01 critical care iv drug infusions - adult.ppt

8/14/2019 01 Critical Care IV Drug Infusions - Adult.ppt

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ADULT CRITICAL CARE IV DRUG INFUSIONS

Angelo P. Ampong, M.D., R.M.T.


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Microdrip:

60 microdrops = 1 mL

Macrodrip:

15 drops = 1 mL


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Computation of IV infusion

Step1: Compute for the Concentration

of the Drug

Step2: Compute for the rate of

infusion


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CONCENTRATION OF DRUG

mL

(Volume of Drug)x(Preparation) mg

mL

1,000 mcg

1 mgx

(Total volume: vol of drug + diluent) mL

= Concentration mcg

mL


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RATE

kg

(Weight)x (Dose) mcg

kg/min

60 min

1 hrx

= rate

mL/hr

Concentration mcgmL


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60 kg, 4 amps + 500 mL D5W

20 mL x40mg

mL

1,000 mcg

1 mg

x

520 mL

1,538.5 mcg

mL

Dopamine 200mg / 5mL ampule

Preparation: 40mg/mL

Dose: 5ug/kg/min

Dilution: 20mL Dopa+ 500mL D5W

Total Volume : 520 mL

60 kg x5 mcg

kg/minx

60 min

1 hrx

__1mL___1538.5 mcg

= 11.7mL

hr

= 11-12mL

hr


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DROP FACTOR METHOD


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Step1: Compute for the Drop Factor

Step2: Compute for the rate ofinfusion


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DROP FACTOR

mg

(Amount of Drug)

1,000 mcg

1 mgx

Volumeof diluent mL

= mcg

mL min/hr

60 min1 hr

x


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RATE

kg

(Weight)x

(Dose) mcg

kg/min

= rate

mL/hr

(Drop factor) mcgmLmin/hr


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DOPAMINE


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Dose Effects

1-2 mcg/kg/min dilates renal and mesenteric blood vessels

(no effect on heart rate or blood pressure).

2-10 mcg/kg/min beta effects on heart usually increase cardiac

output without increasing heart rate.

10-20 mcg/kg/min alpha peripheral effects cause peripheral

vasoconstriction and increased blood

pressure

20-40 mcg/kg/min alpha effects reverse dilatation of renal and

mesenteric vessels with resultant decreased

flow


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60 kg, 4 amps + 500mL D5W

20 mL x40mg

mL

1,000 mcg

1 mg

x

500 mL

26.66 mcg

mLmin/hr



Dose: 5ug/kg/min


Amount of Dopamine : 800 mg

60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

26.66 mcg

= 11.25mL

hr

= 11-12mL

hr

x


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10 mL x40mg

mL

1,000 mcg

1 mg

x

250 mL

26.66 mcg

mLmin/hr



Dose: 5ug/kg/min



60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

26.66 mcg

= 11.25mL

hr

= 11-12mL

hr

x


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10 mL x40mg

mL

1,000 mcg

1 mg

x

500 mL

13.33 mcg

mLmin/hr



Dose: 5ug/kg/min



60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

13.33 mcg

x

= 22.51mL

hr

= 22-23mL

hr


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60 kg, 1 amp + 250mL D5W

5 mL x40mg

mL

1,000 mcg

1 mg

x

250 mL

13.33 mcg

mLmin/hr



Dose: 5ug/kg/min



60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

13.33 mcg

= 22.51mL

hr

= 22-23mL

hr

x


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60 kg, 1 amp + 100mL D5W

5 mL x40mg

mL

1,000 mcg

1 mg

x

100 mL

33.33 mcg

mLmin/hr



Dose: 5ug/kg/min



60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

33.33 mcg

= 9 mL

hr

x


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10 mLx40mg

mL

1,000 mcg

1 mg

x

100 mL

66.67 mcg

mLmin/hr



Dose: 5ug/kg/min



60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

66.67 mcg

= 4 -5 mL

hr

x

= 4.49 mLhr


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DOBUTAMINE


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Dobutamine

250mg / 5mL ampule

Preparation: 50mg/mL Dose: 2.5 20 mcg/kg/min


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60 kg, 1 amp + 250mL D5W

5 mL x50mg

mL

1,000 mcg

1 mg

x

250 mL

16.66 mcg

mLmin/hr



Dose: 5ug/kg/min

Dilution: 5mL Dobu+ 250mL D5W


60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

16.66 mcg

= 18 mL

hr

x


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10 mLx50mg

mL

1,000 mcg

1 mg

x

250 mL

33.33 mcg

mLmin/hr



Dose: 5ug/kg/min

Dilution: 10mL Dobu+ 250mL D5W


60 kg x5 mcg

kg/min

60 min

1 hr

x

1mL min

hr___

33.33 mcg

= 9 mL

hr

x


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RULE OF 6 METHOD


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Step1: Determine volume of

dopamine to be added to makesolution using 6 mg dopamine /kg ofpatients weight

Step2: Compute for the rate ofinfusion


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Dopamine Solution

6 mg Dopamine

kg

Patients weight kgx

=____ mL Dopamine + ____ mL D5W to make a

total infusion of 100 mL

200 mg5 mL


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RATE

kg

(Weight)x

(Dose) mcg

kg/min

60 min

1 hrx

= rate mL/hr

Amt of Dopa mgTotal volume mL

1,000 mcg1 mg

x


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RULE OF 6 METHODCASE 1: 5 KG, 5 mcg/kg/min

h k


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Step 1. Weight: 5 kg

6 mg

kg

5kg

x

= 0.75 mL Dopamine + 99.25 mL D5W

200 mg

5 mL

30 mg ( Amt of Dopamine)

=40 mg (Preparation of Dopa)

mL

h k k


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Step 2. Weight: 5 kg, 5mcg/kg/min

5 kgx

5mcg

kg/min

60 min

1 hrx

= 5 mL/hr

30 mg100mL

1,000 mcg1 mgx


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RULE OF 6 METHODCASE 1: 35 KG, 15 mcg/kg/min

S W i h k


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Step 1. Weight: 35 kg

6 mg

kg

35kg

x

= 5.25 mL Dopamine + 94.75 mL D5W

200 mg

5 mL

210 mg ( Amt of Dopamine)

=40 mg (Preparation of Dopa)

mL

k /k / i


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35 kg, 15mcg/kg/min

35kg

(Weight)x

15mcg

kg/min

60 min

1 hrx

= 15 mL/hr

210 mg100mL

1,000 mcg1 mgx

01 critical care iv drug infusions - adult.ppt

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