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Drug calculation & Dilution
This document provides information on calculating drug dilutions and infusion rates for intravenous medications. It discusses the importance of verifying the medication, dose, time and route by comparing the label to the medication administration record. There are three factors involved in IV medication infusion calculations - concentration, dose, and flow rate. Concentration is the amount of drug diluted in a given volume, dose is the amount ordered over a time period, and flow rate determines the infusion delivery speed. Various formulas are provided to calculate the required volume or flow rate based on the known factors. Examples are given for diluting and calculating infusion rates for several common IV medications.
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Drug calculation & Dilution
- 1. 6/24/2019 1 Drug calculationsand Dilutions Shemil DM WIMS
- 2. 6/24/2019 2 Delivery ofthe correct medication, dose, and infusion rate and time is essential for safe and therapeutic intravenous (IV) medication administration
- 3. 6/24/2019 3 The firststep in determining IV flow-rate calculations is to check the medication label. Compare the label to the medication administration record (MAR) for the correct patient, medication, dose, time, and route. You should perform this comparison a total of three times before you begin the infusion
- 4. 6/24/2019 4 • IVmedications are diluted in a variety of concentrations and delivered in a variety of dose rates. Be sure to clarify any questionable orders and use only approved abbreviations to avoid dangerous adverse events
- 5. 6/24/2019 5 • Thereare three factors involved in performing calculations for IV medication infusions. If you know two factors, you can calculate the third by using the basic formula:
- 6. 6/24/2019 6 • Theconcentration of medications is the amount of drug diluted in a given volume of IV solution, usually measured in units, micrograms (mcg), milligrams (mg), or grams (gm). • The dose of the medication is the amount of drug ordered for infusion over a specific length of time. Doses have varying units of measurement. The length of time is either by the minute or by the hour. If the medication is dosed by weight, the calculation is made using the patient’s weight in kilograms (kg). • The flow rate determines how rapidly the infusion is delivered to the patient. On an infusion pump, the flow rate is set using mL/hr or drops/mit
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- 9. 6/24/2019 9 . 1.Administer Inj.Taxim 350 mg. Available dose of Inj.Taxim is 1g. Here you have to convert the unit available dose to desired dose, And dilute it in 100 ml NS. 1 g = 1 x 1000 mg, 1 g = 1000 mg. Formula, D x V , 350 mg x 100 ml H 1000 mg 35000/1000 = 35 ml. So you will administer 35 ml to the patient.
- 10. 6/24/2019 10 To calculatethe hourly rate (ml/hr), Dose (in mcg/kg/min) x wt (kg) x drug volume in ml x 60 (min/hr) = ml/hr drug concentration in mcg Or Dose (in mcg/min) x drug volume in ml x 60 (min/hr) = ml/hr drug concentration in mcg Or Dose (in mg/kg/hr) x wt (in Kg) x drug volume in ml = ml/hr drug concentration in mg • If the dosage calculation is in mg/min or mcg/min add 60 minutes into the formula. If the dosage calculation is in mg/hr or mg/kg/hr, remove 60 minutes from the formula. If the dosage calculation does not require wt, remove wt from the formula.
- 11. 6/24/2019 11 Weight basedmedication doses measured / minute Formula ml/hr = body weight x dose x 60 min. Concentration of drug Concentration of Drug = mg x 1000 volume of the solution If you are diluting in 50 ml… Ml/hr = body weight x dose x 3 mg
- 12. 6/24/2019 12 • Dose(in mcg/kg/min) x wt (kg) x drug volume in ml x 60 (min/hr) = ml/hr drug concentration in mcg. Dose x wt x 50 x 60 mg x 1000 50 x 60 = 3000 = 3 1000 1000 So, Dose x wt x3 = ml/hr ( only if the dilution is in 50 ml) mg
- 13. 6/24/2019 13 Drug concentration mgx 1000 = mcg
- 14. 6/24/2019 14 Administer Dopamine5 mcg/kg/min. Patient weighs 55kg). Available is Dopamine 200 mg. Ans. 200 mg = 200000 mcg ( 200 x 1000) 1. 5 x 55 x 50 x 60 = 4.12 ml/hr 200000 2. 5 x 55 x 3 = 4.12 ml/hr 200 (50 ml dilution.)
- 15. 6/24/2019 15 To calculatemcg/kg/min ml/hr x mcg solution X 60 X kg or ml/hr X mg 3 X wt (dilution is in 50 ml) Ml/hr x mg x 1000 = ml/hr x mg 50 x 60 x wt 3 x wt
- 16. 6/24/2019 16 A patientis receiving dopamine 4.12 ml/hr. Find the mcg/kg/mint Ans. 4.12 x 200 = 5 mcg/kg/mint 3 x 55
- 17. 6/24/2019 17 Iv fluidcalculation. Drop Factors 1. Microset-60 drops/ml 2. Macroset-20 drops/ml 3.Blood Transfusion set-20drops/ml
- 18. 6/24/2019 18 • IVfluid calculation Amount of fluid to be infused X Drop factor Time(hr) X 60
- 19. 6/24/2019 19 • 120mg/5 ml syrup- 3.5 ml to be given but available dose is 150 mg/5 ml. So how many ml has to be given ?(desired Dose unknown). D X V H D X 5 = 3.5, D = 3.5 ml X 120 mg = 84 mg 120 5 ml 84 mg X 5 ml = 2.8 ml 150 mg
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- 21. 6/24/2019 21 • Inj.Midazolam(1ml) 1 ml= 1 mg direct iv/im
- 22. 6/24/2019 22 each 1ml= 50 mcg Inj.Fentanyl (2ml) BOLUS INFUSION Fenta(2ml) + Ns(8ml)= 10 ml= 100 mcg 1ml=10 mcg 6 ml (300 mcg) +24 ml Ns=30 ml=300mcg 1 ml=10 mcg
- 23. 6/24/2019 23 Morphine(1 ml) each1 ml = 15 mg(iv,im) BOLUS INFUSION Morphine(1 ml)+ Ns(9ml)=10 ml=15mg 1 ml=1.5 mg or Morphine(1 ml)+ Ns(14ml)=15 ml=15mg 1 ml=1 mg Morphine(1 ml)+ Ns(14ml)=15 ml=15mg 1 ml=1 mg
- 24. 6/24/2019 24 NTG(5 ml/25mg) each1 ml = 5 mg(iv) BOLUS INFUSION NTG (5ml)+Ns(45ml)=50 ml=25 mg 1ml=0.5 mg
- 25. 6/24/2019 25 Dopamine (5ml/200mg) each 1 ml = 40 mg ,iv (Consider pt’s wt) INFUSION Dopamine(5 ml)+ Ns(45ml)=50 ml=200 mg 1 ml= 4 mg
- 26. 6/24/2019 26 Calcium Gluconate(10ml) BOLUS INFUSION Calcium gluconate (10 ml)+ Ns(10 ml) slow iv
- 27. 6/24/2019 27 Sodium bicarbonate(25ml/75 mg) BOLUS INFUSION Direct IV
- 28. 6/24/2019 28 Adrenalin (1ml/1mg) BOLUSINFUSION Adrenalin(4 ml)+ Ns(46ml)=50ml=4 mg 1 ml=0.08 mg
- 29. 6/24/2019 29 Atropine(1 ml/0.6mgor 0.5mg) BOLUS INFUSION Direct iv/im
- 30. 6/24/2019 30 Cordarone(3ml/150mg) each 1ml = 50mg BOLUS INFUSION Cordarone (6ml)+5 D (44 ml)=50 ml=300 mg 1 ml=6 mg
- 31. 6/24/2019 31 Noradrenalin(2ml/4mg) each 1ml = 2 mg BOLUS INFUSION Noradrenalin(2ml)+Ns(48ml)=50 ml=4mg 1ml=0.08mg
- 32. 6/24/2019 32 Vassopressin(1ml/20 units) BOLUSINFUSION Vassopressin(1ml)+Ns(19 ml)=20 ml 1ml= 1 unit
- 33. 6/24/2019 33 Epsolin(2ml/100mg) each 1ml = 50 mg BOLUS INFUSION Dilute in 100 ml Ns +slow iv
- 34. 6/24/2019 34 Dobutamin(250 mg) BOLUSINFUSION Dobutamin 250 mg + Ns(50 ml)=50 ml=250mg 1 ml=5mg
- 35. 6/24/2019 35 Octride (1ml/50mg/100mg) 100 mg 50 mg Octride (5ml)+Ns(45 ml)=50 ml=500 mg 1ml= 10 mg Octride (10ml)+Ns(40 ml)=50 ml=500 mg 1ml= 10 mg
- 36. 6/24/2019 36 Atracurium(2.5ml/25mg) each 1ml=10 BOLUS INFUSION Atracurium(5 ml) + Ns(45 ml)=50 ml=50mg 1 ml=1 mg
- 37. 6/24/2019 37 Adenosin (2ml/6mg) each 1 ml=3 mg BOLUS INFUSION Direct iv + 20 ml Ns flush
- 38. 6/24/2019 38 Levosimendan (12.5mg) BOLUSINFUSION Levosimendan 12.5mg + 5 D(50 ml)=12.5 mg 1 ml=0.25 mg.
- 39. 6/24/2019 39 Lasix (2ml/20mg) BOLUS INFUSION Lasix(4ml)+Ns(36ml)=40ml=40 mg 1ml=1 mg
- 40. 6/24/2019 40 Insulin(40 units) 1ml=40 units BOLUS INFUSION Insulin(1ml)+Ns(39 ml)=40 ml=40 units 1ml= 1 unit
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