PEDIATRIC

CALCULATIO
NS
 LEARNING OBJECTIVES
✔ Discuss why children require
different dosages of drugs than
adults.
✔ Explain the calculations used to
determine a safe pediatric dose of
a drug.
PEDIATRIC CONSIDERATIONS
✔ An adult’s body handles drugs differently
and may respond to drugs differently than
a child.
✔A child’s body may handle a drug
differently in all areas of
pharmacokinetics—absorption,
distribution, metabolism, and excretion.
PEDIATRIC CONSIDERATIONS
✔ The responses of the child’s organs to the
effects of the drug may vary because of
the immaturity of the organs.
✔ Most of the time a child requires a
smaller dose of a drug to achieve the
comparable critical concentration as that
for an adult.
 FRIED'S RULE
✔ A calculation method that applies to
a child younger than 1 year of age.
✔ The rule assumes that an adult dose
would be appropriate for a child
who is 12.5 years (150 months) old.
FRIED'S RULE
 PROBLEM # 1
✔ If an adult dose of a particular
medication is 50 mg, what is
the dosage of a 10 months old
infant?
SOLUTION
 PROBLEM # 2
✔ Calculate the dose for a 1 year
old baby, where the adult dose
of the medicine is 400 mg.
SOLUTION
 YOUNG'S RULE
✔ A calculation method that applies to
children 1 to 12 years of age.
✔ The general formula is:
 PROBLEM # 1
✔ If an adult dose of a particular
medication is 100 mg, what is
the dose for a 10 year old
child?
SOLUTION
PROBLEM # 2
✔ A 3-year-old child weighing 30
lb is to receive a therapeutic
dose of aspirin. The average
adult dose is 5 grams, and the
dose to be given is the unknown
.
SOLUTION
 CLARK'S RULE
✔ It uses the child’s weight in pounds to
calculate the dose and assumes that the
adult dose is based on a 150-lb person.
✔ The general formula is:
PROBLEM # 1
✔A child weighs 40 lbs and is
5 years old. The adult dose is
250 mg. Calculate the
correct dose for the child?
SOLUTION
PROBLEM # 2
✔ A 2 years old child weighs
11.4 kg. The adult dose is
125 mg. Calculate the
correct dose for the child.
SOLUTION
SAFE
•Doctors orders Benadryl for a child that weighs 98
lbs. The safe dose for Benadryl is 5mg/kg/day. What
is the safe dose per day for this child/

98 lbs x 1 kg x 5mg/day = 490

1 2.2 lbs 1 kg 2.2

=222.7272 or 222.7 mg/day

•A child weighs 52 lbs. The child has a fever and the doctor
orders Tylenol. The safe dose range 10-15mg q6 hr. What is
the maximum safe dose for this child per dose?

52 lbs x 1 kg x 15 mg q/6 hr = 780 mg/q6 hr =354.5454

1 2.2 1 kg 2.2

=354.5454 mg/6hr

= 354.5 mg/q6hr
•A child weighs 52 lbs. The child has a fever and the doctor
orders Tylenol. The safe dose range 10-15mg q6 hr. What is
the maximum safe dose for this child per day?

52 lbs x 1 kg x 15 mg q/6 hr = 780 mg/q6 hr =354.5454

1 2.2 1 kg 2.2 = 354.5 mg/q6

24 hr x 354.5 mg = 8508 = 1,418 mg/day

1day q6hr 6
• The doctor orders 200 mg of Ibuprofen every 8 hrs. the child's weighs 49 lbs. the
safe dosage range for this medication is 5-10 mg /kg/dose. What is the safe
dosage for this particular child ? Is this a safe dose for this child?

49 lbs x 1 kg x 5mg/day = 245 = 111.3636 or 111.37 mg/day

1 2.2 lbs 1 kg 2.2

49 lbs x kg x 5mg/dose = 245 = 111.3636 or 111.4 mg/dose

1 2.2 lbs kg 2.2

49 lbs x kg x 10 mg/dose = 490 = 222.7272 = 222.7 mg/dose

1 2.2 lbs kg 2.2
• The doctor orders Digoxin 0.92 mg daily for a child that weighs
16 lbs. The safe dosage for this medication is 8-12 mcg/kg/day. Is
this a safe dose order?

16 lbs x kg x 8 mcg/day x 1 mg = 128 mg = 0.0581818

1 2.2 lbs 1kg 1000 mg 2,200 =0.06 mg/day

16 lbs x kg x 12 mcg/day x 1 mg = 192 mg = 0.087272

1 2.2 lbs 1kg 1000 mg 2,200 =0.09 mg/day
 BODY SURFACE AREA
RULE
✔ The child’s surface area is determined with
the use of a nomogram.
✔ The height and weight of the child are
taken into consideration in this chart.
✔ The general formula is:
NOMOGRAM
✔ Draw a straight line
connecting the child’s
height to the child’s
weight.
✔ The BSA value, which is
calculated in square
meters, is found at the
point where the line
intersects the SA column.
PROBLEM # 1
SOLUTION
SOLUTION
PROBLEM # 2
SOLUTION
PROBLEM # 3
SOLUTION
SOLUTION
PROBLEM # 4
SOLUTION
SOLUTION
PROBLEM # 5
SOLUTION
SOLUTION
 MILLIGRAMS/ KILOGRAMS
OF BODY WEIGHT RULE
✔ This method of prescribing takes
into consideration the varying
weights of children and the need
for a higher dose of the drug
when the weight increases.
PROBLEM # 1
✔ If a child with postoperative
nausea is to be treated with
Vistaril (hydroxyzine), the
recommended dose is 1.1 mg/kg
by intramuscular injection.
 SOLUTION
✔ If the child weighs 22 kg:
✔ If the child weighs 6 kg:
SUMMARY