mL x 10 gtt_____ </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>60 min </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>= 17 gtt/min </li></ul></ul></ul></ul></ul>
  20. 20. Exercises <ul><li>Order: 1000mL to be infused at 150 mL/h. The drop factor is 20. How many gtt/min is this? </li></ul><ul><li>= 150mL x 20 </li></ul><ul><li> 60 min </li></ul><ul><li>= 50 gtt/min </li></ul><ul><li>Order: 2000mL to be infused for 12 h. The drop factor is 20. </li></ul><ul><li>a. How many mL/h is this? </li></ul><ul><li>= 2000 mL </li></ul><ul><li>12 hours </li></ul><ul><li>= 167 mL/hour </li></ul><ul><li>b. How many gtt/min is this? </li></ul><ul><li>= 167 mL x 20 </li></ul><ul><li>60 min </li></ul><ul><li>= 56 gtt/min </li></ul>
  21. 21. Solutions <ul><li>Factor-Label Method </li></ul><ul><li>Ratio and Proportion </li></ul><ul><li>Desired sol’n: Available sol’n:: Amount of solute: Total amount </li></ul><ul><li>Formula Method </li></ul><ul><li>Amount of solute = Desired Strength x Total amount </li></ul><ul><li>On-hand strength </li></ul><ul><li>To calculate the quantity of water or diluent used </li></ul><ul><li>Quantity of diluent = quantity (soln) - quantity (solute) </li></ul>
  22. 22. Sample Problems <ul><li>To prepare 400mL of a 2% sodium bicarbonate solution from a pure drug, you would need ___g of solute. </li></ul><ul><li>Desired sol’n: Available sol’n:: Amount of solute: Total amount </li></ul><ul><li> (.02) : 1 :: x : 400 </li></ul><ul><li> x = 8g </li></ul><ul><li>To make 1.5L of a 5% solution from a 25% solution, you would need ___ mL of solute. Add ___mL of water to make 1.5L </li></ul><ul><li>Amount of solute = Desired Strength x Total amount </li></ul><ul><li>On-hand strength </li></ul><ul><li>= .05 / .25 x (1.5L x 1000mL/1L) </li></ul><ul><li>= 300 mL </li></ul><ul><li>Quantity of diluent = quantity (soln) - quantity (solute) </li></ul><ul><li> = 1500 mL - 300 mL </li></ul><ul><li> = 1200 mL </li></ul>
  23. 23. Sample Problems <ul><li>There is 500mL of 40% magnesium sulfate solution available for a soak. To make 30% solution, you would need ___mL of solute. Add ___ mL of water to make 500mL. </li></ul><ul><li>Amount of solute = Desired Strength x Total amount </li></ul><ul><li>On-hand strength </li></ul><ul><li>= .30 / .40 x 500mL </li></ul><ul><li> = 375 mL </li></ul><ul><li>Quantity of diluent = quantity (soln) - quantity (solute) </li></ul><ul><li> = 500 mL - 375 mL </li></ul><ul><li> = 125 mL </li></ul>
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