HUMS Hospital

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Objective
To develop a standalone dosage calculator integrated within the clinical system to assist doctors in calculating adult and paediatric medication dosing based on patient parameters and manually entered dosing references.

This phase will not require full MIMS integration for automated dosage recommendations. The calculator should first support manual dose entry while utilizing available patient clinical data from the system.

• Fetch patient demographic and clinical parameters automatically from existing modules
• Allow users to manually enter medication dosing references

• Dose per administration
• Daily dose
• Volume per dose based on available medication strength
• Support both adult and paediatric calculations
• Support renal function-based calculations using existing creatinine clearance/eGFR formulas

Data Fetching Requirements
Parameter : Source
Age : Clinical / Medcare Demographic
Gender : Clinical Data
Weight (kg) : Vitals
Height (cm) : Vitals
BMI : _ * Vitals*
Serum Creatinine : _Clinical Lab Results (if available)/ manual
Creatinine Clearance : EXPLANATION WITH FORMULA IS WRITTEN MOST

Functional Requirements
1. Patient Information Section
System shall auto-populate:

• Age
• Gender
• Weight
• Height
• BMI
• Serum Creatinine (if available)
• eGFR / Creatinine Clearance

If no values are available: User may manually enter values.

2. Medication Input Section
Phase 1 (Without Full MIMS Integration)
User shall manually enter:

Desired Dose : Free Text
Frequency : Free text
Available Medication Strength : Free Text Numeric

3. Dosage Calculation Logic
System shall support:

A. Weight-Based Dosing (mg/kg)
Formula:
Required dose = Selected dose (mg/kg) × Weight (kg)

If divided doses:
Dose per administration = Total daily dose / Number of doses per day

4. Medication Strength Conversion
System shall calculate volume required based on available medication strength.

Example:
Medication strength = 228mg/5mL
1mL = 45.6mg
Required dose = 125mg
Volume required:
125 / 45.6 = 2.74mL

5. Calculation Output
System shall display Output :

Total Daily Dose
Dose Per Administration
Frequency
Renal Function (if applicable)

6. Example Workflow
Example: Syrup Augmentin
Input:
Weight = 10kg

Dosing reference = 15–25mg/kg/day in 2 divided doses

User selected dose = 25mg/kg/day

Frequency = BD (twice daily)

Medication strength = 228mg/5mL

Calculation:
25 × 10 = 250mg/day

250 / 2 = 125mg per dose

228mg / 5mL = 45.6mg/mL

125 / 45.6 = 2.74mL per dose
Output:
125mg BD
2.74mL per dose

• Drug Name (Generic + Brand)
• Standard Adult Dose
• Paediatric Dose References
• Maximum Dose Limits
• Drug Contraindications
• Renal Dose Adjustment
• Drug Interaction Alerts

1. Be accessible within prescribing workflow
2. Allow quick manual dose entry
3. Auto-fetch patient clinical data
4. Display calculations instantly upon input
5. Allow users to override manually entered dose selections

1. The calculator is intended as a clinical support tool only.
2. Final prescribing responsibility remains with the clinician.
3. System should not auto-prescribe medications.
4. No hard stop validation required in Phase 1.
5. Maximum dose checking will only be available after MIMS integration.

The Cockcroft-Gault (CG) equation estimates creatinine clearance (CrCl) in mL/min, factoring in age, weight, serum creatinine, and gender. It is primarily used for drug dosing adjustments rather than staging chronic kidney disease.
The formula is:
(CrCl) = (140 - age) X {Weight (kg)} / 72 X {Serum Cr (mg/dL)} X (0.85 if female).

Key Considerations for the Formula:
Units: Age (years), Weight (kg), Serum Creatinine (mg/dL).
Female Adjustment: Multiply the final result by (0.85).
Weight Metric: While often using total body weight, studies suggest using ideal body weight (IBW) or adjusted body weight in obese patients to avoid overestimation.

Limitations: It assumes stable renal function and may be inaccurate in patients with extreme body mass index (BMI) or rapid changes in kidney function.
Commonly Used Formulas for Ideal Body Weight (IBW) (Devine formula):
Males: 50 kg + 0.91 x (Height in cm - 152.4)
Females: 45.5 kg + 0.91 x (Height in cm - 152.4)