Module Six

Pharmacy Calculations

Table of Contents

1. Pharmacy Metric and Apothecary Systems

A. Weight and Volume (p 3)
i. Metric Weight and Volume (p 3)
ii. Apothecary Weight and Volume (p 3)
iii. Household Measurements (p 4)

2. Roman Numerals, Fractions, and Decimals

A. Principles of Roman Numerals (p 5)
B. Sample Questions (p 6)
C. Principles of Fractions and Decimals (p 7)
i. Decimal Equivalents of Fractions (p 8)
D. Sample Questions (p 8)
E. Reducing Fractions (p 9)
F. Adding and Subtracting Fractions (p 10)
G. Multiplying and Dividing Fractions (p 11)
H. Sample Questions (p 12)
I. Tips on Solving Word Problems (p 13)
i. Dividing Large Numbers (p 14)

3. Decimal Forms, Ratios, Proportions, Percentages and

Temperature Conversions
A. Decimal Forms (p 15)
i. Adding and Subtracting Decimals (p 16)
ii. Multiplying and Dividing Decimals (p 16)
B. Ratios and Proportions (p 18)
C. Percentages (p 19)
D. Temperature Conversions (p 21)
E. Sample Questions (p 22)

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4. Compounding Calculations
A. Weight and Volume (p 25)
B. Body Weight Calculations (p 27)
C. Sample Questions (p 28)
D. Infusion Rates (p 31)
E. Dilutions (p 32)
F. Sample Questions (p 33)
G. Powdered Drug Preparation
i. Determining the Powder Volume of a Drug (p 35)
ii. Determining Drug Concentration in mg/ml (p 36)
H. Sample Questions (p 38)
I. Alligations (p 39)
J. Total Parenteral Nutrition (TPN) (p 41)
K. Sample Questions (p 42)

5. Business Math
A. Terms Used in Business Math (p 43)
B. Sample Questions (p 45)

6. Answer Key for Sample Questions (p 46)

2
1. Pharmacy Metric and Apothecary Systems

A. W eight and Volume

It is extremely important to memorize all of the following weight and

volume measurements. All of the Math in this Module requires that you
know these measurements in order to do the calculations correctly.

i. Metric Weight and Volume

Weight

1 kilogram (kg) = 1,000 g = 2.2 pounds

1 gram (g) = 1,000 mg = 15 grains
1 milligram (mg) = 1,000 mg = 1/60 grain
1 microgram (mcg) = 0.001 mg = 1/60 grain

Volume

1 milliliter (ml) = 15-16 drops

1 liter (L) = 1,000 ml

ii. Apothecary Weight and Volume

Weight

1 grain (gr) = 60 65 mg
60 grains (gr) = 1 dram = 4-5 grams
8 drams (dr) = 1 ounce = 30 grams

Volume

8 fluid drams = 1 fluid ounce (oz) = 30 ml

6 fluid ounces = 1 teacup = 180 ml
8 fluid ounces = 1 cup = 240 ml
16 fluid ounces = 1 pint (pt) = 500 ml
2 pints = 1 quart (qt) = 1,000 ml
4 quarts = 1 gallon (gal) = 4,000 ml

3
iii. Household Measurements

teaspoon = 2.5 ml
1 teaspoon = 5 ml = 1 dram = 60 drops
2 teaspoons = 10 ml
3 teaspoons = 1 tbsp = 15 ml = ounce
2 tablespoons = 30 ml = 1 ounce

4
2. Roman Numerals, Fractions, and Decimals

A. Principles of Roman Numerals

Roman Numerals are expressed by letters of the alphabet and are

still used on written prescriptions for the quantity to be dispensed.

There are a fixed amount of Roman Numerals representing specific

numbers, they are as follows:

Roman Numeral Number Value

I 1
V 5
X 10
L 50
C 100
D 500
M 1,000

! A Roman Numeral that is repeated equals that many times the value.

Examples: III = 3, XX = 20, CCC = 300,

! A Roman Numeral placed after another of greater value increases the

value by the amount of the smaller.

Examples: VIII = 8, LX = 60, CX = 110

! A Roman Numeral placed before another of greater value decreases

the value by the amount of the smaller.

Examples: IX = 9, XL = 40, CM = 900

5
B. Sample Questions

For each Roman Numeral, give the correct number.

1. II = ____
2. V = ____
3. XXII = ____
4. VIII = ____
5. CIX = ____
6. XLIII = ____
7. CCC = ____
8. IV = ____
9. XX = ____
10. LX = ____

For each number, give the correct Roman Numeral.

11. 3 = ____
12. 9 = ____
13. 12 = ____
14. 30 = ____
15. 50 = ____
16. 100 = ____
17. 500 = ____
18. 90 = ____
19. 1,000 = ____
20. 10 = ____

6
C. Principles of Fractions and Decimals

A fraction is used to indicate an amount that is a part of a whole

number (a fraction of the whole).

A fraction has two parts, the numerator and the denominator. The numerator
is always above (or before) the denominator.

Example: = 3/4 - 3 is the numerator, 4 is the denominator.

There are two types of fractions, proper and improper.

# A proper fraction has a numerator that is smaller than the

denominator and is less than one.

Examples: 2/3, 3/5, 4/10

# An improper fraction has a numerator that is greater than the

denominator and is greater than or equal to one.

Examples: 4/1, 5/2, 10/3

When doing fractions, think in terms of a pie .

This pie has removed from the

whole pie, leaving remaining.

+ = 1 (whole pie).

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i. Decimal Equivalents of Fractions

Every fraction can be expressed in decimals.

To find the decimal equivalent of any fraction, divide the numerator by

the denominator.

Example: 2/5 = 0.4

Divide the 2 by the 5.

5 goes into 2 how many times?
0.4 times.

There are many ways to write a fraction. When fractions represent the same
number they are called equivalent fractions.

Example: 1/2 = 2/4 = 4/8 = 0.5

D. Sample Questions

Give the equivalent decimal for each fraction below.

Fraction Decimal
1. 1/2 = ______
2. 2/5 = ______
3. 1/20 = ______
4. 4/5 = ______
5. 3/4 = ______
6. 1/100 = ______
7. 1/3 = ______
8. 1/10 = ______
9. 1/8 = ______
10. 1/4 = ______

8
E. Reducing Fractions

Reducing fractions to their lowest terms makes it easier to add,

subtract, multiply and divide fractions.

To reduce a fraction to its lowest terms, divide the numerator and

denominator by their Greatest Common Factor (GCF). To find the GCF you
will need to first find the prime factors. Prime Factors are numbers that will
go into the numerator and denominator.

Example: 20
45

Step 1. Find the Prime Factors for this example.

Numerator: 1, 2, 4, 5, 10
Denominator: 1, 3, 5, 9

Step 2. Find the Greatest Common Factor for this problem:

the number that will go into both the numerator and the
denominator and reduce the fraction to the lowest term.

Greatest Common Factor is 5.

Solve: 20 divided by 5 = 4
45 divided by 5 = 9

Answer: 4/9 is the lowest term for 20/45.

9
F. Adding and Subtracting Fractions

To add or subtract fractions, simply add or subtract the numerators

and write the sum over the denominator. In addition and subtraction
of fractions, the denominators must be the same.

When the denominators are not the same, find the smallest multiple of both
denominators, this is called the Least Common Denominator.

Examples: 3/8 + 1/8 = 4/8 = (lowest term)

3/8 1/8 = 2/8 = (lowest term)

Example: 1/3 + 1/5

The least common denominator is 15.

1/3 (1 x 5) over (3 x 5) = 5/15

1/5 (1 x 3) over (5 x 3) = 3/15

The problem is rewritten as:

5/15 + 3/15 = (5 + 3) over 15

= 8/15

Example: 1/3 - 1/4

The least common denominator is 12.

1/3 (1 x 4) over (3 x 4) = 4/12

1/4 (1 x 3) over (4 x 3) = 3/12

The problem is rewritten as:

4/12 3/12 = (4 3) over 12

= 1/12

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G. Multiplying and Dividing Fractions

Multiply the numerators and denominators by each other for the

answer. Multiplication and Division of Fractions does not require a
common denominator.

If a word problem uses the word of this means to multiply.

Example: 1/4 x 2/3

Step 1. Multiply the numerators (1 x 2 = 2).

Step 2. Multiply the denominators (4 x 3 = 12).

= 2/12.

Step 3. Now reduce 2/12 to the lowest term.

Answer: 1/6.

To divide fractions, reverse the numerator and denominator in the

divisor. Then perform multiplication on the fractions as described
above.

If a question uses the word by this means to divide.

Example: 1/4 divided by 2/3

Step 1. Reverse 2/3 and it becomes 3/2.

The new problem is 1/4 multiplied by 3/2.

Step 2. Multiply the numerators (1 x 3 = 3)

Step 3. Multiple the denominators (4 x 2 =8)

Answer: 3/8 (cant be reduced)

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H. Sample Questions

1. 1/2 + 1/2 = _____

2. 1/8 + 2/8 = _____
3. 3/5 + 1/5 = _____
4. 1/8 + 3/8 = _____
5. 1/5 + 3/5 = _____
6. 4/25 + 1/5 = _____
7. 1/6 + 2/6 + 5/6 = _____
8. 5/8 + 4/27 + 1/48 = _____
9. 1/10 + 3/10 + 9/100 = _____
10. 7/8 3/8 = _____
11. 1/3 1/5 = _____
12. 7/8 1/4 = _____
13. 6/10 4/10 = _____
14. 7/5 - 3/5 = _____
15. 5/10 - 4/10 = _____
16. 11/15 - 7/15 = _____
17. 9/10 - 5/10 = _____
18. 1/8 of 3/8 = _____
19. 1/5 of 3/5 = _____
20. 7/8 of 3/8 = _____
21. 3/8 x 3/5 = _____
22. 1/3 x 1/5 = _____
23. 1/9 x 4/9 = _____
24. 1/3 x 1/20 x 6/7 = _____
25. 5/8 divided by 3/8 = _____
26. 2/3 divided by 1/3 = _____
27. 3/4 divided by 8/5 = _____
28. 7/5 divided by 5/7 = _____
29. 1/3 divided by 1/5 = _____
30. 5/15 divided by 5 = _____

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I. Tips on Solving Word Problems

After reading a word problem, ask yourself the following questions

and take the following steps in the order shown below.

! What am I solving?
X = Answer

! What do I know?
List all math calculations that are given to you within the word
problem.

Step 1. Do any Conversions necessary to set up the problem correctly.

Step 2. Make sure you set up your problem with mg to mg, ml to ml,
etc., across from each other.

Example: mg to mg
ml to ml

Step 3. Solving a calculation problem is basically Cross Multiplying

the two given amounts and then Dividing by the other given
amount.

Example: 10 mg 60 mg
1 ml X

Step 1. Multiply 1 ml by 60 mg. = 60 mg

Step 2. Divide 60 mg by 10 mg.

Answer: 6 ml

$ Always round off decimals for the answer.

$ Always reduce fractions to their lowest terms for the answer.

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i. Dividing Large Numbers

When dividing large numbers for word problems, remember you can
reduce each number by removing the same amount of zeros in each
number and then performing normal division. This makes division of
large numbers easier.

Example: 140,000 divided by 70,000.

This can be reduced to 14 divided by 7

(by removing the same amount of zeros in each
number, in this case, 4 zeros are removed).

140,000 divided by 70,000 is the same as

14 divided by 7.

The answer for both is 2.

Example: 800,000 divided by 20,000

Reduced to 80 divided by 2 (removed 4 zeros from

each number).

The answer for both is 40.

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3. Decimal Forms, Ratios and Proportions, Percentages,
and Temperature Conversions

A. Decimal Forms

This Decimal Number system lets us write the whole number to the
left of the decimal point and the fraction of the whole number to the
right of the decimal point.

Think of money: $10.50

10 is the whole number, and 0.5 is 5 tenths

Remember the place values to the left of a decimal point are tens, hundreds
and thousands. And the place values to the right of the decimal point are
tenths, hundredths, and thousandths.

Examples: 600 = six hundred

60 = sixty
0.6 = six tenths
0.06 = six hundredths

Rounding off decimals: Find the decimal point and look at the digit in the
tenths place, then look at the digit in the hundredths place. If the digit in the
hundredths place is less than 5, do not change the digit in the tenths place,
just leave it the same and drop all digits to the right of it. If the digit in the
hundredths place is greater than or equal to 5, then round up the digit in the
tenths place by 1 and drop the following numbers.

Example: 10.32
Look at the 3 in the tenths place, the number in the
hundredths place is less than 5, so leave 3 and drop the 2.
Answer = 10.3

10.49
Look at the 4 in the tenths place, the number in the
hundredths place is greater than 5. Round up the 5 to 6,
and drop the 9.
Answer: 10.5

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i. Adding and Subtracting Decimals

Adding and subtracting decimals is as easy as aligning the decimal

points and then performing normal addition and subtraction.

Example adding: 221.345

+ 56.332
277.677

Example subtracting: 52.444

- 1.203
51.241

ii. Multiplying and Dividing Decimals

Decimal multiplication is performed like normal multiplication. Just

remember to add the total places of decimal points in each number
from right to left, and then insert this decimal placement into the
answer.

Example multiplying: 37.3 x 2.2

37.3 (1 decimal place to the right of the whole number)

x 2.2 (1 decimal place to the right of the whole number)
746
746
= 82.06 (2 decimal places are counted from the right)

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Decimal division requires first converting the divisor (the number
performing the division) to a whole number. To do this, simply move
the decimal point in the divisor to the right until the number is a whole
number.

Example: 3.25 divided by 0.5 3.25 (dividend)

0.5 (divisor)

Step 1. Move the decimal point in the divisor to the right until
the number is a whole number.

0.5 is now 5

Solve. Perform the calculation:

5 divided into 32.5

= 6.5

Answer: 6.5

! The answer to a division problem is called the quotient.

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B. Ratios and Proportions

Ratios are a way of expressing the relationship of one quantity to

another.

Ratios can be written in different ways:

! As a fraction. 1/1,000
! Using the word to. 1 to 1,000
! With a colon. 1:1,000

Ratio strengths are reduced to the lowest terms when the first
number in the ratio is 1.

Example: 4:100 (4 divided by 4, 100 divided by 4)

= 1:25 or 1 in 25 (lowest terms).

Example: How many mg of a drug are needed to make 150 ml of 1:400

w/v solution?

! What are you solving?

X = mg of drug

! What do you know?

Need 150 ml of 1:400 solution.

Step 1. Convert Grams to milligrams for 1:400 w/v.

Step 2. Set up your problem.

1,000 mg x
400 ml 150 ml

Solve: Cross-Multiply and Divide

Multiply 1,000 mg by 150 ml = 15,000 mg
Divide 15,000 mg by 400 ml (or 150 divided by 4,
reduced by 2 zeros)

Answer: 37.5 mg

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Proportion is the expression of the equality of two ratios or fractions
to each other. This can be written in two different ways.

Example: 10/40 =
Ten is to forty as one is to four.

C. Percentages

Percentages are a ratio of parts per 100.

In pharmacy calculations, percentages are expressed as the strength of a

solution. Percent means per 100 or out of 100. When expressing
percentages in fraction form, the denominator is always 100.

Examples: 20 out of 100 = 20/100 = 20%

5 out of 100 = 5/100 = 5%
35% = 35/100 = 0.35
5% of dextrose is expressed as 5 gm/100 ml

When you are calculating a word problem, always:

! Convert your % into grams and put it over 100 in a fraction form.
! If you are solving for mg/ml convert the grams to milligrams.

Example: The pharmacy has on hand 500 mg of a powder. How many

milliliters of 2% solution can you prepare?

! What are you solving?

X = ml of 2% solution

! What do you know?

You have 500 mg in powder form.

Step 1. Convert 2% to 2 grams and put it over 100 ml.

2 gm
100 ml

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 Step 2. Convert 2 grams into milligrams so that both sides
of the equation are equal. (mg to mg) (ml to ml).
2 g = 2,000 mg

Step 3. Set up the problem.

2,000 mg 500 mg
100 ml X

Solve: Cross Multiply and Divide.

100 x 500 = 50,000
50,000 divided by 2,000 (or 50 divided by 2)

Answer: 25 ml

Example: If you dissolve 170 grams of a drug into 2 liters of

water, what is the percentage strength of the resulting solution?

! What are you solving?

X = % strength of resulting solution.

! What do you know?

170 g into 2 liters of water.

Step 1. Convert the liters to ml and put 170 grams over it.

170 gm
2000 ml

Step 2. Set up your problem. Put X over 100 ml.

170 gm X
2000 ml 100 ml

Solve: Cross Multiply and Divide.

170 x 100 = 17,000
17,000 divided by 2000 (17 divided by 2)

Answer: 8.5%

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D. Temperature Conversion

Temperatures can be given in Fahrenheit and Celsius.

Temperatures can easily be converted from Fahrenheit to Celsius and from

Celsius to Fahrenheit using the following guidelines and standard
calculations.

! Always remember Fahrenheit is a larger number than Celsius.

! Fahrenheit is 32 degrees freezing, and Celsius is 0 degrees freezing.

! To convert from Celsius to Fahrenheit use the fraction formulation

9/5.

! To convert from Fahrenheit to Celsius use the fraction formulation

5/9.

! Also use the freezing temperature of 32 degrees.

Example: Convert 100 degrees Celsius into Fahrenheit using 9/5.

Step 1. Multiply 9 x 100 = 900

Step 2. Divide 900 by 5 = 180
Step 3. Add 32 to 180

Answer: 100 degrees Celsius = 212 degrees Fahrenheit.

Example: Convert 212 degrees Fahrenheit into Celsius using 5/9.

Step 1. Subtract 32 degrees from 212 degrees = 180

Step 2. Multiply 180 x 5 = 900
Step 3. Divide 900 by 9

Answer: 212 degrees Fahrenheit = 100 degrees Celsius.

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E. Sample Questions

1. Fill in the blank for each pair of ratios to form a proportion:

a. 2/8 and 3/______
b. 5/7 and 15/_____
c. 2/3 and 4/______
d. 5/10 and 7/______
e. 10/12 and 5/_____
f. 5/6 and 10/_____
g. 1/8 and 3/______

2. A 20% solution would be

a. 20 mg/100 ml
b. 100 g/20 ml
c. 20 g/ 100 ml
d. 20 mg/1000 ml

3. A 10% of 50 g would be equal to what?

a. 5000 mg
b. 5 g
c. 50 mg
d. a and b

4. How much of a 1:1000 stock solution is required to prepare 500 ml of a

1:4000 solution?
a. 100 ml
b. 125 ml
c. 500 ml
d. 1000 ml

5. You receive an order for heparin 14,000 units in 500 ml of sodium

chloride solution. If the strength of the heparin available in stock is 10,000
units/ml, how many ml of heparin do you use?
a. 1.2
b. 1.3
c. 1.4
d. 2.8

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6. Digoxin elixir contains 25 mcg per ml. How many mcg are in 0.2 ml of
the solution?
a. 5
b. 10
c. 15
d. 18

7. You receive an order for 0.2 g of Phenergan IM. You have a 5 ml vial
labeled 100 mg/ml in stock. How many ml are required to fill the order?
a. 6 ml
b. 4 ml
c. 2 ml
d. 1 ml

8. What is the quantity of hydrocortisone powder needed to prepare 4 oz of

2% hydrocortisone cream?
a. 0. 120 gm
b. 0.24 gm
c. 120 gm
d. 2.40 gm

9. How many grams of 10% zinc oxide ointment are used to prepare 8
grams of zinc oxide?
a. 20
b. 40
c. 60
d. 80

10. How much of salicylic acid 5% will be needed to prepare a compound

of 500 grams?
a. 0.5 gm
b. 2.5 gm
c. 5 gm
d. 25 gm

23
11. What is the final percent concentration of an IV solution containing 25 g
of a medication in 1000 ml?
a. 0.25%
b. 1.25%
c. 2.5%
d. 25%

12. Convert the following in degrees from Celsius to Fahrenheit:

a. 20 C to _______F
b. 50 C to _______F
c. 15 C to _______F
d. -9 C to _______F
e. 38 C to _______F

13. Convert the following in degrees from Fahrenheit to Celsius:

a. 70 F to _______C
b. 25 F to _______C
c. 59 F to _______C
d. 113 F to ______C
e. 86 F to _______C

14. What is the percentage strength of a solution containing 250 mg/ml?

a. 0.25
b. 2.5
c. 25
d. 12.5

15. Calculate the milligrams of a drug needed to prepare 400 gm of a

1:2500 w/w ointment?
a. 0.16 gm
b. 160 mg
c. 0.20 gm
d. 20 mg

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4. Compounding Calculations

Some prescriptions are not commercially available and must be

prepared in the pharmacy. When prepared, they are called
compounds. Compounded drugs must deliver the correct dose of
medication to the patient. For this reason, it is very important to do
compounding calculations correctly.

Always use the correct units when setting up your problem. Below are the
weight and volume measurements used in compounding.

Remember when setting up your proportions use:

weight to weight
volume to volume

Example:

100 mg 50 mg
5 ml X = 2.5 ml

A. W eight and Volume

Weight is solid = kilograms, grams, milligrams, micrograms,

grains.
Volume is liquid = liters, milliliters, ounces, drams, units.

! w/v - w stands for weight and is the solid weight

measurement in milligrams or grams. v stands for volume
and is the liquid measurement of milliliters or liters.

! w/w - Stands for solid weight over weight (mg over mg, grams
over grams).

! v/v - Stands for liquid volume over volume (ml over ml, liters
over liters).

25
Example: The daily dose for a medication is 2.4 grams; the drug is
available in 200 mg tablets; how many tablets are needed for a
one day supply?

! What are you solving?

X = Number of tablets for a one day supply

! What do you know?

2.4 grams is the daily dose
200 mg is the availability of the drug

Step 1. Convert 2.4 grams to milligrams. (1 gram = 1,000 mg)

2.4 gm = 2,400 mg

Step 2. Set up the problem: (set up mg to mg, ml to ml, etc.

across from each other.)

200 mg 2,400 mg
1 tablet X (number of tablets for a one day supply)

Solve: Cross-Multiply and Divide.

Multiply 1 tablet x 2,400 mg = 2,400
Divide 2,400 by 200 mg (or 24 divided by 2).

Answer: 12 tablets

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B. Body W eight Calculations

Dosage calculations are based on body weight.

! 1 kg = 2.2 pounds

Example: The physician prescribed a dose of Amoxil 15 mg/kg/day for a

child weighing 22 lbs. What would be the dosage amount per
day?

! What are you solving?

X = Dosage per day

! What do you know?

22 lbs is the childs weight.
15 mg/kg/day is the dosage.

Step 1. Convert pounds into kilograms. (2.2 lbs = 1 kilogram)

22 lbs divided by 2.2 lbs = 10 kg

Step 2. Set up the problem. Notice the problem is set up in mg

to mg and kg to kg.

15 mg X
1 kg 10 kg

Solve: Cross Multiply and Divide.

15 mg x 10 kg = 150 mg
Divide 150 by 1 = 150 mg

Answer: 150 mg per day.

27
C. Sample Questions

1. How much Clindamycin 75 mg/ml and how much Eucerin lotion are
needed to prepare a compound of 300 mg of Clindamycin in Eucerin lotion
to dispense 30 ml?
a. 6 ml of Clindamycin and 30 ml of Eucerin
b. 4 ml of Clindamycin and 26 ml of Eucerin
c. 2 ml of Clindamycin and 28 ml of Eucerin
d. 4 ml of Clindamycin and 30 ml of Eucerin

2. A prescription is written for 25 mg/ml of Dilantin Suspension. How

many capsules of Dilantin 100 mg are needed to prepare 250 ml?
a. 30
b. 40
c. 45.5
d. 62.5

3. A prescription is written for Aspirin 20% cream. How much Aspirin

powder is needed to prepare 30 grams of this compound?
a. 3 gm
b. 4 gm
c. 6 gm
d. 8 gm

4. A patient weighs 186 pounds and the dosing schedule for a medication is
given for weight measured in kilograms. How many kilograms would you
calculate the patient weighs?
a. 84.5
b. 86
c. 88
d. 90

5. A dose of 65 units of regular insulin is to be given to a patient. How

many ml would you give if your concentration was 100 units/ml?
a. 65 ml
b. 6.5 ml
c. 0.65 ml
d. 0.06 ml

28
6. How many 500 mg doses can be prepared from 5 gram vial of Cefazolin?
a. 8
b. 10
c. 20
d. 30

7. How much Adriamycin 100 mg/ml is needed to prepare a 50 mg?

a. 1 ml
b. 2 ml
c. 5 ml
d. 10 ml

8. What would be the total daily dose of a drug concentration of 100 mg/2.5
ml if administrated qid?
a. 2.5 ml containing 400 mg
b. 5 ml containing 400 mg
c. 2.4 ml containing 0.4 gm
d. 2.5 ml containing 0.4 gm

9. What amount of a 16 mg/ml solution is needed to make a 120 ml bottle of

0.8 mg/ml solution?
a. 4 ml
b. 6 ml
c. 12 ml
d. 24 ml

10. How many tablets should be dispensed to the patient receiving 0.030 gm
dose using a stock bottle of 5 mg tablets?
a. 2
b. 3
c. 6
d. 10

11. How much elixir 80 mg/15 ml is required for a dose of 240 mg?
a. 1.5 tbsp
b. 3 tbsp
c. 0.5 tbsp
d. 2 tbsp

29
12. How many 250 mg doses are in a 5 oz. bottle of Amoxicillin suspension
125 mg/5 ml?
a. 5 doses
b. 10 doses
c. 15 doses
c. 20 doses

13. How many grains are in 500 tablets, if 125 tablets contain 260 mg?
a. 5
b. 16
c. 64
d. 250

14. What is the amount of drug to be given to a patient, if the recommended

dosage is 0.5 mg/kg and the patient weighs 15 lb?
a. 1.2 mg
b. 2.4 mg
c. 3.4 mg
d. 4.4 mg

15. An order is written for Cytoxan to be given 5 mg/kg qid in 50 ml of

solution and the patient weighs 132 pounds. The drug is available in a
concentration of 500 mg/10 ml, how many ml should be given to the
patient?
a. 6 ml
b. 12 ml
c. 18 ml
d. 20 ml

30
D. Infusion Rates

Infusion rates and drip rates are expressed as the number of

milliliters per minute (ml/min), milliliters per hour (mil/hr), amount of
drug per hour, length of time for a volume to be infused, drops per
minute (gtts/min) or units per milliliters.

If the volume is 1000 ml over 10 hours the rate would be 100 ml/hr.
(Divide 1000 ml by 10 hours = 100 ml/hr)

! There are approximately 15 drops per ml (gtts/ml).

! Units are calculated only when a drugs dosage is in units.

Example: A solution is to be administered by IV infusion at a rate of 120

ml/hr. How many drops/min should be infused if 1 ml =15
drops?

! What are you solving?

X = gtts/min

! What do you know?

120 ml to be infused in 1 hour.
15 drops in 1 ml.

Step 1. How many minutes are in 1 hour?

120 ml divided by 60 minutes = 2 ml/min

Step 2. Set up the problem.

15 gtts X
1 ml 2 ml

Solve: Cross Multiple and Divide.

Multiply 15 gtts by 2 ml = 30 gtts.
Divide 30 gtts by 1 ml.

Answer: 30 gtts/min.

31
E. Dilutions

Dilutions are a concentrated solution before dispensing. When a

dilution is made the percentage strength becomes weaker.

Example: If 500 ml of a 20% strength solution is diluted to 600 ml, what

will be the % strength of the resulting solution?

! What are you solving?

X = Percent (grams) of resulting solution.

! What do you know?

You have 500 ml of a 20% solution and need to dilute it
to 600 ml.

Step 1. First determine how many grams are in the 20% solution.
Change the 20% to 20 grams and put over 100 ml.
(Remember to always turn your % into grams and put it
over 100.) Then put X over 500 ml.

20 g X
100 ml 500 ml

Solve: Cross-Multiply and Divide.

Multiply 20 g by 500 ml = 10,000
Divide 10,000 by 100 (or 100 by 1)
= 100g in the 20% solution.

Step 2. Set up your problem:

100 g is then diluted into 600 ml.

100 g X
600 ml 100 ml

Solve: Cross Multiply and Divide.

Multiply 100 g by 100 ml = 10,000
Divide 10,000 by 600 (or 100 by 6)

Answer: 16.6 g or 16.6%

32
F. Sample Questions

1. A 0.25% solution of Lidocaine is flowing at 50 ml per hour. What is the

hourly dose?
a. 125 mg
b. 25 mg
c. 50 mg
d. 1.25 mg

2. You prepare a 250 ml bag of D5W containing 500 units of heparin. The
solution is to be infused over 2 hours. What is the hourly dose in ml?
a. 125 ml
b. 100 ml
c. 50 ml
d. 250 ml

3. If a 1000 ml bag of D5W is to run at 100 ml/hr, how long will the bag
last?
a. 2 hours
b. 5 hours
c. 10 hours
d. 12 hours

4. If a 500 ml bag of D5W is to run over eight hours, what is the rate of
infusion?
a. 62.5 ml/hr
b. 82 ml/hr
c. 50 ml/hr
d. 42.5 ml/hr

5. If the infusion rate for an IV is 80 ml/hr and is to run for four and half-
hours, how many ml will the patient receive?
a. 120 ml
b. 240 ml
c. 320 ml
d. 360 ml

33
6. What will the flow rate be with an IV infusion order of Aminophylline
500 mg in 500 ml of sodium chloride to be infused at 1 mg/kg/hr and the
weight of the patient is 154 pounds?
a. 2.2 ml/min
b. 2.1 ml/min
c. 1.2 ml/min
d. 4.2 ml/min

7. What flow rate is needed to deliver 1000 ml if the rate is 12 gtts/ml over a
24 hour period?
a. 4 gtts/min
b. 6 gtts/min
c. 8 gtts/min
d. 12 gtts/min

8. A solution of heparin 25,000 units in sodium chloride 500 ml is to run 15

ml/hr. What is the hourly dose be given to the patient?
a. 18 units/hr
b. 60 units/hr
c. 250 units/hr
d. 750 units/hr

9. You have 400 ml of a 50% solution. You dilute the solution to 1000 ml.
What is the percent strength of the final solution?
a. 5%
b. 10%
c. 40%
d. 50%

10. What is the percentage strength of a dilution of 50 ml of an 8% solution

in 500 ml?
a. 0.2%
b. 0.4%
c. 0.8%
d. 8%

34
G. Powdered Drug Preparation

Powdered drug preparation is expressed in volume or space that the

powdered drug occupies.

The space that the powdered drug occupies after reconstitution is called
Powder Volume and is expressed in ml.

! Liquid and powder both take up space.

i. Determining the Powder Volume of a Drug

1. Find the concentration of the drug in mg/ml.

2. Find the amount of dry powder.
3. Solve for X (cross multiply and then divide).
4. Subtract sterile water used in the reconstitution for injection.

Example: The Pharmacy stocks a drug with 10 mg per 10 ml. After the
powder has been reconstituted with 10 ml of a diluent, the
concentration changes to 10.5 ml. The original concentration
of powder volume is the 0.5 ml. The doctor has ordered the
patient to receive 2 mg of the drug. How many ml are needed
to give the correct dose?

! What are you solving?

X= ml

! What do you know?

Volume of diluent = 10 ml
Powder Volume = 0.5 ml
Final Volume = 10.5 ml
The amount of drug in the vial = 10 mg
The doctor has ordered the patient to receive 2 mg

Step 1. Add the 10 ml and the 0.5 ml of powder volume

together for your final volume.

10 ml + 0.5 ml = 10.5 ml

35
 Step 2. Set up your problem:

10 mg 2 mg
10.5 ml X ml

Solve: Cross-Multiply and Divide.

Multiply 10.5 ml x 2 mg = 21 ml
Divide 21 ml by 10 mg

Answer: 2.1 ml

ii. Determining Drug Concentration in mg / ml

1. Find the powder amount of the drug in grams.

2. Find the concentration in mg/ml.
3. Convert grams to milligrams.
4. Solve for X (cross multiply and divide).
5. X is in ml.

Example: A powdered drug of 20 grams requires 36 ml of Sterile

Water for Injection to give a concentration of 500 mg/ml.
What is the powder volume of the drug?

! What are you solving?

X = ml

! What do you know?

Powder weight 20 grams

Amount of Sterile Water 36 ml
Concentration needed 500 mg/ml
Solve for the powder volume (remember volume is solved from
the weight after it is reconstituted with the water).

Step 1. Convert 20 grams into milligrams (1 gm = 1000 mg)

20 grams = 20,000 milligrams

36
Step 2. Set up your problem.

500 mg 20,000 mg
1 ml X

Solve: Cross Multiply and Divide.

Multiply 1 ml by 20,000 mg = 20,000 mg
Divide 20,000 mg by 500 mg (or 200 divided by 5)

Answer: 40 ml

37
H. Sample Questions

1. How many milligrams of neomycin powder are needed for a compound of

60 grams with 0.5% neomycin?
a. 120 mg
b. 240 mg
c. 300 mg
d. 600 mg

2. What is the powder volume of a drug when 10 gm of bulk powder is

added with a concentration of 100 mg/ml in 95 ml of sterile water?
a. 50 ml
b. 45 ml
c. 10 ml
d. 5 ml

3. A drug vial containing 500 mg of powder is reconstituted with 1.8 ml of

sterile water and will deliver a solution of 250 mg/ml. What is the powder
volume of the drug?
a. 0.2 ml
b. 0.4 ml
c. 0.5 ml
d 1 ml

38
I. Alligations

Alligations are percentage strength solutions created by mixing

together a stronger percentage strength solution and a weaker
percentage strength solution in appropriate proportions to achieve the
desired strength.

All alligations must be in a percentage form and the strength of the

desired solution must lie between the stronger and weaker solutions.

Example: You receive an order for 500 ml of 30% solution. On hand in

the pharmacy you have a stock solution of 60 % and 25%. How
many ml of each of the stock solutions will you need to prepare
the order?

! What are you solving?

X = ml of stock solutions.

! What do you know?

I need a 30% solution and only have a 60% and a 25%.

Step 1. Set up a Tic-Tac-Toe Board with the information

you know.

! The higher % strength is placed in the upper left box.

! The lower % strength is placed in the lower left box.
! The required % strength is placed in the center box.

60% X = Parts
higher
30 %
required
25% X = Parts
lower

Step 2. Subtract the required 30% strength from the higher

60% strength. The resulting strength = the number
of parts of the lower % strength solution needed.
= 30 parts.

39
 Step 3. Subtract the lower 25% strength from the required
30% strength. The resulting strength = the number
of parts of the higher % strength solution needed.
= 5 parts.
Fill the resulting parts into the Tic-Tac-Toe board:

60% 5 parts
higher
30 %
required
25% 30 parts
lower

Step 4. Add your parts together for your total parts needed
to solve the problem.
30 + 5 = 35

Step 5. Put the 5 parts into a fraction using the total parts
of 35. Put the 30 parts into a fraction using the
total parts of 35. Multiply each by 500 ml.

Multiply 5 parts times 500 ml. = 2,500

Then divide your answer by 35.

5 x 500 ml = 71.4 ml (of 60% solution).

35

Multiple 30 parts times 500 ml. = 15,000

Then divide your answer by 35.

30 x 500 ml = 428.57 ml (of 25% solution).

35

Answer: 71.4 of 60% and 428.6 of 25% solutions

To verify your answer is correct, add 71.4 ml and 428.6 ml (which is 428.57
ml rounded up). The result should equal 500 ml.
71.4 + 428.6 = 500 ml.

40
J. Total Parenteral Nutrition (TPN)

Total Parenteral Nutrition solutions provide a patient with essential

nutrients intravenously.

Parenteral Nutrition Solutions consists of a base solution and additives.

! Base solutions are carbohydrates, proteins, and essential fatty

acids.

! Additives are electrolytes, vitamins, insulin, and other trace

elements or additives.

Normally, a TPN will have 6 to 10 nutrients from the above additives mixed
with the base solution.

Example: A dose of 19.6 meq of a protein solution is added to a TPN. In

stock the protein is 4.4 meq/ml. How many ml is required to
receive a dose of 19.6 meq?

! What are you solving?

X = ml required for a dose of 19.6 meq.

! What do you know?

4.4 meq/ml in stock

Step 1. Set up your problem.

Set up a ratio and proportion.

4.4 meq 19.6 meq

1 ml x

Solve: Cross-Multiply and Divide.

Multiply 1 ml by 19.6 meq. = 19.6 meq
Divide 19.6 meq by 4.4 meq.
= 4.45 ml

Answer: 4.5 ml (4.45 rounded up).

41
K. Sample Questions

1. To process a prescription order for a 12.5% dextrose solution, what

would be the ratio if the stock mix solution was a 20% dextrose and 5%
dextrose solution in which ratio?
a. 1:1
b. 1:2
c. 1:4
d. 2:1

2. What amount of a 6% ointment must be diluted to fill an order for one

pound of a 2% ointment?
a. 115 gm
b. 150 gm
c. 151 gm
d. 12 gm

3. An order for 12.5% dextrose solution is ordered. The stock solution is

20% dextrose and a 5% dextrose solution. What is the ratio to compound?
a. 1:1
b. 1:2
c. 1:3
d. 2:1

4. A dose of 15 meq of KCL is needed for a TPN. The concentration comes

is 3 meq/ml. What is the amount needed to fill the order?
a. 15 ml
b. 10 ml
c. 5 ml
d. 2 ml

5. A dose of 125 mg of Vitamins is needed for a TPN. The concentration

comes in 250 mg/2 ml. What is the amount needed to fill the order?
a. 1 ml
b. 2 ml
c. 3 ml
d. 4 ml

42
5. Business Math

Business Math is important to know as one of the functions of a

pharmacy technician is inventory maintenance and control.

A. Terms Used in Business Math

Usual and Customary Price (U&C) - The lowest price charged for a
medication not covered by an insurance plan. This is determined at the
corporate level or by a formula. Most pharmacy computers calculate the
amount automatically when the prescription is filled.

Selling Price / Retail Cost - For prescriptions, this is the usual and
customary price. For all inventory, it is the price charged to consumers.

Acquisition Cost / Merchandise Cost - The cost the pharmacy pays for a
product.

Gross Profit - The difference between the selling price and the acquisition
cost of the product.

Example: Amoxicillin 250 mg #30 has a usual and customary price of

$9.50. The acquisition cost of Amoxicillin 250 mg #30 is $2.49.
What is the gross profit?

$9.50 - $2.49 = $7.01

Net Profit is the difference between the selling price and the sum of all the
other costs (including the acquisition cost, overhead, dispensing fees, etc.).

Example: Amoxicillin 500 mg #20 has a selling price of

$10.04. The acquisition cost plus all other costs of Amoxicillin 500
mg # 20 is $2.83. What is the net profit?

$10.04 - $2.83 = $7.21

43
Discounts are commonly sales or specials on normal inventory. For
prescriptions, discounts of approximately 10% can be given to senior
citizens who do not participate in a third-party program insurance company.

Example: A senior citizen is paying for a prescription for Amoxicillin

500 mg #20. The usual and customary price is $10.04. The patient
qualifies for a 10% discount. How much will the prescription cost the
patient?

! What are you solving?

X = Cost to patient

! What do you know?

U & C price is $10.04
Patient receives a 10% discount

Step 1: 10 % is the same as 0.1

($10.04 x 0.1) = 1.004 (drop the 4 and round to $1.00)

Solve: Subtract $1.00 from $10.04 = $9.04

Answer: $9.04

Markups and Markdowns - Difference between merchandise cost and the

selling price of a product. Mark-ups have a higher selling price than the
acquisition cost. Mark-downs have a lower selling price.

Average wholesale price (AWP) - The average cost of a product which is

between the acquisition cost and retail cost.

Inventory - Itemized list of merchandise and its acquisition cost.

Turnover Rate - How often the total inventory is sold over a specific time
period.

44
B. Sample Questions

1. The cost of a drug is $20.00 and has a 100% mark-up. What is the selling
price?
a. $ 20.00
b. $ 40.00
c. $ 50.00
d. $ 30.00

2. If the pharmacy pays $56.70 for a carton of 48 Fleet enema kits and sells
them at markup of 50%, what is the retail price on one kit?
a. $1.19
b. $1.77
c. $2.09
D. $2.36

3. How much money will 4 gallons of distilled water cost if 15 gallons are
$36.25?
a. $6.25
b. $7.48
c. $8.24
d. $9.67

4. What is the percentage cash discount on $110.00 on a pharmacy invoice

for $5,500?
a. 2%
b. 4%
c. 10%
d. 55%

5. What is the selling price used to yield a 40% gross profit on 100 tablets at
$1.50 per tablet?
a. $1.00
b. $2.00
c. $2.10
d. $2.60

45
6. Answer Key for Sample Questions

2. B 2. D 2. H 3. E
1. 1
1. 2 1. 0.5 2. 3/8 1. a. 12
2. 5 2. 0.4 3. 4/5 b. 21
3. 22 3. 0.05 4. 1/2 c. 6
4. 8 4. 0.8 5. 4/5 d. 14
5. 109 5. 0.75 6. 9/25 e. 6
6. 43 6. .01 7. 8/6 f. 12
7. 300 7. 0.33 8. 343/432 g. 24
8. 4 8. 0.1 9. 49/100 2. c
9. 20 9. 0.125 10. 1/2 3. d
10. 60 10. 0.25 11. 2/15 4. b
11. III 12. 5/8 5. c
12. IX 13. 1/5 6. a
13. XII 14. 4/5 7. c
14. XXX 15. 1/10 8. d
15. L 16. 4/15 9. d
16. C 17. 2/5 10. d
17. D 18. 3/64 11. c
18. XC 19. 3/25 12. a. 68
19. M 20. 21/64 b. 122
20. X 21. 9/40 c. 59
22. 1/15 d. 15
23. 4/81 e. 100
24. 6/420 13. a. 21
25. 1 2/3 b. -4
26. 2 c. 15
27. 15/32 d. 45
28. 49/25 e. 30
29. 1 2/3 14. c
30. 1/15 15. b

46
4. C 4. F 4. K 5. B

1. b 1. a 1. b 1. b
2. d 2. a 2. c 2. b
3. c 3. c 3. a 3. d
4. a 4. a 4. c 4. a
5. c 5. d 5. a 5. c
6. b 6. c
7. b 7. c
8. d 8. d
9. b 9. a
10. c 10. c
11. b
12. c
13. b
14. c 4. H
15. d
1. c
2. d
3. a

47