DOSAGE CALCULATION
1. The normal therapeutic adult dose of a drug is 100mg (IV) two times a day. Its
clearance is almost entirely by glomerular filtration. A patient with renal
disease shows creatinine clearance of 33ml/min. what shall be the corrected
dose regimen of this drug for this patient in such a situation?
Ans:
Corrected dose = Normal dose X Patient Creatinine clearance
Normal Creatinine clearance
Corrected dose = 100mg x 33ml/min
100ml/min
= 33mg (IV) twice a day
2. In a male patient weighing 70kg male, determine the total body clearance for a
drug with an elimination half life of 3 hours and apparent volume of distribution
of 100mL/kg.
Ans:
Half life= 0.693 xVd --------------------------Equation--1
CL
Half life = 3 hours
Vd = 70kg x100ml/kg =7000ml
Substituting the values for half life and Vd in Equation -1 Above
3 hours=0.693x7000ml/CL
CL=0.693x7000ml
3Hours
=0.231x7000ml
=1617mlperhour
[Link] has a therapeutic plasma concentration of 1ng/ml and aVd of 7 L/Kg.
Oral bioavailability of Digoxin is 70% and clearance of 6.96 l/hr. Calculate
Loading dose and maintenance dose of Digoxin .
Answer:
Loading dose oral=Desired concentration(mg/L) X aVd (L/kg body weight)
= 0.001mg/L X 490L
0.7
= 0.001 X 490
0.7
= 0.7 mg
Maintenance doseoral = Dose rate(amount/hr)
Foral
= CL x Css
Foral
= 6.96 x 0.001
0.7
=0.0099 = 0.01 mg
4. A patient weighing 60 kg has been diagnosed with liver failure and is admitted in
ICU. Suddenly he developed cardiac arrhythmia. He needs to be treated with an
anti arrhythmic drug X. According to literature the pharmacokinetic parameters of
the anti arrhythmic drug X in individuals with normal liver function and body
weight 60 kg are: Clearance = 45 L/h, volume of distribution = 150 L. However, in
patients weighing 60 kg and having liver failure, clearance becomes 1/3rd of
normal and volume of distribution is doubled. Given these pharmacokinetic
changes in liver failure, calculate the loading dose and maintenance dose to
achieve a steady state concentration of 10 mg/L in this patient.
Answer:
The altered clearance in the above patient is 1/3 of 45 L/hr and the volume of
distribution is doubled that is 150LX2 =300L
CL = 15L/hr, Vd = 300 L, Css = 10mg/L
Loading dose = Vd x Css
= 300L x 10 mg/L
= 3000 mg intravenous bolus
Maintenance dose = CL x Css
= 15 L/h x 10 mg/L
= 150 mg/hr intravenous infusion.
[Link] has been prescribed to a patient weighing 70 kg presenting with
severe acute bronchial spasm not responding to other bronchodilators.
Aminophylline has to be administered to this patient as an i.v infusion at a rate of
0.8 mg/kg/hour. Aminophylline is available as 250 mg/10 ml ampoule. Write the
steps in the preparation of Aminophylline infusion and calculate the rate of
infusion.
Answer:
Steps: convert rate of infusion into mg/min ; i.e 0.8x70
60
Prepare infusion solution- mix 250mg (10ml Aminophylline) in 490ml of normal
saline
Amount per minute = Rate of infusion
Strength of solution
= 0.8x70x500
60x250
= 5.6
3
Drops per minute = 5.6x15 = 28 drops/min
3
6 .An adult male patient of aged 40 years, weighing 60 kg came to hospital with
hypovolemic shock. He has oliguria. Apart from other measures and drugs, it is
decided to administer dopamine which is available as 40 mg/ml- 5ml vial. Write
the steps in setting up Dopamine drip for this patient.
Answer:
Dopamine available as 40mg/ml, 5ml vial
Rate of infusion = 2µg/kg/min x 60kgs = 120 µg/ min
To prepare IV infusion solution 200mg/5ml is mixed with 500ml of 0.9% Normal
saline
Strength of dopamine = 200 = 2 mg/ml x 1000 = 400 µg/ml
500 5
No. of drops/min infused using microdrip = Rate of infusion (µg/ min) x 60
Strength of solution
= 120 x60
400
= 18 drops/min
