This document provides information and formulas for calculating pediatric drug and fluid dosages based on adult doses. It discusses Fried's Rule and Young's Rule for calculating drug dosages for infants and children based on their age. Clark's Rule calculates drug dosages based on a child's weight. It also provides the Parkland Burn Formula for calculating fluid replacement after burns based on burn percentage and body surface area. Examples are provided for calculating appropriate pediatric doses and fluid amounts using these formulas.

1. DRUG & FLUID
CACULATION
IN
PEDIATRIC

2. Pediatric Dosing
• Dosages for medication administration to pediatric patients are almost
always determined by the patient's size (height and weight).
• However, most reference manuals for medications focus primarily on the
adult dosages.
• Therefore, the healthcare provider must be able to determine the appropriate
dosage for the pediatric patient when given the adult dosage.
• Several different methods may be used to determine the correct dosage of
medication for a pediatric patient.

3. Introduction
Calculate the proper dose for a child when given the adult dose of a drug
using the following methods:
1. Friend's Rule (Using the Child's Age in Months).
2. Young's Rule (Using the Child's Age in Years).
3. Clark's Rule (Child's Weight in Pounds).
4. Clark's Rule (Child's body surface area).
5. Parkland's Burn Formula.

4. Fried's Rule
• Fried's Rule is another method used to calculate the correct dose of
medication for the pediatric patient when given only the adult dose.
• This method should not be considered as accurate as the nomogram
method because it is based on the assumption that the child is of average
size and utilizes age rather than weight.
• It is important to note that because age does not necessarily indicate the
patient's weight, medication adjustments may be necessary once the
patient's response is determined.
Fried's Rule

5. Fried's Rule (Infants)
EXAMPLE: https://youtu.be/nWIOY_YzRiY
Paediatric dose =
Child's age in
months
150
X adult dose

6. Young's Rule
• Utilizes similar concepts as Fried’s Rule except it is based on the child’s age in
years.
EXAMPLE: https://youtu.be/aOTDqGq7TAI
Paediatric dose =
Child's age in years
child's age in years + 12 years
X adult dose

7. Clark's Rule
• Clark's Rule is used to calculate the amount of medicine to give to a
child aged 2-17.
• 2.2 pounds = 1 kg
Pediatric dose =
Child's
weight(Pounds)
150
x Adult Dose

8. Clark’s body area rule
Child dose=
𝑩𝒐𝒅𝒚 𝒔𝒖𝒓𝒇𝒂𝒄𝒆 𝒂𝒓𝒆𝒂 (𝒊𝒏 𝒎𝟐)
𝟏.𝟕𝟑 (𝒂𝒑𝒑𝒓𝒐𝒙 𝒂𝒅𝒖𝒍𝒕 𝑩𝑺𝑨)𝒎𝟐 x Adult dose

9. FLUID THERAPY

10. CALCULATION FOR FLUID REQUIREMENT
DROP FACTOR
1. Normal IV set 1 ml = 16 macro drops
2. Micro volume 1 ml = 60 micro drops

11. CALCULATING FLOW RATE

12. Formula For Calculation Of Daily Fluid
Requirement
BODY WEIGHT FLUID/DAY
0-10 kg 100 / kg / day
11-20 kg 1000ml + 50ml / kg for each kg
Above 20 kg 1500 ml + 20 ml / kg for each kg

13. EXAMPLE
Q. Calculate daily fluid requirement for a child with 13 kg?

14. Daily fluid requirement for first week of life

15. FLUID REPLACEMENT
FORMULA

16. Parkland's Burn Formula
• This formula was designed to help the healthcare provider determine the
proper amount of fluids to administer to a patient following a burn.
• Parkland's burn formula is most useful during the first twenty four hours
of fluid resuscitation with second degree or greater burns.
• Ringers lactate is the fluid of choice and should be administered at 4 mL/kg
of body weight per percentage of burn using total body surface area
(TBSA) as a guide.

17. DETERMINING TBSA
• Lund-Browder Chart is one
method that might be utilized.
• In a pediatric patient the head
comprises a much larger portion
of the BSA than with an adult.

18. Parkland's Formula
• Administer ½ of fluid requirements in 1st 8 hours, then administer the
2nd half of fluid requirements over the next 16 hours.
EXAMPLE: https://youtu.be/xNeBkACWGEU

20. EXAMPLE
Q. How many milligrams of Zofran will a 10 year old
child receive if the adult dose is 4 mg?

21. Q. An infant 10 months, 5 pounds need septromycin sulfate which is
usually administered in adults 1 gm, daily in IM injection. Find out the
approximate dosage of the infant?
EXAMPLE