DOSAGE
CALCULATIONS
Assoc. Prof. Gina C. Castro, RPh. PhD
Faculty of Pharmacy
USUAL DOSE
Amount that ordinarily produces the desired
therapeutic response in the majority of patients
USUAL DOSAGE RANGE
Range of dosage determined to be safe and effective
in the population group
PEDIATRICS
Neonate Early childhood Adolescence
(birth to 1 month) (1 year to 5 years) (13 years to 17 years)
Late childhood
Infant (6 years to 12 years)
(1 month to 1 year)
PEDIATRIC DOSING
• Doses should be based on accepted clinical studies
as reported in literature
• Doses should be age appropriate and generally
based on body weight or body surface area
• Pediatric formulations should be used when available
• All caregivers should be properly advised with regard
the dosage, dose administration, and important
clinical signs to observe
• Calibrated oral syringes should be used to measure or
administer oral liquids
GERIATRICS
• Functional capacities of most organ systems decline
throughout adulthood
• Many elderly patients have coexisting pathologies
• Long-term use of maintenance drugs, need for
multidrug therapy, increased possibility of drug
interactions and adverse drug effects, and difficulties
in patient adherence
GERIATRIC DOSING
• Therapy is often initiated with lower-than-usual adult
dose
• Dose adjustment may be required based on
therapeutic response
• Patient’s physical condition may determine the drug
dose and route of administration
• Dose is based on patient’s weight, body surface
area, health and disease status, and
pharmacokinetic factors
GERIATRIC DOSING
• Concomitant drug therapy may affect drug/dose
effectiveness
• Drug dose may produce undesired adverse effects
and affect patient adherence
• Complex dosage regimens of multiple drug therapy
may affect patient adherence
RULES FOR PEDIATRIC DRUG DOSING
YOUNG’S RULE
COWLING’S RULE
FRIED’S RULE (for infants)
CLARK’S RULE (based on weight)
DRUG DOSAGE CALCULATIONS
No.10/125.
Rx
Acetaminophen oral drops
Disp. 15 mL
Sig. 0.5 mL t.i.d.
a. If acetaminophen oral drops contain 1.5 g of
acetaminophen per 15-mL container, how many milligrams
are there in each prescribed dose?
b. If the dropper is calibrated to deliver 22 drops/mL, how
many drops should be administered per dose?
DRUG DOSAGE CALCULATIONS
No.16/125.
A pediatric patient is prescribed 40 mg of
prednisolone per day in two divided doses. How
many divided doses are available in 6 fl. oz. of
oral solution containing prednisolone 20 mg/5 mL
dispensed to the patient?
DRUG DOSAGE CALCULATIONS
No.19/126.
Ipecac oral solution has the following formula:
Powdered ipecac 70 g
Glycerin 100 mL
Syrup ad 1000 mL
Powdered ipecac contains 2 grams of the combined
alkaloids emetine and cephaline in each 100 grams of
powder. Calculate the quantity of these alkaloids, in
milligrams, in each 5-mL dose of ipecac oral solution.
DRUG DOSAGE BASED ON BODY WEIGHT
Patient dose (mg) = Patient’s weight (kg) x Drug dose (mg/kg)
No.1/137.
The usual initial dose of chlorambucil is 150
mcg/kg of body weight. How many milligrams
should be administered to a person weighing
154 lbs?
DRUG DOSAGE BASED ON BODY WEIGHT
Case in point 8.1 (p.133)
A hospital pharmacist is asked to determine the dose of
clindamycin for a 3-day old neonate weighing 3 lb 7 oz.
In checking the literature, the pharmacist determines that the
dose is listed as follows:
<1200 g : 10 mg/kg/day divided q12h
<2000 g and 0 to 7 days old : 10 mg/kg/day divided q12h
<2000 g and >7days old: 15 mg/kg/day divided q8h
>2000 g and 0 to 7 days old: 15 mg/kg/day divided q8h
>2000 g and >7days old: 20 to 30 mg/kg/day divided q12h
Each divided dose is to be added to an intravenous infusion at the
scheduled hour and infused over a period of 20 minutes.
DRUG DOSAGE BASED ON BODY WEIGHT
Case in point 8.1 (p.133) (cont…)
The product shown in Figure 8.1 was used to
prepare an IV bag containing 600 mg/50 mL of
injectable solution. How many milliliters of this
solution should be given for each dose?
600 mg/ 4 mL*
DRUG DOSAGE BASED ON BODY WEIGHT
Case in point 8.2 (p.134)
A pediatric patient is being administered enalapril
(Vasotec IV) every 12 hours by intravenous injection to
manage hypertension and possible heart failure. Based
on a dose of 5 mcg/kg, the patient is receiving 55 mcg of
enalapril per dose. The physician wishes to convert the
patient to oral enalapril at a dosage of 100 mcg/kg as a
single daily dose. The standard procedure is to crush a
2.5-mg tablet of enalapril, mix with sterile water to make
12.5 mL, and administer the appropriate dose using a
calibrated oral dispenser. Calculate the dose, in milliliters,
to be administered to this patient.
DRUG DOSAGE BASED ON BODY SURFACE AREA
(BSA)
DRUG DOSAGE BASED ON BODY SURFACE AREA
(BSA)
THE
NOMOGRAM
Patient BSA: 1.3 m2
Patient height: 5’1”
Patient weight: 36 kg
DRUG DOSAGE BASED ON BODY SURFACE AREA
(BSA)
No.1/143
If the usual adult dose of a drug is 120 mg,
what would be the dose based on BSA for a
person measuring 6 feet tall and weighing
200 lbs.?
DRUG DOSAGE BASED ON BODY SURFACE AREA
(BSA)
The recommended dose for an anticancer
drug is 25 mg/m2 once per week for 6 weeks.
How many grams of the drug should be
given to a patient who weighs 165 lbs. and is
5 ft. 6 in. tall over the course of the
treatment?
THANK YOU!
