Please Check My Med Calc!!!!!

hypocaffeinemia, BSN, RN · Jan 24, 2009

#1.The physican orders 300mg amp to be given q6hrs to an infant that weighs 5kg. the rec. safe dose range is
50 - 100mg per kg per dose. Is this dose safe for this child?
order: 300mg x 5kg = 1500mg per dose
Safe dose: 50mg x 5kg = 250mg per dose
100mgx 5kg = 500mg per dose
the ordered dose of 1500mg per dose is too high.

The doctor ordered a dose of 300mg, not 300mg/Kg.

The safe dose range is 250-500mg, so the dose is safe.

#2. the phys. orders 50mg/kg of amp q6hrs. the child's weight is 3kg. the recommende safe dose is 50 - 100mg/kg . is this dose safe?
order: 50mg x3kg = 150mg per dose
safe dose: 50mg x 3kg = 150mg per dose
max : 100mgx 3kg = 300mg per dose
this ordered dose is safe. 150mg/kg/ per dose for this child.

You don't even need to do math for this one: He ordered 50mg/kg, and you're given that a safe dosage is 50-100mg/kg. The dose given to the child is 150 mg, not 150mg/kg.

This problem I had a little trouble with:banghead:
#3. the phys. orders 3mg/kg of neumbutal TID. the child weighs 12kg. the recommended safe dose range is 2.6 mg/kg TID with a max dose of 100mg. Is this dose safe?
I got no, but the system said YES, safe dose....
order: 3mg x 12kg = 36mg per dose x 3 = 108 mg total daily dose.
safe dose: 2.6mg x 12kg = 31.2mg per dose x 3 = 93.6mg total daily dose.
i figured since the dose went over 100mg max dosing that this order wasn't safe for the child? I would appreciate any assistance Thank you.....

I think the "2.6" is a typo here (after all, 2.6 isn't a range). The safe dose range for nembutal, per my sources, is 2-6mg/kg/dose, which would in the case of this child, be 12-72mg per dose, with no more than 100mg per dose. The maximum dose, in this drug's case, is the maximum at once, not in a day. 36 mg would meet both criteria for safe dosing.

Here's my sourcing, btw:

1.4.1.A.1 Intramuscular route
1.4.1.A.1.a Insomnia, Short-term treatment 1) The recommended pediatric dose of intramuscular pentobarbital is 2 to 6 milligrams/kilogram/dose given as a single injection, not to exceed 100 milligrams (Rowe, 1987; Prod Info Nembutal®, 1995).
4.1.A.7 MAXIMUM DOSE
a) The maximum recommended intravenous dose of pentobarbital in patients 17 years and younger is 2 to 6 milligrams/kilogram/dose up to 100 milligrams (Anon, 1984; Prod Info Nembutal®, 1995).

Daytonite, BSN, RN · Jan 24, 2009

#1. the physician orders 300mg amp to be given q6hrs to an infant that weighs 5kg. the rec. safe dose range is 50 - 100mg per kg per dose. is this dose safe for this child?

order: 300mg x 5kg =

1500mg per dose

- this is incorrect. the order is for

300mg q6h

. the patient should be given 300 mg at each dose because

that is what has been ordered

. we follow doctor's orders. to give 1500 mg would overdose the patient and be a medication error.

safe dose range: 50mg x 5kg = 250mg per dose and

100mg x 5kg = 500mg per dose so the safe range is

250 mg to 500 mg

per dose

. since the ordered dose is 300 mg and that falls between the 250 mg to 500 mg range, the dose the doctor ordered is a safe dose for this child.

#2. the physician orders 50mg/kg of amp q6h. the child's weight is 3kg. the recommended safe dose is 50 - 100mg/kg, is this dose safe?

order: 50mg x 3kg = 150mg per dose

[order: 50 mg/kg q6h] [one dose: 50 mg x 3 kg = 150 mg]

safe dose: 50mg x 3kg = 150mg per dose

and

max : 100mg x 3kg = 300mg per dose

so the safe range is 150 mg to 300 mg per dose. since the ordered dose is 150 mg this is a safe dose for this child.

this ordered dose is safe. 150mg/kg/ per dose for this child.

#3. the physician orders 3mg/kg of nembutal tid. the child weighs 12kg. the recommended safe dose range is 2.6 mg/kg tid with a max dose of 100mg. is this dose safe?

safe dose 2.6 mg x 12 kg = 31.2mg

safe range: 31.2 mg tid to 100 mg per dose, or 31.2 mg/3 to 100 mg, or

10.4 mg per dose to 100 mg per dose

.

ordered: 3 mg/kg for a 12 kg child, or 3 mg x 12 kg = 36 mg per dose which you will give tid (3 times a day). yes, this is a safe dose because it falls within the 10.4 mg to 100 mg range per dose.

this is a tricky one. read the problem carefully.

the recommended safe dose range is 2.6 mg/kg tid with a max dose of 100mg.

it says "with a max dose of 100 mg" but does not say that the 100 mg is divided into tid doses. therefore, it has to be a per dose amount. so, whatever you calculate as one dose amount for this patient to be safe must never go above 100 mg.

read carefully! you are having difficulty interpreting what is being said.

give drug x 30 mg tid means you give a 30 mg dose three times in a 24 hour period.
safe dose of drug x is 30 mg/kg/tid means that the entire calculated amount that is safe to give the patient has to be divided into three doses over the course of a 24-hour day. you will also see this written as mcg/kg/minute with iv calculations and will be asked to convert the problems to mg/hour and be told the patient's weight in pounds. the giveaway is that the units are all connected by forward slashes which means they are "married" to each other and must be treated as joined units.