Comprehensive

Pharmacy Review
for NAPLEX
Eighth Edition

EDITORS

Leon Shargel, PhD, RPh

Alan H. Mutnick, PharmD, FASHP, RPh
Paul F. Souney, MS, RPh
Larry N. Swanson, PharmD, FASHP, RPh

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 Pharmaceutical
Calculations
1
ROBERT B. GREENWOOD

I. FUNDAMENTALS OF MEASUREMENT AND CALCULATION. The

pharmacist is often required to perform or evaluate a variety of calculations. Many of these calculations
involve the use of direct or inverse proportions. Dimensional (or unit) analysis and approximation can
be useful in solving these problems. In dimensional analysis, dimensions (or units) are included with each
number used in the calculation. Units common to the numerator and denominator may be canceled and
the remaining units provide the units for the final answer. In approximation, each number used in the
calculation is rounded to a single significant digit. Factors common to the numerator and denominator
may be canceled, and the answer to this approximation should be reasonably close to the final exact answer.
A. Ratio and proportion
1. Ratio. The relative magnitude of two like quantities is a ratio, which is expressed as a fraction.
Certain basic principles apply to the ratio, as they do to all fractions.
a. When the two terms of a ratio are multiplied or divided by the same number, the value of the
ratio is unchanged.
_ 2_
1_ 2_
1
3 2 6 3
b. Two ratios with the same value are equivalent. Equivalent ratios have equal cross products and
equal reciprocals. For example:
1_
_ 2
3 6
and
16326
If two ratios are equal, then their reciprocals are equal:
1_
if _ 3_
2 , then _ 6
3 6 1 2
2. Proportion. The expression of the equality of two ratios is a proportion. The product of the
extremes is equal to the product of the means for any proportion. The way to express this, from
the example cited, would be 1:3  2:6, where the means are 3 and 2, and the extremes are 1 and 6.
Furthermore, the numerator of the one fraction equals the product of its denominator and the
other fraction (i.e., one missing term can always be found given the other three terms). Most
pharmaceutical calculations can be performed by use of proportion.
a. Proper ratios. Some pharmacists use proper ratios (in which similar units are used in the numer-
ator and denominator of each ratio) in their proportion calculations. Several examples follow:
(1) If 240 mL of a cough syrup contains 480 mg of dextromethorphan hydrobromide, then
what mass of drug is contained in a child’s dose, 1 teaspoon (5 mL) of syrup?
240 mL _ 480 mg
_ 
5 mL x mg
x_ 480  5  10 mg
240
1

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 2 Chapter 1 I. A

(2) If a child’s dose (5 mL) of a cough syrup contains 10 mg of dextromethorphan hydrobro-

mide, what mass of drug is contained in 240 mL?
240 mL _x mg
_ 
5 mL 10 mg
240  10  480 mg
x_
5
(3) If the amount of dextromethorphan hydrobromide in 240 mL of cough syrup is 480 mg,
what would be the volume required for a child’s dose of 10 mg?
x mL 10 mg
_ _
240 mL 480 mg
10  240  5mL
x_
480
(4) How many milligrams of dextromethorphan base (molecular weight  271.4) are equiva-
lent to 10 mg of dextromethorphan hydrobromide (molecular weight  352.3)?
x mg 271.4
_ _
10 mg 352.3
271.4  7.7 mg
x  10  _
352.3

b. Mixed ratios. Some pharmacists use mixed ratios (in which dissimilar units are used in the numer-
ator and denominator of each ratio) in their proportion calculations. Such computations generally
give correct answers, providing the conditions in which mixed ratios cannot be used are known. A
later example shows mixed ratios leading to failure in the case of dilution, when inverse proportions
are required. For inverse proportions, similar units must be used in the numerator and denomina-
tor of each ratio. Following is an example of a mixed ratio calculation using the previous problem.
480 mg _240 mg
_ 
10 mL x mL

x  240  _10  5 mL
480

The same answer is obtained in this example whether we use proper ratios, with similar units
in numerator and denominator, or mixed ratios. This is not the case when dealing with inverse
proportions.
3. Inverse proportion. The most common example of the need for inverse proportion for the pharmacist
is the case of dilution. Whereas in the previous examples of proportion the relationships involved direct
proportion, the case of dilution calls for an inverse proportion (i.e., as volume increases, concentration
decreases). The necessity of using inverse proportions for dilution problems is shown in this example.
If 120 mL of a 10% stock solution is diluted to 240 mL, what is the final concentration? Using
inverse proportion,
x%
120 mL  _
_
240 mL 10%

120  _10  5%
240
As expected, the final concentration is one-half of the original concentration because the volume
is doubled. However, if the pharmacist attempts to use direct proportion and neglects to estimate
an appropriate answer, the resulting calculation would provide an answer of 20%, which is twice
the actual concentration.
10%
120 mL  _
_
240 mL x%
240  _10  20% (incorrect answer)
120

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 Pharmaceutical Calculations 3

Likewise, the pharmacist using mixed ratios fails in this case

120 mL  _
_ 240 mL
10% x%
and
240  20% (again, incorrect answer)
10  _
120

B. Aliquot. A pharmacist requires the aliquot method of measurement when the sensitivity (the
smallest quantity that can be measured with the required accuracy and precision) of the measuring
device is not great enough for the required measurement. Aliquot calculations can be used for mea-
surement of solids or liquids, allowing the pharmacist to realize the required precision through a
process of measuring a multiple of the desired amount, followed by dilution, and finally selection and
measurement of an aliquot part that contains the desired amount of material. This example problem
involves weighing by the aliquot method, using a prescription balance.
A prescription balance has a sensitivity requirement of 6 mg. How would you weigh 10 mg of drug
with an accuracy of  5% using a suitable diluent?
1. First, calculate the least weighable quantity for the balance with a sensitivity requirement of 6 mg,
assuming  5% accuracy is required.

6 mg _5%
_  ; x  120 mg (least weighable quantity for our balance)
x mg 100%
2. Now it is obvious that an aliquot calculation is required because 10 mg of drug is required, whereas
the least weighable quantity is 120 mg to achieve the required percentage of error. Using the least
weighable quantity method of aliquot measurement, use the smallest quantity weighable on the
balance at each step to preserve materials.
a. Weigh 12  10 mg  120 mg of drug.
b. Dilute the 120 mg of drug (from step a) with a suitable diluent by geometrical dilution to
achieve a mixture that will provide 10 mg of drug in each 120-mg aliquot. The amount of
diluent to be used can be determined through proportion.

x mg total mixture
120 mg drug __
__ 
10 mg drug 120 mg aliquot mixture
x  1440 mg total mixture
1440 mg total 120 mg drug  1320 mg diluent

c. Weigh 120 mg (1/12) of the total mixture of 1440 mg that will contain the required 10 mg of
drug, which is 1/12 of the 120 mg.

II. SYSTEMS OF MEASURE. The pharmacist must be familiar with three systems of measure:
the metric system and two common systems of measure (the avoirdupois and apothecaries’ systems).
The primary system of measure in pharmacy and medicine is the metric system. Most students find it
easiest to convert measurements in the common systems to metric units. A table of conversion equivalents
is provided and should be memorized by the pharmacist (see Appendix B). The metric system, because
of its universal acceptance and broad use, will not be reviewed here.
A. Apothecaries’ system of fluid measure. The apothecaries’ system of fluid measure is summarized in
Appendix B.
B. Apothecaries’ system for measuring weight. The apothecaries’ system for measuring weight in-
cludes units of grains, scruples, drams, ounces, and pounds (see Appendix B).
C. Avoirdupois system of measuring weight. The avoirdupois (AV) system of measuring weight
includes the grain, ounce, and pound. The grain is a unit common with the apothecaries’ system and
allows for easy conversion between the systems. The avoirdupois pound, however, is 16 AV ounces in
contrast to the apothecaries’ pound that is 12 apothecaries’ ounces (see Appendix B).
D. Conversion equivalents. See Appendix B.

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 4 Chapter 1 III. A

III. REDUCING AND ENLARGING FORMULAS. The pharmacist is often required to

reduce or enlarge a recipe. Problems of this type are solved through proportion or by multiplication or
division by the appropriate factor to obtain the required amount of each ingredient that will give the
desired total mass or volume of the formula. Formulas can be provided in amounts or in parts.
A. Formulas that indicate parts. When dealing with formulas that specify parts, parts by weight will
require the determination of weights of ingredients, whereas parts by volume warrant the calculation
of volumes of ingredients. Always find the total number of parts indicated in the formula and equate
that total with the total mass or volume of the desired formula in order to set up a proportion. Such
a proportion will allow calculation of the mass or volume of each ingredient in units common to the
total mass or volume.
What quantities should be used to prepare 100 g of “Diaper paste” from the following formula?
Rx mineral oil 6 parts
nystatin powder 1 part
hydrocortisone powder 2 parts
zinc oxide ointment 200 parts
Label: diaper paste, maximum 1 year expiration
Total number of parts  200  2  1  6  209 parts
For each of the ingredients, the ratio is then set up, such as
6 parts xg
_  _ , with x  2.87 g for mineral oil or
209 parts 100 g
1 part yg
_  _, with y  0.48 g for nystatin powder
209 parts 100 g

B. Formulas that indicate quantities. The following prescription for cold cream provides a 100-g
quantity.
What mass of each ingredient is required to provide 1 lb (AV) of cream?
Rx white wax 12.5 g
mineral oil 60.0 g
lanolin 2.5 g
sodium borate 1.0 g
rose water 24.0 g
1 lb  454 g
454  4.54 (multiplication factor to use in calculating the quantities of each ingredient)
_
100
12.5 g  4.54  56.8 g of white wax
60.0 g  4.54  272 g of mineral oil
2.5 g  4.54  11.4 g of lanolin
1.0 g  4.54  4.54 g of sodium borate
24.0 g  4.54  109 g of rose water

IV. CALCULATING DOSES. Calculation of doses generally can be performed with dimensional
analysis. Problems encountered in the pharmacy include calculation of the number of doses, quantities
in a dose or total mass/volume, amount of active or inactive ingredients, and size of dose. Calculation of
children’s doses is commonly performed by the pharmacist. Dosage is optimally calculated by using the
child’s body weight or mass and the appropriate dose in milligrams per kilogram (mg/kg). Without these
data, the following formulas based on an adult dose can be used.
A. Fried’s rule for infants
age (in months)  adult dose
___  dose for infant
150

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 Pharmaceutical Calculations 5

B. Clark’s rule

weight (lb)  adult dose

__  dose for child
150 lb (avg wt of adult)

C. Child’s dosage based on body surface area (BSA)

BSA of child (m )  adult dose

2
___
2  approximate dose for child
1.73 m (avg adult BSA)
D. Young’s rule for children 2 years old or older

age (in years)

__  adult dose  dose for child
age (in years)  12

E. Constant rate intravenous infusions. Some drugs are administered intravenously at a constant
(zero-order) rate by using a continuous-drip infusion set or a constant-rate infusion pump. The flow
rate (volume per unit time) required can be calculated from the volume to be administered and the
duration of the infusion. The rate of drug administration can be calculated from the concentration of
drug in the infused solution and the flow rate of the infusion set or pump. Conversion factors may be
required to obtain the final answer in the correct units (drops per minute or milliliters per hour).
A vancomycin solution containing 1000 mg of vancomycin hydrochloride diluted to 250 mL with
D5W is to be infused at a constant rate with a continuous-drip intravenous infusion set that delivers
25 drops/mL. What flow rate (drops per minute) should be used to infuse all 250 mL of the
vancomycin hydrochloride solution in 2 hrs?

250 mL _1 hr 25 drops
_   _  52 drops/min
2 hrs 60 mins 1 mL

V. PERCENTAGE, RATIO STRENGTH, AND OTHER

CONCENTRATION EXPRESSIONS
A. Percentage weight in volume (w/v)
1. Definition. Percentage, indicating parts per hundred, is an important means of expressing con-
centration in pharmacy practice. Percentage w/v indicates the number of grams of a constituent
per 100 mL of solution or liquid formulation. The pharmacist may be required to perform three
types of calculations: determine the weight of active ingredient in a certain volume when given the
percentage strength, determine the percentage w/v when the weight of substance and volume of
liquid formulation are known, and determine the volume of liquid mixture when the percentage
strength and amount of substance are known.
2. Tolu balsam syrup (from the National Formulary). Tolu balsam tincture contains 20% w/v tolu
balsam.
What is the percentage concentration of tolu balsam in the syrup from the formula shown in
the following?
tolu balsam tincture 50 mL
magnesium carbonate 10 g
sucrose 820 g
purified water, q.s. a.d. 1000 mL
a. First, determine what the amount of tolu balsam is contained in the 50 mL quantity of tincture
used for the syrup. Then, by proportion, calculate the concentration of tolu balsam in the syrup.

tolu balsam tincture  50 mL  _20 g  10 g tolu balsam

100 mL
10 g xg 1g
_  _ ; x  _  1% tolu balsam in the syrup
1000 mL 100 mL 100 mL

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 6 Chapter 1 V. A

In answering this one question, the first two types of problems listed beforehand have been
solved, while exhibiting two methods of solving percentage problems—namely, by dimen-
sional analysis and proportion.
b. For an example of the third type of percentage w/v problem, determine what volume of syrup
could be prepared if we had only 8 g of magnesium carbonate. Use proportion to find the
total volume of syrup that can be made using only 8 g of magnesium carbonate. If we have
10 g of magnesium carbonate in 1000 mL of solution, then, according to the recipe, 800 mL of
solution can be prepared using all 8 g of the drug.
10 g 8g
_  _; x  800 mL
1000 mL x mL
B. Percentage volume in volume (v/v). Percentage v/v indicates the number of milliliters of a con-
stituent in 100 mL of liquid formulation. The percentage strength of mixtures of liquids in liquids is
indicated by percentage v/v, which indicates the parts by volume of a substance in 100 parts of the
liquid preparation. The three types of problems that are encountered involve calculating percentage
strength, calculating volume of ingredient, and calculating volume of the liquid preparation.
Using the same tolu balsam syrup formula from earlier, we’ll now work a percentage v/v problem.
What is the percentage strength v/v of the tolu balsam tincture in the syrup preparation? By
proportion, we can solve the problem in one step.
1000 mL syrup
50 mL tolu balsam tincture __
___  ; x  5%
x mL tolu balsam tincture 100 mL syrup
C. Percentage weight in weight (w/w). Percentage w/w indicates the number of grams of a constituent
per 100 g of formulation (solid or liquid). Solution of problems involving percentage w/w is straight-
forward when the total mass of the mixture is available or when the total mass can be determined
from the available data. In calculations similar to those for percentage w/v and v/v, the pharmacist
might need to solve several types of problems, including determination of the weight of a constituent,
the total weight of a mixture, or the percentage w/w.
1. How many grams of drug substance should be used to prepare 240 g of a 5% w/w solution in
water?
a. The first step in any percentage w/w problem is to attempt identification of the total mass of
the mixture. In this problem, the total mass is, obviously, provided (240 g).
b. The problem can be easily solved through dimensional analysis.
5.0 g drug
240 g mixture  _  12 g
100 g drug
2. When the total mass of the mixture is unavailable or cannot be determined, an extra step is required
in the calculations. Because it is usually impossible to know how much volume is displaced by a solid
material, the pharmacist is unable to prepare a specified volume of a solution given the percentage w/w.
How much drug should be added to 30 mL of water to make a 10% w/w solution? The volume
of water that is displaced by the drug is unknown, so the final volume is unknown. Likewise, even
though the mass of solvent is known (30 mL  1 g/mL  30 g), it is not known how much drug
is needed, so the total mass is unknown. The water represents 100%  10%  90% of the total
mixture. Then, by proportion, the mass of drug to be used can be identified.
30 g of mixture (water) _
__  90% ; x  3.33 g of drug required to make a solution
x g of mixture (drug) 10%
The common error that many students make in solving problems of this type is to assume that 30
g is the total mass of the mixture. Solving the problem with that assumption gives the following
incorrect answer.
x g drug 30 g mixture
_  __; x  3 g of drug (incorrect answer)
10 g drug 100 g mixture
D. Ratio strength. Solid or liquid formulations that contain low concentrations of active ingredients
will often have concentration expressed in ratio strength. Ratio strength, as the name implies, is the

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 Pharmaceutical Calculations 7

expression of concentration by means of a ratio. The numerator and denominator of the ratio indicate
grams (g) or milliliters (mL) of a solid or liquid constituent in the total mass (g) or volume (mL) of a
solid or liquid preparation. Because percentage strength is essentially a ratio of parts per hundred,
conversion between ratio strength and percentage strength is easily accomplished by proportion.
1. Express 0.1% w/v as a ratio strength.
a. Ratio strengths are by convention expressed in reduced form, so in setting up our proportion to
solve for ratio strength, use the numeral 1 in the numerator of the right-hand ratio as shown:
0.1 g 1 part
_  _;  1000 parts, for ratio strength of 1:1000
x parts
100 mL
b. Likewise, conversion from ratio strength to percentage strength by proportion is easy, as
seen in the following example. Keep in mind the definition of percentage strength (parts per
hundred) when setting up the proportion.
2. Express 1:2500 as a percentage strength.
1 part x parts
_  _; x  0.04, indicating 0.04%
2500 parts 100 parts
E. Other concentration expressions
1. Molarity (M) is the expression of the number of moles of solute dissolved per liter of solution. It
is calculated by dividing the moles of solute by the volume of solution in liters.

MA  _ nA
solution (L)
2. Normality. A convenient way of dealing with acids, bases, and electrolytes involves the use of
equivalents. One equivalent of an acid is the quantity of that acid that supplies or donates 1 mole
of H ions. One equivalent of a base is the quantity that furnishes 1 mole of OH ions. One
equivalent of acid reacts with one equivalent of base. Equivalent weight can be calculated for
atoms or molecules.
atomic weight or molecular weight
Equivalent weight  ___
valence
The normality (N) of a solution is the number of gram-equivalent weights (equivalents) of
solute per liter of solution. Normality is analogous to molarity; however, it is defined in terms of
equivalents rather than moles.
# equivalents of solute
Normality  __
# liters of solution
3. Molality (m) is the moles of solute dissolved per kilogram of solvent. Molality is calculated by
dividing the number of moles of solute by the number of kilograms of solvent. Molality offers an
advantage over molarity because it is based on solvent weight and avoids problems associated with
volume expansion or contraction owing to the addition of solutes or from a change in temperature.
nA
mA  __
mass solvent (kg)
4. Mole fraction (X) is the ratio of the number of moles of one component to the total moles of a
mixture or solution.
nA
XA  __
nA, nB, nC . . . , where XA  X  XC  . . .  1

VI. DILUTION AND CONCENTRATION. If the amount of drug remains constant in a

dilution or concentration, then any change in the mass or volume of a mixture is inversely proportional
to the concentration.
A. Dilution and concentration problems can be solved by the following:
1. Inverse proportion (as mentioned earlier)
2. The equation quantity1  concentration1  quantity2  concentration2

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 8 Chapter 1 VI. A

3. Determining the amount of active ingredient present in the initial mixture and, with the assump-
tion that the initial quantity does not change, calculating the final concentration of the new total
mass or volume
4. Alligation medial. A method for calculating the average concentration of a mixture of two or
more substances
5. Alligation alternate. A method for calculating the number of parts of two or more components
of known concentration to be mixed when the final desired concentration is known
B. Dilution of alcohols and acids
1. Dilution of alcohols. When alcohol and water are mixed, a contraction of volume occurs. As a
result, the final volume of solution cannot be determined accurately, nor can the volume of water
needed to dilute to a certain percentage v/v be identified. Accordingly, percentage w/w is often
used for solutions of alcohol.
2. The percentage strength of concentrated acids is expressed as percentage w/w. The concentration
of diluted acids is expressed as percentage w/v. Determining the volume of concentrated acid to
be used in preparing a diluted acid requires the specific gravity of the concentrated acid.
C. Dilution and concentration of liquids and solids. Dilution and concentration problems are solved
by identifying the amount of drug involved followed by use of an appropriate proportion.
1. How many milliliters of a 1:50 stock solution of ephedrine sulfate should be used in com-
pounding the following prescription?
Rx ephedrine sulfate 0.25%
rose water, a.d. 30 mL
0.25 g
_  30 mL  0.075 g drug required
100 mL
50 mL  _
_ x mL ;
1g 0.075 g
x  3.75 mL of stock solution required for prescription
2. How many milliliters of a 15% w/v concentrate of benzalkonium chloride should be used in
preparing 300 mL of a stock solution such that 15 mL diluted to 1 L will yield a 1:5000 solution?
a. First, determine the amount of drug in 1 L of a 1:5000 solution.
1g
5000 mL _
_  ;  0.2 g of benzalkonium chloride in the final solution
1000 mL xg
b. Now, because 15 mL of the stock solution is being diluted to 1 L, a stock solution is needed in
which 15 mL contain 0.2 g of drug. The amount of drug required to make 300 mL of the stock
solution is found by proportion.
0.2 g _15 mL
_  ; x  4 g of drug required to make 300 mL of solution
xg 300 mL
c. Finally, to determine the amount of 15% concentrate required.
15 g 100 mL
_  _; x  26.7 mL of 15% solution required to obtain necessary drug
4g x mL
3. When the relative amount of components must be determined for preparation of a mixture of a
desired concentration, the problem can be solved using alligation alternate.
How many grams of 2.5% hydrocortisone cream should be mixed with 360 g of 0.25% cream
to make a 1% hydrocortisone cream?
2.5% 0.75 parts of 2.5% cream  1 part 0.75/2.25  1/3
1% 1.5 parts of 0.25% cream  2 parts
0.25% __ _ 1.5/2.25  2/3
2.25 parts total  3 parts
The relative amounts of the 2.5% and 1% creams are 1 to 2, respectively. By proportion, the mass
of 2.5% cream to use can be determined. If 2 parts of 0.25% cream is represented by 360 g, then
the total mass (3 parts) is represented by what mass?

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 Pharmaceutical Calculations 9

2 parts _360 g
_  ; x  540 g total
3 parts xg
With the total mass known, the amount of 2.5% cream can be identified. If 3 parts represent the
total mass of 540 g, then 1 part represents the mass of 2.5% cream (x g  180 g).
1 part xg
_  _; x  180 g of 2.5% cream
3 parts 540 g

VII. ELECTROLYTE SOLUTIONS. Electrolyte solutions contain species (electrolytes) that

dissociate into ions. The milliequivalent (mEq) is the unit most frequently used to express the
concentration of electrolytes in solution. Table 1-1 exhibits some physiologically important ions and their
properties.
A. Milliequivalents. The milliequivalent is the amount, in milligrams, of a solute equal to 1/1000 of
its gram-equivalent weight. Conversion of concentrations in the form of milliequivalent to concen-
trations in percentage strength, milligrams per milliliter (mg/mL) or any other terms, begins with
calculation of the number of milliequivalents of drug. The following examples demonstrate the
computation of milliequivalents and manipulation of data from Table 1-1 to perform the required
calculations for preparing electrolyte solutions.
What is the concentration, in percent w/v, of a solution containing 2 mEq of potassium chloride
per milliliter?
Calculations involving milliequivalents are easily solved if the practitioner follows a predefined pro-
cedure to determine the milliequivalent weight. This involves three steps.
1. Find the molecular weight (mol wt).
Atomic wt K  39
Atomic wt Cl  35.5
39  35.5  74.5 g  mol wt of KCl

Table 1-1 VALENCES, ATOMIC WEIGHTS, AND MILLIEQUIVALENT WEIGHTS OF

SELECTED IONS

Atomic/Formula Milliequivalent
Ion Formula Valence Weight Weight (mg)

Aluminum A 3 27 9
Ammonium NH4 1 18 18
Calcium Ca 2 40 20
Ferric Fe 3 56 18.7
Ferrous Fe 2 56 28
Lithium Li 1 7 7
Magnesium Mg 2 24 12
Bicarbonate HCO3 1 61 61
Carbonate CO3 1 60 30
Chloride Cl 1 35.5 35.5
Citrate C6H5O7 3 189 63
Gluconate C6H11O7 1 195 195
Lactate C3H5O3 1 89 89
Phosphate H2PO4 1 97 97
Sulfate SO4 2 96 48
Potassium K 1 29 39
Sodium Na 1 23 23
Acetate C2H3O2 1 59 59

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 10 Chapter 1 VII. A

2. Calculate the equivalent weight (Eq wt) of KCl.

mol wt  _
Eq wt  _ 74.5  74.5 g
valence 1
3. Determine the milliequivalent weight, which is 1/1000 of the equivalent weight.
mEq wt  74.5 g/1000  0.745 g or 74.5 mg
Now that we know the milliequivalent weight, we can calculate by dimensional analysis and pro-
portion the concentration in percentage in a fourth step.
4. 0.0745 g/mEq  2 mEq  0.149 g of drug
0.149 g drug _x g drug
__  ; x  14.9 g/100 mL  14.9%
1 mL 100 mL
ⴙ
How many milliequivalents of Na would be contained in a 15-mL volume of the following
buffer?
Na2HPO47H2O 180 g
NaH2PO4H2O 480 g
Purified water a.d. 1000 mL
For each salt, the mass (and milliequivalents) must be found in a 15-mL dose.
mol wt Na2HPO47H2O (disodium hydrogen phosphate)  268 g
Eq wt  268/2  134 g
1 mEq  0.134 g or 134 mg
180 g _1000 mL
_  ; x  2.7 g of disodium hydrogen phosphate in each 15 mL
xg 15 mL
1 mEq
2.7 g  _  20.1 mEq of disodium hydrogen phosphate
0.134 g
mol wt NaH2PO4H2O (sodium biphosphate)  138 g
Eq wt  138 g
1 mEq  0.138 g
480 g _1000 mL
_  ; x  7.2 g of sodium biphosphate in each 15 mL
xg 15 mL
1 mEq
7.2 g  _  52.2 mEq of sodium biphosphate
0.138 g

20.1 mEq  52.2 mEq  72.3 mEq of sodium in each 15 mL of solution

B. Milliosmoles (mOsmol). Osmotic pressure is directly proportional to the total number of particles
in solution. The milliosmole is the unit of measure for osmotic concentration. For nonelectrolytes,
1 millimole represents 1 mOsmol. However, for electrolytes, the total number of particles in a solu-
tion is determined by the number of particles produced in a solution and influenced by the degree
of dissociation. Assuming complete dissociation, 1 millimole of KCl represents 2 mOsmol of total
particles, 1 millimole of CaCl2 represents 3 mOsmol of total particles, etc. The ideal osmolar concen-
tration can be calculated with the following equation.
wt of substance in g/L
mOsmol/L  __  number of species  1000
mol wt in g
The pharmacist should recognize the difference between ideal osmolar concentration and actual
osmolarity. As the concentration of solute increases, interaction between dissolved particles increases,
resulting in a reduction of the actual osmolar values.
C. Isotonic solutions. An isotonic solution is one that has the same osmotic pressure as body flu-
ids. Isosmotic fluids are fluids with the same osmotic pressure. Solutions to be administered to

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 Pharmaceutical Calculations 11

patients should be isosmotic with body fluids. A hypotonic solution is one with a lower osmotic
pressure than body fluids, whereas a hypertonic solution has an osmotic pressure that is greater
than body fluids.
1. Preparation of isotonic solutions. Colligative properties, including freezing point depression,
are representative of the number of particles in a solution and are considered in preparation of
isotonic solutions.
a. When 1 g mol wt of any nonelectrolyte is dissolved in 1000 g of water, the freezing point of
the solution is depressed by 1.86°C. By proportion, the weight of any nonelectrolyte needed to
make the solution isotonic with body fluid can be calculated.
b. Boric acid (H3BO3) has a mol wt of 61.8 g. Thus, 61.8 g of H3BO3 in 1000 g of water should
produce a freezing point of 1.86°C. Therefore, knowing that the freezing point depression of
body fluids is 0.52°C,

1.86°C _61.8 g
_  ; x  17.3 g
0.52°C xg

and 17.3 g of H3BO3 in 1000 g of water provides a solution that is isotonic.

c. The degree of dissociation of electrolytes must be taken into account in such calculations. For
example, NaCl is approximately 80% dissociated in weak solutions, yielding 180 particles in a
solution for each 100 molecules of NaCl. Therefore,

1.86°C  1.8 _
__ 58 g
 ; x  9.09 g
0.52°C xg

indicating that 9.09 g of NaCl in 1000 g of water (0.9% w/v) should make a solution isotonic.
Lacking any information on the degree of dissociation of an electrolyte, the following disso-
ciation values (i) may be used:
(1) Substances that dissociate into two ions: 1.8
(2) Substances that dissociate into three ions: 2.6
(3) Substances that dissociate into four ions: 3.4
(4) Substances that dissociate into five ions: 4.2
2. Sodium chloride equivalents. The pharmacist will often be required to prepare an isotonic solu-
tion by adding an appropriate amount of another substance (drug or inert electrolyte or nonelec-
trolyte). Considering that isotonic fluids contain the equivalent of 0.9% NaCl, the question arises,
how much of the added ingredient is required to make the solution isotonic? A common method
for computing the amount of added ingredient to use for reaching isotonicity involves the use of
sodium chloride equivalents.
a. Definition. The sodium chloride equivalent represents the amount of NaCl that is equivalent
to the amount of particular drug in question. For every substance, there is one quantity that
should have a constant tonic effect when dissolved in 1000 g of water. This is 1 g mol wt of the
substance divided by its dissociation value (i).
b. Examples
(1) Considering H3BO3, from the last section, 17.3 g of H3BO3 is equivalent to 0.52 g of NaCl
in tonicity. Therefore, the relative quantity of NaCl that is equivalent to H3BO3 in tonicity
effects is determined as follows:

mol wt of NaCl/i value  _

__ 58.5/1.8
mol wt of H3BO3/i value 61.8/1.0

Applying this method to atropine sulfate, recall that the molecular weight of NaCl and the
molecular weight of atropine sulfate are 58.5 and 695 g, respectively, and their i values are
1.8 and 2.6, respectively. Calculate the mass of NaCl represented by 1 g of atropine sulfate
(Table 1-2).

695  1.8 _
1g
_  ; x  0.12 g NaCl represented by 1 g of atropine sulfate
58.5  2.6 xg

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 12 Chapter 1 VII. C

Table 1-2 SODIUM CHLORIDE (NaCl)

EQUIVALENTS

NaCl
Substance Equivalent

Atropine sulfate (H2O) 0.12

Boric acid 0.52
Chlorobutanol 0.24
Dextrose (anhydrous) 0.18
Ephedrine hydrochloride 0.29
Phenacaine hydrochloride 0.20
Potassium chloride 0.78

(2) An example of the practical use of sodium chloride equivalents is seen in the following
problem:
How many grams of boric acid should be used in compounding the following
prescription?
Rx phenacaine hydrochloride 1%
chlorobutanol 0.5%
boric acid q.s.
purified water, a.d. 60.0 mL
make isotonic solution
The prescription calls for 0.3 g of chlorobutanol and 0.6 g of phenacaine. How much boric
acid is required to prepare this prescription? The question is best answered in four steps:
(a) Find the mass of sodium chloride represented by all ingredients.

0.20  0.6  0.120 g of sodium choloride represented by phenacaine

hydrochloride
0.24  0.3  0.072 g of sodium chloride represented by chlorobutanol
0.192 g of sodium chloride represented by the two active
ingredients

(b) Find the mass of sodium chloride required to prepare an equal volume of isotonic
solution.
0.9 g NaCl _x g NaCL
_  ; x  0.540 g of sodium chloride
100 mL 60 mL
in 60 mL of an isotonic sodium chloride solution
(c) Calculate, by subtraction, the amount of NaCl required to make the solution
isotonic.

0.540 g NaCl required for isotonicity

0.192 g NaCl represented by ingredients
0.348 g NaCl required to make isotonic solution

(d) Because the prescription calls for boric acid to be used, one last step is required

0.348 g
_ (sodium chloride equivalent for boric acid)  0.669 g of boric acid
0.52
to be used

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 Pharmaceutical Calculations 13

Study Questions
Directions for questions 1–30: Each question, statement, 7. Using the formula for calamine lotion, determine the
or incomplete statement in this section can be correctly amount of calamine (in grams) necessary to prepare
answered or completed by one of the suggested answers or 240 mL of lotion.
phrases. Choose the best answer.
calamine 80 g
1. If a vitamin solution contains 0.5 mg of fluoride ion in zinc oxide 80 g
each milliliter, then how many milligrams of fluoride ion glycerin 20 mL
would be provided by a dropper that delivers 0.6 mL? bentonite magma 250 mL
(A) 0.30 mg calcium hydroxide sufficient quantity to
(B) 0.10 mg topical solution make 1000 mL
(C) 1.00 mg
(A) 19.2 g
(D) 0.83 mg
(B) 140.0 g
2. How many chloramphenicol capsules, each containing (C) 100.0 g
250 mg, are needed to provide 25 mg/kg/d for 7 days (D) 24.0 g
for a person weighing 200 lb?
8. From the following formula, calculate the amount
(A) 90 capsules of white wax required to make 1 lb of cold cream.
(B) 64 capsules Determine the mass in grams.
(C) 13 capsules
(D) 25 capsules cetyl esters wax 12.5 parts
white wax 12.0 parts
3. If 3.17 kg of a drug is used to make 50000 tablets, how mineral oil 56.0 parts
many milligrams will 30 tablets contain? sodium borate 0.5 parts
(A) 1.9 mg purified water 19.0 parts
(B) 1900 mg
(A) 56.75 g
(C) 0.0019 mg
(B) 254.24 g
(D) 3.2 mg
(C) 54.48 g
4. A capsule contains ⅛ gr of ephedrine sulfate, ¼ gr of (D) 86.26 g
theophylline, and ¹⁄16 gr of phenobarbital. What is the
9. How many grams of aspirin should be used to prepare
total mass of the active ingredients in milligrams?
1.255 kg of the powder?
(A) 20 mg
(B) 8 mg Aspirin 6 parts
(C) 28 mg phenacetin 3 parts
(D) 4 mg caffeine 1 part

5. If 1 fluid ounce of a cough syrup contains 10 gr of (A) 125 g

sodium citrate, how many milligrams are contained in (B) 750 g
10 mL? (C) 175 g
(D) 360 g
(A) 650 mg
(B) 65 mg 10. A solution contains 1.25 mg of a drug per milliliter.
(C) 217 mg At what rate should the solution be infused (drops per
(D) 20 mg minute) if the drug is to be administered at a rate of
80 mg/hr? (1 mL  30 drops)
6. How many capsules, each containing ¼ gr of
phenobarbital, can be manufactured if a bottle (A) 64.00 drops/min
containing 2 avoirdupois ounces of phenobarbital is (B) 1.06 drops/min
available? (C) 32.00 drops/min
(D) 20.00 drops/min
(A) 771 capsules
(B) 350 capsules
(C) 3500 capsules
(D) 1250 capsules

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 14 Chapter 1

11. The recommended maintenance dose of aminophylline 15. How many milligrams of papaverine will the patient
for children is 1.0 mg/kg/hr by injection. If 10 mL of receive each day?
a 25-mg/mL solution of aminophylline is added to a Rx papaverine hcl 1.0 g
100-mL bottle of 5% dextrose, what should be the rate aqua 30.0 mL
of delivery in mL/hr for a 40-lb child? syrup tolu, q.s. a.d. 90.0 mL
(A) 2.30 mL/hr Sig: 1 teaspoon t.i.d.
(B) 8.00 mL/hr (A) 56.0 mg
(C) 18.90 mL/hr (B) 5.6 mg
(D) 18.20 mL/hr (C) 166.0 mg
12. For children, streptomycin is to be administered at (D) 2.5 mg
a dose of 30 mg/kg of body weight daily in divided 16. Considering the following formula, how many grams
doses every 6 to 12 hrs. The dry powder is dissolved of sodium bromide should be used in filling this
by adding water for injection, in an amount to yield prescription?
the desired concentration as indicated in the following
Rx sodium bromide 1.2 g
table (for a 1-g vial).
syrup tolu 2.0 mL
Approximate syrup wild cherry, q.s. a.d. 5.0 mL
Concentration (mg/mL) Volume (mL) d.t.d. #24
200 4.2
(A) 1.2 g
250 3.2
(B) 1200.0 g
400 1.8
(C) 28.8 g
Reconstituting at the lowest possible concentration, (D) 220.0 g
what volume (in mL) would be withdrawn to obtain a
17. How many milliliters of a 7.5% stock solution of
day’s dose for a 50-lb child?
KMnO4 should be used to obtain the KMnO needed?
(A) 3.40 mL
KMnO4, q.s.
(B) 22.73 mL
Distilled water, a.d. 1000 mL
(C) 2.50 mL
Sig: 2 teaspoons diluted to 500 mL yield a 1:5000
(D) 2.27 mL
solution
13. The atropine sulfate is available only in the form (A) 267.0 mL
of 1/150 gr tablets. How many atropine sulfate (B) 133.0 mL
tablets would you use to compound the following (C) 26.7 mL
prescription? (D) 13.3 mL
atropine sulfate 1/200 gr 18. The formula for Ringer’s solution follows. How much
codeine phosphate ¼ gr sodium chloride is needed to make 120 mL?
aspirin 5 gr
Rx sodium chloride 8.60 g
d.t.d. #24 capsules
potassium chloride 0.30 g
Sig: 1 capsule p.r.n.
calcium chloride 0.33 g
(A) 3 tablets water for injection, q.s. a.d. 1000 mL
(B) 6 tablets (A) 120.00 g
(C) 12 tablets (B) 1.03 g
(D) 18 tablets (C) 0.12 g
14. In 25.0 mL of a solution for injection, there are (D) 103.00 g
4.00 mg of the drug. If the dose to be administered 19. How many grams of talc should be added to 1 lb of a
to a patient is 200 g, what quantity (in mL) of this powder containing 20 g of zinc undecylenate per
solution should be used? 100 g to reduce the concentration of zinc undecylenate
(A) 1.25 mL to 3%?
(B) 125.00 mL (A) 3026.7 g
(C) 12.00 mL (B) 2572.7 g
(D) None of the above (C) 17.0 g
(D) 257.0 g

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 Pharmaceutical Calculations 15

20. How many milliliters of a 0.9% aqueous solution can 26. The manufacturer specifies that one Domeboro tablet
be made from 20.0 g of sodium chloride? dissolved in 1 pint of water makes a modified Burow’s
(A) 2222 mL solution approximately equivalent to a 1:40 dilution.
(B) 100 mL How many tablets should be used in preparing ½ gal
(C) 222 mL of a 1:10 dilution?
(D) 122 mL (A) 16 tablets
(B) 189 tablets
21. The blood of a reckless driver contains 0.1% alcohol.
(C) 12 tablets
Express the concentration of alcohol in parts per
(D) 45 tablets
million.
(A) 100 ppm 27. How many milliosmoles of calcium chloride
(B) 1000 ppm (CaCl2∙2H2O  mol wt  147) are represented in
(C) 1 ppm 147 mL of a 10% w/v calcium chloride solution?
(D) 250 ppm (A) 100 mOsmol
(B) 200 mOsmol
22. Syrup is an 85% w/v solution of sucrose in water. It has
(C) 300 mOsmol
a density of 1.313 g/mL. How many milliliters of water
(D) 3 mOsmol
should be used to make 125 mL of syrup?
(A) 106.25 mL 28. How many grams of boric acid should be used in
(B) 164.10 mL compounding the following prescription?
(C) 57.90 mL Phenacaine HCl 1.0% (NaCl eq  0.17)
(D) 25.00 mL Chlorobutanol 0.5% (NaCl eq  0.18)
23. How many grams of benzethonium chloride should be Boric acid, q.s. (NaCl eq  0.52)
used in preparing 5 gal of a 0.025% w/v solution? Purified H2O, a.d. 30 mL
Make isotonic solution
(A) 189.25 g
Sig: 1 drop in each eye
(B) 18.90 g
(C) 4.73 g (A) 0.37 g
(D) 35.00 g (B) 0.74 g
(C) 0.27 g
24. How many grams of menthol should be used to
(D) 0.47 g
prepare this prescription?
29. A pharmacist prepares 1 gal of KCl solution by mixing
Rx menthol 0.8%
565 g of KCl (valence  1) in an appropriate vehicle.
alcohol, q.s. a.d. 60.0 mL
How many milliequivalents of K are in 15 mL of this
(A) 0.48 g solution? (atomic weights: K  39; Cl  35.5)
(B) 0.80 g (A) 7.5 mEq
(C) 4.80 g (B) 10.0 mEq
(D) 1.48 g (C) 20.0 mEq
25. How many milliliters of a 1:1500 solution can be made (D) 30.0 mEq
by dissolving 4.8 g of cetylpyridinium chloride in (E) 40.0 mEq
water? 30. A vancomycin solution containing 1000 mg of
(A) 7200.0 mL vancomycin hydrochloride diluted to 250 mL with
(B) 7.2 mL D5W is to be infused at a constant rate with an
(C) 48.0 mL infusion pump in 2 hrs. What is the rate of drug
(D) 4.8 mL administration?
(A) 2.08 mg/min
(B) 8.33 mg/min
(C) 4.17 mg/min
(D) 16.70 mg/min
(E) 5.21 mg/min

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 16 Chapter 1

Answers and Explanations

1. The answer is A [see I.A.2]. Finally, to obtain the correct amount of drug to for-
mulate the prescription (10 g), we are to use a 7.5%
2. The answer is B [see II].
stock solution. Recalling the definition of percentage
3. The answer is B [see II]. strength w/v
4. The answer is C [see II]. 100 mL  10 g  133.3 mL or 133 mL
_
7.5 g
5. The answer is C [see I.A.2].
6. The answer is C [see II]. 18. The answer is B [see III.B].

7. The answer is A [see III]. 19. The answer is B [see V.C; VI.C].

8. The answer is C [see II; III.A]. 20. The answer is A [see I.A.2; V.A].
The formula tells the pharmacist that white wax (W.W.) Using dimensional analysis
represents 12 parts out of the total 100 parts in the pre- 20 g  100 mL
scription. What we wish to determine is the mass of
__  2222 mL
0.9 g
white wax required to prepare 454 g (1 lb) of the recipe.
This can be easily solved by proportion: 21. The answer is B [see V.D.1].

12 parts W.W. __ x 22. The answer is C [see I.A; V.A.1].

__  ; x  54.48 g Using the density, the weight of 125 mL of syrup can
100 parts total 454 parts (grams)
be calculated:
9. The answer is B [see III.A].
125 mL  1.313 g/mL  164.125 g
10. The answer is C [see IV.E].
Using proportion and the sucrose concentration in
11. The answer is B [see II; IV]. w/v, the weight of sucrose in 125 mL of syrup can be
12. The answer is A [see IV]. calculated:
13. The answer is D [see II; III.B]. 100 mL _85 g
_  ; x  106.25 g
125 mL xg
14. The answer is A [see I.A.2; II].
Dimensional analysis is often useful for calculating Finally, the weight of water in 125 mL of syrup can be
doses. Considering that 4 mg of the drug is present in calculated:
each 25 mL of solution, we can easily calculate the num- 164.125 g  106.25 g  57.875 g
ber of milliliters to be used to give a dose of 0.200 mg
(200  g). Always include units in your calculations. which has a volume of 57.90 mL.

25 mL  0.200 mg  1.25 mL 23. The answer is C [see I; II; V].

_
4 mg 24. The answer is A [see I; V].
15. The answer is C [see III.B]. 25. The answer is A [see I; V].
16. The answer is C [see III.B]. The problem is easily solved by proportion. The ques-
tion to be answered is if 1 g of drug is present in
17. The answer is B [see V.A; VI]. 1500 mL of a solution, what volume can be made with
First, determine the mass of drug in the final diluted 4.8 g of drug?
solution.
1g 1500 mL
1 part xg
_  _; x  7200.0 mL
4.8 g x mL
_  _; x  0.1 g
5000 parts 500 g
(the volume of 1 to 1500 solution that can be prepared
Now, if 0.1 g of drug is present in 500 mL of 1:5000 from 4.8 g of drug)
solution, 2 teaspoons (10 mL) of the prescription con-
tains the same amount of drug (0.1 g) before dilution. 26. The answer is A [see I; V].
From this, the amount of drug in 1000 mL (the total
volume) of the prescription can be determined:
0.1 g xg
_  _; x  10 g
10 mL 1000 mL

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 Pharmaceutical Calculations 17

27. The answer is C [see VII.B]. 28. The answer is A [see VII.C].
Recalling the expression for ideal osmolar concentration:
29. The answer is D [see VII.A].
100 g/L 30. The answer is B [see IV.E].
mOsmol/L  _  3  1000
147 g/mol Using dimensional analysis:
 mOsmol/L  0.147 L 1000 mg _250 mL _1 hr
 300 mOsmol
_    8.33 mg/min
250 mL 2 hr 60 min

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