GUIA DE CÁLCULO DE GOTEOS Y DOSIS DE MEDICAMENTOS

<br /> <div class="Default" style="clear: left; float: left; line-height: 115%; margin-bottom: 1em; margin-right: 1em; text-align: justify;"> <img alt="" height="138" 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115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Introducción</span></b></div> <div class="Default" style="line-height: 115%; margin-bottom: 12pt; text-align: justify;"> <b><span style="font-size: 11pt; line-height: 115%;"></span></b><span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">En medicina se usan diferentes sistemas para medir, expresar dosis y presentaciones de medicamentos: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Concentración de fármacos: Ej.: morfina 10 mg/ 1ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Dosis de medicamentos: Dopamina: dosis 10 mcg/kg/min </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Ampollas de electrolitos o fármacos al 2%, 10%, etc. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Es importante tener comprensión de las unidades en las que los fármacos son indicados, y como convertir de una unidad a otra </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Nunca confundir <b>ml </b>con unidades cuando trabaje con dosis para fármacos tales como insulina o Heparina. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Tener mucho cuidado cuando se prepare y administren medicamentos que están indicados en unidades. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Las jeringas correctas deben ser usadas para medir unidades o ml y determinar que la dosis es la correspondiente a la indicación medica. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">En medicina o farmacología no se usa cm</span><span style="font-size: 7.0pt; line-height: 115%;">3 </span><span style="font-size: 11.0pt; line-height: 115%;">, sino que se debe emplear ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Reflexione sobre el calculo realizado: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">¿Es razonable el resultado? </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">¿Está dentro de los rangos a pasar? </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Si tiene dudas, revise la dosis y sus cálculos con otra persona. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Aumento de volumen al reconstituir </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Medicamentos que vienen en presentación en liofilizado (o polvo seco) necesitan ser reconstituidos con un diluyente o solvente antes de ser administrado. Generalmente el volumen final del medicamento reconstituido es mayor que el volumen de líquido que se agregó para disolver el liofilizado. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Los antibióticos en suspensión son un ejemplo que ilustra este desplazamiento a aumento del volumen final al disolver. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Ej.: Para preparar una suspensión de 100 ml de Amoxicilina, sólo se deben agregar 68 ml de agua. La Amoxicilina en polvo ocupa un volumen de 32 ml. Por lo que de los 100 ml de Amoxicilina 68 son de agua y 32 de Amoxicilina. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">¿Es importante este aumento del volumen final? </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Para la mayoría de los pacientes esto no tiene importancia porque se le administra el total del volumen que se prepara en una jeringa. Sin embargo esto puede ser importante cuando usted necesita administrarle una dosis que es menor que el total del contenido de la jeringa, lo que ocurre frecuentemente en pediatría y neonatología. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Se debe considerar el volumen final que resulta en la jeringa después de la dilución del medicamento para efectos de dosis de mg/ml. El volumen puede estar aumentado significativamente, y si no se toma en cuenta para el calculo, pueden haber errores en las dosis administradas (menor o mayor de lo indicado), especialmente cuando son dosis muy pequeñas las indicadas en neonatos. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Las cantidades de aumento de los medicamentos diluidos dependen del fármaco, fabricante y de su concentración. Se debe revisar la información incluida con los medicamentos por el fabricante para observar las estimaciones de aumento de volumen al diluir. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">1. SISTEMA INTERNACIONAL DE UNIDADES (SISTEMA MÉTRICO DE MEDICIÓN) </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Las principales unidades son aquellas usadas para medir peso, volumen y cantidad de una sustancia. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><b><span style="font-size: 11.0pt; line-height: 115%;">Peso: </span></b><span style="font-size: 11.0pt; line-height: 115%;">expresado en Kilos, kg, mg, mcg </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><b><span style="font-size: 11.0pt; line-height: 115%;">Volumen: </span></b><span style="font-size: 11.0pt; line-height: 115%;">expresado en litros, ml. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><b><span style="font-size: 11.0pt; line-height: 115%;">Cantidad </span></b><span style="font-size: 11.0pt; line-height: 115%;">de una Sustancia: expresado en Moles (Mol, milimoles) </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Pequeños volúmenes de líquidos son expresados en mililitros (ml) y se usan para describir pequeñas dosis. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">La concentración de un fármaco se expresa usualmente en miligramos (mg). </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Equivalencias Métricas: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1g = 1000 mg </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 mg = 1000 mcg o 1000 μg = 1000 gamas </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 litro = 1000 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 Mol = 1000 milimoles </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Solución molar o Molaridad de una Solución </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Molaridad es un término usado en química para describir concentraciones: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Cuando <b>una Mol </b>de una sustancia está disuelta en <b>UN LITRO </b>de solución, es conocida como una solución a <b>Un Molar </b>(<b>1 M</b>). Si 2 Moles de una sustancia están disueltas en 1 Litro de liquido, entonces se dice que es una solución 2 M (Molar). </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">2. PRESENTACION DE MEDICAMENTOS Y SOLUCIONES ENDOVENOSAS </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">a) Concentración en Porcentaje % </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Al expresar en Porcentaje (%) se quiere expresar una cantidad de sustancia sólida disuelta en un determinado volumen líquido. Para efectos prácticos corresponde al número de gramos disueltos en 100 ml. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">% peso/volumen = numero de gramos en 100 ml </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Ej.: al 5 % significa que hay 5 gr en 100 ml </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Siempre será la misma cantidad de fármaco presente en 100 ml independiente del volumen total. En el ejemplo, al 5 %, hay siempre 5 g disueltos en cada 100 ml de líquido, y habrá la misma concentración si es una bolsa de 500 ml o 1 litro de la solución. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Para encontrar la cantidad total del fármaco presente, el volumen total debe ser tomado en cuenta, por lo que 500 ml al 5% significa que la solución tiene un total de 25 gr. ( 5 gr/100 ml, 5 x 5 = 25 gr) </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">b) Concentración expresados en mg / ml </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Expresa el numero de miligramos del fármaco x mililitro de liquido (mg/ml). </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Las presentaciones parenterales usualmente están expresadas en el numero de miligramos (mg) disueltos en el volumen de liquido de la ampolla (1ml, 2ml, 5 ml, 10 ml, 20 ml) Ej.: Adrenalina 1mg/1ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">c) Conversión de concentración en Porcentaje % a concentración de mg/ml </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Multiplicar el porcentaje % por 10 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><b><span style="font-size: 11.0pt; line-height: 115%;">Ej.: Lidocaína 2% ampolla 10 ml = </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span lang="EN-US" style="font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US;">2 x 10 = 20 mg / ml = 200 mg/10 ml = 2 gr / 100ml (2000 mg/100 ml) </span></b><span lang="EN-US" style="font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">A veces es más útil convertir el la concentración expresada en porcentaje a concentraciones en mg/ml, x Ej.: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Cloruro Sodio 0,9% 0,9 gr / 100 ml 900 mg / 100 ml 9 mg/ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Glucosa 5% 5 g/100 ml 5000 mg/100 ml 50 mg/ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Si la solución esta expresada en %, es fácil convertir la concentración en mg/ml multiplicando el % x 10: Ej.: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Lidocaína 2% x 10 = 20 mg/ml Glucosa 5% x 10 = 50 mg/ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">d) Concentraciones: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Definida como 1 gramo en muchos mililitros </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 en 1.000 significa 1 gramo en 1000 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 en 10.000 significa 1 gramo en 10.000 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">De esto se puede decir que una concentración de 1 gr en 10.000 es mas débil que una de 1gr en 1.000 (mientras mas alto el numero, mas débil la concentración) </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Ej.: </span></b><span style="font-size: 11.0pt; line-height: 115%;">Adrenalina 1 en 1.000 equivale a 1 mg de adrenalina en 1 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Adrenalina 1 en 10.000 equivale a 1 mg en 10 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Para recordar fácilmente la concentración, se deben eliminar los 3 ceros que están después del punto: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Adrenalina 1 en 1.000 = eliminar 1.Ø Ø Ø = 1 en 1 lo que corresponde a 1mg en 1ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 en 10. 000 = eliminar 10.Ø Ø Ø = 1 en 10 = 1mg en 10 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Ejemplo de esta dilución: <b>Morfina 10% </b>= 10 mg/1 ml + 9 cc SF = 10 mg/10 cc = 1mg / 1cc </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Adrenalina 1 mg/1 ml </span></b><span style="font-size: 11.0pt; line-height: 115%;">= 1 ml + 9 cc SF = 1 mg/ 10 ml = 0,1 mg / 1 cc </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">e) Medicamentos expresados en Unidades </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Debido a la pureza de medicamentos tales como Insulina y Heparina de origen biosintetico o animal, deben ser expresadas en términos de unidades en vez de las medidas estándar de peso o volumen. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Se debe estar alerta para no confundir unidades con ml y evitar errores en la dosificación. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">No hay cálculos que se deban realizar en la administración de insulina, sino que solo medir las unidades de insulina a administrar en una jeringa para insulina, graduadas en unidades y no ml. La jeringa de insulina están calibradas en 100 unidades en 1 ml. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">3. CALCULOS DE DOSIS DE FARMACOS </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Existen muchas formas de realizar cálculos de dosis de medicamentos. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">La forma más fácil es la regla de 3. lo que colocas en un lado de la ecuación, hace lo mismo al otro lado. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Se debe expresar en las mismas unidades para resultados correctos. Utilizar números enteros en vez de decimales para evitar errores. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Siempre se debería realizar una estimación rápida de la respuesta, una aproximación, para saber en que rangos debería estar la respuesta. Esto se realiza con aquellas cifras que son fáciles de calcular. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; page-break-before: always; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Ej.: Se requiere una dosis de 125 mcg. La presentación del fármaco es de 50 mcg/ml. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Se tiene: 50 mcg / 1 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Entonces hay: 100 mcg / 2ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">150 mcg / 3ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">De esto se deduce que nuestra respuesta debería estar en el rango de 2 – 3 ml del fármaco. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Para calcular este ejemplo deberíamos: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 1: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Escriba lo que tenemos: presentación 50 mcg 1 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 2: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Escriba la proporción de la unidad que tiene (presentación del fármaco) esta es su unidad y divida los números: 50 mcg en 1 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 = 0,02 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">50 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 3 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Multiplique su resultado por la dosis que necesita administrar <b>0,02 x 125 = 2,5 ml </b></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Respuesta: </span></b><span style="font-size: 11.0pt; line-height: 115%;">se deben administrar 2,5 ml del medicamento. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Este resultado está dentro del rango de la aproximación inicial de la dosis. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">De la formula del cálculo descrita se puede derivar que para el cálculo de la dosis UD. debe calcular: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Dosis que se necesita x volumen en que esta la dosis </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Dosis que se tiene en la presentacion presentada </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Ejm: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Dosis que se necesita: 125 mcg </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Dosis que se tiene en la presentación: 50 mcg </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Volumen en que esta la dosis presentada: 1 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Sustituyendo los números de la formula: 125 x 1 = 2.5 ml </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">50 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Usted puede aplicar este tipo de formula a cualquier tipo calculo. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">4. CALCULO DE GOTEO </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">a) Gotas/minuto </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">En todos los cálculos de goteo, debes recordar que tú simplemente debes convertir un volumen de líquido en gotas, o viceversa, y horas a minutos. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Los set de Goteo o (Flebo o Perfus) entregan: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Set Estándar de goteo entrega <b>20 gotas/ml de solución. </b></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">15 gotas/ml de sangre </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-family: "Times New Roman","serif"; font-size: 11.0pt; line-height: 115%;">- </span><span style="font-size: 11.0pt; line-height: 115%;">Set de Microgoteo entrega <b>60 microgotas/ml </b></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Ejemplo: administrar 1000 cc Sol. Fisiológica en 8 horas </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 1: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Convertir el volumen total en número de gotas. </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1 Litro de Solución = 1000 ml entonces será 1.000 x 20 = 20.000 gotas en 1000 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 2: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Convertir las horas en minutos, multiplicando el número de horas en que se debe pasar la solución por 60 minutos. </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">8 horas x 60 minutos = 480 minutos </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Con estos cálculos se han convertido la indicación en términos de gotas y minutos, que es lo que se desea conocer. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Si no se requiere convertir en minutos no es necesaria esta operación. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 3 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Junte ambos cálculos realizados: </span></b><span style="font-size: 11.0pt; line-height: 115%;">20.000 gotas a pasar en 480 minutos. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 4 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Calcule el número de gotas por minuto, dividiendo el total de gotas por el número de minutos. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">20.000 = 41.76 gotas / minuto = 42 gotas/min </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">480 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Como es imposible dividir la gota, aproxime al número entero siguiente a la cifra obtenida. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Respuesta: </span></b><span style="font-size: 11.0pt; line-height: 115%;">para administrar un Litro de Sol. Fisiológica en 8 horas usando un equipo de fleboclisis Standard, el goteo debe ser a 42 gotas x minuto. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">También se puede usar la siguiente formula: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Gotas/min = (Gotas/ml que entrega el flebo) x volumen total a infundir (ml) </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Numero de horas en que debe pasar la infusión x 60 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">En este caso sería: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Gotas / ml que entrega el Equipo de Fleboclisis = </span></b><span style="font-size: 11.0pt; line-height: 115%;">20 gotas / ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Volumen a Infundir (en ml) </span></b><span style="font-size: 11.0pt; line-height: 115%;">= 1000 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Numero de Horas a infundir la Solución </span></b><span style="font-size: 11.0pt; line-height: 115%;">= 8 horas </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Numero de minutos en una Hora (factor para convertir horas en minutos) = </span></b><span style="font-size: 11.0pt; line-height: 115%;">60 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Al sustituir los números en la formula sería: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">20 x 1000 = 41.67 = 42 gotas/min </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">8 x 60 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">b) Conversión de Dosis a ml/hr (para programar Bomba Infusión Continua): </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Las dosis pueden ser expresadas de varias formas: mg/min, mcg/min, gamas/min, mg/kg/min o mcg/kg/min y debe ser necesario convertir a ml/hr para uso en BIC. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">El siguiente ejemplo muestra los varios pasos en este tipo de cálculo y que se adopta para cualquier dosis a calcular en goteo a infundir. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Ejemplo: Usted debe administrar una infusión de dopamina de 800 mg en 250 ml. La dosis requerida es 2 mcg/kg/min para un paciente de 68 kg. Cual es el goteo ml/hr a programar? </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 1 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Calcular la dosis requerida para el paciente: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Dosis Requerida = Peso del paciente (kg) x dosis indicada </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Dosis requerida </span></b><span style="font-size: 11.0pt; line-height: 115%;">= 68 kg x 2 mcg/min = <b>136 mcg/ min </b></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Si la dosis es indicada como un total y no se toma el peso del paciente, entonces no realice este paso. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 2 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">La dosis es 136 mcg/min. Como la respuesta final se necesita en términos de horas, multiplique por 60 para convertir minutos en horas. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">136 x 60 = 8160 mcg/hora </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Convertir mcg a mg dividiendo por 1000 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">8160 = 8,16 mg/hr </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">1000 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 3 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Calcule el volumen que se requiere para esa dosis. </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Calcule el volumen para 1 mg de fármaco. </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Usted tiene 800 mg en 250 ml = 250 = 0,3 ml 1mg esta en 0,3 ml </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">800 </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Paso 4 </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Multiplique la dosis necesaria para el paciente por los ml que contienen 1 mg del fármaco. </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Entonces para la dosis de 8,16 mg/ hr el volumen corresponde a: </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span lang="EN-US" style="font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US;">8,16 mg/hr x 0,3 ml = 2,5 ml/hr = 3 ml / hr </span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <b><span style="font-size: 11.0pt; line-height: 115%;">Respuesta: </span></b><span style="font-size: 11.0pt; line-height: 115%;"></span></div> <div class="Default" style="line-height: 115%; margin-bottom: 12.0pt; text-align: justify;"> <span style="font-size: 11.0pt; line-height: 115%;">Para administrar una dosis de 2 mcg/kg/min de dopamina para el paciente, se requiere programar la bomba a un goteo de 3 ml/hora, de una dilución de 800 mg de dopamina en 250 cc de SF. </span></div> <b></b><br /> <b><span style="font-size: 11.0pt; line-height: 115%;">Fuente: Universidad San Sebastian - Escuela de Enfermeras</span></b><span style="font-size: 11.0pt; line-height: 115%;"></span><b><span style="font-size: 10.0pt; line-height: 115%;"></span></b><span style="font-size: 10.0pt; line-height: 115%;"></span><br /> <table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; border: none; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed;"><tbody> <tr align="center" style="height: 4.2pt;"><td style="border: medium none; height: 4.2pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.2pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.2pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.2pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td></tr> <tr align="center" style="height: 4.7pt;"><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td></tr> <tr align="center" style="height: 4.7pt;"><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td></tr> <tr align="center" style="height: 4.7pt;"><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td></tr> <tr align="center" style="height: 4.7pt;"><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td></tr> <tr align="center" style="height: 4.7pt;"><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; width: 62.35pt;" valign="top" width="83"><br /></td></tr> <tr style="height: 4.7pt; mso-yfti-irow: 6; mso-yfti-lastrow: yes;"><td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; text-align: center; width: 62.35pt;" valign="top" width="83"> </td> <td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; text-align: center; width: 62.35pt;" valign="top" width="83"><br /></td> <td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; text-align: center; width: 62.35pt;" valign="top" width="83"><br /></td> <td style="border: medium none; height: 4.7pt; padding: 0cm 5.4pt; text-align: center; width: 62.35pt;" valign="top" width="83"><br /></td> </tr> </tbody></table> <div class="MsoNormal" style="margin-bottom: 12.0pt; text-align: justify;"> <br /></div> <div class="ecxMsoNormal" style="text-align: justify; text-indent: 0cm;"> <br /></div>

GUIA DE CÁLCULO DE GOTEOS Y DOSIS DE MEDICAMENTOS

Introducción - En medicina se usan diferentes sistemas para medir, expresar dosis y presentaciones de medicamentos: - Conce...

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