copyright © 2015 cengage learning® chapter 9 parenteral medication labels and dosage calculation
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Copyright © 2015 Cengage Learning®
Chapter 9
Parenteral Medication Labels and Dosage Calculation
Copyright © 2015 Cengage Learning®Copyright © 2015 Cengage Learning®
Parenteral Routes
• IV (intravenous)– Most common
• IM (intramuscular)
• Subcutaneous– Second most common
• Intradermal
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Packaging
• Parenteral medications are available in ampules, vials, prefilled syringes, bag solutions, and bottled solutions.
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Labels of Parental Solutions
• The labels of oral parental solutions are very similar, but the size of the average parental dosage label is much smaller.
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IM Solutions
• Manufactured so average adult dosage is contained in a volume between 0.5 mL and 3 mL.
• Most dosages prepared using 3 mL syringe.
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Subcutaneous Solutions
• Manufactured so average adult dosage is contained in a volume between 0.5 mL and 1 mL.
• Most dosages prepared using 3 mL or TB syringe.
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IV Medication Preparation
• Administration usually two-step procedure:1. Prepare dosage
2. Dilute in IV fluids
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Solution Labels
• Metric/SI (examples)– morphine sulfate 4 mg/mL
– digoxin 75 mcg/mL
– cefazolin 1 gram/50 mL
• Percent (examples)– 1% lidocaine
– 10% calcium gluconate
– 0.45% sodium chloride(continues)
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Solution Labels (cont’d)
• Ratio (examples)– 5000 : 1 heparin
– 2500 : 1 heparin
– 1000 : 1 epinephrine
• International unit (examples)– heparin: 5000 international units
– Factor VIII: 4550 international units
– Factor IX: 2300 international units(continues)
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Solution Labels (cont’d)
• mEq (examples)– 20 mEq potassium chloride (KCl)
– 50 mEq sodium bicarbonate (NaHCO3)
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Safety Point
• Labels of most parenteral solutions are quite small.– Read with particular care.
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Example 1
• Prescription for atropine 1/150 grains subcutaneously
• Atropine vial labeled 0.4 mg/mL
• How many mL should be administered subcutaneously?
(continues)
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Example 1 (cont’d)
• Convert 1/150 grains to 0.4 mg
• Use basic formula:
0.4 mg0.4 mg
1 mL 1 mL
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Example 2
• Prescription for heparin 5000 units subcutaneously
• Heparin vial labeled 10,000 : 1 mL heparin
• How many mL should be administered subcutaneously?
(continues)
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Example 2 (cont’d)
• Use basic formula:
5, 000 units10,000 units
1 mL 0.5 mL
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Example 3
• Prescription for morphine sulfate 2 mg IV
• Morphine sulfate prefilled syringe contains 4 mg/mL
• How many mL should be administered intravenously?
(continues)
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Example 3 (cont’d)
• Use basic formula:
2 mg4 mg
1 mL 0.5 mL
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Example 4
• Prescription for promethazine sulfate 25 mg IV bolus
• Promethazine sulfate vial labeled 25 mg/mL
(continues)
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Example 4 (cont’d)
• IV drug resource states each 12.5 mg of promethazine sulfate should be diluted with 5 mL normal saline for injection prior to administration via IV bolus.
• How many total fluid and medication bolus mL should be administered intravenously?
(continues)
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Example 4 (cont’d)
• Each 12.5 mg requires 5 mL normal saline dilution
• To dilute 25 mg requires 10 mL of normal saline
• 10 mL normal saline + 1 mL (25 mg) medication = 11 mL total volume
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Example 5
• Prescription for 2550 international units Factor IX concentrate intravenously each day
• Pharmacy supplies Factor IX in concentration of 250 international units/5 mL
(continues)
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Example 5 (cont’d)
• How many mL should be administered per intravenous bolus?
(continues)
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• Use basic formula:
Example 5 (cont’d)
2550 units 5 mL 51 mL250 units
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