DRUG DOSAGE CALCULATION IN PEDIATRICS BY MANISHA THAKURManisha Thakur
DRUG DOSAGE CALCULATION IN PEDIATRICS:
PEDIATRIC DOSAGE DIFFERENT FROM ADULTS
FORMULAS: YOUNG, CLARK, DILLING, FRIED RULES
BASED ON AGE, BASED ON BODY SURFACE AREA, WEIGHT
EXAMPLES.
DRUG DOSAGE CALCULATION
DAILY FLUID REQUIREMENT
CALCULATION OF DRIP RATE
INFUSION PUMP FLOW RATE CALCULATION.
Pediatric Drug calculations |drug calculation formulasNEHA MALIK
Most drugs in children are dosed according to body weight (mg/kg) or body surface area (BSA) (mg/m2). Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight. Doses are often expressed as mg/kg/day or mg/kg/dose, therefore orders written "mg/kg/d," which is confusing, require further clarification from the prescriber.
DRUG DOSAGE CALCULATION IN PEDIATRICS BY MANISHA THAKURManisha Thakur
DRUG DOSAGE CALCULATION IN PEDIATRICS:
PEDIATRIC DOSAGE DIFFERENT FROM ADULTS
FORMULAS: YOUNG, CLARK, DILLING, FRIED RULES
BASED ON AGE, BASED ON BODY SURFACE AREA, WEIGHT
EXAMPLES.
DRUG DOSAGE CALCULATION
DAILY FLUID REQUIREMENT
CALCULATION OF DRIP RATE
INFUSION PUMP FLOW RATE CALCULATION.
Pediatric Drug calculations |drug calculation formulasNEHA MALIK
Most drugs in children are dosed according to body weight (mg/kg) or body surface area (BSA) (mg/m2). Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight. Doses are often expressed as mg/kg/day or mg/kg/dose, therefore orders written "mg/kg/d," which is confusing, require further clarification from the prescriber.
Different medications must be absorbed to be effective. For absorption, the drug must be administered in proper manner. To choose a route of administration we need to relate the dosage form, the advantages and disadvantages etc.
Different medications must be absorbed to be effective. For absorption, the drug must be administered in proper manner. To choose a route of administration we need to relate the dosage form, the advantages and disadvantages etc.
To sum up, the risk/benefit ratio should be always weighed before prescribing antibiotics.
Appropriately selected patients will benefit from systemically administered antibiotics.
A restrictive and conservative use of antibiotics is highly recommended in endodontic practice, but indiscriminate use is contrary to sound clinical practice
Future generations will thank us for today’s conscientious and judicious use of antibiotics
Introduction to Medication Calculationsscooter1969
A tutorial to help nursing students to better get a handle on drug calculations. This will make students safer and competent.
This will also make it a safer outcome for the Patient.
Dosage Calculations for Dental Drugs Prescription LubabahGadi
A how to lesson to learn how to calculate the dosage of antibiotics and analgesics used in dentistry. Especially in case of pediatric patients with consideration to child weight.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Pediatric drug dose calculation
1. Techniques of calculation and
prescribing drug dosage in
pediatric practice
Dr. Paul, Shubhra Prakash
Assistant Registrar
Rajshahi Shishu(children) Hospital
2. Dose of Commonly used drugs
(parenteral)
Drugs Indication with Frequency Preparation
Dose
Aminophylline 5mg/kg/dose stat 125mg/5mL
2.5mg/kg/dose for
maintenance
therapy
Meropenem Other than 8 hourly 500 mg/vial
meningitis
20-30 mg/kg/dose
Meningitis 8 hourly
60mg/kg/dose
Azithromycin 10mg/kg/dose Once daily for 3 500mg/vial
days
Vancomycin 10-15mg/kg/dose 8 hourly 500mg/vial
Dopamine 5 gm/kg/min 200mg/5mL
followed by gradual vial
increase up to
3. Dose of Commonly used drugs
(parenteral)
Drugs Indication with Dose Frequency Preparation
Netilmycin 3mg/kg/dose 12 hourly 50mg/2mL
Phenobarbitone 20mg/kg/dose as 8 hourly 200 mg/ml
loading dose
Maintenance
5-20mg/kg/day in
divided dose
Clarithromycin 15mg/kg/day in2 12 hourly 500mg/vial
divided dose
Phenytoin 20mg/kg/dose as 125 mg/5ml
loading dose
Maintenance
5-20mg/kg/day in
divided dose
4. Relation of Dosage frequency
with weight and age
Dosage frequency of
Gentamycin for an example
Thrice
Twice daily Adult
daily
Children
Once
daily Neonate
7. Example I
Case I:
• A 4 months old child weighing 5kg requiring
Meropenem for an indication of meningitis.
How will you calculate the dose and
infusion rate?
8. Basic Calculation
As the indication is meningitis
the baby will receive Injection
Meropenem 60mg/kg/dose 8
hourly.
So the dose for this baby is
300mg/kg/dose
9. Example I with meropenem
As Meropenem is to be infused not less
than 30 minutes, it should be infused
with IV fluid. So for the example case IV
fluid of choice either Normal saline or
Dextrose in aqua or Dexstrose saline is
chosen. A measured volume , suppose
30 ml may be taken as carrier for
meropenem infusion
10. Example I with meropenem
A vial of Meropenem contains 500mg of
active drug in powder format. So it
should be reconstituted with distilled
water. Here comes the measurement of
Dilution. If smaller dose is required the
dilution should be with more amount of
diluents and vice versa.
11. Example I with meropenem
So if dilution is made with 10 ml of D/W
then each ml will contain 50 mg of the
drug, similarly if dilution is made with 5
ml of D/W then each ml will 100 mg of
meropenem. From this diluted drug the
exact dose is taken and poured into
measured infusion fluid and to be
infused.
12. Example I with meropenem
In our example case I the dose is
required 6 ml (if diluted with 10 ml D/W
) or 3 ml (if diluted with 5 ml D/W).
Now this 3 or 6 ml is poured in to
desired amount of fluid to be infused cat
calculated time.
13. Calculation of infusion rate
e.g. 30 ml fluid should be infused over 1
hour.
So infusion rate is 30ml/hr which stands
for 30ml/60min i.e. 0.5ml/min is the
infusion rate.
Then 0.5ml/min means
0.5 X 15 drops/min
=7.5 drops/min (if used with infusion set)
=7.5X 4 drops/min (if used with micro burette
)
= 30 drops/min
14. Calculation of infusion rate
e.g. 30 ml fluid should be infused over
1/2 hour.
So infusion rate is 30ml/30min which
stands for 30ml/60min i.e. 1ml/min is
the infusion rate.
Then 1ml/min means
1X 15 drops/min
=15 drops/min (if used with infusion set)
=15X 4 drops/min (if used with micro burette )
= 60 drops/min
15. Calculation of infusion rate
So in case of infusing 30 ml fluid the
rate will be as follows ( drops/min)
2 hours 1hour 30
minutes
• 15 • 30
• 60
16. Example II
Case II:
• A 7 months old child weighing 8 kg
requiring Azithromycin for an indication
of Acute watery Diarrhea
How will you calculate the dose and infusion
rate?
17. Basic Calculation
As the indication is acute
watery Diarrhoeathe baby will
receive Injection Azithromycin
@ 10mg/kg/day.
So the dose for this baby is
80mg/kg/dose
18. Example II with Azithromycin
As Azithromycin is to be infused over 30
minutes, it should be infused with IV
fluid. So for the example case IV fluid of
choice either Normal saline (as it is
provided with the drug as combipack) or
Dextrose in aqua or Dexstrose saline is
chosen. A measured volume , suppose
30 ml may be taken as carrier for
Azithromycin infusion.
19. Example II with Azithromycin
A vial of Azithromycin contains 500mg
of active drug in powder format. So it
should be reconstituted with distilled
water. Here comes the measurement of
Dilution. If smaller dose is required the
dilution should be with more amount of
diluents and vice versa.
20. Example II with Azithromycin
So if dilution is made with 10 ml of D/W
then each ml will contain 50 mg of the
drug, similarly if dilution is made with 5
ml of D/W then each ml will 100 mg of
Azithromycin From this diluted drug the
exact dose is taken and poured into
measured infusion fluid and to be
infused.
21. Example II with Azithromycin
In our example case II the dose is
required 1.6 ml (if diluted with 10 ml
D/W ) or 0.8 ml (if diluted with 5 ml
D/W).
Now this 0.8 or 1.6 ml is poured in to
desired amount of fluid to be infused cat
calculated time.
22. Example III
Case II:
• A 2 months old child weighing 4 kg
requiring Netilmycin for an indication of
sepsis.
How will you calculate the dose?
23. Example III
Recommended dose of netilmycin in sepsis is
3mg/kg/dose 12 hourly.
•The baby requires 4.5mg/dose of Netilmycin
only.
A vial of Netilmycin contains 50mg/2ml.
•So the baby requires only 0.18 ml of
netilmycin
24. Example III
Here an insulin syringe of 100 U will
be helpful for the required dose.
As in 100 unit insulin syringe 1ml=100
unit, 0.18 ml refers to 18 unit.
So, the dose becomes 18 unit/dose.