How to do Drug Calculations

Workbook
 DRUG CALCULATIONS

Drug calculations are an important aspect of nursing practice and you will have a number of
drug calculation quizzes in both theory and Simulated Practice/Practice modules throughout
your programme. In Stage 2 or 3 of your programme you will be expected to pass an online
summative drug calculation examination (100% pass mark) as part of your practice module.
The examination will last 1 hour.

This guide is designed to get you started with drug calculations. The methods and formulae
given are ones that you may find useful to help you with your drug calculations. If you have
other tried and tested methods and formulae which you find easier to use then do not
confuse yourself by trying to learn a new method. As long as you come to the correct
answer, it does not matter which formulae you use.

A number of resources that you might find helpful are listed at the end of this document.

A. Converting from one unit of measurement to another:

It is sometimes necessary to convert from one unit of measurement to another in
order to be able to dispense the correct amount of medication.

To convert units you need to know the following:

1 kilogram (kg) = 1000 gram (g)

1 gram (g) = 1000 milligram (mg)
1 milligram (mg) = 1000 microgram (mcg)
1 litre (L) = 1000 millilitre (mL)

To convert a large unit to smaller units you will end up with a number that looks
bigger, e.g. if you cut one cake into portions you end up with a larger number of
portions.

To convert grams (g) to milligrams (mg) or milligrams (mg) to micrograms (mcg) you
need to multiply by 1000. This is achieved by moving the decimal point 3 places to
the right.

e.g. 6.5 mg is the same as 6.500 mg

Move the decimal point 3 places to the right
6.5 mg = 6500 mcg
or
0.005 mg = 5 mcg

To convert a small unit to larger units you will end up with a number that looks
smaller, e.g. if you put 1 litre of water into a 2 litre jug, it will only be half full.

Therefore, to convert micrograms (mcg) into milligrams (mg), or milligrams (mg) to

grams (g), you need to divide by 1000. This is achieved by moving the decimal
point 3 places to the left.

e.g. 2500 mcg move the decimal point 3 places to the left
2500 mcg = 2.5 mg
or
2000 mg - move the decimal point 3 places to the left

2000 mg =2.0 g

You can use these conversions in order to work out how many tablets to give, if what
is prescribed is not available in the stated dose.
 The following formula may be helpful:

No: of measures required = dose prescribed (what you want)

(i.e. tablets) dose per measure (what you’ve got)

e.g. 0.2g is prescribed. You only have 100 mg tablets. How many tablets do you
need to give your patient?

Firstly, you need to convert the amount required into the same units of measurement
as the tablets that are available.

i.e. convert 0.2g into milligram

0.2g is the same as 0.200g
Move the decimal point 3 places to the right
0.200 g = 200 mg
No tablets = 200mg
100mg
= 2 tablets

B. Percentage concentration and ratios

Sometimes drug concentration may be measured as a percentage (%) weight to
volume (w/v).
The percentage means the number of grams (weight) per 100 mL (volume).

i.e. 1% Lignocaine means that there is one gram of Lignocaine dissolved in

every 100 mL of fluid.

2% Lignocaine means there are two grams of Lignocaine dissolved in every

100 mL of fluid

5% glucose means there are five grams of glucose in every 100 mL of fluid.

This percentage remains constant irrespective of the size of the container.

Occasionally drug concentrations are written as ratios.

The ratio 1:1,000 means there is 1 gram per 1000 mL.

i.e. 1g:1000 mL = 1000mg:1000mL

= 1mg per mL

The ratio 1:10,000 means there is 1 gram per 10,000 mL

i.e. 1g:10,000 mL = 1000mg:10,000mL

= 0.1mg per mL

e.g. Adrenaline 1:10,000 means there is 1.0 gram of

adrenaline for every 10,000 mL

C Working out how much volume to give:

Sometimes a certain amount of medication is prescribed and you do not have an
ampoule containing that exact amount.

To help you work out how much volume to give to the patient there is a formula to
use:
 Volume to give = Dose required x volume available
Dose available

e.g. Pethidine 75mg is prescribed. You have an ampoule of pethidine containing

100mg in 2 mL. How much needs to be drawn up into the syringe?
Using the formula -
Volume to give = 75mg x 2 mL
100mg

= 150
100

= 1.5mL

To use this formula the unit of measurement for the dose required and the dose
available must be the same. Therefore you may need to convert from one unit of
measurement to another before using the formula

e.g. A child has been prescribed 0.3mg of digoxin elixir. The stock elixir contains
100mcg/2mL.
Firstly you need to convert mg to mcg
0.3mg = 300mcg

You can now use the formula:

Vol. to give = dose required x volume available
dose available
= 300 x 2
100

= 600
100

= 6mL

Or the required dose may be expressed in a different form:

e.g. 100mg of Lignocaine is required
You have 1% Lignocaine in a 10mL vial

Using the formula:

Vol. to give = dose required x volume available
dose available

1% means 1gm in 100 mL or 1000mg in 100mL

Vol. to give = 100mg x 100
1000mg

= 10000
1000

= 10 mL

D. Infusion rates and drip rate calculations:

Sometimes you need to work out infusion rates when an intravenous infusion is to be
run through an infusion pump.
Infusion rate mL/hr = number of mL prescribed
number of hours

e.g. 1 litre glucose 5% to be infused over 4 hours

= 1000 mL
4
= 250mL/hr

When an infusion pump is not going to be used, the drip rate in drops per minute has
to be calculated.

The following formula can be used:

Drops per minute = mL x number of drops per ml
hours 60 (minutes)

It is important to note that standard giving sets deliver 20 drops per mL , Paediatric
giving sets 60 drops per mL and blood giving sets 15 drops per mL for blood. If you
are in doubt as to how many drops per mL a giving set delivers, check on the
packaging.

e.g. A 500 mL bag of normal saline is to be run over 4 hours. How many drops
per minute should be given?

Using a standard giving set (20 drops per mL)

Drops per minute = 500 x 20
4 60

= 125 x 1
3

= 125
3

= 41.66

This can be rounded up to 42 drops/minute

Using a paediatric giving set (60 drops per mL)

Drops per minute =500 x 60
4 60
= 125 drops/per minute

Sometimes when drugs are added to the infusion fluid, the prescription is written up
in terms of the amount of the drug to be given over a given time rather than the
amount of fluid. The nurse then needs to work out the infusion rate depending on
the type of infusion pump that is used, e.g. mL/hr for a syringe driver or
drops/minute for some infusion pumps.

e.g. A doctor prescribes GTN at 4mg per hour

GTN is available in ampoules of 50mg/10mL, this is made up to 50mL by
mixing it with normal saline

Volume required = Dose required x volume available

Dose available

= 4 x 50
50
 = 200
50

= 4 mL/ hour

If this was to be given via a syringe pump it could be set at 4mL/hour.

Sometimes the dosage is written up in mg/minute and the nurse needs to

work out how much to give per hour.
e.g. Lignocaine Infusion 0.2% in Glucose 5% is to be given at 120mg/hr.

i. How much Lignocaine is in 1mL of the solution?

0.2% = 0.2g in 100mL

200mg = 100mL

2mg = 1 mL

ii. What volume should be given each hour?

Volume required = Dose req x volume available

Dose available

= 120 x 1
2

= 60 mL/ hr

Therefore, 60mL an hour is required.

 Resources to help you with drug calculations

There are numerous textbooks on the market to help with drug calculations.
Some examples are:

Shihab P (2014) Numeracy in Nursing and Healthcare: Calculations and Practice 2nd ed
Harlow: Pearson Education
Starkings S & Krause L (2018) 4th Ed. Passing Calculations Tests for Nursing Students 2nd
ed. Exeter : Learning Matters

Articles:
Brindley B (2017) Undertaking drug calculations for oral medicines and suppositories
Nursing Standard 32(7):56-62
Brindley J (2018) Undertaking drug calculations for intravenous medicines and infusions
Nursing Standard 32(20): 55-61
Wright K & Shepherd E (2017) How to calculate drug doses and infusion rates accurately
Nursing Times 113(11): 34-37

Websites:
There are various free, open source-web sites that have drug calculation exercises.
www.qub.ac.uk/elearning/public/NumeracySkillsforDrugCalculations
This is a website developed for students at Queen’s University Belfast, but is open source so
students at other universities can access it. There are presentations, quizzes and practice
papers. NB The contact details for Tim Crawford are only for students at Queen’s! If you are
struggling with drug calculations then please see your personal tutor.

http://www.testandcalc.com/
This has several quizzes and shows both the solutions and the answers.

Free phone apps

There are several free phone apps on the market for both android and iPhones

Reviewed and updated 2021