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4. Dose calculation exercises

The document contains a series of dose calculation exercises for various medical scenarios, including IV fluid administration, medication dosing based on patient weight, and adjustments for renal function. Each exercise provides a detailed calculation process for determining the required dosages and drip rates for medications such as heparin, insulin, dopamine, gentamicin, and mannitol. The exercises emphasize the importance of accurate dosing in clinical settings and include specific calculations based on patient parameters.

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9 views

4. Dose calculation exercises

The document contains a series of dose calculation exercises for various medical scenarios, including IV fluid administration, medication dosing based on patient weight, and adjustments for renal function. Each exercise provides a detailed calculation process for determining the required dosages and drip rates for medications such as heparin, insulin, dopamine, gentamicin, and mannitol. The exercises emphasize the importance of accurate dosing in clinical settings and include specific calculations based on patient parameters.

Uploaded by

r3993851
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DOSE CALCULATION EXERCISES

Exercise 1

1A. The volume of the fluid is 0.9 L and the IV pump set at 75 mL/hour. How long
will it take for the fluid to run?
Time (hours) = Volume (mL)/Drip Rate (mL/hour).
0.9 L = 900ml
900/75=12 Hr

1B. A patient has been prescribed 6,000 units of heparin SC every 12 hours. As
mentioned on vial 1 ml contain 5000 units of heparin. How many ml will you
give?
Dose ordered = 6,000 units
1 ml =5,000 units,
So,
6000/5000=1.2ml
Exercise 2

2. A patient has been set a total daily insulin requirement at 0.75 units per kg per
day SC. What is the total daily requirement in ml (1ml=100units) if patient
weighs 83 Kg?
Ans:

83X0.75= 62.25=63 Units,

1ml = 100 units, so for 63 units daily requirement is 0.63ml.


Exercise 3

500ml of 5%dextrose solution is to be given intravenously. The infusion controller


has a dropfactor 20 drops per ml and you are instructed to ensure that the patient
receives this volume in 12 hours. What should be the drop rate be set to?
Answer:
Drop rate = drop factor X volume in ml/60 X time in hours.

Drop rate = 20 drops per ml X 500ml/60x12 = 13.89.

Note that it is necessary to round to the nearest whole number, because infusion
controllers which are calibrated to operate in drops per minute do not have the
facility for decimals, so the answer would be 14 drops per minute.
Exercise 4
A 55-year-old male patient weighing 50 kg is diagnosed to have gram negative lower
respiratory tract infection. Physician prescribed gentamicin 4mg/kg/day i.m. in 3
divided doses. The creatinine clearance of patient is 35ml/ min. how will you modify
the dose of gentamicin in this patient.Also calculate the amount to be injected at each
dose from given preparation (Gentamicin is available as 80mg/ 2ml vial)
Answer:
Weight: 50kg
Dose: 4mg/kg/day in three divided doses
CrCl: 35ml/min

Dose required in this patient is = 4 X 50 = 200mg/day divided in three doses


Now, the CrCl of patient is 35ml/min
So, according to guidelines for dose adjustment of gentamicin in renal failure patients
we need to give 30% of prescribed dose

So, 30% of 200mg = 60mg/ day in three doses


= 20mg three times a day
As gentamicin is available as 80mg/ 2ml vial, to administer 20 mg we need to give
0.5ml three times a day

Modified dose of gentamicin in this patient is =20mg three times a day = 0.5ml
three times a day i.m.
Exercise 5
A patient comes to your hospital in unconscious state. After evaluation you
diagnosed it as hypovolemic shock and you decided to start dopamine drip at the
rate of 4mcg/kg/min. The weight of patient is 75 kg. calculate the drip rate for
dopamine infusion in this patient. (Dopamine is available as 200mg/5 ml ampoule)

Answer: Patient weight: 75 kg


Prescribed drip rate: 4mcg/kg/min
Dopamine available: 200mg/5ml

Required dose = 4mcg × 75 kg = 300mcg /min


Dopamine is infused in 5% dextrose i.v. fluid
Take 500ml of 5% dextrose and discard 5ml from it
↓
Add 5ml (200mg) of dopamine in 495ml of dextrose

200 mg/ 500ml = 200000 mcg/500ml


↓

400 mcg/ml
Now we need to infuse at rate of 300 mcg/min
So, 1 ml contains 400 mcg then 300mcg will be in 0.75ml
300 mcg/min = 0.75ml/min
Now, we know 1ml = 16 drops (Drop factor)
So, 0.75 ml = 12 drops

Required drip rate for dopamine in this patient is 12 drops/min


Exercise 6
A8-year-old boy weighing 15 kg brought to your hospital with complain of watery
diarrhea (20 episodes in last 4 hours) and vomiting. On examination the eyes were
sunken, dry tongue, increased capillary refill time & rapidand feeble pulse you
diagnosed it as severe dehydration and decided to rehydrate the patient with i.v. N.S.
with rate of 30ml/kg in first 30min then 70ml/kg in next 2 ½ hour. Calculate the
Driprate required for first 30 minutes OR for next 2 ½ hour. (any one will be asked)
Available data:
1) NS- 500 ml bottle, 1000ml bottle
2) Dose of IV fluid: 100ml/kg divided into 30ml/kg in first 30min and
70 ml/kg in next 2 ½ hour
3) Patient weight – 15 kg
Answer:
For first 30 min:
Fluid to be infused is = 30 ml × 15kg = 450 ml in 30 min
= 15 ml/ min
Now by multiplying with drop factor
= 15 × 16 drops/ min
= 240 drops/ min
For first 30 min = 4 drops/ second
For next 2 ½ hour.
Fluid to be infused is = 70ml ×15kg = 1050ml in 2 ½ hr (150min)
= 7 ml/min
By multiplying with drop factor
= 7 ml ×16 drops/ min
= 112 drops/min
= 2 drops /sec (1.86 drop/sec)

For next 2 ½ hour = 2 drops/ sec


Exercise 7
A 60-year-old known case of hypertension comes to your hospital with complain of
severe throbbing headache & giddiness. On measuring blood pressure, it is found to be
230 /130 mm Hg. This is the hypertensive urgency. In this patient to prevent further
target organ damage you decided to lower blood pressure by using sodium
nitroprusside calculate the drip rate of sodium nitroprusside in this patient with dose of
0.02mg/min (sodium nitroprusside is available on 50mg/5ml ampoule)

Answer:
Dose to be given: 0.02mg/min
Availability: 50 mg / 5 ml

Sodium nitroprusside is usually administered in NS/ Dextrose 5%


1) Take 500ml of NS & discard 5ml from it.
2) Add 50 mg (5ml) sodium nitroprusside in 495 ml of NS
↓
50mg/ 500ml
↓
0.1mg/ml
↓
0.1mg in 16 drops(drop factor)

If 0.1mg in 16 drops then how many drops required for 0.02mg


= (0.02 X 16)/0.1
=3.2

So, to administer 0.02mg/min we need to set drip rate to 3 to 4 drops/min (3.2 drops)
Exercise 8
A 23-year-old male patientweighing 65 kg brought to your hospital with a road traffic
accident and head injury. The patient is in unconscious state. After a CT scan of brain,
it is found that there is cerebral edema. You decided to start mannitol to reduce
cerebral edema with a dose of 1.5g/kg of 20% solution over 1 hour. Mannitol is
available as 20% solution 500 ml bottle.

Answer:
Dose = 1.5g/kg over 1 hour
Weight = 65 kg
Required dose for patient is = 1.5g × 65 kg = 97.5 gm

20% mannitol solution contains 20gm mannitol in 100ml

So, to infuse dose 97.5gm

(97.5 × 100) / 20 = 487.5ml of 20% mannitol solution

487.5 ml of 20 % mannitol solution to be infused over 60 min

So, in one minute = 8.13 ml


= 8.13 × 16 (drop factor)
= 130 drops / min
= 2.16 drops /sec.

Required Driprate of mannitol is = 130 drops/ minute (2 drops/ sec)


Exercise 9
A 50-year-old male patient known case of DM weighing 70kg brought to your hospital
in unconscious state. Relatives given history of lower respiratory tract infection 3 days
back.On measurement of blood sugar level, it is found to be 620mg/dL. Patients is in
dehydrated state.On blood and urine examination ketone bodies are present in trace
amount.You diagnosed it asdiabetic ketoacidosis& decided to start insulin
(Regular).You decided to start Insulin as bolus dose of 0.2U/kg i.v. followed by 0.1U/
kg/hr till BSL comes down to 300mg/dL. Calculate the bolus dose required and drip
rate. [Regular insulin is available as 40U/ml (10ml vial]

Answer:
Weight: 70kg
Bolus dose: 0.2U/ kg
Drip dose: 0.1U/ kg/hr

1) Bolus dose: 0.2 × 70 =14U i.v.

2) Drip rate :
Dose is = 0.1U/ kg/hr
= 0.1 × 70/hr
= 7U/ hr.
Add 40 U in 500 ml of Normal saline

Now, in 500 ml → 40U, so how much will be there in 1ml


40U/500 ml = 0.08U/ml

Now, 0.08U in 1ml, then how many ml required for 7U


7/0.08 = 87.5ml

87.5 ml fluid to be infused in 1 hour.


In 60 min→ 87.5 ml, then how many ml in 1 min
87.5/60 = 1.45ml/min

1.45ml X 16 (drop factor)


=23.2 drops/ min

Bolus dose required in this patient is = 14U i.v.


Drip rate of insulin in this patient is = 23 drops/ min (23.2 drops)

Exercise 10
A male child aged 2 years weighing 12kg brought to your clinic with complains of
fever, runny nose, cough since 3 days.On examination child wasirritable with greenish
mucus in the nose. On auscultation there was congestion in the chest.You diagnosed it
as bacterial pharyngitis and decided to prescribe cefpodoxime proxetil for
him.Calculate therequired dose for this child (Cefpodoxime proxetil dose is
5mg/kg/dose, two times a day.Cefpodoxime proxetil is available os 100mg /5 ml
syrup).

Answer:
Weight = 12 kg
Dose: 5mg/kg/dose
Preparation available: 100 mg/5ml

Dose required for child is = 5mg × 12 = 60mg/dose

Available preparation is 100mg/ml

So, for 60 mg it will be 3ml

The dose to be prescribed in this child is 3 ml two times a day

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