Specialties NICU

Published Feb 6, 2002

Could anyone please please :-) give me to formula for calculating the dosage and ranges for dopamine and dobutamine? I can't seem to find it. And some people explain it making it difficult.

:roll :roll

babynurselsa, RN

1,129 Posts

drs order X baby wgt in kg X 60 min

5mcg X 2.5kg X 60

Divide by rate ordered

750 - 0.5ml

multiply result by total volume

1500 X 30ml = 45,000mcg/syringe

convert medication in vial to mcg

40mg/ml = 40,000mcg/ml

divide result by 40,000 for the amount of Dopamine to add to syringe

45,000 divided by 40,000 = 1.125 ml

Subtract the amount of Dopamine from total volume of syringe so that Med added and D5w + volume of syringe

dobutamine is 12,500mcg/ml

just be sure to double check teh concentrations that you are using

NicuGal, MSN, RN

2,743 Posts

Dopamine drip (1cc/hr=10mcg/kg/min)

60 x kg = # mg to add to a total of 100cc

For double concentration

60 x kg =#mg to add to a total of 50cc

This will give you 20mcg/kg/min

Do the same for Dobutamine :)

So...for a standard concentration 1cc=10mcg/kg/min

1.2cc=12mcg/kg/min

Double concentration 1cc=20mcg/kg/minute

0.5cc=10mcg/kg/min

0.2cc=4mcg/kg/min

We have to have two RN's signatures on the order before it is made :)

Teshiee

712 Posts

OOh thanks a lot. You two have made my day. When it comes to math I swear I have an infarct there. :-)

We have to sign it twice as well. It is a very potent drug that does it job when need be. I was in training and the nurse was punching in numbers and I couldn't for the life of me figure it out. Thanks guys.:chuckle

AlaskaKat

84 Posts

Hi guys, I am just going back into NICU after five years of working L&D, and boy have I forgotten a lot! I am trying to remember the whole dopamine thing and am apparently having issues. Bear with me...

According to NicuGal if I want to mix standard strength I am to do the following:

So if I have a 2 kilo kid I would multiply 60 x 2 to get 120, which can't be right, right?? So what am I missing here?

Also, when a doc orders dopamine, he orders it in mcg/k/min, right, not as a rate of infusion?? so for example he orders dopamine at 5 mcg/k/min, and my kid weighs 2 kilos again, and I have mixed my dopamine standard (1 cc/hr = 10mcg/k/min) then I would run my pump at 0.5, right?

I guess I need serious remediation here...I forgot too much! I'll never be able to do this!

Gompers, BSN, RN

2,691 Posts

Yep, AlaskaKat, you got it right for the # mg. Everyone kind of calculates things in a different order, depending on where you've worked before, etc. but it all comes out the same in the end! Here is how we do it:

For standard concentration (10mcg/kg/min=1cc/hr) add 60mg times the # kg of the baby. Standard for 3 kg baby:

3 x 60= 180mg Dop should be added to 100cc

180mg x 1000= 180,000mcg Dop in 100cc IV bag

180,000mcg divided by 100= 1,800 mcg/cc Dop

1,800mcg/cc divided by 3kg= 600 mcg/kg/cc

600mcg/kg/cc divided by 60 minutes= 10mcg/kg/min per 1cc

For double concentration (20mcg/kg/min=1cc/hr) multiply the baby's weight by 120mg. Double for 500 gram baby:

0.5 x 120 = 60mg Dop added to 100cc

60mg x 1000= 60,000 mcg Dop in 100cc IV bag

60,000mcg divided by 100= 600 mcg/cc Dop

600mcg/cc divided by 0.5kg= 1,200 mcg/kg/cc

1,200mcg/kg/cc divided by 60 minutes= 20mcg/kg/min per 1cc

Dosages range from 2mcg/kg/min to 20mcg/kg/min. I suppose some places do as low as 1mcg/kg/min but I was told that that dose really doesn't do anything. Once you get down to 4mcg/kg/min it's basically for renal perfusion and really doesn't do much for the systemic blood pressure.

Our docs vary in how they write for infusion changes. Some write the IV rate and others write how many mcg/kg/min they want. Usually they write the # mcg because that way they don't have to worry about whether the pharmacy has sent standard or double concentrated dopamine or dobutamine.

Thank you thank you thank you!!!! It's all coming back now...

bluedevils83

9 Posts

Sorry for this question.....if physician orders Dobutamine at 2.5 mcg/kg/min and pt weighs 99.7 kg and dose on hand is 500mcg/250 ml, what would the rate per hour be in cc's?? I need to check my answer.....thanks in advance.

UTVOL3

281 Posts

hmmmm my brain does not compute a weight of 99.7 kg. :)

I am not sure what you are asking (mommy brain.) Your answer could be in mcg/min depending on how far you got with your calculation but yes you would have to convert it to ml/hr to run it on the pump. Hopefully someone will come along that can help you! If I am on the right track that bag is not going to last you very long!

SteveNNP, MSN, NP

2 Articles; 2,512 Posts

99.7 kgs! That's a little out of our realm! LOL

Check your concentration. You'd have to deliver WAAAY too much fluid to give that dose.

BittyBabyGrower, MSN, RN

1,823 Posts

Your bag would run out quick LOL Recheck the weight, your kid might be in failure LOL I hope you know I am joking LOL

prmenrs, RN

4,565 Posts

I don't take care of anyone >6K unless we're related!!

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