Drug Dilated

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Dilution of drugs

Name of drugs Route ml of diluting by distil


water
Ampicillin 500mg IV 5ml
Cloxacillin 500mg IV 5ml
Ceftriaxone 1gm IV 10ml
Ceftriaxone 500mg IV 5ml
Ceftriaxone 1gm IM 3.6ml
Ceftriaxone 500mg IM 1.8ml

CAF 500mg IV- IV 4ml


Hydrocortisone 100mg IV 2ml
C.penicillin 1 million IU IV 2ml or 3ml
B. penicillin 1.2 million IU IM only 4ml
B. penicillin 2.4 million IU IM only 8ml

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Dilution of drugs…
Name of drugs Route ml of diluting by distil
water

PPF 4Million IU IM 9ml


Diazepam 10mg IM/Iv 4ml
Diazepam 5mg IM/Iv

Hydralazine 20mg IV 1ml


Lasix 20mgI IV 2ml
Diclofenac 75mg IM 3ml

Dexamethasone4mg IM/IV 1ml


Adraline 1mg SC 1ml
Gentamicin 80mg- IV/IM 2ml
CpZ 50mg IV 2ml
Cimethidine 200mg IV 2ml

Plasil 10mg- IV 2ml


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Dilution of drugs…
• Example wt=8kg, ordered drugs, Ampicilin
50mg/kg,gentamicin 5mg/kg
Since the wt of pt`s was=8kg
1kg=50mg of Ampiccillin
8kg=?
=50mg x8kg/1kg
=400mg
500mg of Ampiccillin is diluted by 5ml
500mg = 5ml
400mg =?
=400mg x 5ml/500mg
=4ml
If the ordered ampicillin was per dose all 4ml given as one dose,if it is ordered as
dividing dose 4ml is divided as ordered frequency e.g if ordered as QID (four
times)/day 4ml divided into four ,1ml of ampicillin per dose

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Dilution of drugs…
Since the wt of pt`s was=8kg
1kg=5mg of Gentamicin
8kg=?
=5mg x8kg/1kg
=40mg
Since 80mg of Gentamicin is contain by 2ml
80mg = 2ml
40mg =?
=40mg x 2ml/80mg
=1ml per day
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Dilution of drugs…
• Example wt=5kg, ordered drugs, Cloxacillin
50mg/kg,QID
Since the wt of pt`s was=5kg
1kg=50mg of Cloxacillin
5kg=?
=50mg x5kg/1kg
=250mg
500mg of Cloxacillin is diluted by 5ml
500mg = 5ml
250mg =?
= 250mg x 5ml/500mg
=2.5ml
• Since it is ordered as QID (four times)/day 2.5 ml divided into four ,0.625 ~
0.6ml of Cloxacillin per dose
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Dilution of drugs…
• Example wt=6kg, ordered drugs, crystalline penicillin
50,000IU/kg ,
Since the wt of pt`s was=6kg
1kg=50,000IU of crystalline penicillin
6kg=?
=50,000IU x 6kg/1kg
=300,000IU
1 million IU of crystalline penicillin is diluted by 2ml
1 million IU = 2ml
300,000IU =?
=300,000IU x 2ml / 1 million IU
=0.6ml
• if it is ordered as QID (four times)/day 0.6ml divided into four , 0.15 ~ 0.2 ml
of crystalline penicillin per dose
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Dilution of drugs…
• Artesunate drugs given for severe malaria
• It can be given through IV/IM
• Dose of Artesunate based on pt`s weight
• If pt`s weight is equal and less than 20kg ,3mg/kg
• If pt`s weight is greater than 20kg ,2.4 mg/kg
• Steps of Artesunate dilution :-
first diluted by 1ml 0f Sodium bicarbonate wait for 2-3
second if it is changed into foam it must be discarded,
other wise diluting by 5ml of distil water & administering .

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Dilution of drugs…
• Example wt=10kg, ordered drugs, artesunate
3mg/kg ,
Since the wt of pt`s was=10kg
1kg=3mg of artesunate
10kg=?
=3mg x 10kg/1kg
=30mg
Since 60mgof artesunate is diluted by 1ml of Sodium bicarbonate,5ml of distil
water.
60mg = 5ml +1ml(6ml)
30mg =?
= 30mg x 6ml / 60mg
=3ml
• 3ml of artesunate is given at zero hours , at 12 hours, at 24hours
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Fluid preparation
General formula is
Vb = ( a - x ) Tv.
(a – x ) + ( x – b )

Va = ( x – b ) Tv.
(a – x ) + ( x – b )
• Where
x = conc. of DW wanted Vb = volume of b
a = highest conc. of DW Va = volume of a
b = lowest conc. of a of DW
Tv = total volume needed = ( Vb + Va )
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Fluid preparation …
How to prepare Total volume (Tv) of 10%DW
from 40%DW & 5% DW.
• Given
x = 10% Vb = Volume of 5%
a= 40 Va = volume of 40%
b = 5%
Tv = total volume needed = ( Vb + Va )

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Fluid preparation …
• Using the general formula
• Vb = ( 40 - 10 ) Tv. Va = ( 10 – 5 ) Tv.
(40 –10 ) + (10 – 5) (40 – 10 ) + ( 10– 5 )

Vb = (30)Tv/35 Va = (5)Tv/35

Example
Total daily fluid volume required by baby girl weighing 3000gm (3kg) is -
3 x 100 = 300 ml/day and type of fluid to be given is 10% DW:
Therefore
Tv = 300ml, Vb = 30 x 300/35 Va = 5 x 300
= 257.1ml = 42.85ml
Thus total volume = V of b (257.1) + V of a (42.85) ml
= 299. 95ml ( ~ 300 ml) 10% DW
N.B This fluid is calculated by using dextrose 5% And Dextrose (glucose)
40%,so Dextrose (glucose) 40%,
05/05/2024 Bachahas
Mergahigh
(BSCN)concentration of sugar when 11
Fluid preparation …
Simple ways
To calculate 10%DW from Dextrose 5% & Dextrose (glucose) 40%
10%DW= 0.85 X 10%DW from Dextrose 5% + 0.15 X10%DW
from Dextrose (glucose) 40%
Example if 10%DW=300ml is given
10%DW= 0.85 X 300ml from Dextrose 5% + 0.15x300ml from
Dextrose (glucose) 40%
10%DW= 255ml from Dextrose 5% + 45ml from Dextrose
(glucose) 40%
10%DW= 255ml + 45ml=300ml

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Fluid preparation …
Simple ways
To calculate 10%DW from Normal saline or Ringer lactate &
Dextrose (glucose) 40%
10%DW= 0.75 X 10%DW from Normal saline + 0.25
X10%DW from Dextrose (glucose) 40%
Example if 10%DW=300ml is given
10%DW= 0.75 X 300ml from Normal saline + 0.25x300ml from
Dextrose (glucose) 40%
10%DW= 225ml from Normal saline + 75ml from Dextrose
(glucose) 40%
10%DW= 225ml + 75ml=300ml
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Maintenance fluid calculation

a/ pediatrics vs adults
• 1st 10kg………………………………….100ml/kg
• Next 10kg……………………………….50ml/kg
• The rest next kg……………………...20ml/25/kg
Example if pt`s wt=22kg the maintainance fluid required for
this pt`s;-
1st 10kg….100ml/kg 100mlx10=1000ml
Next 10kg…50ml/kg 50ml X10=500ml
The rest next kg…..20ml 20X2=40ml
The amount maintenance fluid required for this pt`s is
MF=1000ml+500ml+40ml=1540/24hrs
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Maintenance fluid calculation…
• maintenance fluid For pediatrics
MF peda = 1/3 MF from NS/RL + 2/3 MF from 10%DW MF
Example if child wt =6kg,
MF=600ml by using fluid calculation formula
MF peda = 1/3 600 from NS/RL + 2/3 600 from 10%DW MF
= 200ml from NS/RL + 400 from 10%DW MF
=200ml +400ml=600ml/24hrs
10%DW= 0.85 X 10%DW from Dextrose 5% + 0.15 X10%DW from Dextrose
(glucose) 40%
=0.85x400 from Dextrose 5% +0.15x400ml from glucose 40%
=340ml from Dextrose 5% + 60 from glucose 40%
=400ml 10%DW
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Maintenance fluid calculation…
Maintenance fluid Burn
• MF = 4ml/kg/%TBSA burn in first 24 hours
• N.B for burn half of maintenance fluid run
over 8hrs ,the rest half run over 16hours

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