PEDIATRIC

CALCULATIONS
 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
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