PHARMACOLOGY III
DOSAGE CALCULATION IN PHARMACOLOGICAL EXPERIMENTS
EXPERIMENT – 1
DOSE CALCULATION IN PHARMACOLOGICAL EXPERIMENTS
Children and old people need lesser amount of drug than the standard adult dose.
Children need smaller doses in proportion to their age. Infants are also found
intolerant to certain drugs [opium] tolerant to others [belladonna].
Following are the reasons why neonates need different doses as compared to adults:
1. Compare to the adult, water content in neonates is higher [75%],
2. Membrane permeability and blood brain barrier permeability is greater neonates
as compared to adults.
3. Protein binding is considerably less in the neonates as compared to adults.
4. Hydroxylation and glucuronidation are very slow to develop while sulfate
conjugation is much faster in neonates.
5. Glomerular filtration at birth is 30-40% that of the adult and it increases to about
50% after 5 days. It reaches adult rate at about 5months of age.
Similarly transition from middle to old age is accompanied by substantial changes:
Age related changes in upper gastrointestinal functions [achlorhydria,
changes in motility or diminished blood flow].
Decrease in serum albumin concentration.
Reduction in liver microsomal drug metabolising activity.
Decrease in renal functions.
DOSAGE CALCULATIONS
Rules for Infant’s and children’s doses:
1. Young’s Rule (for children 2 years and above ):
Age ( yr )
× Adult dose=C h il d ' s dose ( ¿ ) .
Age ( yr )+ 12
2.Clark’s Rule:
Weigh t (lb)
× Adult dose=C hil d' sdose(¿) .
150
3. Fried’s Rule (for infants upto 2 years ago)
Age (mont h s )
× Adult dose=Infan t ' s dose ( ¿ ) .
150
Rules for calculating dosage on prescription orders :
1. To find the amount of an ingredient /dose in a compound prescription order,
divide the total amount of ingredients prescribed by the number of doses
administered.
2. To find the total amount of an ingredient used in a compound prescription order,
multiply the amount /dose prescribed by the total number of doses.
3. The squaremeter surface area method relates to the surface area of the individual
to dose.
Body surface areaof c h ild '
× Adult dose =C h il d sdose ( ¿ ) .
Body surface area of adult
The average body surface area for an adult has been given as 1.73 sq. meters:
2
Body surface areaof c h ild (m )
× Adult dose=C hil d' sdose .
1.73 m2
Many drugs have doses stated in mg/kg. Body weight and may be calculated as
follows :
Amount of drug ×body surface area ( m2) =Individual' s dose .
4. Drug doses are often stated in mg/kg body weight and may be calculated.
5. Drug doses may also be started in units , e.g.: vitamin D ,antibiotics and
hormones. This means that a certain quantity of biologic activity of the drug is
called 1 unit.
These schedules are more of theoritical interest (with simple drug) hands of
pediatric practice.
SEX: Females requires 0.85 of the male dose , partly because of their lesser weight
and partly because they are more receptive to drugs. Females have to be given
moderate doses during (a) Menstruation, (b) Pregnancy, (c) Lactation.
Strong purgatives (e.g. aloes) have to be avoided during menstruation,whereas
drugs which stimulate contractions of the uterus (e.g. Anticholinesterases, pituitary,
ergot) have to be avoided during pregnancy since they may provoke abortion or
miscarriage. Morphine is transplacentally transmitted and depresses foetal
respiration therefore, it should be avoided. When the mother is breastfeeding the
baby (i.e. during lactation) ,drugs excreted through the milk are to be given with
caution. Drugs like antihistaminics, morphine and chloramphenicol etc. are highly
excreted in mother’s milk.
Body weight: While administering potent drugs, weight of the person is to be
considered, e.g. a slender build would need less drug than a hafty patient.
Route, Method and Time of drug administration:
A drug is absorbed quicker and more completely in soluble form as against a
powder, pill, tablet or capsule. The method of drug administrations is also of
importance. Injections are swiftly and completely absorbed, in approximately the
following order of speed: Intravenous, intramuscular, and subcutaneous . Drugs are
better and more quickly absorbed on an empty stomach as against a full stomach.
Iron salts are given after meals to prevent irritation, whereas appetizers are given
before meals as their names suggest and digestants after meals. Laxatives are better
administered at night and purgatives in early morning, since the latter are brisk in
action. Aspirin is less effective if taken at night whereas, sleeping pills like
barbiturates or diazepam are less effective if taken during day time.
