Dosage Calculations “Amount of drug” serves as the unit, so this
information must be in the numerator of each ratio.
Measuring Systems
• There are four different systems that are Example: An order is written for 0.05 g Aldactone
currently used in drug preparation and (spironolactone) to be given orally (PO). The
delivery: aldactone is available in 25-mg tablets. How many
A. Metric system tablets would you have to give?
B. Apothecary system First, we’ll need to convert the grams to milligrams:
C. Household system 1 g___ = 0.05 g X = 50 mg
D. Avoirdupois system 1000 mg X
A. Metric system - the most widely used system Try this easier-to-remember formula.
of measure. Based on the decimal system, so D (Desired dose) x Q (Quantity) = X
all units are determined as multiples of 10. H (Drug on hand/available)
✓ Gram as the basic unit of solid measure
✓ Liter as the basic unit of liquid measure
B. Apothecary system - a very old system of
PEDIATRIC CONSIDERATIONS:
measurement that was specifically developed
for use of apothecaries or pharmacists. A. FRIED’s RULE - applies to a child younger than
• Minim as the basic unit of liquid measure 1 year of age. assumes that an adult dose
• Grain as the basic unit of solid measure
would be appropriate for a child who is 12.5
years (150 months) old.
C. Household system - found in recipe books.
• Teaspoon as the basic unit of fluid measure child’s age (months) x average adult dose
• Pound as the basic unit of solid measure 150 months -- constant
D. Avoirdupois system - another older system EX. A child, 12 months old, needs erythromycin, and
that was very popular when pharmacists the normal adult dose is 250 mg QID. What is the
routinely had to compound medications. appropriate dosage for the child?
• Uses ounces and grains but they measure
CD = _12 mos x 250 mg
differently.
150 mos
CD = 20 mg
1 mg = 1000 mcg 30 mL = 1 oz
1 g = 1000 mg 1 oz = 2 tbsp
1 L = 1000 mL 8 oz = 1 cup B. YOUNG’S RULE — 1-12 years of age
child’s age (years) x average adult dose
5 mL = 1 tsp 1 kg = 1000 g child’s age + 12 -- constant
EX. A 2-year old needs amoxicillin, the normal adult
3 Tsp = 1 tbsp 1 kg = 2.2 lbs
dose is 250 mg. What is the appropriate dose?
CD= _2_ x 250 mg
Calculating Dose:
2+12
A. Oral drugs (tablet/capsule/liquid)
CD = _2_ x 250 mg
amount of drug available = amount of drug 14
prescribed number of tablets/capsules to give CD = 36 mg
A pediatric patient with a BSA of 1.02 m², the doctor
orders an oral medication with a normal adult dose of
C. CLARK’s RULE— weight of child
250 mg. How many mg should be administered?
Lbs →kg ÷ 2.2
Kg → Lbs x 2.2 1.02 m² x 250 mg
1.73 m²
weight of child (in lb) x average adult dose
CD = 147 mg
150 lb --constant
EX. A child weighing 70 lbs is prescribed quinine
sulfate, and the normal adult dose is 325 mg TID. Without the nomogram, you may use these
What is the appropriate dosage for the child?
formulas:
CD = 70 lbs x 325 mg
m² = weight (kg) x height (cm) - metric system
150 lbs
3600
CD = 152 mg m² = weight (lb) x height (in) - household system
3131
D. BODY SURFACE AREA – the child’s surface area
is determined with the use of a nomogram. The
height and weight of the child are taken into Milligrams/Kilograms of Body Weight
consideration in this chart.
BSA (m²) x average adult dose • When safe and effective pediatric dose has
1.73 been established.
• Also may be used for adults taking drugs with
small margin of safety or high potential for
toxic effects.
A child with postoperative nausea is to be treated with
Vistaril (hydroxyzine), the recommended dose is 1.1
mg/kg by IM. If the child weighs 22 kg, what is the
dose?
CD = 1.1 mg x 22 kg
CD = 24.2 or 24 mg
