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November 13, 1987

A Formula for Calculating the Dosages of Drugs in Emergencies

Author Affiliations

Marshfield Clinic Marshfield, Wis

Marshfield Clinic Marshfield, Wis

JAMA. 1987;258(18):2528. doi:10.1001/jama.1987.03400180062019

To the Editor.—  I read with great interest the letters by Kirshenbaum1 and Byerly et al2 that suggested simple methods for calculating the dosages of drugs in emergencies. Dr Kirshenbaum's formula fixes the intravenous rate at 30 mL/h and calculates the amount of a cardiovascular drug to be added to 250 mL of dextrose as (x mg/kg/min) (y kg) (0.5), where x is the desired infusion rate (in micrograms per kilogram per minute) and y is the body weight (in kilograms). In 500 mL of dextrose, the formula simplifies further to (x mg/kg/min) (y kg). However, in these formulas the units are incorrect. The "minute" in the denominator should have been omitted.I would like to point out a problem in using this formula. In young infants, the drip rate cannot be increased without causing fluid overload. For example, say a dopamine drip is prepared to provide 5