Drug Calculations

Drug Calculations
Example
Continue
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Converting factors
Common
Abbreviations
Dosage Forms
Solution
Measurements
Miscellaneous Usage
in the
Hospital
Abbreviations to
Avoid
Micrograms should be written out, insist on
µg
it!
__
Write out one-half or 1/2 clearly.
ss or ss
Ordered daily? Write out daily. QD, if legible,

OD
should be acceptable.
n or N Nightly? QN? Write out nightly or use hs.
d or D Daily? Write out how many days.
Ordered at bedtime? Write out bedtime or

BT
use the standard hs.
Fishing
for
answers?
Examples
Example 1 ‫نصف ملغ‬ ‫تعادل‬ ‫حبة‬
‫ ملغ‬0.25 ‫تعادل‬ ‫كم حبة‬

Doctor's order:
0.25 mg of digoxin p.o. 1 X ‫=كم حبة‬
0.25
0.5
On hand: 0.5 mg tablets
Answer
Example 1 ‫نصف ملغ‬ ‫تعادل‬ ‫حبة‬
‫ ملغ‬0.25 ‫تعادل‬ ‫كم حبة‬

Doctor's order:
0.25 mg of digoxin p.o. 1 X ‫=كم حبة‬
0.25
0.5
On hand: 0.5 mg tablets
0.5 tablet
Example
AVAILABLE
‫المتوفر حاليا‬
Doctor's order:
Give deltasone 7.5 mg PO now.
Available : deltasone 2.5 mg tablet.
Answer
Example
AVAILABLE
‫المتوفر حاليا‬
Doctor's order:
Give deltasone 7.5 mg PO now.
Available : deltasone 2.5 mg tablet.
3 tablet
Example
Doctor's order:
Give ranitidine 40 mg PO ABT.
Available is ranitidine 20 mg tablet
How many tablet you should give?
Answer
Solution
ABT ‫عند النوم‬
40 X 1
20
40
20
2 tablets
Example
Doctor's order:
Give 7500 i.u of heparin injection S/C .
Available:( heparin injection 5000
i.u/ml)
How many ml you should give?
Answer
Solution
7500 X 1
5000
7500
5000
1.5 ml
Example
Doctor's order:
Give 500 cc D5RL to be infused in 6
hrs.
You should regulate the I.V at:
Answer
‫المعادلة‬
‫‪Solution‬‬ ‫(عامل التنقيط ‪x‬الكمية بالمل (‬
‫مقسومة على‬
‫(دقيقة ‪X 60‬عدد الساعات (‬
‫‪500 cc‬‬ ‫‪X‬‬ ‫دائما يعتبر عامل التنقيط‬

‫‪ 15‬ال اذا ذكر في السؤال‬
‫‪15‬‬
‫‪6 hrs‬‬ ‫‪X‬‬ ‫غير ذلك‬
‫‪60 m‬‬
‫‪7500‬‬
‫‪360‬‬
‫‪21 drop/m‬‬
Example
Doctor's order:
Give 1500 cc normal saline over 4 hrs.
Answer
‫المعادلة‬
‫‪Solution‬‬ ‫(عامل التنقيط ‪x‬الكمية بالمل (‬
‫مقسومة على‬
‫(دقيقة ‪X 60‬عدد الساعات (‬
‫‪1500 cc X‬‬ ‫دائما يعتبر عامل التنقيط‬

‫‪4 hrs‬‬
‫‪15‬‬ ‫‪X‬‬ ‫غير ذلك‬
‫‪60 m‬‬
‫‪22500‬‬
‫‪240‬‬
‫‪94 drop/m‬‬
Example
Doctor's order:
Give 1000 cc dextrose 5% I.V Q 8 hrs.
Answer
‫‪Solution‬‬ ‫دائما يعتبر عامل التنقيط‬
‫‪ 15‬ال اذا ذكر في‬
‫السؤال غير ذلك‬
‫‪1000 cc X‬‬
‫‪15‬‬
‫‪8 hrs‬‬ ‫‪X‬‬
‫‪60 m‬‬
‫‪15000‬‬
‫‪480‬‬
‫‪31 drop/m‬‬
‫‪exit‬‬
Example
Doctor's order:
Give 3 L of I.V fluid 5% D/0.45%
normal saline over 24 hrs.(the drop
factor is 60 gtt/ml).
Answer
‫غير ذلك‬
‫‪3000 cc‬‬ ‫‪X‬‬

‫‪24‬‬
‫‪60hrs‬‬ ‫‪X‬‬
‫‪60 m‬‬
‫‪180000‬‬
‫‪1440‬‬
‫‪125‬‬
‫‪drop/m‬‬
Example
Doctor's order:
Give 3000 cc dextrose 5% I.V Q 6 hrs,
drop factor is 20 gtt/m)
How many drops should you give per
minute?
Answer
‫غير ذلك‬
‫‪3000 cc X‬‬
‫‪6 hrs‬‬
‫‪20‬‬ ‫‪X‬‬
‫‪60 m‬‬
‫‪60000‬‬
‫‪360‬‬
‫‪166.66‬‬
‫)‪(167‬‬
Example
Doctor's order:
Give penicillin 600.000 u I.M stat
Available: (penicillin 800.000 u/2 cc)
How many ml should you give?
Answer
Example
Doctor's order:
Give penicillin 600.000 u I.M stat
Available: (penicillin 800.000 u/2 cc)
How many ml should you give?
1.5 ml
Example
Doctor's order:
Give G/S 2000 cc I.V Q 24 hrs,
The rate will be how many drop per
minute?
Answer
Example
Doctor's order:
Give G/S 2000 cc I.V Q 24 hrs,
The rate will be how many drop per
minute?
21 drop/m
Example
• The physician orders IV fluids to
hydrate a client. The order is written
as "D5NS 4 Liters over 24 hours."
Looking at the package indicates the
drip factor of the tubing is 15 gtt/ml.
What is the drip rate?
Answer
Example
• The physician orders IV fluids to
hydrate a client. The order is written
as "D5NS 4 Liters over 24 hours."
Looking at the package indicates the
drip factor of the tubing is 15 gtt/ml.
What is the drip rate?
42 gtt/m
:Shortcut method when you know the ordered ml/hr
gtt/ml: divide the ml/hr by 4 15
gtt/ml (typically blood products): divide ml/hr by 6 10
gtt/ml: divide ml/hr by 3 20
43.75
4 / 175 =
gtt/min
29.16
6 / 175 =
gtt/min
58.33
3 / 175 =
gtt/min
Example
The client's K+ is 2.0 mEq/dl and the •
physician orders a potassium bolus
of 40 mEq of KCl in 200 ml of NS to
be delivered at a rate of 10 mEq/hr.
What is the drip rate inmicrodrops?
(.(Ideal, deliver on a pump
Answer
•This is a two-part problem.
•Calculate the concentration of the KCl
in the NS using ratio and proportion
mEq 40 mEq 10
=
ml 200 x ml
40x = 2000
x = 50
• Now you can use the IV formula.
ml 50 gtt 60
60 min x 1 cc
x 60 50 = 3000
60 / 3000 = 50
Answer: 50 (microgtts/min)
Calculating flow rate
• Flow rate refers to number of ml of
fluid to be infused over one hour
(ml/hr).
)total # of milliliters )volume

total # of hours = X ml/hr
Example
Order:
500 ml NS bolus over 3 hours
Answer
Example
Order:
500 ml NS bolus over 3 hours
167 ml/h
Example
• The nurse makes rounds and notes
that the current IV bag contains
approximately 450 ml. The IV flow
rate is 150 ml/hr. How long will it be
before the nurse must hang a new
bag?
Answer
exit
Example
• The nurse makes rounds and notes
that the current IV bag contains
approximately 450 ml. The IV flow
rate is 150 ml/hr. How long will it be
before the nurse must hang a new
bag?
3 hrs
exit
Example
• Order:
Administer 1000 cc at 50 gtt/min.
Answer
exit
Example
• Order:
Administer 1000 cc at 50 gtt/min.
5 hrs
exit
Example
• John is to receive Cleocin 150 mg IV
q 8 hours. The nurse dilutes the
medication to a total volume of 30 ml
and plans to deliver it via an infusion
pump over thirty minutes. What
would be the flow rate?
Answer
exit
Example
• John is to receive Cleocin 150 mg IV
q 8 hours. The nurse dilutes the
medication to a total volume of 30 ml
and plans to deliver it via an infusion
pump over thirty minutes. What
would be the flow rate?
60
exit
Example
• For the client whose weight is 130 lbs
and has dopamine ordered at 8
mcg/kg/min, what rate should the
infusion pump be set for a solution of
400 mg dopamine in 250 ml D5W?
Answer
exit
• Client's weight: 130 lbs
• Dosage: 8 mcg/kg/min
• Solution: 400 (mg) in 250 (ml)
Tip
• Convert wt to kg. 130 / 2.2 =
59.09 kg
• Find concentration of dopamine in
mg 400 x mg
1 cc.
250 ml
=
1 ml
250x = 400
x = 1.6
• 3) Concentration is 1.6 mg /cc.
Convert the mg to micrograms.
• 1.6 (mg) x 1000 (mcg per 1 mg) =
1600 mcg/cc.
Now that you have gathered all
the information, plug it into the
formula
28363.32
=
unit"/kg/min) ") 8 X 59.09 )wt in kg)X 60 )min/hr)
)1600 )"unit" / ml
1600
x = 17.727
17.727 or 18 ( ml/hr) will dialed on the pump

Example
• A client is receiving dopamine at 12
ml/hr. The solution hanging indicates
"D5W 250 ml/200 mg dopamine".
The client weighs 133 lbs. What is
the dosage (mcg/kg/min) the client is
receiving?
Answer
exit
• Flow rate: 12 ml/hr
• Solution: 200 mg dopa / 250 cc D5W
• Client's weight: 133 lbs
Tip
1) Convert wt to kg. 133 / 2.2 =
60.45 kg
2) Find concentration ofx dopamine
mg 200 mg
in 1 cc.
250 ml = 1 ml
250x = 200
x = 0.8
3) Concentration is 0.8 mg/ml.
Convert mg to mcg.
0.8 (mg) X 1000 (mcg per 1 mg) =
800 mcg /ml.
Now that you have gathered all
the information, plug it into the
formula.
ml/hr) ) 12X 800 ("unit"/ml) 9600

(Time) 60 min/hr X( 60.45 (weight in kgs = 3627
X = 2.65
The dosage the client is receiving is 2.65 mcg/kg/min.

Example
• A client is receiving a heparin drip at
22 ml/hr via an infusion pump. The
label on the liter bag of D5W
indicates 40,000 U of heparin. How
many units of heparin does the client
receive per hour?
Answer
U 40,000 xU
1000 ml = 22 ml
1000x
= 880,000
x
= 880
.The client is receiving 880 U of heparin per hour
3) Concentration is 0.8 mg/ml.
Convert mg to mcg.
0.8 (mg) X 1000 (mcg per 1 mg) =
800 mcg /ml.
Now that you have gathered all the information,
plug it into the formula.
ml/hr) ) 12X 800 ("unit"/ml) 9600

(Time) 60 min/hr X( 60.45 (weight in kgs = 3627
X = 2.65
The dosage the client is receiving is 2.65 mcg/kg/min.

Example
• The physician becomes concerned
about John’s renal function and orders
the Vancomycin dose (60 mg) to be
infused over 90 minutes instead of the
usual 60 minutes. If the Vancomycin
dosage is diluted into 60 ml of IV fluid,
what will be the flow rate? (Given on an
IV pump for control.)
X ml
ml 60 60 min
=
90 min
x 90 = 3600
x = (ml/hr) 40
exit
Example
• John's primary IV is running at 34 ml/hr while
NPO. When the nurse runs the Vancomycin
(250 mg IV q 8 hr) in over 90 minutes [volume
is 100 ml--(2 50 ml syringes)], the primary IV is
stopped. The ampicillin (395 mg IV q 6 hr) is
given concurrently in 10 ml of fluid over 30
minutes. He received 2 boluses of
aminophylline (20 ml each over 20 minutes).
The IV fluids were stopped while the
aminophylline infused. Since microtubing was
used for the medications, total flush is
negligible (approximately 3 ml). What is John’s
total intake for 24 hours?
exit
Answer
Vancomycin runs for 1.5 hrs x 3 doses .hrs IV is stopped 4.5 =
Primary or maintenance IV
hr) minus 4.5) 24 .hrs 19.5 =
:fluids
Primary fluid is stopped while

min x 2 20 minutes 40 =
:aminophylline is infusing
hr 30 minutes minus 19 hr 50 minutes )18.84 hrs) 18 =

ml 640.5 =
40 minutes x 34 ml
:Vancomycin cc x 3 100 .ml 300 =

:Ampicillin cc x 4 10 .ml 40 =
:Aminophylline cc x 2 20 .ml 40 =
Normal saline
)approximate) 3ml =
:flush
3 + 40 + 40 + 300 + 640.5 = .ml / 24 hrs 1023.5
.John's daily intake, based on all therapeutic modalities, is 1023.5 ml

Example
• Crystal has an IV infusing at KVO (10
ml/hr). She receives an antibiotic in
22.5 ml q 8° concurrently. One ml flush
is given after each antibiotic. She is
given 30 ml of formula q 3°.
• She had diaper weights of 17 ml, 33 ml,
55 ml, 45 ml, 52 ml, 50 ml, 15 ml, and
36 ml.
• Calculate her I & O for the past 24
hours.
Answer
Intake:
IV @ 10 ml/hr x 24 hr = 240 ml
Med of 22.5 ml x 3 )q8°) = 67.5 ml
Flush of 1 ml x3 = 3 ml
Formula of 30 ml x 8 )q 3°) = 240 ml
.Crystal's intake is 550.5 ml for the past 24 hours
Output:
36 + 15 + 50 + 52 + 45 + 55 + 33 + 17 ml 303 =
.Crystal's output is 303 ml for the past 24 hours

Example
• John also has an order for ampicillin
sodium 395 mg IV q 6 hr. The safe
range for his type of infection in the
literature is 100-200 mg /kg /day. Is
this a safe dose?
Answer
Calculate the recommended range:
•Minimal: 100 mg x 20 kg = 2000 mg
•Maximal: 200 mg x 20 kg = 4000 mg
Recommended range is 2000 - 4000 mg.

Actual dose is: 395 x 4 )q 6 hr) = 1580 mg
/ day
Compare the two values. The actual dose is
less than the recommended dose. Dose is
“safe”, but not necessarily therapeutic.
Example
• The physician stopped John’s
gentamicin and cleocin when the
culture report came back. His new
orders include Vancomycin 250 mg IV q
8°. The literature indicates that the
minimal dilution concentration for
infusion should be 2.5 mg / ml if given
through a peripheral intravenous line
(PIV). How many ml of diluent will the
nurse need to mix the Vancomycin to
meet this safety requirement?
Answer
Example
• The physician stopped John’s
gentamicin and cleocin when the
culture report came back. His new
orders include Vancomycin 250 mg IV q
8°. The literature indicates that the
minimal dilution concentration for
infusion should be 2.5 mg / ml if given
through a peripheral intravenous line
(PIV). How many ml of diluent will the
nurse need to mix the Vancomycin to
meet this safety requirement?
100 ml
Example
• A newborn has an order for 0.15
micrograms of Prostin VR
(alprostadil) per hour to maintain
patency of the ductus arteriosus.
The pharmacy prepared a Prostin
drip with 25 mcg alprostadil in 50 ml
of D5W. What hourly rate is needed
to deliver the dosage of medication
as ordered?
Answer
Example
• A newborn has an order for 0.15
micrograms of Prostin VR
(alprostadil) per hour to maintain
patency of the ductus arteriosus.
The pharmacy prepared a Prostin
drip with 25 mcg alprostadil in 50 ml
of D5W. What hourly rate is needed
to deliver the dosage of medication
as ordered?
0.3exit
ml/h
Example
• John is to be given an Aminophylline
bolus of 30 mg in 20 ml of fluid over
20 minutes. The primary IV is
running at 40 ml/hr. The drip factor
of the tubing (buretrol) is 60 gtts/cc
or minidrip. What is the flow rate
needed to deliver the Aminophylline
bolus as ordered?
Answer
exit
Example
• John is to be given an Aminophylline
bolus of 30 mg in 20 ml of fluid over
20 minutes. The primary IV is
running at 40 ml/hr. The drip factor
of the tubing (buretrol) is 60 gtts/cc
or minidrip. What is the flow rate
needed to deliver the Aminophylline
bolus as ordered?
60 exit
ml/h
Example
• John is a pediatric client in a hospital in
which the policy is to place all children
on IV therapy on a buretrol and to only
fill the buretrol no more than two-three
hours worth of fluid. The nurse fills the
buretrol to 90 ml at 10 a.m. If John’s IV
is running at 34 ml per hour, how long
will it be before the nurse will need to
fill it again?
exit
Answer
90 ml ÷ 34 (ml/hr) = 2.65 hrs
However, 0.65 hrs = ? minutes
hr 1 hr 0.65
=
60 min X min
1x = 39.00
X = 39
Answer = 39 minutes Add this to the 2

hours. 10 a.m. + 2 hr 39 minutes = 12:39
p.m.
At 12:39 p.m. the buretrol will need

more fluid added so that air does not get
into the tubing.

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Drug Calculations

Ordered daily? Write out daily. QD, if legible,

n or N Nightly? QN? Write out nightly or use hs.

d or D Daily? Write out how many days.

Ordered at bedtime? Write out bedtime or

‫ ملغ‬0.25 ‫تعادل‬ ‫كم حبة‬

‫ ملغ‬0.25 ‫تعادل‬ ‫كم حبة‬

‫‪500 cc‬‬ ‫‪X‬‬ ‫دائما يعتبر عامل التنقيط‬

‫‪1500 cc X‬‬ ‫دائما يعتبر عامل التنقيط‬

‫‪3000 cc‬‬ ‫‪X‬‬

gtt/ml: divide the ml/hr by 4 15

gtt/ml (typically blood products): divide ml/hr by 6 10

gtt/ml: divide ml/hr by 3 20

)total # of milliliters )volume

17.727 or 18 ( ml/hr) will dialed on the pump

ml/hr) ) 12X 800 ("unit"/ml) 9600

The dosage the client is receiving is 2.65 mcg/kg/min.

.The client is receiving 880 U of heparin per hour

ml/hr) ) 12X 800 ("unit"/ml) 9600

The dosage the client is receiving is 2.65 mcg/kg/min.

Primary fluid is stopped while

hr 30 minutes minus 19 hr 50 minutes )18.84 hrs) 18 =

:Vancomycin cc x 3 100 .ml 300 =

3 + 40 + 40 + 300 + 640.5 = .ml / 24 hrs 1023.5

.John's daily intake, based on all therapeutic modalities, is 1023.5 ml

.Crystal's intake is 550.5 ml for the past 24 hours

.Crystal's output is 303 ml for the past 24 hours

Recommended range is 2000 - 4000 mg.

Answer = 39 minutes Add this to the 2

At 12:39 p.m. the buretrol will need

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