Chapter III

Medications and
Calculations
Metric System
⚫It is a decimal system based on the power of
10.
⚫Basic units of measure are gram ( g, gm, G,
Gm) for weight; liter (l, L) for volume; and
meter (m, M) for linear measurement or
length.
⚫Kilo is the prefix used for larger units and
mili, centi, micro, and nano are the prefixes
for smaller units.
Metric Units of Measurement
Unit Names & Abbreviations Measurements

Gram (weight) 1 kilogram (kg, Kg) 1000 g

1 gram (g, gm, G, Gm) 1g
1 milligram (mg) 0.001 g
1 microgram (ug, mcg) 0.000001 g
1 nanogram (ng) 0.000000001 g

Liter (volume) 1 kiloliter (kl, KL) 1000 L

1 Liter (L, l) 1L
1 mililiter (ml) 0.001 L

Meter (length) 1 kilometer (km) 1000 m

1 meter (m, M) 1m
1 centimeter (cm) 0.01 m
1 millimeter (mm) 0.001 m
⚫Note:

⚫1 ml (milliliter) = 1 cc (cubic centimeter)

⚫1 mg (milligram) = 1000 ug (micrograms)
Conversion with Metric System
⚫The metric units most frequently used in drug
notation are the following:
⚫1 g = 1000 mg
⚫1 L = 1000 ml
⚫1 mg = 1000 ug (mcg)
⚫When converting larger units to smaller units,
move the decimal point one space to the right
for each degree of magnitude change. Note:
this does not apply to micro and nano units.
⚫Ex.
⚫Change 1 gram to milligrams.
⚫Grams are 3 degrees of magnitude greater
than milligrams. Move the decimal point 3
spaces to the right.
⚫1 g = 1.000 mg or 1 g = 1000 mg
⚫When converting smaller units to larger units,
move the decimal point one space to the left
for each degree of magnitude of change.
⚫Ex. change 1000 milligrams to grams
⚫Milligrams are three degrees of magnitude
smaller than grams. Move the decimal point
three spaces to the left.
⚫1000 mg = 1 000. g or 1000 mg = 1 g
Converting Grams and Milligrams
1 g =1,000 mg
1.16 g = _________ mg
2.3.7 g = _________ mg
3.22,000 mg = ___________ g
4.5,382.9 mg = ___________
g
Converting Liters and Milliliters
1L =1,000 mL

1.8 L = _________ mL
2.71.46 L = _________ mL
3.13,000 mL = ___________
L
4.289 mL = ___________ L
Converting Kilograms and Grams
1 kg =1,000 g

1.9 kg = _________ g
2.61.44 kg = _________ g
3.4,000 g = ___________ kg
4.54,320 g = ___________ kg
REMEMBER: When changing
larger units to smaller units,
move the decimal point to
the right, and when changing
smaller units to larger units,
move the decimal point to
the left.
Practice Problems
Larger to Smaller Units:
1. Change 2 g to mg
2. Change 0.5 g to mg
3. Change 2.5 L to ml

Smaller to Larger Units

4. Change 1500 mg to g
5. Change 3 g to kg
6. Change 500 ml to L
Household System
⚫Household measurement is not as accurate as
the metric system because of the lack of
standardization of spoons, cups, and glasses.
Household and 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)
Household Conversion
⚫When converting larger units to smaller units,
multiply the requested number by the basic
equivalent value.
⚫Ex: Change 2 glasses of water to ounces.
⚫The equivalent value is 1 medium-size glass =
8 oz.
⚫2 glassess x 8 oz. = 16 oz.
 REMEMBER: To change larger
units to smaller units, multiply the
requested number of units by the
basic equivalent value. To change
smaller units to larger units, divide
the requested number of units by
the basic equivalent value.
Practice Problem
Larger to Smaller Units:
1. Change 3 oz to T
2. Change 5 T to t
3. Change 3 coffee cups to oz
Smaller to Larger Units
4. Change 3 T to oz
5. Change 16 oz to a measuring cup
6. Change 12 t to T
Approximate Metric and Household
Equivalent
Metric System Household System
Weight 1 kg; 1000 g 2.2 lb
Volume 0.24 L; 240 ml 1 glass
0.18 L; 180 ml 1c
30 ml 2 T; 6 t
15 ml 1 T; 3 t
5 ml 1t
1 ml 15 – 16 gtt
Height/Distance 2.54 cm 1 inch
25.4 mm 1 inch
Methods for Calculations
⚫The four general methods for the calculation of
drug dosages are:
⚫Basic formula
⚫Ratio and proportion
⚫Fractional equation
⚫Dimensional analysis
⚫For drugs that require individualized dosing,
calculation by body weight or body surface
area may be necessary.
⚫Before calculation, all units of measure must be
converted to a single system.
Interpreting Oral & Injectable Drug Labels
Method 1: Basic Formula (BF)
⚫D/S x V = A
⚫Where:
⚫ D is the desired dose (drug dose ordered by
physician)
⚫ S is the stock on hand (drug dose on the label)
⚫ V is the vehicle (drug form in which the drug
comes)
⚫ A is the amount calculated to be given to the client
Example:
⚫Order: Give cefaclor (Ceclor) 0.5 g PO BID
Practice:
You need to administer 75 mg of a
medication. The drug concentration
available from the pharmacy is 15
mg/mL. How many mL will you need to
administer a 75 mg dose?
Method 2: Ratio & Proportion (RP)
S : V :: D : x
means

extremes

Where:
⚫ S is the stock on hand
⚫ V is the vehicle or drug form
⚫ D is the desired dose
⚫ X is the unknown amount
⚫ :: stands for “as” or “equal to”
⚫ Multiply the extremes and means
Example:
⚫Please give amoxicillin suspension 100 mg PO
QID
Practice:
⚫The provider ordered 25 mg PO BID. You’re
supplied with 50 mg/tab. How many
tablets/dose will be administered?

⚫The provider ordered 2 grams IM x 1 dose.

You’re supplied with 1000 mg/2 mL vial. How
many mL/dose will you administer?
Method 3: Fractional Equation (FE)
S/V = D/x

Where:
⚫S is the stock on hand
⚫V is the vehicle or drug form
⚫D is the desired dose
⚫X is the unknown amount

Cross-multiply.
Example:
⚫Please give meropenem 250mg IVTT q8

Diluted in 5 ml sterile water

Method 4: Dimensional Analysis
⚫This calculates dosages using three factors:
1. Drug label factor: The form of the drug dose (V)
with the equivalence in unit (S); for example, 1
capsule = 500 mg

2. Conversion factor (C): for example 1 g = 1000 mg

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

⚫ These 3 factors are set up in an equation that
allows the units to be cancelled, resulting in the
correct unit of delivery.
X = V (vehicle) x C(S) x D (desired)
S (on hand) x C(D) x 1

⚫ With dimensional analysis, the conversion factor is built

into the equation and is included when the units of
measurements of the drug order and drug container differ.
If the two are of the same units of measurement, the
conversion factor is eliminated from the equation.
Example
⚫Give acitaminophen (Tylenol) 0.5 g PRN for
pain q4H
Method 5: Body Surface Area (BSA)
⚫The BSA method is considered to be 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 (m 2) is determined
by where the person’s height and weight
intersect the normogram scale.
⚫To calculate, multiply the drug dose ordered by
the number of square meters.
⚫Ex. 100 mg x 1.8 m2 (BSA) = 180 mg per day
How to compute BSA?
⚫ Mosteller Formula:
BSA (m2) =√weight(kg) x height (cm)
3600
⚫ Average BSA is generally taken to be 1.73 m² for an
adult.
⚫ Average BSA values:
⚫ Neonate (Newborn)0.25m²
⚫ Child 2 years 0.5m²
⚫ Child 9 years 1.07m²
⚫ Child 10 years 1.14m²
⚫ Child 12-13 years 1.33m²
⚫ For men 1.9m²
⚫ For women 1.6m²
Example:
⚫ Please give Ampicillin suspension 900 mg/m2 /day
in 6 divided dosage for a child 2 years old.
Pediatric Considerations
⚫ To calculate the pediatric dosage from the adult
dosage, determine the child’s BSA and refer to
the formula:

Surface area (m2) x Adult dose = Pediatric dose

1.73 m2
Example:
⚫ Please give ampicillin suspension PO q6H. Child
is 2 years old. Adult dose is 2000 mg/day.