Lesson Three– In this lesson we will cover other methods  of medication calculation.– I will review some tips and tricks f...
Calculating Fluids• When using a minidrip, the final gtts/min  will be equal to the DD per hour.
Calculating Fluids• When using a minidrip, the final gtts/min  will be equal to the DD per hour.Example: you are ordered t...
Calculating Fluids• When using a minidrip, the final gtts/min  will be equal to the DD per hour.DD: 1200mlSS: 60gtts/mlT: ...
Calculating Fluids• When using a minidrip, the final gtts/min  will be equal to the DD per hour.DD: 1200ml             120...
Calculating Fluids• When using a minidrip, the final gtts/min  will be equal to the DD per hour.DD: 1200ml           1200 ...
Calculating Fluids• When using a minidrip, the final gtts/min  will be equal to the DD per hour.DD: 1200ml           400 g...
Calculating Fluids• When using a minidrip, the final gtts/min will  be equal to the DD per hour.-   You wanted to give 120...
The Clock Method
The Clock Method• Lidocaine Clock  – 2gm/500ml or 1gm/250ml
The Dopamine Trick•   Take the patient’s weight in pounds.•   Drop the last digit.•   Subtract two•   The resulting number...
The Dopamine Trick•   Take the patient’s weight in pounds.•   Drop the last digit.•   Subtract two•   The resulting number...
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg     5mcg/kg/min x 80kg x 60gtts/ml             400mg/250ml
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg     5mcg/kg/min x 80kg x 60gtts/ml          400,000mcg/250ml
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg     5mcg/kg/min x 80kg x 60gtts/ml             1600mcg/ml
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg           5 x 8 x 6 gtts/min              16
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg           5 x 1 x 6 gtts/min               2
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg           5 x 1 x 3 gtts/min               1
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg             5 x 3 gtts/min               1
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg              15 gtts/min               1
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg                  15 gtts/min
The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg                  15 gtts/min                  IT WORKS!
Practice• You have a patient who is in SVT.• You are ordered to administer 6mg of  Adenosine, rapid IV push.• You have a 4...
Practice• DD - 6mg• C - 12mg / 4ml
Practice• DD - 6mg• C - 12mg / 4ml  6mg12mg/4ml
Practice• DD - 6mg• C - 12mg / 4ml  6mg 3mg/ml
Practice• DD - 6mg• C - 12mg / 4ml    6    3   ml
Practice• DD - 6mg• C - 12mg / 4ml    2ml
Practice• You administer the Adenosine, and the  SVT only breaks momentarily.• You are ordered to administer 0.25  mg/kg o...
Practice• DD - 0.25mg/kg• Wt - 154 lbs• C - 25mg / 5ml
Practice• DD - 0.25mg/kg• Wt - 154 lbs• C - 25mg / 5ml154 ÷ 2= 77
Practice• DD - 0.25mg/kg• Wt - 154 lbs• C - 25mg / 5ml154 ÷ 2= 77 - 7 = 70
Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml0.25mg/kg x 70kg   25mg/5ml
Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml0.25mg/kg x 70kg   5mg/ml
Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml0.25 x 70   5        ml
Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml 17.5  5       ml
Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml   3.5ml
Practice• You are ordered to administer 0.1mg/kg  of Ativan to a patient for seizures.• You have a 1cc vial with 2mg of At...
Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml
Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2
Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2 = 60.5
Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2 = 61 - 6
Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2 = 61 - 6 = 55
Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml0.1mg/kg x 55kg    2mg/ml
Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml0.1 x 55    2      ml
Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml  5.5   2      ml
Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml   2.75ml
Practice• You are preparing to perform rapid  sequence induction, to intubate your  patient.• Your orders are to begin wit...
Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml
Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2
Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2 = 93.5
Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2 = 94 - 9
Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2 = 94 - 9 = 85
Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml
Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml0.3mg/kg x 85kg  40mg/20ml
Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml0.3mg/kg x 85kg    2mg/ml
Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml 25.5  2       ml
Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml   12.75ml
Practice• Your RSI protocol also requires that you  administer 2mg/kg of succinylcholine  immediately after the Etomidate....
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml2mg/kg x 85kg 200mg/10ml
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml2mg/kg x 85kg  20mg/ml
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml2 x 85 20    ml
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml170 20    ml
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml17 2    ml
Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml  8.5ml
Practice• After you intubate your patient, you are  ordered to administer 10mcg/kg/min of  Propofol/Diprivan to keep the p...
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml10mcg/kg/min x 85kg x 60gtts/ml         500m...
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml10mcg/kg/min x 85kg x 60gtts/ml       500,00...
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml10mcg/kg/min x 85kg x 60gtts/ml        10,00...
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml10 x 85 x 60  10,000          gtts/min
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml1 x 85 x 6   100         gtts/min
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml    85 x 6     100       gtts/min
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml    510    100       gtts/min
Practice•   DD - 10mcg/kg/min•   Wt - 85kg•   SS - 60gtts/ml•   C - 500mg/50ml    5.1gtts/min
Conclusion
Drug math   lesson 4
Drug math   lesson 4
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Drug math lesson 4

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Drug math lesson 4

  1. 1. Lesson Three– In this lesson we will cover other methods of medication calculation.– I will review some tips and tricks for easier, and faster calculation.– We will apply all methods, and calculations learned thus far and practice some common drug doses.
  2. 2. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.
  3. 3. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.Example: you are ordered to administer 1200ml over 3 hours using a 60gtts/ml solution set.
  4. 4. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.DD: 1200mlSS: 60gtts/mlT: 180 min
  5. 5. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.DD: 1200ml 1200ml x 60gtts/mlSS: 60gtts/ml 180minT: 180 min
  6. 6. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.DD: 1200ml 1200 x 1 gtts/minSS: 60gtts/ml 3T: 180 min
  7. 7. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.DD: 1200ml 400 gtts/minSS: 60gtts/mlT: 180 min
  8. 8. Calculating Fluids• When using a minidrip, the final gtts/min will be equal to the DD per hour.- You wanted to give 1200ml over 3 hours.- That is equal to 400ml per hour- The answer was 400gtts/min- THIS ONLY WORKS WITH A MINIDRIP
  9. 9. The Clock Method
  10. 10. The Clock Method• Lidocaine Clock – 2gm/500ml or 1gm/250ml
  11. 11. The Dopamine Trick• Take the patient’s weight in pounds.• Drop the last digit.• Subtract two• The resulting number is your gtts/min for a starting dose of 5mcg/kg/min
  12. 12. The Dopamine Trick• Take the patient’s weight in pounds.• Drop the last digit.• Subtract two• The resulting number is your gtts/min for a starting dose of 5mcg/kg/min – 176 lb ----drop the last number – 17 ----subtract 2 from this number – 15gtts/min = 5mcg/kg/min • This only works with a minidrip and 1600mcg/ml concentration
  13. 13. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5mcg/kg/min x 80kg x 60gtts/ml 400mg/250ml
  14. 14. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5mcg/kg/min x 80kg x 60gtts/ml 400,000mcg/250ml
  15. 15. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5mcg/kg/min x 80kg x 60gtts/ml 1600mcg/ml
  16. 16. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5 x 8 x 6 gtts/min 16
  17. 17. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5 x 1 x 6 gtts/min 2
  18. 18. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5 x 1 x 3 gtts/min 1
  19. 19. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 5 x 3 gtts/min 1
  20. 20. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 15 gtts/min 1
  21. 21. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 15 gtts/min
  22. 22. The Dopamine Trick• 15gtts/min• Lets check it• 176 lb = 80kg 15 gtts/min IT WORKS!
  23. 23. Practice• You have a patient who is in SVT.• You are ordered to administer 6mg of Adenosine, rapid IV push.• You have a 4cc pre-filled syringe with 12 mg of Adenosine.• Your patient is 154 lbs• You have a patent IV.
  24. 24. Practice• DD - 6mg• C - 12mg / 4ml
  25. 25. Practice• DD - 6mg• C - 12mg / 4ml 6mg12mg/4ml
  26. 26. Practice• DD - 6mg• C - 12mg / 4ml 6mg 3mg/ml
  27. 27. Practice• DD - 6mg• C - 12mg / 4ml 6 3 ml
  28. 28. Practice• DD - 6mg• C - 12mg / 4ml 2ml
  29. 29. Practice• You administer the Adenosine, and the SVT only breaks momentarily.• You are ordered to administer 0.25 mg/kg of Cardizem slow IV push.• You have a 5ml vial containing 25mg of Cardizem.• Your patient weighs 154 lbs.
  30. 30. Practice• DD - 0.25mg/kg• Wt - 154 lbs• C - 25mg / 5ml
  31. 31. Practice• DD - 0.25mg/kg• Wt - 154 lbs• C - 25mg / 5ml154 ÷ 2= 77
  32. 32. Practice• DD - 0.25mg/kg• Wt - 154 lbs• C - 25mg / 5ml154 ÷ 2= 77 - 7 = 70
  33. 33. Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml0.25mg/kg x 70kg 25mg/5ml
  34. 34. Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml0.25mg/kg x 70kg 5mg/ml
  35. 35. Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml0.25 x 70 5 ml
  36. 36. Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml 17.5 5 ml
  37. 37. Practice• DD - 0.25mg/kg• Wt - 70kg• C - 25mg / 5ml 3.5ml
  38. 38. Practice• You are ordered to administer 0.1mg/kg of Ativan to a patient for seizures.• You have a 1cc vial with 2mg of Ativan in it.• Your patient weighs 121 lbs.
  39. 39. Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml
  40. 40. Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2
  41. 41. Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2 = 60.5
  42. 42. Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2 = 61 - 6
  43. 43. Practice• DD - 0.1mg/kg• Wt - 121 lbs• C - 2mg / ml121 ÷ 2 = 61 - 6 = 55
  44. 44. Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml0.1mg/kg x 55kg 2mg/ml
  45. 45. Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml0.1 x 55 2 ml
  46. 46. Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml 5.5 2 ml
  47. 47. Practice• DD - 0.1mg/kg• Wt - 55kg• C - 2mg / ml 2.75ml
  48. 48. Practice• You are preparing to perform rapid sequence induction, to intubate your patient.• Your orders are to begin with 0.3mg/kg of Etomidate/Amidate.• Your Patient weighs 187 lbs.• You have a 20ml pre-filled syringe, containing 40mg of Etomidate.
  49. 49. Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml
  50. 50. Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2
  51. 51. Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2 = 93.5
  52. 52. Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2 = 94 - 9
  53. 53. Practice• DD - 0.3mg/kg• Wt - 187 lbs• C - 40mg/20ml187 ÷ 2 = 94 - 9 = 85
  54. 54. Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml
  55. 55. Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml0.3mg/kg x 85kg 40mg/20ml
  56. 56. Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml0.3mg/kg x 85kg 2mg/ml
  57. 57. Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml 25.5 2 ml
  58. 58. Practice• DD - 0.3mg/kg• Wt - 85kg• C - 40mg/20ml 12.75ml
  59. 59. Practice• Your RSI protocol also requires that you administer 2mg/kg of succinylcholine immediately after the Etomidate.• You have a 10cc vial with 200mg of Succs.• The patient weighs 85kg
  60. 60. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml
  61. 61. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml2mg/kg x 85kg 200mg/10ml
  62. 62. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml2mg/kg x 85kg 20mg/ml
  63. 63. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml2 x 85 20 ml
  64. 64. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml170 20 ml
  65. 65. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml17 2 ml
  66. 66. Practice• DD - 2mg/kg• Wt - 85kg• C - 200mg/10ml 8.5ml
  67. 67. Practice• After you intubate your patient, you are ordered to administer 10mcg/kg/min of Propofol/Diprivan to keep the patient from becoming responsive.• You have a 50ml vial, containing 500mg of Diprivan.
  68. 68. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml
  69. 69. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml10mcg/kg/min x 85kg x 60gtts/ml 500mg/50ml
  70. 70. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml10mcg/kg/min x 85kg x 60gtts/ml 500,000mcg/50ml
  71. 71. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml10mcg/kg/min x 85kg x 60gtts/ml 10,000mcg/ml
  72. 72. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml10 x 85 x 60 10,000 gtts/min
  73. 73. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml1 x 85 x 6 100 gtts/min
  74. 74. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml 85 x 6 100 gtts/min
  75. 75. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml 510 100 gtts/min
  76. 76. Practice• DD - 10mcg/kg/min• Wt - 85kg• SS - 60gtts/ml• C - 500mg/50ml 5.1gtts/min
  77. 77. Conclusion

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