Parenteral Dosage of Drugs Chapter 11 Calculation of Drug Dosage: Parenteral 2 Calculation of Drug Dosage: Parenteral • Order – Cleocin 150 mg IM every 12 hours • Available – Cleocin (clindamycin phosphate) 300 mg per 2 mL 3 Calculation of Drug Dosage: Parenteral • Step 1. Convert – No conversion is necessary. 4 Calculation of Drug Dosage: Parenteral • Step 2. Think – You want to give less than 2 mL – Actually, you want to give 150 mg, which is of 300 mg and 1 of 2 mL, or 1 mL 2 – Calculate to double-check your estimate. 1 2 5 Calculation of Drug Dosage: Parenteral • Step 3. Calculate 300 mg 150 mg 2 mL X 300 X 300 X 1 mL 6 Calculation of Drug Dosage: Parenteral • Given intramuscularly every 12 hours • Select a 3 mL syringe • Measure 1 mL of Cleocin 300 mg per 2 mL 7 Ratio-Proportion Method: Parenteral with Conversion • Order: Robinul 150 mcg IM stat • Supply: Robinul 0.2 mg per mL 8 Ratio-Proportion Method: Parenteral with Conversion • Step 1. Convert – Equivalent: 1 mg = 1,000 mcg 1,000 mcg X 1 mg 0.2 mg X 200 mcg 9 Ratio-Proportion Method: Parenteral with Conversion • Step 2. Think – Give less than 1 mL but more than 0.5 mL • Don’t be fooled into thinking 0.2 mg is less than 150 mcg • 0.2 mg is more than 150 mcg • 0.2 mg = 200 mcg 10 Ratio-Proportion Method: Parenteral with Conversion • Step 3. Calculate 200 mcg 150 mcg 1 mL X 200 X 150 X 0.75 mL 11 Ratio-Proportion Method: Parenteral with Conversion • Given intramuscularly immediately • Select a 1 mL syringe • Measure 0.75 mL Robinul 0.2 mg per mL • You may have to change needles, as this is an IM injection. 12 Guidelines for Syringe Selection • Standard doses more than 1 mL – Round to tenths and measure in a 3 mL syringe – 3 mL syringe is calibrated to 0.1 mL increments • 1.53 mL is rounded to 1.5 mL • Drawn up in a 3 mL syringe 13 Guidelines for Syringe Selection • Small (less than 1 mL), critical care, or children’s doses – Round to hundredths and measure in 1 mL syringe – 1mL syringe is calibrated in 0.01 increments • 0.257 mL is rounded to 0.26 mL • Drawn up in a 1 mL syringe 14 Guidelines for Syringe Selection • Amounts of 0.5 –1 mL calculated in tenths • Can be accurately measured in either a 1 mL or 3 mL syringe 15 Insulin Label Manufacturer Concentration Type Expiration Date Brand Name Storage Species Generic Name 16 Combination Insulin Dosage 40 units NPH Units-100 insulin 12 units Regular Units -100 insulin Total insulin dosage = 52 units 17 Preparing Combination Insulin Dosage 1. Inject 30 units of air. 2. Inject 10 units of air. 18 Preparing Combination Insulin Dosage 3. Withdraw 10 units regular. 4. Withdraw 30 units NPH for a total of 40 units. 19 Insulin Sliding Scale • Order – Humulin R Regular units-100 insulin subcut based on glucose reading at 1600 20 Insulin Sliding Scale * Insulin Dose Glucose Reading* No coverage Glucose less than 160 2 units 160–220 4 units 221–280 6 units 281–340 8 units 341–400 Glucose is greater than 400: Hold insulin; call MD stat. 21