DOSAGE CALCULATIONS
Measuring Systems
1. Metric System – most widely used; uses
gram as the basic unit of solid measures and
the liter as the basic unit of liquid measures.
2. Apothecary System – very old system; uses
minim as the basic unit of liquid measures
and grain as basic unit of solid measures.
3. Household System – uses teaspoon as basic unit
of fluid measure and pound as basic unit of solid
measure; requires a standardized measuring
devise.
4. Avoirdupois System – uses ounces and grains
but measures differently from household and
apothecary; seldom used and may be used for
bulk medications that come directly from
manufacturer.
5. Other Systems – these measures may reflect
chemical activity or biological equivalence.
Unit (U) – usually reflects the biological activity
of the drug in 1 ml of solution; unique for the
drug it measures.
Milliequivalents (mEq) – used to measure
electrolytes; refers to the ionic activity of the
drug; order is written for a number of mEq
instead of volume of drug
International Units (IU) – used to measure
certain vitamins or enzymes.
Mathematical Calculations :
METHOD :
First step – be sure that the drug on hand are
both on the same system or unit of
measurement.
Second step – If not the same, convert
Converting Metric to Apothecaries
Grams to Grains (1 gm = 15 gr. ) multiply the
number of grams by 15
e.g. Change 40 gm to gr.
40 X 15 = 600 gr.
Milliliters to minims (1 mL = 15 minims ) multiply
the number of mL by 15
e.g. Change 60 mL to minims
60 X 15 = 900 minims
Converting Apothecaries to Metric
Grains to grams (1 gr. = 0.060 gm) Divide the
numbers of grains by 15.
e.g. Change 30 grains to grams
30/15 = 2 gms
OR
Multiply the number of grains by 0.060
e.g. Change 5 grains to grams
5 X 0.060 = 0.3 gms
Grains to milligrams ( 1 gr. = 60 mg ) Multiply the
number of grains by 60.
e.g. Change gr. V to mg
5 gr. X 60 + 300 mg.
NOTE :
When converting a LARGER unit to a SMALLER
unit MULTIPLY the measurement that is
requested by the basic equivalent value.
To change SMALLER units to LARGER units,
DIVIDE the requested number of units by the
basic equivalent value.
Converting Metric to Metric
Milligrams to grams ( 1,000 mg = 1 gm ) Divide
by 1,000
e.g. Change 200 mg to gm
200 mg / 1,000 = 0.2 gm
OR
Move the decimal point of the milligrams 3
places to the LEFT
e.g. 0.6 mg = .000 gm
Grams to milligrams
Multiply the number of grams by 1,000
e.g. 0.006 gm X 1,000 = 6 mg
OR
Move the decimal point 3 places to the RIGHT
e.g. 0.5 gm = 500 mg
Converting weight kilograms to pounds
1 kg = 2.2 lbs
METHODS FOR CALCULATION :
1. Basic Formula
D x V=A
H
D – desired dose (drug dose ordered by the health
care provider )
H – the on-hand dose (drug dose on label of
container)
V – vehicle (drug form – tablet, capsule, liquid )
A – amount calculated to be given
EXAMPLE :
Order : cefaclor (Ceclor) 0.5 g PO b.i.d.
Available : cefaclor (Ceclor) 250 mg/capsule
Step 1 : Convert grams to milligrams
0.5 g = 500 mg
D x V =A
H
5oo mg x 1 capsule = 2 capsules
250 mg
2. Ratio and Proportion
1st ratio is the Known equivalent; H : V
2nd ratio is the desired amount and the Unknown;
D :X
H – on-hand dose
V – vehicle
D – desired dose
X – unknown amount to be given
:: - stands for “as” or “equal to”
Solve for x; x is the divisor
Steps :
Multiply the means (inner 2 numbers) and the
extremes (outer 2 numbers)
Clear X by dividing both sides by H
Solve for X
EXAMPLE :
Order : amoxicillin (Amoxil) 100 mg PO q.i.d.
Available : amoxicillin (Amoxil) 250 mg/5 ml
H : V :: D : X
250 mg 5 ml 100 mg x ml
250 mg ( x ) = 100 mg (5 ml)
x = 500/250 x = 2 ml
3. Fractional Equation
Formula :
H = D
V x
Cross multiply and solve for X
EXAMPLE :
Order : ciprofloxacin (Cipro) 500 mg PO q 12h
Available : ciprofloxacin (Cipro) 250 mg/ tablet
How many tablet/s should the client receive per
dose?
H = D
V x
250 mg = 500 mg x = 500
1 ml x ml 250
= 2 tablets
4. Dimensional Analysis or factor labeling
3 Factors :
Drug label factor – form of the drug dose ( V )
with the equivalence in units ( H )
e.g. 1 capsule = 500 mg
Conversion factor
Common Conversions :
1 g = 1,000 mg 1 g = 15 gr.
1,000 mg = 15 gr. 1 gr. = 60 mg
Drug order factor – dosage desired
Formula :
V = V (vehicle) x C (H) x D (desired)
H (on-hand) x C ( D) x 1
(drug label) (conversion (drug order)
factor)
Note : The conversion factor is built into the
equation and is included when the units of
measurement of the drug order and drug
container differ.
EXAMPLE :
Order : acetaminophen (Tylenol) gr. Xv, PO, PRN
Available : acetaminophen (Tylenol) 325 mg/tab.
Factors : drug label 325 mg = 1 tablet
drug order 15 gr./1
conversion factor 1000 mg = 15 gr.
How many tablet/s should be administered?
Answer :
Tab = 1 tab x 1000 mg x 15 gr.
325 mg x 15 gr. x 1
= 1000
325
= 3.07 or 3 tablets
PEDIATRIC DOSAGE CALCULATION :
Dosage based on mg/kg body weight and body surface
area
1. mg/kg body weight
Steps and Rule :
1. Convert lb to kg
2. Determine the safe dosage rang in mg/kg using a
reference
3. Decide if the order dose is safe by comparing the
order with the safe dose range listed in the reference
4. Calculate the dose needed
EXAMPLE : A child weighing 33 lbs is ordered
Augmentin 150 mg PO q 8h. The accompanying
prescribing information states that children <
40 kg receive 6.7 – 13.3 mg/kg q 8h.
Step 1 : Convert 33 lbs to kg
33lbs / 2.2 = 15 kg
Step 2 : Calculate the low and high safe dose range
: literature states dose should be between 6.7 –
13.3 mg/kg q 8h
Low dose : 6.7 mg X 15 kg = 100 mg
High dose : 13.3 mg X 15 kg = 199.5 mg
Step 3 : Is the dose safe ? The safe range is 100-200
mg q 8h. The dose ordered 150 mg q8h is safe
because it falls within 100-200 mg range.
Step 4 : calculate the dose. The label states that
134 mL of water should be added gradually to
make a concentration of 125 mg/5 mL.
Exercise : A child weighing 16 lb 10 oz is ordered
Lasix 15 mg PO BID, is the dose safe?
Convert lb to kg
Determine the safe dose range in mg/kg :
package insert states – initial dose of oral Lasix
in infant and children is 2 mg/kg body weight,
given as a single dose. Doses greater than 6
mg/kg body weight is not recommended.
Decide if the ordered dose is safe.
Ans. : The order is 15 mg PO BID. The child will
receive 30 mg in a day. The high range is 45 mg,
so the dose is safe.
Calculate the dose needed. The stock is 10
mg/mL.
2. Body Surface Area – The BSA, in square meters
(m2), is determined by where the person’s
height and weight intersect in the nomogram
scale.
To calculate the drug dosage using BSA method,
MULTIPLY the drug dose ordered by the number
of square meters.
e.g. 100 mg x 1.8 m2 (BSA) = 180 mg/day
Example :
Order : cyclophosphamide (Cytoxan) 100
mg/m2/day IV
Available : cyclophosphamide (Cytoxan) 200 mg
Client is 70 inches tall and weighs 160 lb (intersect
the nomogram scale at 1.97 m2)
100 x 1.97 m2 (BSA) = 197 mg
PEDIATRIC DOSES :
Example :
Percentage of Solution :
Dilution of tube feedings are ordered in
percentage, which indicates its strenght. Tube
feeding solutions are considered to be 100%.
D – desired percentage
H – on-hand strenght, which is 100%
V – desired total volume
X – unknown amount of solution
Example :
Order : 250 ml of 30% solution q 4h for 6 days
Calculate how much Ensure and water is needed to
make 250 ml of 30% solution
ANS : 30/100 x 250 mL
=7500/100
= 75 mL Ensure
Total Amount – 250 mL
Amount of feeding – 75 mL
Amount of water – 175 mL
Intravenous Fluid Therapy – used to administer
fluids containing water, dextrose, vitamins,
electrolytes, and drugs for direct absorption and
fast action.
2 Methods :
1. Continuous IV infusion – replace fluid losses,
maintain fluid balance and vehicle for drug
administration
2. Intermittent IV infusion – primarily to give drugs
Intravenous Sets :
Drop factor – number of drops per milliliter
A set that delivers large drops per mL ( 10-20
gtt/mL ) is called macrodrip set.
Small drops per mL ( 60 gtt/mL ) is called a
microdrip (minidrip) set
Macrodrip set - if the IV rate is to infuse at 100
mL/h or more.
Microdrip set – infusion < 100 mL/h
Keep Vein Open (KVO) – IV infusions at slow rate
(10 mL/h)
Calculating IV Flow Rates :
METHOD I : Three-step
1. Amount of solution = milliliter per hour
hours to administer (mL/h)
2. milliliters per hour = milliliters per minute
60 min (mL/min)
3. milliliter per min x drops per mL (IV set)
= drops per minute (gtt/min)
METHOD II : Two-step
1. Amount of fluid = milliliters per hour
hours to administer (mL/h)
2. Milliliters per hour x drops per mL (IV set)
60 minutes per hour
= drops per minute (gtt/min)
METHOD III : One-step
Amount of fluid x drops per mL (IV set)
hours to administer x minutes per hour (60)
= drops/ minute (gtt/min)
Exercises :
Infuse 1000 mL Lactated Ringer’s (LR)
solution over 10 hours, using a drop factor of
10
Calculate the flow rates ( mL/h)
Calculate the drops / min. (gtt/min)
