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

ADULT CRITICAL CARE IV DRUG INFUSIONS

Microdrip: 60 microdrops = 1 mL Macrodrip: 15 drops = 1 mL

Computation of IV infusion
Step1: Compute for the Concentration of the Drug Step2: Compute for the rate of infusion

CONCENTRATION OF DRUG

mL x (Preparation) mg x 1,000 mcg (Volume of Drug) mL 1 mg (Total volume: vol of drug + diluent) mL = Concentration mcg mL

RATE

kg x (Weight)

(Dose) mcg x 60 min kg/min 1 hr Concentration mcg mL = rate mL/hr

60 kg, 4 amps + 500 mL D5W

20 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 20mL Dopa+ 500mL D5W Total Volume : 520 mL

520 mL
1,538.5 mcg mL 60 kg x 5 mcg x 60 min kg/min 1 hr

__1mL___
x
1538.5 mcg

= 11.7mL hr = 11-12mL hr

DROP FACTOR METHOD

Computation of IV infusion
Step1: Compute for the Drop Factor

Step2: Compute for the rate of infusion

DROP FACTOR

mg (Amount of Drug) Volumeof diluent mL =

x 1,000 mcg
1 mg

60 min 1 hr

mcg mL min/hr

RATE

kg x (Weight)

(Dose) mcg kg/min

(Drop factor) mcg mL min/hr = rate mL/hr

DOPAMINE

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

60 kg, 4 amps + 500mL D5W

20 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 20mL Dopa+ 500mL D5W Amount of Dopamine : 800 mg

500 mL x 60 min 1 hr 26.66 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 26.66 mcg

= 11.25mL hr = 11-12mL hr

60 kg, 2 amps + 250mL D5W

10 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 10mL Dopa+ 250mL D5W Amount of Dopamine : 400 mg

250 mL x 60 min 1 hr 26.66 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 26.66 mcg

= 11.25mL hr = 11-12mL hr

60 kg, 2 amps + 500mL D5W

10 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 10mL Dopa+ 250mL D5W Amount of Dopamine : 400 mg

500 mL x 60 min 1 hr 13.33 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 13.33 mcg

= 22.51mL hr = 22-23mL hr

60 kg, 1 amp + 250mL D5W

5 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 5mL Dopa+ 250mL D5W Amount of Dopamine : 200 mg

250 mL x 60 min 1 hr 13.33 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 13.33 mcg

= 22.51mL hr = 22-23mL hr

60 kg, 1 amp + 100mL D5W

5 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 5mL Dopa+ 250mL D5W Amount of Dopamine : 200 mg

100 mL x 60 min 1 hr 33.33 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 33.33 mcg

= 9 mL hr

60 kg, 2 amps + 100mL D5W

10 mL x 40mg x 1,000 mcg mL 1 mg
Dopamine 200mg / 5mL ampule Preparation: 40mg/mL Dose: 5ug/kg/min Dilution: 10mL Dopa+ 100mL D5W Amount of Dopamine : 400 mg

100 mL x 60 min 1 hr 66.67 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 66.67 mcg

= 4.49 mL hr = 4 -5 mL hr

DOBUTAMINE

Dobutamine
250mg / 5mL ampule Preparation: 50mg/mL Dose: 2.5 20 mcg/kg/min

60 kg, 1 amp + 250mL D5W

5 mL x 50mg x 1,000 mcg mL 1 mg
Dopamine 250mg / 5mL ampule Preparation: 50mg/mL Dose: 5ug/kg/min Dilution: 5mL Dobu+ 250mL D5W Amount of Dopamine : 250 mg

250 mL x 60 min 1 hr 16.66 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 16.66 mcg

= 18 mL hr

60 kg, 2 amps + 250mL D5W

10 mL x 50mg x 1,000 mcg mL 1 mg
Dopamine 250mg / 5mL ampule Preparation: 50mg/mL Dose: 5ug/kg/min Dilution: 10mL Dobu+ 250mL D5W Amount of Dopamine : 500 mg

250 mL x 60 min 1 hr 33.33 mcg mLmin/hr 1mL min 60 kg x 5 mcg kg/min x hr___ 33.33 mcg

= 9 mL hr

RULE OF 6 METHOD

Computation of IV infusion
Step1: Determine volume of dopamine to be added to make solution using 6 mg dopamine /kg of patients weight

Step2: Compute for the rate of infusion

Dopamine Solution

6 mg Dopamine Patients weight kg x kg 200 mg 5 mL =____ mL Dopamine + ____ mL D5W to make a total infusion of 100 mL

RATE

kg (Dose) mcg x 60 min x (Weight) kg/min 1 hr Amt of Dopa mg Total volume mL

x 1,000 mcg
1 mg

= rate mL/hr

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

Step 1. Weight: 5 kg
6 mg 5kg kg x 30 mg ( Amt of Dopamine)

200 mg 5 mL = 0.75 mL Dopamine + 99.25 mL D5W

40 mg (Preparation of Dopa) mL

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

5 kg

5mcg 60 min x kg/min 1 hr

30 mg 1,000 mcg x 100mL 1 mg

= 5 mL/hr

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

Step 1. Weight: 35 kg
6 mg 35kg kg x 200 mg 5 mL 210 mg ( Amt of Dopamine)

40 mg (Preparation of Dopa) mL

= 5.25 mL Dopamine + 94.75 mL D5W

35 kg, 15mcg/kg/min

35kg x (Weight)

15mcg 60 min x kg/min 1 hr

210 mg 1,000 mcg x 100mL 1 mg

= 15 mL/hr