DRUG DOSAGE CALCULATIONS

Dr. RAMANUJAM NARAYANAN, MBBS, MD (PHARMACOLOGY), PhD,

PROFESSOR (PHARMACOLOGY),
Department of Pharmacology,
PSG IMS & R

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 % CONCENTRATION

V/V
•ML (Preparation) × % concentration =
ml (component)

W/V
•ML (Preparation) × % concentration =
g (component)

W/W
•G (preparation) × % concentration = g
(component)

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 Number of doses

HOUSEHOLD ABBREVIATION METRIC MEASURE

MEASURE

1 teaspoon Tsp 5 ml

1 tablespoon Tbsp 15 ml

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 Dosing based on age

– Young’s rule based on age

• [ = dose (child)
– Cowling’s rule

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 Body Mass Index (BMI)
• BMI = Weight (kg) / Height (sq. m) = 703 x
Weight (lb) / Height (sq.in)
BMI Scaling classification
< 18.5 Underweight
18.5-24.9 Normal
25-29.9 Overweight
30-34.9 Obesity class I
35-39.9 Obesity class II
> 40 Extreme Obesity

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 Total Body weight (TBW)

• TBW = LBW + Adipose weight

– LBW = Lean BW
– In obese patients, Adipose weight is higher than
LBW
– In obese patients, LBW / Adipose weight ratio
increases more than in normal weight people

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 Obesity dosing
IBW = IDEAL •IBW (kg) = 45.4 + 0.89 * Height (cm) – 152.4 + 4.5 (if male)
•IBW (kg) = 45.4 + 0.89 * Height (cm) – 152.4 (If Female)
BODY WEIGHT
ADJUSTED BODY •ABW = correction factor * (TBW – IBW) + IBW
•Correction factor ~ 0.6 (Aminoglycosides)
WEIGHT (ABW) •TBW = Total BW (Kg)

BSA (sq.m) = BODY •

BSA = √[{TBW * Height (cm)}/3600]
SURFACE AREA
LBW = LEAN BODY •LBW (kg) – males = [9270 * TBW (kg)] / [6680 + 216 + BMI (kg/sq.m)]
WEIGHT (LEAN BODY •LBW (kg) - females = [9270 * TBW (kg)] / [8780 + 244 + BMI
(kg/sq.m)]
MASS)

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 Anthropometric drug dosing
• [age (months) × adult dose] / 150 = infant’s dose
– Fried’s rule for infants

• [Weight (lb) × adult dose] / [150 × average adult weight (lb)] =

child’s dose
– Clark’s rule based on weight

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DIGOXIN DOSAGE BASED ON AGE &
WEIGHT OF PEDIATRIC PATIENT
AGE DIGOXIN DOSE (mcg / ml)

Premature 15-25

Full term 20-30

1-24 months 30-50

2-5 years 25-35

5-10 years 15-30

Over 10 years 8-12

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 Dosing based on body weight & Surface
area

• = patient’s dose (mg)

• 𝑝𝑎𝑡𝑖𝑒𝑛𝑡′ 𝑠 BSA (m 2)× [𝑑𝑟𝑢𝑔 𝑑𝑜𝑠𝑒 (𝑚𝑔))/(1.73 (m 2)] = patient’s dose

(mg)

– BODY SURFACE AREA (BSA) =

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 UNITS OF ACTIVITY

𝑢𝑛𝑖𝑡𝑠𝑜𝑓𝑎𝑐𝑡𝑖𝑣𝑖𝑡𝑦(𝑔𝑖𝑣𝑒𝑛) 𝑢𝑛𝑖𝑡𝑠𝑜𝑓𝑎𝑐𝑡𝑖𝑣𝑖𝑡𝑦(𝑑𝑒𝑠𝑖𝑟𝑒𝑑)
=
𝑤𝑒𝑖𝑔h𝑡𝑜𝑟𝑣𝑜𝑙𝑢𝑚𝑒(𝑔𝑖𝑣𝑒𝑛) 𝑤𝑒𝑖𝑔h𝑡𝑜𝑟𝑣𝑜𝑙𝑢𝑚𝑒(𝑑𝑒𝑠𝑖𝑟𝑒𝑑)
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 CREATININE CLEARANCE EQUATIONS
• Adjusting creatinine clearance (CrCl) for BSA:

• Schwartz equation:
– For pediatric & adolescent patients –

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 Contd…
• Cockcroft-Gault equation:

• Jelliffe equation:

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Intravenous infusion formulae

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 Adult nutrition:
Harris-Benedict’s equation
• Basal energy expenditure (BEE) – Harris-
Benedict equation:

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 Lean Body Mass:
Cunningham’s equation

• RMR = 500 + 22 (LBM)

– RMR = Resting Metabolic Rate

– LBM = Lean Body Mass

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DOSE CALCULATION EXERCISES

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 Q1
A 45 year old male engineer, 65 kg BW, is suffering from acute decompensated
Heart Failure along with hypovolemic shock. He is a known case of
hypertension, and is also suffering from chronic renal insufficiency (GFR ~ 70
ml/min) since 6 months with type II diabetes mellitus on Metformin 500 mg
BD.
a) Calculate the dose based infusion flow rate (ml/hr) of Dobutamine IV if
2.5 mcg were to be infused every hour per Kg BW. Assume the drug
concentration in the Dobutamine vial is 5 mcg/ml vehicle.
b) Can you give [Metformin + Sulfonylurea] combination instead of only
Metformin orally in this patient? Justify with reason(s).
c) Name TWO emergency drugs for treating this patient’s hypovolemia. What
are the adverse effects of these drugs?
d) What are vasopressors? Give two examples of vasopressors.
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 Q2
A 32 year old female artist is to be given Heparin 20000 IU in 5%
Dextrose IV (500 ml) and Gentamicin 40 mg/ml IV for prevention of
DVT and bacterial meningitis via parenteral routes, respectively. He is
also suffering from Acute Renal Failure (Cr.CL ~ 55 ml /min).
a) Calculate the dose of Heparin that reaches the patient’s body if it is
given for 30 minutes in 5 % Dextrose solution of 750 ml total volume.
b) How the dose of IV Gentamicin is to be altered in this patient? Why?
c) If Heparin overdose causes excessive thrombocytopenia and
bleeding, what is the antidote of choice?
d) If the patient is posted for Hemodialysis, can the physician give the
same dose of Heparin & Gentamicin? Justify.

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