Presented By:

Pandya Tejas.J

2nd Year M.Sc nursing

Dep. Of Child Health Nrsing

Sumandeep Nursing College

CALCULATION OF CHILD DOSES

Introduction

The usual dose of a drug is the amount that ordinarily produces the desired therapeutic response in the majority of patients in a general, or otherwise defined, population group.

The drug's usual dosage range is the range of dosage determined to be safe and effective in that same population group.

Provides the prescriber with dosing guidelines in initially selecting a drug dose for a particular patient and the flexibility to change that dose as the patient's clinical response warrants.

For certain drugs and for certain patients, drug dosage is determined on the basis of specific patient parameters.*Include the patient's age, weight, body surface area, and

nutritional and functional status. Patients requiring individualized dosage are

*neonates and other pediatric patients, elderly patients with diminished biologic functions,

*individuals of all age groups with compromised liver and/or kidney function (and thus reduced ability to metabolize and eliminate drug substances),

*Critically ill patients and patients being treated with highly toxic chemotherapeutic agents.

PediatricDefinition: Pediatrics is the branch of medicine that deals with disease in children from birth through adolescence.

*Neonate (newborn): from birth to 1 month;

*Premature: born at less than 37 weeks’gestation.

*Infant: 1 month to 1 year;

*Early childhood: 1 year through 5 years;

*Late childhood: 6 years through 12 years;

*Adolescence: 13 years through 17 years of age.

Route of Drug Administration Or Locations

*Nasal administration (through the nose).

*Intra-arterial (into an artery),

*Intra-articular into a joint space.

*Intra-cardiac (into the heart),

*Intramuscular (into a muscle),

*Intra-cavernous injection, an injection into the base of the penis

*intradermal, (into the skin itself) is used for skin testing some allergens, and also for mantoux test for Tuberculosis

*Intra-lesional (into a skin lesion),

*intraosseous infusion(into the bone marrow)

*Intra-peritoneal, (infusion or injection into the peritoneum)

*intrathecal (into the spinal canal) is most commonly used for spinal anesthesia and chemotherapy

*Intrauterine

*Intra-vaginal administration, in the vagina

*intravenous (into a vein), e.g. many drugs, total parenteral nutrition

*Intravesical infusion is into the urinary bladder.

*intravitreal, through the eye

*subcutaneous (under the skin), e.g. insulin.

*Epicutaneous or topical (application onto the skin).

*Transmucosal (diffusion through a mucous membrane)

Dose Definitions:Dose of a drug: the quantitative amount administered or taken by a patient for the intended medicinal effect

Single dose: the amount taken at one time

Total dose (Daily dose) : the amount taken during the course of therapy (may be subdivided in divided doses)

Dosage regimen: the schedule of dosing (4 times per day for 10 days)

Usual adult dose: the amount that ordinarily produces the medicinal effect intended in the adult patient

Usual pediatric dose: : the amount that ordinarily produces the medicinal effect intended in the infant or child patient

Usual dosage range : the quantitative range or amounts of the drug that may be prescribed within the guidelines of usual medical practice

Median effective dose: the amount that produces the desired intensity or effect in 50% of the individuals tested.

Minimum effective concentration: the minimum concentration determined that can be expected to produce the drug’s desired effects in a patient.

Minimum toxic concentration: The base level of blood serum concentration that produces dose-related toxic effects.

LABEL DOSE

One teaspoonful 5 ml

One dessertspoonful 10 ml

One tablespoonful 15 ml

One coffee cupful 30

Dose Measurement•Doses are measured and administered by professional and paraprofessional personnel in case of institutional setting.•adults or child’s parents are generally measures and administers medication in the home setting.•Household measures

Pediatric Dosage*There are several methods for calculating pediatric medication dosage

based on various combinations of age, height, weight, body surface area and adult dose.

*Due to variation above the concern about overdosing or under dosing medication for infants and children is of prime importance.

*Proper drug dosing of the pediatric patient depends on a number of factors:

the child's age and weight,

overall health status,

the condition of such biologic functions as respiration and circulation,

The stage of development of body systems for drug metabolism (e.g., liver enzymes) and drug elimination (e.g., renal system).

1) According to Body Surface area:

x adult dose

Calculation of the body surface area

2) According to Age:Young’s Formula

x adult dose

Fried’s formula

x adult dose

This formula used in only under 1 year children.

3) According to body weight

Clark’s formula

x adult dose

Note: 1kg=2.2pound(lb)

4) Calculation flow rate

Drop Factors:

*10 drops/ml (blood set),

*15 drops / ml (regular set),

*60 drops / ml (micro drop).

x drop factor

5) Calculate Liquid Medication

X Quantity in ml = Volume to be administer

6) Infusion time calculation:

*Flow rate (mL/hr) = total volume (mL) ÷ infusion time (hr)

*Infusion time (hr) = total volume (mL) ÷ flow rate (mL/hr)

*Total volume (mL) = flow rate (mL/hr) × infusion time (hr)

7) Parkland formula:

4mls x %burns x body weight in kg = quantity 24 hours

Give 50% of the fluid in the first 8 hours

Give 50% of the fluid in the next 16 hours

6) For Tablet Calculation:

X Quantity in Tablet = Number of Tablet to be given

e.g tablet digoxin 0.375 p.o dailly available digoxin tablet is 0.25 mg so how many tablets will be give?

Desire dose: 0.375 mg

Dose on Hand: 0.25 mg

Quantity in Table:1

Calculation is

0.375 X 1= No. of Tablets to be given

0.25

Ans: 1 ½ tablet

Questions