Drug

Calculation
Three Systems of Measurement

Metric Apothecary Household

Developed in the late 18th Century, Used during Middle Ages and had Commonly used in community and
is the internationally accepted been used in England since the 17th home settings in the
system of measure. Century United States
Metric Units of Measurements
Unit Names and Abbreviations Measurements
1 kilogram (kg, Kg) 1000 g
1 gram (g, gm, G, Gm) 1g
Gram (weight) 1 milligram (mg) 0.001 g
1 microgram (mcg) 0.000001 g
1 Nanogram (ng) 0.000000001 g
1 kiloliter (kl, KL) 1000 L
Liter (volume) 1 liter (L, l) 1L
1 milliliter (mL) 0.001 L
1 kilometer (km) 1000 m
1 meter (m, M) 1m
Meter (length)
1 centimeter (cm) 0.01 m
1 millimeter (mm) 0.001 m
Note: 1 ml = 1 cc; 1 mg = 1000 mcg
METRIC CONVERSION EXERCISES
Larger to Smaller Units Smaller to Larger Units
1. Change 2 g to mg 4. Change 1500 mg to g
2. Change 0.5 g to mg 5. Change 3 g to kg
3. Change 2.5 L to ml 6. Change 500 ml to L
Apothecary Equivalents in
Weights and Fluid Volume
Dry Weight Fluid Volume
Larger Units Smaller Units Larger Units Smaller Units
1 ounce (oz) = 480 grains (gr) 1 quart (qt) = 2 pints (pt)
1 ounce (oz) = 8 drams 1 pint (pt) = 16 fluid ounces
1 dram = 60 grains (gr) 1 fluid ounce = 8 fluid dram
1 scruple = 20 grains (gr) 1 fluid dram = 60 minims
1 minim = 1 drop (gt)
Household Equivalents
in Fluid Volume
1 measuring cup = 8 ounces (oz)
1 medium-size glass (tumbler size) = 8 ounces (oz)
1 coffee cup (c) = 6 ounces (oz) (varies with cup size)
1 ounce (oz) = 2 tablespoons (T)
1 tablespoon (T) = 3 teaspoons (t)
1 teaspoon (t) = 60 drops (gtt)
1 drop (gt) = 1 minim (min)
 METRIC APOTHECARY

METRIC and Grams (g)

1
Milligrams (mg)
1000
Grains (gr)
15
0.5 500 7 1/2
APOTHECARY 0.3
0.1
300 (325)
100
5
1 1/2

CONVERSION
0.06 60 (54) 1
0.03 30 (32) 1/2
0.015 15 (16) 1/4
0.010 10 1/8
0.0006 0.6 1/100
0.0004 0.4 1/150
0.0003 0.3 1/200
Liquid (Approximate)
30 ml (cc) 1 oz = 2 tbsp = 6 tsp
15 ml (cc) 0.5 oz = 1 tbsp = 3 tsp
1000 ml (cc) 1 quart = 1 liter
500 ml (cc) 1 pint
5 ml (cc) 1 tsp
4 ml (cc) 1 fl dr
1 ml (cc)
15 minims = 15 drops (gtt)
Methods of
CALCULATION
Method 1: Basic Formula (BF)
The basic formula is easy to recall and is most frequently
used in calculating drug dosages. The basic formula is the
following:

Where D is the desired dose

H is the on-hand dose
V is the vehicle
A is the amount calculated to be given to the patient
Method 2: Ratio & Proportion (RP)
The ratio-and-proportion method is the oldest method
currently used in the calculation of drug dosages. The
formula is the following:

Where H is the drug on hand

V is the vehicle of drug form
D is the desired dose
X is the unknown amount to give , and
:: stands for “as” or “equal to”

Multiply the means and the extremes.

Solve for x; x is the divisor
Method 3: Fractional Equation (FE)
The fractional equation method is similar to ratio and
proportion except it is written as a fraction.

H=D H Dosage on hand = D desired dosage

V X V Vehicle X unknown

Cross-multiply and solve for X

Method 4: Dimensional Analysis (DA)
The dimensional analysis method (also called factor labelling or
the label factor method) calculates dosages using three factors:

1. Drug label factor: the form of the drug dose (V) with the
equivalence in units (H).

2. Conversion factor (C): it will help to memorise the following

common conversions.

3. Drug order factor: the dosage desired (D).

V = V (vehicle) x C (H) x D (desired)

H (on hand) x C (D) x 1
(drug label) (conversion factor) (drug order)
Method 6: Body Surface Area (BSA)
The body surface area (BSA) method is considered the most
accurate way to calculate the drug dose for infants, children,
older adults, and clients who are on antineoplastic agents or
whose BW is low. The BSA, in square meters (m2), is determined
by where the person’s height and weight intersect the
nomogram scale. To calculate the drug dosage using the BSA
method, multiply the drug dose ordered by the number of
square meters.

100 mg X 1.8 m2 (BSA) = 180 mg/day

Intravenous Fluid
Intravenous Set
Manufacturer Drop Factor
MACROSET

Baxter 10 gtts / ml
Abbott 15 gtts / ml
BBraun 20 gtts / ml
MICROSET

BBraun 60 ugtts / ml
KVO - Keep Vein Open ; TKO - To Keep Open KSS - Keep Set Sterile
Calculating
Intravenous
Flow Rate
Calculating Intravenous Flow Rate
Calculating Intravenous Flow Rate
DRUG
CALCULATION DRILL
Aspirin 650 mg 1 tablet PO now

What is the dose on hand?

How many aspirin would you give?

The doctor ordered atorvastatin 40 mg tablet OD HS.

What is available on hand?

How many tablets would you give to the patient?
Furosemide 15 mg IV push over 5 minutes.

What is the dose on hand?

How much furosemide would you give?
You receive an order for hydrocortisone (Solu-cortef) 85 mg IV.

The pharmacist dispensed to you this vial.

What is the dose on hand?

How much hydrocortisone would you give?
Would you use a 3-mL or a tuberculin syringe to measure the drug?
You receive an order for clindamycin (Dalacin-C)

50 mg TID PO. The pharmacist dispensed to you this oral

solution.

What is the dose on hand?

How much clindamycin would you give?
Would you use to measure the drug?
Start cefuroxime (Zinacef) 175 mg IVTT q 8 ANST ( ).

Powder for injection diluted in 5 mL sterile water.

How much cefuroxime would you give?

Would you use a 3-mL or 5-mL syringe to measure this drug?
Start ampicillin 370 mg IVTT q 6 ANST ( ).

Powder for injection diluted in 5 mL sterile water.

How much ampicillin would you give?

Would you use a 3-mL or 5-mL syringe to measure this drug?
Start phenytoin (Dilantin) 25 mg BID PO.

How much phenytoin would you give?

What are you going measure this drug?
Give phenytoin (Dilantin) 85mg IVTT for frank seizure?

How much phenytoin would you give?

Would you use a 3-mL or 5-mL syringe to measure this
drug?
Incorporate 15 meqs potassium chloride to 1 liter
PNSS to run for 16 hours. Drop Factor 15.

How much KCl would you incorporate to IV bottle?

How many mL per hour?
How many gtts/minute?
 Patient X
Body Weight
55 kgs

Start Norepinephrine 16 mg to be diluted in NSS to make 100 mL. Start

drip at 2 mcg/kg/min with increment of 1 mcg every 30 minutes to
achieve systolic BP of 90/60 mmHg?

How much norepinephrine would you prepare?

How much NSS would you add to make a 100 mL?
What IV delivery set would you use to administer the drug?
What is the flow rate?
Patient X
Body Weight
55 kgs
Start dopamine drip 400 mg/250 mL with 5 mcg/kg/min
flow rate. Increase the rate at 3 mcg every 30 minutes.
Patient is 60 kgs.

What IV delivery set would you use to administer the drug?

What is the flow rate?
Calculations of
ORAL DOSAGES
ADVANTAGES of Oral Medications
01 The client frequently can take oral medications without assistance.

02 The cost of oral medication is usually less than other routes.

03 Oral medications are easy to store.

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DISADVANTAGES of Oral Medications
01 Variation in absorption.

02 Irritation of the gastric mucosa by certain drugs.

03 Destruction or partial inactivation of the drugs by liver enzymes.

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Calculation for Tablet, Capsule,
and Liquid Doses
Calculations of
INJECTABLE DOSAGES
CONSIDERATIONS for Injectable Medications
01 An inability to swallow.

02 A decreased level of consciousness.

03 An inactivation of the drug by gastric juices.

04 A desire to increase the effectiveness of the drug.

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Insulin Syringe
Insulin dosage must not be calculated in milliliters.
Insulin syringes must be used for administration of insulin.
Insulin is administered subQ at a 45-, 60-, or 90-degree
angle into the subQ tissue.
Only clear (regular) insulin can be given IV as well as subQ.
Insulin can be categorised as (1) fast-acting, (2)
intermediate, and long-acting.
 TYPE INSULIN / BRAND ONSET PEAK DURATION
Rapid Lispro, Aspart, Glulisine 5 -15 min - 1 hr 3 - 4 hrs
(Clear) (Humalog, Novorapid, Apidra)
Short Regular (HR, Scilin R) SimpleIV 5 min 2 - 4 hrs 6 - 8 hrs
(Clear) SQ ½ - 1 hr
Portfolio
Intermediate NPH (HN, Insulatard)Presentation
2 hrs 4 - 8 hrs 12 - 16 hrs
(Cloudy)
Designed
Long Glargine (Lantus) 2 hrs Peakless - 24 hrs
(Clear) Detemir (Levemir) You can simply impress
your audience and add a
Combination Human Insulin unique zing and appeal to
your Presentations.
(Cloudy) Mixtard 30, Scilin M30
Humulin 70/30
Insulin Analogs
Humalog Mix 25
Novomix 30
Mixing Insulins
METHOD:
* Order: Regular insulin 10 units and NPH insulin 35 units subQ q 7:00 AM
* Available: Regular insulin 100 units/ml and NPH insulin 100 units/ml.
Clean the rubber tops of the insulin bottles.
Draw up 35 units of air and inject into the NPH insulin bottle. Avoid letting the
needle contact the NPH insulin solution. Withdraw the needle.
Draw up 10 units of air and inject into the regular insulin bottle.
First, withdraw 10 units of regular insulin. Regular insulin is always drawn up first.
Insert needle into NPH bottle and withdraw 35 units of NPH insulin. The total is 45
units.
Administer the two insulins immediately after mixing.

Mnemonics: Air - Cloudy, Clear; Withdraw - Clear, Cloudy

Mixing Injectable Drugs
METHOD 1: Mixing Two Drugs in the Same Syringe from Two Vials
Draw air into the syringe to equal the amount of solution to be withdrawn from the
first vial, and inject the air into the first vial. Do not allow the needle to come into
contact with the solution. Remove the needle.
Draw air into the syringe to equal the amount of solution to be withdrawn from the
second vial. Invert the second vial, and inject the air. Withdraw the desired
amount of solution from the second vial.
Change the needle, unless the entire volume in the first vial will be used.
Invert the first vial, and withdraw the desired amount of solution.
Calculations of
INTRAVENOUS FLUIDS
Mixing Injectable Drugs
METHOD 2: Mixing Two Drugs in the Same Syringe from One Vial and One
Ampule.
Inject air into the vial.
Remove the desired amount of solution from the vial.
Withdraw the desired amount of solution from the ampule.
Mixing Injectable Drugs
METHOD 3: Mixing Two Drugs in a Prefilled Cartridge from a Vial.
Check the drug dose and the amount of solution in the prefilled cartridge. If a
smaller dose is needed, expel the excess solution.
Draw air into the cartridge to equal the amount of solution to be withdrawn from
the vial. Invert the vial, and inject the air.
Withdraw desired amount of solution from the vial. Be sure that the needle remains
in the fluid, and do not take more solution than needed.
Mixing Drugs for Continuous
Intravenous Administration
Intermittent Intravenous Administration
Secondary Intravenous Sets Without IV Pumps
Intermittent Infusion Adapters/Devices
SASH Procedure
S = Solution (saline) flush (2 ml)
A = Administer drug into rubber stopper
S = Solution (saline) flush (2 ml)
H = Heparin 1:100 solution (1 ml)
Direct Intravenous Injections
Electronic Intravenous Regulators
Patient-Controlled Anesthesia
Thank you