Medication Calculation

In paediatric practice medication dosages are calculated based on the childs weight making the dosages much
more precise.
It is important that the childs most recent weight in kilograms is entered into the KidCare system so that drug
dosage calculations are accurate.
Use the SickKids Formulary, or eFormulary, to check if the prescribed dose is within a therapeutic range. Another
source of information is the electronic CPS (eCPS) found on the hospital internal webpage
Use the online IV Medication Administration guidelines found on hospital internal webpage to check reconstitution
and stability guidelines, administration guidelines, implications and side effects.

Dosage Calculation
Dosages may be calculated based on:

Milligrams/kg (e.g. Lasix)

Micrograms/kg (e.g. Fentanyl)

Units/kg (e.g. Heparin)

Body surface area (BSA)

Medication Calculation (milligrams/kg)

A 20kg patient has been ordered Ampicillin 500mg IV q6h.

(a) Validating ordered dose to make sure it is within the therapeutic range:
The recommended dose of Ampicillin is 100-200mg/kg/day div q6h, and the nurse must ensure that the dose
prescribed is within therapeutic range by calculating the minimum and maximum dosages.
Minimum Dose

Maximum Dose

100mg x 20kg = 2000mg/kg/day divided q6h

200mg x 20kg = 4000mg/kg/day divided q6h

500mg per dose

1000mg per dose

The child would receive 20kg x 100 mg/kg/day = 2000 mg/day divided into four doses (24 hours divided by 6
hours) or 500 mg/dose. Therefore, the prescribed dose is within the therapeutic range.

(b) Correct medication reconstitution:

Prescribed dose/ mg available) x mL diluted in = Volume of medication to be administered

Calculation Example 1
Example of Medication Label:
AMPICILLIN SODIUM

Physician Order: Give 500 mg of Ampicillin IV q6h

The instructions on a 500mg vial of Ampicillin indicate

500mg
For IM use: Add 1.8mL
Sterile Water for Injection to
yield approximately 2mL
(250mg/mL). For
IV use: Further dilute to
10mL (50mg/mL). Shake
Well. Use within 1 hour of
reconstitution.

to reconstitute with 1.8ml of sterile water to provide

250mg of Ampicillin per 1 ml.
To administer the desired dose of 500 mg will require
to draw 2 ml of already reconstituted Ampicillin (500mg
/ 250mg) x 1ml = 2ml

Calculation Example 2
Example of Medication Label:
Ibuprofen 100mg/5mL
suspension for oral use:

This child now has a temperature of 39.0C, and the

physician has ordered Ibuprofen as an
antipyretic. Physician Order: Give 200mg (10mg/kg)
of Ibuprofen PO Q6h prn for fever
The instructions on the bottle of Ibuprofen indicate that
there is 100 mg of Ibuprofen in 5 ml of liquid, or as you
can calculate 20mg per 1 ml.
To administer 200 mg, you will need to draw 10mL of
Ibuprofen (200 mg x 1ml) / 20 mg = 10 ml