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Drug Calculations



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Jan 17, 2009 02:51 AM

Drug Calculations


I just returned to ICU nursing after being away from it for 5 years. Most everything has come back to me, however I'm still struggling with calculating drip rates. Our educator is useless, and I'm somewhat embarrassed to ask other nurses for help on this. Hoping someone hear can make it easy for me to understand. Thanks


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8 Comments
No. 1
from Mobiusrain
Old Jan 17, 2009, 03:06 AM

Default Re: Drug Calculations
Drip Rate per minute =

(Amount to infuse in mL) x (Drop Factor of IV set)
-------------------------------------------------------------
(No. of hrs to infuse) x 60

Basic formula ^.^
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No. 2
from burn out
Old Jan 17, 2009, 07:55 PM

Default Re: Drug Calculations
Do you not have IV pumps that do the calculations for you?
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No. 3
from RNFELICITY
Old Jan 18, 2009, 07:38 PM

Default Re: Drug Calculations
Originally Posted by burn out View Post
Do you not have IV pumps that do the calculations for you?
at one major hospital here in Cincinnati, they will not allow you to use the pumps to calculate...you have to do the math each titrationa dn double check with another nurse
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No. 4
from Mobiusrain
Old Jan 18, 2009, 08:44 PM

Default Re: Drug Calculations
Besides, it's always important to know how to do the math, not solely relying on infusion pumps to do the calculations.
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No. 5
from nycpicurn
Old Jan 24, 2009, 04:23 PM

Default Re: Drug Calculations
I feel your pain after being away from the bedside for 3 months on a family leave.
I think it is sad that your educator is useless, and there has to be one colleague that you
can turn to for a drip review? Better to be a bit embarrassed now then make a life altering mistake later though.

I work in a PICU and will give you some examples of how I calculate my drips. I also agree that we should never rely on the pump to do the calculations.

Dopamine (800mg in 250 cc bag) = a concentration of 32 mg/cc or 3200 mcg/cc. Dopamine runs in mcg/kg/min
so to calculate the drip multiply the patients weight x dose x 60 and divide by the concentration in mcgs to get the cc/hour to set the pump.

The order reads 20mcg/kg/min and my patient weighs 58 kg Sooooooooo here we go

20(dose) x 58(wt) x 60(min)
________________________ = 21.75 cc/hr
3200(mcgs)

Epinephrine (6 mg in 50 cc bag) = 0.12 mg/cc or 120 mcgs/cc Order read Epi drip 0.15 mcg/kg/min
0.12 x 58 x 60
____________ = 4.35 cc/hr
120

Milrinone (20 mg in 100 cc bag) = 0.2 mg/cc or 200 mcgs/cc Order read Milrinone 0.5 mcg/kg/min
0.5 x 58 x 60 = 8.7 cc/hr
____________
200

Morphine (5 mg per cc) Order read 0.18 mg/kg/hr
0.18 x 58 = 10.44 and then divide by 5 (the concentration ) to get 2.09 cc/hr

Nimbex (2 mg per cc or 2000 mcg per cc) Order read Nimbex 2.2 mcg/kg/min

2.2 x 58 x 60
_____________ = 3.82 cc/hr
2000
I hope this helps and just give another should out if you need more practice.
My first week back to work was nuts. Patient on Epi, dopa, vaso, morphine, versed, nimbex, calcium, mg, nexium
and CVVHDF. I completely leaned on my neighbors for both help and a confidence boost and that is o.k.

Good luck to you
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No. 6
from dorimar
Old Jan 29, 2009, 12:15 AM

Default Re: Drug Calculations
Always figure out concentration first--figure out the mg, mcg, or unit you want to deliver per ml to start. If the dosage is not weight based, and is only to be delivered per hour rather than per minute--you are done-you have your constant (constant X ml/hour = dose). However, if it is to be delivered per minute, divide that number by 60. Then, if it is to be weight based, divide that number by the patient's dry weight in Kg. This is your constant (never changes). Then you just multiply your constatn by the rate (ml/hour), so you always know what your dosage is with every rate change.
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No. 7
from MatVau40
Old May 12, 2009, 10:41 AM

Default Re: Drug Calculations
The facility I am at uses this "K Constant" formula for drip calculations for verifying the pump is set correctly. I struggled with learning this formula because I am a bit of a math/science purest and this "K" really isn't a constant. I have not found or seen the source documentation for this formula or an article that discusses the theory, rationale and application. Can someone cite a link?
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No. 8
from whitebunny
Old Oct 30, 2009, 09:08 PM

Default Re: Drug Calculations
mark~~~~~~~~~~~~~~~~~~
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