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<div id="how-to-calculate-drug-dose" class="section level1">
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<h1><strong>How to Calculate Drug Dose</strong></h1>
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<p>These conventions have been curated to show how to consider
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calculating cumulative and daily drug dose for a given exposure record.
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These are high-level examples meant to demonstrate how one might use the
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DRUG_STRENGTH table and they do not take into account switching or
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stockpiling.</p>
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<p><strong>1. Tablets and other fixed amount
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formulations</strong><br><br> <strong>Example</strong>: Acetaminophen
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(Paracetamol) 500 mg, 20 tablets.<br> <strong>DRUG_STRENGTH</strong> The
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denominator_unit is empty<br> <strong>DRUG_EXPOSURE</strong> The
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quantity refers to number of pieces, e.g. tablets.<br> <em>In the
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example</em>: 20<br>
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<code>Ingredient dose= quantity x amount_value [amount_unit_concept_id]</code><br>
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Acetaminophen dose = 20 x 500mg = 10,000mg<br> Daily dose =
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Acetaminophen dose/drug duration<br><br></p>
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<p><strong>2. Puffs of an inhaler</strong><br><br>
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<strong>Note</strong>: There is no difference to use case 1 above
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besides that the DRUG_STRENGTH table may put {actuat} in the denominator
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unit. In this case the strength is provided in the numerator.<br>
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<strong>DRUG_STRENGTH</strong> The denominator_unit is {actuat}<br>
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<strong>DRUG_EXPOSURE</strong> The quantity refers to the number of
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pieces, e.g. puffs<br>
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<code>Ingredient dose= quantity x numerator_value [numerator_unit_concept_id]</code><br>
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Daily dose = Ingredient dose/drug duration<br><br> <strong>3. Quantified
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Drugs which are formulated as a concentration</strong><br><br>
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<strong>Example</strong>: The Clinical Drug is Acetaminophen 250 mg/mL
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in a 5mL oral suspension. The Quantified Clinical Drug would have 1250
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mg / 5 ml in the DRUG_STRENGTH table. Two suspensions are dispensed.<br>
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<strong>DRUG_STRENGTH</strong> The denominator_unit is either mg or mL.
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The denominator_value might be different from 1.<br>
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<strong>DRUG_EXPOSURE</strong> The quantity refers to a fraction or
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multiple of the pack.<br> <em>In the example</em>: 2<br>
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<code>Ingredient dose= quantity x numerator_value [numerator_unit_concept_id]</code><br>
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<em>Acetaminophen dose</em> = 2 x 1250mg = 2500mg<br> Daily dose =
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Acetaminophen dose/drug duration<br><br> <strong>4. Drugs with the total
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amount provided in quantity, e.g. chemotherapeutics</strong><br><br>
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<strong>Example</strong>: 42799258 “Benzyl Alcohol 0.1 ML/ML / Pramoxine
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hydrochloride 0.01 MG/MG Topical Gel” dispensed in a 1.25oz pack.<br>
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<strong>DRUG_STRENGTH</strong> The denominator_unit is either mg or
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mL.<br> <strong>Example</strong>: Benzyl Alcohol in mL and Pramoxine
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hydrochloride in mg<br> <strong>DRUG_EXPOSURE</strong> The quantity
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refers to mL or g.<br> <strong>Example</strong>: 1.25 x 30
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<em>(conversion factor oz -> mL)</em> = 37<br>
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<code>Ingredient dose= quantity x numerator_value [numerator_unit_concept_id]</code><br>
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<em>Benzyl Alcohol dose</em> = 37 x 0.1mL = 3.7mL<br> Daily dose =
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Benzyl Alcohol dose/drug duration<br> <em>Pramoxine hydrochloride
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dose</em> = 37 x 0.01mg x 1000 = 370mg<br> Daily dose = Pramoxine
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hydrochloride dose/drug duration<br><br> <strong>Note</strong>: The
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analytical side should check the denominator in the DRUG_STRENGTH table.
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As mg is used for the second ingredient the factor 1000 will be applied
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to convert between g and mg.<br><br> <strong>5. Compounded
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drugs</strong><br><br> <strong>Example</strong>: Ibuprofen 20%/Piroxicam
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1% Cream, 30ml in 5ml tubes.<br> <strong>DRUG_STRENGTH</strong> We need
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entries for the ingredients of Ibuprofen and Piroxicam, probably with an
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amount_value of 1 and a unit of mg.<br> <strong>DRUG_EXPOSURE</strong>
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The quantity refers to the total amount of the compound. Use one record
|
||
in the DRUG_EXPOSURE table for each compound.<br>
|
||
<strong>Example</strong>: 20% Ibuprofen of 30ml = 6mL, 1% Piroxicam of
|
||
30ml = 0.3mL<br>
|
||
<code>Ingredient dose= Depends on the drugs involved: One of the use cases above.</code>
|
||
<em>Ibuprofen dose</em> = 6 x 1mg x 1000 = 6000mg<br> Daily dose =
|
||
Ibuprofen dose/drug duration<br> <em>Piroxicam dose</em> = 0.3 x 1mg x
|
||
1000 = 300mg<br> Daily dose = Piroxicam dose/drug duration<br>
|
||
<strong>Note</strong>: The analytical side determines that the
|
||
denominator for both ingredients in the DRUG_STRENGTH table is mg and
|
||
applies the factor 1000 to convert between mL/g and mg.<br><br>
|
||
<strong>6. Drugs with the active ingredient released over time,
|
||
e.g. patches</strong><br><br> <strong>Example</strong>: Ethinyl
|
||
Estradiol 0.000833 MG/HR / norelgestromin 0.00625 MG/HR Weekly
|
||
Transdermal Patch<br> <strong>DRUG_STRENGTH</strong> The denominator
|
||
units refer to hour.<br> <strong>Example</strong>: Ethinyl Estradiol
|
||
0.000833 mg/h / norelgestromin 0.00625 mg/h<br>
|
||
<strong>DRUG_EXPOSURE</strong> The quantity refers to the number of
|
||
pieces.<br> <strong>Example</strong>: 1 patch<br>
|
||
<code>Ingredient rate= numerator_value [numerator_unit_concept_id]</code><br>
|
||
<em>Ethinyl Estradiol rate</em> = 0.000833 mg/h<br> <em>norelgestromin
|
||
rate</em> 0.00625 mg/h<br> <strong>Note</strong>: This can be converted
|
||
to a daily dosage by multiplying it with 24. (Assuming 1 patch at a time
|
||
for at least 24 hours)</p>
|
||
</div>
|
||
|
||
|
||
|
||
|
||
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|
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