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Lesson Two
• In this lesson we will cover all of the components that make up a drug dose.– The Desired Dose– Weight– The Solution Set– The Concentration
• We will also discuss the ultimate goal when considering drug calculations.
Objectives
• Learn how to assess a desired dose.• Learn when to implement weight
conversions.• Learn the different solution sets and
which one to select for medication administration.
• Learn how to simplify a medication concentration.
Desired Dose
• The desired dose is the actual order you are going to carry out.
• The desired dose holds all the information you will need to determine how many more calculations you will need to do.– For example a desired dose of 2mg/kg lets you
know that you will need to be doing a weight calculation to convert pounds to kilograms.
Desired Dose
• There are many different possible forms:– 5mg– 5mg/kg– 5mg/kg/min
Weight
• When the desired dose includes a weight component, you know you will need to obtain your patient’s weight and convert it to kilograms.– 5 mg/kg– 5 mcg/kg/min– 20 ml/kg
Solution Set
• The choice of solution set becomes very important when calculating a drip.– 5 mcg/kg/min
• The time component (min), tells you that you will be calculating a drip or “infusion”.
Solution Set
• There are two basic types of solution sets “macro” and “mini”, with a few different options.– 10 gtts/ml - Macro– 15 gtts/ml - Macro– 20 gtts/ml - Macro– 60 gtts/ml - Mini /Micro
gtts = drops
Solution Set
• 10 gtts/ml means that for every ten drops, one milliliter (cc) will be infused.
• The choice of solution set will be dependant on the amount of fluid needed to be infused.
Solution Set
• Certain medications require doses that will always be easier to administer using specific drip sets.– Tridil(Nitro), Diprivan, & Dopamine = Mini
drip-set– Amiodarone, Mag Sulfate, & Procainamide
= Macro drip-set
Concentration
• The concentration refers to how much drug exists in a specific amount of volume. – 400mg / 100ml
• The goal is to reduce the concentration to amount of drug per 1 ml.– 400mg / 100ml = 4mg / ml
Concentration
• The concentration can be found on the packaging of all medications.
Atropine:
1 mg /10ml
0.1 mg /ml
Concentration
• If you are doing a drip/infusion, you will have to use the bag size for your total volume.
+ 250ml
Concentration
• You have 400mg / 5ml of Dopamine and a 250ml bag of Normal Saline. If you add the Dopamine, what’s your concentration?
+ 250ml
Concentration
• Technically, your concentration would be 400mg/255ml because you would have to count the 5ml that is in the vial.
+ 250ml
Concentration
• To fix this, just take 5ml out of the bag prior to adding the medication.
+ 250ml
Concentration
• The medication variable in the concentration should be converted to the variable within the desired dose.– DD = 5mcg/kg– C = 500mg/50ml
Concentration
• The medication variable in the concentration should be converted to the variable within the desired dose.– DD = 5 mcg /kg– C = 500 mg /50ml
Concentration
• The medication variable in the concentration should be converted to the variable within the desired dose.– DD = 5 mcg /kg– C = 500 mg /50ml
• 500 mg / 50ml = 500,000 mcg / 50ml
Concentration
• The medication variable in the concentration should be converted to the variable within the desired dose.– DD = 5 mcg /kg– C = 500 mg /50ml
• 500 mg / 50ml = 500,000 mcg / 50ml– 500,000 mcg / 50ml = 10,000 mcg / ml
Concentration
• The medication variable in the concentration should be converted to the variable within the desired dose.– DD = 5 mcg /kg– C = 500 mg /50ml
• 500 mg / 50ml = 500,000 mcg / 50ml– 500,000 mcg / 50ml = 10,000 mcg/ml
» Reduced concentration = 10,000 mcg/ml
Practice
Reduce the concentration:
• DD = 20mg
• C = 25mg /5ml
Practice
Reduce the concentration:
• DD = 20mg
• C = 25mg / 5ml ÷ 5 ÷ 5
Practice
Reduce the concentration:
• DD = 20mg
• C = 25mg / 5ml ÷ 5 ÷ 5
5mg / 1ml
Practice
Reduce the concentration:
• DD = 20mg
• C = 25mg / 5ml ÷ 5 ÷ 5
5mg / 1ml
Answer = 5mg/ml
Practice
• Reduce the concentration:– DD = 5mcg/kg/min of Dopamine– You have a 400mg/5ml vial of Dopamine– You have a 250ml bag of Normal Saline
Practice
• Reduce the concentration:– DD = 5mcg/kg/min of Dopamine– C = 400mg / 250ml
Practice
• Reduce the concentration:– DD = 5 mcg /kg/min of Dopamine– C = 400mg / 250ml
Practice
• Reduce the concentration:– DD = 5 mcg /kg/min of Dopamine– C = 400mg / 250ml
• 400,000mcg / 250ml
Practice
• Reduce the concentration:– DD = 5 mcg /kg/min of Dopamine– C = 400mg / 250ml
• 400,000mcg / 250ml
÷ 250 ÷ 250
Practice
• Reduce the concentration:– DD = 5 mcg /kg/min of Dopamine– C = 400mg / 250ml
• 400,000mcg / 250ml
÷ 250 ÷ 250
1600mcg / ml
Practice
• Reduce the concentration:– DD = 5 mcg /kg/min of Dopamine– C = 400mg / 250ml
• 400,000mcg / 250ml
÷ 250 ÷ 250
1600mcg / ml
Goal
• The goal of drug calculations is to figure out how you will deliver the dose.
• To do this, you must always find a solution in volume or gtts/min form.
• We can not give 5mg if we do not know how much volume it takes to give the 5mg.
Lesson Two
• This concludes lesson two
