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Techniques of calculation and

prescribing drug dosage in


pediatric practice

Dr. Paul, Shubhra Prakash


Assistant Registrar
Rajshahi Shishu(children) Hospital

Dose of Commonly used drugs


(parenteral)
Drugs

Indication with
Dose

Frequency

Preparati
on

Aminophylline

5mg/kg/dose stat
2.5mg/kg/dose for
maintenance
therapy

125mg/5m
L

Meropenem

Other than
8 hourly
meningitis
20-30 mg/kg/dose

500
mg/vial

Meningitis
60mg/kg/dose

8 hourly

Azithromycin

10mg/kg/dose

Once daily for


3 days

500mg/vial

Vancomycin

10-15mg/kg/dose

8 hourly

500mg/vial

Dopamine

5gm/kg/min
followed by
gradual increase

200mg/5m
L vial

Dose of Commonly used


drugs (parenteral)
Drugs

Indication with
Dose

Frequenc
y

Preparation

Netilmycin

3mg/kg/dose

12 hourly

50mg/2mL

Phenobarbitone

20mg/kg/dose as
loading dose

8 hourly

200 mg/ml

12 hourly

500mg/vial

Maintenance
5-20mg/kg/day in
divided dose
Clarithromycin

15mg/kg/day in2
divided dose

Phenytoin

20mg/kg/dose as
loading dose
Maintenance
5-20mg/kg/day in
divided dose

125 mg/5ml

Relation of Dosage frequency


with weight and age
Once
daily
Dosage
frequency of
Gentamycin for an
example

Adult

Children
Neonat
e

Age

Weig
ht

The younger
lesser isthe
thechild
weight
thethe
more
more
is the
is the
dilution
dilution

Example

Example I
Case I:

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

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

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.

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.

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.

Calculation of infusion
rate

Calculation of infusion
rate

Calculation of infusion
rate
So in case of infusing 30 ml fluid
the rate will be as follows
(drops/min)
2 hours

Example II
Case II:

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

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.

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.

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.

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.

Example III
Case II:

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

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.

Thank you all

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