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A Formula for Calculating the Dosages of Drugs in Emergencies-Reply

Wesley G. Byerly, PharmD; Joseph A. Barone, PharmD; Gerald Melnick, MD
JAMA. 1987;258(18):2529. doi:10.1001/jama.1987.03400180062021.
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In Reply.—  We are pleased to note the interest and concerns that have been raised regarding the development of drug administration guidelines for pediatric resuscitation. Our original letter identified two potential problems with the formula published in the American Heart Association (AHA) "Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care" for the preparation of isoproterenol, epinephrine, and norepinephrine infusions used in pediatric resuscitation.1 These original concerns regarding the volume of drug needed to prepare the infusions and the number of ampules of drug needed also can be raised with the formula proposed by Dr Chen.As the volume of drug to be added to an intravenous (IV) solution increases, the empty space in the IV container may not be sufficient to hold the additional volume, thereby necessitating the time-consuming process of withdrawing enough fluid from the IV container to allow for the addition of the drug. The


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