Chapter 12 Objectives Calculate dosages using the dosage formula and/or dimensional analysis Use drug labels to gather dosage information to calculate the supply on hand Shade syringes to the proper dosage per the doctor’s order Convert among systems to calculate dosages Convert a drug order to the format of the supply on hand Continue to next slide

Parenteral Dosage Unit 12

Parenteral Dosage Page 253 Parenteral medications are not taken orally. Instead, these medications may be in the form of injections, inhalants, patches, or suppositories. The common parenteral routes are: Route Abbreviation Entry point intradermal ID between the layers of skin intramuscular IM into a muscle intravenous IV into a vein subcutanous sub-Q under the skin Another abbreviation that is off limits for charting

Pages 255 – 256 Injections Injections are mixtures of pure drug dissolved in an appropriate liquid. The dosage or solution strength will be be provided on the medication label and will be given in milligrams per milliliter as a ratio or as a percent. It is important to remember that parenteral doses are calculated based on the amount of drug contained in a specific volume of solution. Parenteral dosages are prescribed in grams (g), milligrams (mg), units, or in milliequivalents (mEq). Example of Dosage Given Form Dosage Interpretation Neurontin 250 milligrams/ 5 milliliter milligram per milliliter 5 milliliters contains 250 milligrams of Neurontin Epinephrine 1 : 1000 ratio 1000 milliliters contains 1 gram of Epinephrine Lidocaine 2.5% percent 100 milliliters contains 2.5 grams of Lidocaine The Do Not Use List from the Joint Commission suggests that the abbreviation for “units” not be used. Just write “units”.

Syringes Page 256 Continue to next slide 3 cubic centimeter per milliliter syringe 1 milliliter per milliliter syringe, which is also called the tubercullin syringe The insulin syringe, which come in various sizes. The dilution of insulin is such that 1 milliliter of insulin fluid has 100 standard units of insulin. Note that “cubic centimeter” is not used much anymore, as it has been replaced with “millililiter.”

IM Injection Guidelines Page 257 IM Injection Guidelines There are guidelines for maximum volumes for injection sites. This is important for accurate dosage calculation and consideration of multiple syringes. Any dosage larger than the recommended amount is usually checked and verified with the physician, and the dosage is then divided equally or as close to equal as possible and given in two separate injection sites. Continue to next slide Client AGE Maximum Dos Per Site Adult 12+ 3 milliliters IM deltoid arm Child 6-12 years 2 milliliters 0-5 years 1 milliliter Infant Premature 0.5 milliliter

Units of Measures Pages 257 – 258 dosage (D) supply on hand (H) To calculate the dosage, there are several means of getting to the correct dose. One may use the dosage formula, ratio and proportion, or dimensional analysis. Choose your favorite and stick with it. dosage (D) supply on hand (H) medication given x quantity (Q) = Examples – pages 258-260 – practice 1: evens Group work – pages 258-260 – practice 1: odds dosage (D) : medication given :: supply on hand (H): quantity (Q) quantity (Q) supply on hand (H) dosage (D) 1 medication given x =