LESSON 1: PHARMACOLOGY NCM 106

SEMESTER 1 | ACADEMIC YEAR 2024-2025|MIDTERMS

I.e. move the decimal place 3 places to the right

DRUG CALCULATION
E.g. 1mg = 1000 micrograms
The NMC Guidelines for the administration of 0.56mg = 560 micrograms
medicines (20001 states: “Some drug administrations 0.008mg = 8 micrograms
can require complex calculations to ensure that the
correct volume or quantity of medication is ➢ To change from milligrams to grams, divide by
administered. In these situations, it may be necessary 1000
for a second practitioner to check the calculation in
order to minimize the risk of error. The use of a I.e. move the decimal point 3 places to the left
calculator to determine volume or quantity of
medication should not act as a substitute for e.g. 100 mg = 0.1g
arithmetical knowledge and skill “. 62,000mg = 62g
35mg = 0.035g
CONVERTING UNITS
➢ To change from micrograms to milligrams,
Most drugs are prescribed in milligram or microgram divide by 1000
quantities.
Occasionally, gram or nanogram quantities are i.e. move the decimal point 3 places to the left
also used. It is frequently necessary to convert units
(e.g. from micrograms to milligrams), in order to e.g. 2000 micrograms = 2mg
calculate the correct dose to administer. 375 micrograms = 0.375mg
62.5 micrograms = 0.0625mg
1 gram (g) = 1000 milligrams (mg)
1 milligram (mg) = 1000 micrograms TABLET/CAPSULE CALCULATION
(mcg or g)
1 microgram (mcg or g) = 1000 nanograms (ng) The following formula can be used as an aid to work out
1 liter (L) = 1000 milliliters (ml)
the
number of tablets required:
➢ To change from grams to milligrams, multiply
by 1000 Number of tablets required = what you want
I.e. move the decimal point 3 places to the right what you’ve got

E.g. 1g = 1000mg E.g. a prescription requires you to administer 150mg.

4.2g = 4200mg You have a pot of 50mg tablets. How many tablets do
0.07g = 70mg you need?

➢ To change milligrams to micrograms, multiply Number of tablets required = 150 mg = 3 tablets.

by 1000 50mg

NCM 106 LESSON 1: PHARMACOLOGY 1

 LESSON 1: PHARMACOLOGY NCM 106

SEMESTER 1 | ACADEMIC YEAR 2024-2025|MIDTERMS

❖ When using this formula you must make sure

the units are the same. Volume needed = What you want x Volume it’s
in
E.g. a prescription requires you to administer 25 What you’ve got
micrograms.
You have a pot of 0.05mg tablets. How many tablets do
you need? E.g. you need to give 300 mg Paracetamol to a
child.The suspension contains 120 mg in 5ml. What
volume of suspension do you give?
❖ Your first step is to make sure the units are the
same. When converting units for this type of Volume needed = 300 mg/120 mg x 5ml
calculation it is usually easier to convert the
number containing the decimal point into a = 30/12 x 5ml (simplified, crushed out
larger figure, rather than the other way round. 1 zero each from 300 & 120)

= 75/6 (30 & 12 divisible by 2)

So, first multiply 0.05mg by 1000 to convert it to = 12.5ml

micrograms.
OTHER UNITS
0.05mg = 50 micrograms.
Some drugs are expressed in other units, e.g. millimoles
of potassium, or units of heparin, etc. You can use the
Now you can use this figure to calculate the number of
formula in exactly the same way provided “what you
tablets needed. want” and “what you’ve got” are in the same units.

Number of tablets needed = what you want E.g. 7500 units’ heparin required from ampoules
what you’ve got containing 5000 units per ml.

Volume needed = 7500 units/ 5000 units x 1ml

Number of tablets needed = 25 micrograms = 1
tablet = 75 / 50 (simplified, crushed out 2
50 micrograms 2 zeros from 7500 & 5000)
= 0.5 (since tab/cap)
= 15 / 10 (75 & 50 divisible by 5)
= ½ (tunga-un ang tambal)
= 1.5ml
LIQUID MEDICATION CALCULATION
MG/KG CALCULATIONS
The following formula can be used for calculating the
volume needed of oral liquid medication or injectable Many medication doses, particularly for children, are
drugs. It is essential when using this formula that you calculated on a mg/kg basis. The prescribing doctor
use the same units for “what you want” and “what should work this out and prescribe the dose required.
you’ve got”. Nurses should be able to check the prescribed dose.

NCM 106 LESSON 1: PHARMACOLOGY 2

 LESSON 1: PHARMACOLOGY NCM 106

SEMESTER 1 | ACADEMIC YEAR 2024-2025|MIDTERMS

E.g. The dose required is 4 mg/kg. The child weighs ➔ Step 2 - How many ml per minute?
5kg.
This is the number of mls per hour (125) divided by the
★ I.e. The child needs 4mg of medicine for every number of minutes per hour (60)
kg of body weight.
= 125/60 It is a good idea to keep this as a fraction and
So the dose needed is 4mg x 5 = 20mg. move on to step 3

Care should be taken when using pediatric dose ➔ Step 3 - How many drops per minute
references as some books state the total daily dose in
mg/kg, which then has to be divided into the number of This is the number of drops per ml multiplied by the
doses per day. number of ml per minute

★ E.g. The dose required is 4 mg/kg total daily The number of drops per ml depends on the fluid you
dose, divided into 4 doses. are giving (the thicker the fluid the bigger the drops, so
there are less drops in 1 ml) and the type of
In this case, for a 5kg child, the total daily dose is 20mg. administration set you are using.

Each individual dose is 5mg given 4 times daily. = 15/20 ( adult)

INTRAVENOUS DRUGS CALCULATION = 60 (pedia)

Drip Rate Infusion Calculations ● Using a standard giving set: -

It is important to calculate the rate of i.v. administration Number of drops per minute = number of drops per ml
is accurate. For some drugs there are specific x number of ml per minute
monograms and calculation aids available. However, it is
= 20 x 125/60 = 120 x 125/60 (3) = 125/3
useful to be able to perform these calculations from
first principles and to do them step-by-step.
Replace 60 with 3

So 41.6/ [3] 125

DRIP RATE - 15/20 — ADULT (MACRO SET) As it is not possible to give a fraction of a drop the
- 60 — PEDIA (MICRO SET) note for answer is 'rounded up' to 42. If we are giving solutions
needle via a giving set the number of drops per ml and the 60
minutes per hour always stay the same. This means that
E.g. At what rate (drops per minute) do you need to steps 2 and 3 can be combined
set the giving set to administer 1000 ml of glucose 5%
over 8 hours? So whenever aqueous solutions are given via a
standard giving set:
➔ Step 1 - How many ml per hour? Drops per minute = ml per hour divided by 3

This is the total volume (1000ml) divided by the time (8 For aqueous solutions given by a pediatric (micro
hours). drop) giving set:
Drops per minute = ml per hour
125/(8) 1,000 = 125mls

NCM 106 LESSON 1: PHARMACOLOGY 3

 LESSON 1: PHARMACOLOGY NCM 106

SEMESTER 1 | ACADEMIC YEAR 2024-2025|MIDTERMS

RATIO CALCULATION

PERCENTAGE CALCULATION This is only used for measuring the concentration of

drugs such as adrenaline (epinephrine) or tuberculin. It
Drug concentration may also be measured as % (w/v). is stated as 1 in 100, 1 in 10,000 etc.

% Means the number of grams dissolved in 100ml of One in something concentrations means grams in
solution mls
I.e.
I.e. grams per 100ml. 1 in 100 means 1g in 100ml
1 in 1000 means 1g in 1000 ml
This is the same whatever the size of the container 1 in 10,000 means 1g in 10,000ml

➢ E.g. Glucose 5% means that 5 grams of glucose

is dissolved in 100ml of fluid. E.g. give 1mg of adrenaline (epinephrine) using 1 in
10,000 injection
This is the same if in a 500ml bag as it is in a 1 liter bag,
but obviously the 1 liter bag actually contains twice as 1 in 10,000 = 1g in 10,000ml
much glucose as the 500ml one.
= 1000mg in 10,000ml
This way of measuring the concentration is also
sometimes used in ointments and creams. Volume needed = what you want x what it is in

In calculations we can use the same formula as before: What you've got

➢ E.g. a patient is prescribed 20g of glucose to be = 1/1000 x 10,000ml

given as Glucose 50% injection.
= 10ml
What volume (ml) do you give?
DISPLACEMENT VALUES
Volume needed = what you want x what it is in
Displacement values need to be considered when using
What you've got
part-vials of freeze-dried injections that require
reconstitution.
50% glucose contains 50g in 100ml
The displacement value is the volume of fluid
Volume needed = 20/50 x 100ml
displaced by the powder.
= 20 x 2
For some drugs this volume is negligible, but for others
= 40ml it will make a significant difference if only a small
fraction of the vial is needed, e.g. for neonates.
20 x 100 = 2000/50
★ E.g. The displacement value for cefotaxime is
= 40mL 0.2ml per 500mg vial.

NCM 106 LESSON 1: PHARMACOLOGY 4

 LESSON 1: PHARMACOLOGY NCM 106

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If 2ml water for injection is added, the final ❖ E.g. Administer Lignocaine 1 mg per minute
concentration is 500mg in 2.2ml, not 2ml. This is using a solution of 1 gram Lignocaine in 500 ml
important if a small dose is needed. It is better to adjust glucose 5%.
the volume of diluent according to the displacement
value - in this case 1.8ml water for injection is used to What is the required rate of administration in ml per
reconstitute the vial to give a final concentration of 500 hour?
mg in 2ml.
Step 1 - How many ml per minute
The displacement value can usually be found in the
package insert. Firstly ensure all the units are the same by converting
the solution strength from g to mg.
DRUG INFUSION CALCULATION
Lignocaine 1g in 500ml
Intermittent infusions
= 1000mg in 500ml
Intermittent infusions usually involve administering a
certain dose over a short time period, e.g.
clarithromycin 500 mg in 250 ml glucose 5% over 60 Now you can use the formula:
minutes.
Volume needed = what you want x what it is in
This can be given in drops per minute via a standard
giving set, or via a volumatic device. what you've got
Using a volumatic device = 1/1000 x 500
Number of ml per hour = 250ml/hr. = 0.5ml per minute
Using drip rate Step 2 - How many ml per hour
Number of ml per hour = 250ml/hr To change ml per minute into ml per hour, multiply by
60
Number of ml per minute = 250 ml / min [/60]
So: 0.5 x 60
Number of drops per minute = 250/60 x 20
= 30 ml per hour.
= 83 drops/min.
MICROGRAM/KG/ MIN CALCULATION
Continuous Infusions

Some drugs, particularly in ITU, CCU, HDU etc. are E.g. a woman weighing 40kg needs Dobutamine at 5
prescribed by continuous infusion, for example in mg mcg/kg/minute. The stock solution, which has been
per minute or micrograms per kg per minute. prepared, contains 500 mg in 500ml of glucose 5%.

Often the drugs are very potent and it is crucial that What is the required rate of administration in ml per
they are given at the correct rate. This may often mean hour?
making up a stock solution and setting a suitable rate of
administration.

NCM 106 LESSON 1: PHARMACOLOGY 5

 LESSON 1: PHARMACOLOGY NCM 106

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➔ Step 1 - How many micrograms per minute

Percentages
The patient needs 5 micrograms per minute for every kg
% means the number of grams dissolved in 100ml of
of body weight.
solution
Dose required = 5 x 40 = 200 micrograms/minute i.e. grams per 100ml.
e.g. 5% = 5g in 100ml
➔ Step 2 - How many micrograms per hour 0.25% = 0.25g in 100ml

Multiply by 60 to convert minutes to hours

Dose required = 200 x 60 = 12,000 micrograms per hour

Ratios
➔ Step 3 – How many mg per hour
1 in 100 means 1g in 100ml
Divide by 1000 to convert micrograms to mg 1 in 1000 means 1g in 1000 ml
1 in 10,000 means 1g in 10,000ml
Dose required = 12,000/1000 = 12 mg/hr

➔ Step 4 – How many ml per hour

Volume required (ml/hr)

Drip Rates
= what you want (mg/hr) x Volume it’s in (ml)
A standard giving set gives 15 drops per ml of blood
What you’ve got (mg) Or 20 drops per ml of solutions

ml /hour = 12 mg/hr[/500g] x 500ml= 12 ml/hr A micro drop or pediatric giving set gives 60 drops
per ml of solutions

Aqueous solutions are given via a standard giving set:

REMEMBER! Drops per minute = ml per hour divided by 3

1 gram (g) = 1000 milligrams (mg) Aqueous solutions given by a pediatric (micro drop)
1 milligram (mg) = 1000 micrograms (mcg or g) giving set:
1 microgram (mcg or g) = 1000 nanograms (ng) Drops per minute = ml per hour

Volume needed = What you want x Volume it’s in Dilutions

What you’ve got Dilute 50:50 means dilute the drug solution with an
equal volume of diluent,
i.e. dilute 1ml drug solution with 1 ml diluent to give
2ml.

NCM 106 LESSON 1: PHARMACOLOGY 6

 LESSON 1: PHARMACOLOGY NCM 106

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Tablet/capsule calculations
Dilute 1 part with 4 parts means dilute 1 part drug
solution with 4 parts
Complete the following table: -
diluent,
i.e. dilute 1ml drug solution with 4 ml diluent to give
5ml. Prescription Tablet strength Number of
tablets
Dilute 1 in 20 means dilute 1 part drug solution to a needed.
total volume of 20 parts
i.e. dilute 1 ml drug solution with 19 ml diluent to 1. Sodium 500mg tablets
give Valproate
20ml 1.5g

2. Co-amilozide 2.5/25mg
Converting Units 5/50 mg tablets

Please complete the following: - 3. Captopril 12.5mg tablets

6.25mg

1. 0.3g = ...................mg Liquid Medication Calculations

2. 725 micrograms = ................... mg Complete the following table: -

3. 300ml = ..................liters Prescription Liquid Volume needed

Concentration
4. 0.025 mg = .............micrograms
1. 200mg in 5ml
5. 27,500 micrograms = ...................mg Metronidazole
120mg

2. Diazepam 2mg in 5ml

Convert the following fractions to decimals: - 500 micrograms

1. 200/5 = .........................
3. 25mg in 5ml
2. 3/2 = ........................ Spironolactone
7mg
3. 180/150 = ........................

mg/kg calculations

Round the following numbers to one decimal place: - Complete the following table: -

1. 5.769 = ........................... Prescription Patients Body Dose required

Weight per dose
2. 0.853 = ...........................
1. Gentamicin 55kg
3. 8.3333 = ...........................

NCM 106 LESSON 1: PHARMACOLOGY 7

 LESSON 1: PHARMACOLOGY NCM 106

SEMESTER 1 | ACADEMIC YEAR 2024-2025|MIDTERMS

7mg/kg

3. Digoxin 3 16kg What is the concentration (in mg/ml) of a 4.2% sodium

micrograms bicarbonate infusion?
per kg 500
micrograms

3. Cefotaxime 7.5kg
Ratio calculations
200mg/kg/day
in 4 divided How many mg of adrenaline does 7 ml of 1: 10,000
doses adrenaline (epinephrine) contain?

Please complete the following:

Drip rate infusion calculations Displacement value calculations

1. What rate of administration (drops per minute) The displacement value for co-amoxiclav is 0.9ml per
is required to give 500ml sodium chloride 0.9% 1.2g vial.
over 6 hours using a standard giving set?
What volume of water for injection would you add to
the vial to give a

2. What rate (drops/minute) is needed to give 250 concentration of 60 mg in 1ml?

ml glucose 5% over 8 hours using a micro drop
(pediatric) giving set?

Drug infusion calculations

Dilutions

An intravenous dose of 300mg Phenobarbitone has 1. Aminophylline 0.5mg/kg/hr is prescribed for an 80kg
been prescribed, which must be diluted 1 in 10 with man. A 500mg in 500ml infusion is prepared. At what
water for injections prior to administration. rate should the infusion run (in ml/hr)?

The ampoules contain 60 mg phenobarbital in 1ml.

What volume of concentrated phenobarbitone do you 2. A bag of 0.2% Lignocaine is prescribed at a rate of
need? 3mg per minute for a 65 kg

b) What volume of water for injections do you need? lady. At what rate should the infusion run (in ml/hr)?

Percentage calculations

What volume of 20% potassium chloride injection 3. Dobutamine is prescribed at 6micrograms/kg/min for
contains 3g of potassium chloride? a 75kg man. The infusion prepared contains 250 mg in
50ml. At what rate should the infusion run (in ml/hr)?

NCM 106 LESSON 1: PHARMACOLOGY 8

 LESSON 1: PHARMACOLOGY NCM 106

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NCM 106 LESSON 1: PHARMACOLOGY 9