Calculation of Doses I
Dr. Osama A. A. Ahmed
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)
number of doses total quantity
Dr. Osama A. A. Ahmed
Size of dose
2
Dose Definitions
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 drugs
desired effects in a patient.
Average serum conc. (g/ml)
MTC
MEC
Time after drug administration (hours)
Minimum toxic concentration:
The base level of blood serum concentration that produces dose-related toxic effects.
Dr. Osama A. A. Ahmed
Dose Measurement
Doses are measured and administered by professional and paraprofessional
personnel in case of institutional setting.
adults or childs parents are generally measures and administers medication
in the home setting.
Household measures
Household measure
(Abbreviation)
ounce
Metric system
1 teaspoonful (tsp)
1 tablespoonful (tbsp)
1/6 fluidounce
1/2 fluidounce
5 ml
15 ml
Dr. Osama A. A. Ahmed
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Dose Measurement
Household measures
Signa
Label
dose
One teaspoonful
5 ml
One dessertspoonful
10 ml
One tablespoonful
15 ml
One coffee cupful
30
One drop
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Calibrated droppers
US Pharmacopeia, official medicinal dropper held vertically
delivers approximately 20 drops water per millilitre.
A drop (abbreviated gtt) doesnt represent a definite quantity
(few liquids have the same surface and flow characteristics as
water).
Dr. Osama A. A. Ahmed
Dose Measurement
Case 1
A physician asks a pharmacist to calculate the dose of a cough syrup so that it may be
safely administered dropwise to a child. The cough syrup contains the active ingredient
dextromethorphan HBr, 30 mg/15 ml, in a 120- ml bottle. Based on the childs weight
and literature references, the pharmacist determines the dose of dextromethorphan HBr
to be 1.5 mg for the child.
The medicine dropper to be dispensed with the medication is calibrated by the
pharmacist and shown to deliver 20 drops of the cough syrup per 1 ml.
Calculate the dose in drops, for the child.
Answer
30 mg dextromethorphan HBr
15 ml
1.5 mg dextromethorphan HBr
X ml
X = 15 * 1.5/30 = 0.75 ml
Number of drops of cough syrup in 0.75 ml dose
1 ml
20 drops of cough syrup
0.75 ml
X drops of cough syrup
X = 0.75 * 20/1 = 15 drops of cough syrup
Dr. Osama A. A. Ahmed
Calculation of doses
Patient Parameters
Geriatric medicine or geriatrics: is the field that encompasses the
management of illness in the elderly
Pediatrics: is the branch of medicine that deals with disease in
children from birth through adolescence.
Neonate (newborn): from birth to 1 month, neonate is considered
premature if born 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
Dr. Osama A. A. Ahmed
Calculation of doses
Patient Parameters
According to age
Child and infant doses
Youngs rule
X adult dose
Dose for Child Age of child years
age years 12
Cowlings rule
Dose for Child Age at next birthday years X adult dose
24
Frieds rule for infants
X adult dose
Dose for Infant Age months
150
Dr. Osama A. A. Ahmed
Calculation of doses
Patient Parameters
According to body weight
Clarks rule
X adult dose
Child dose weight lb
150
According to body surface area (BSA)
BSA of the child m 2
Child dose
2 X adult dose
1.73 m
Child dose BSA of the child m 2 X dose per m 2
To determine patients BSA, use standard Nomogram or this equation
Patient ' s BSA m
2
Dr. Osama A. A. Ahmed
Patient ' s height cm Patient ' s weight kg
3600
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Calculation of doses
If the adult dose of phenobarbital is 15 mg, what will be
the dose for an 8 year-old child?
Youngs rule
X adult dose
Dose for Child Age of child years
age years 12
= (8/8+12)X 15 = 6 mg
Cowlings rule
Dose for Child Age at next birthday years X adult dose
24
= (9/24)X 15 = 5.625
Dr. Osama A. A. Ahmed
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