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
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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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