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Pharmacy Intravenous (IV) Calculations Intravenous (IV) Calculations are used for assembling fluids to beadministered parenterally over

time directly into a patients bloodstream. This is commonly referred to as a "drip". Let's start with some basics: Take a look at these 3 formulas: VOLUME TIME = RATE RATE x TIME = VOLUME VOLUME RATE = TIME Notice:If you know two parts of the formula you can determine the third.

The first consideration is calculating the RATE OF FLOW based on how much the patient is to receive over a given time. VOLUME TIME = RATE

The patient is prescribed: 3.6L of mixture over 6 hours. Use the formula from above: 3600 ml 6 Hrs = 600ml/Hr Next, from here you can easily determine how much per minute. 600ml/Hr 60(min/Hr) = 10ml min

How would we determine the volume to fill a prescription?. RATE x TIME = VOLUME

The patient is prescribed: 300ml/Hr for 4 Hours 300ml X 4Hr = 1200ml 1.2L will be needed (volume)

If you want to determine the amount of Time a volume will last, use the formula: VOLUME RATE = TIME

The patient is prescribed: 1.5L of a solution at a rate of 150ml/Hr 1500ml 150ml/Hr = 10 Hours The solution will last for 10 Hours (Time) IV Infusion Set Calculations (Intravenous)

It is imperative to understandhow to calculate IV Infusion/IV mixture, dosage, and rate of flow in preparing for the PTCB or ExCPT exams. This page is dedicated to IV administration sets that serve the mixture to the end user (Patient).

IV Infusion sets are pre-calibrated to how many drops per ml(gtt/ml) of asolution they administer to the patient. This is NOT to be confused with Drops per Minute (gtt/min). Drops per minute can be adjusted on the device. It is very important to never confuse the two.

Here is the basic formula:

Memorize the difference of the two. Drop Factor gtt/mL IV Infusion devices are calibrated to deliver so many Drops per Milliliter. Flow Rate gtt/min A nurse will set the device to dispense so many drops per minute in order to achieve the proper ml/min.

Let's use an example similar to the one on the last page : The patient is prescribed: 720ml of mixture over 6 hours 720mL 6 Hrs = 120mL/Hr determine how much per Minute. 120mL/Hr 60(min/Hr) = 2mL/min

We arrived at 2mL/min

The Infusion set device delivers 10 gtt/ml, Now, simply take the amount of ml/min and multiply it by the gtt/ml. 2ml/min x 10gtt/ml = 20gtt/min

This example seemed very easy, right? Well, it really is just that easy. The only things that makes it more complicated are fractions, decimals and rounding up to the nearest drop. As long as you keep gtt/ml and gtt/min straight the rest is just math. Would you rather watch a video? Here's one -Video Tutorial

Another flow rate calculation example

Question from Angel on Yahoo! Answers A 110lb woman is started on a nitroglycerin IV drip.The order is to administer the nitroglycerin at 5mcg/min. The pharmacy sends a 250ml IV container with 25mg of nitroglycerin added to the container. What rate in ml/hr should the IV run? The patients weight is irrelevant. The 250ml IV is just saline and used as a vehicle to carry the active drug into the patient's body. Angel is in pharmacytech school and I know she knows some math. So.... First you need to convert your mg's to mcg's. Next, using proportions math you can determine how many mL's are needed to deliver 5mcg's. Here is how it will look: 25mg 25,000mcg 5mcg

= 250ml 250ml

.05ml

You now know that 0.05 ml contains 5mcg The patient needs 5mcg/min, so they need 0.05 ml/min 0.05 ml x 60 min = 3ml/Hour The Answer is 3ml/Hour

Pharmacy Dilution Math Pharmacy Dilution Math is a process of reducing the concentration of asolution by adding more solvent. The formulas explained here are only to be used for the purpose of diluting a solution from a higher percentage to a lower percentage. These methods are shortcuts to algebra methods and should only be used for taking the pharmacy tech test. A tech who will be compounding solutions should always use the proper algebra formula. Click here to see the Proper Algebra Method

The pharmacist hands you a 1.5L bottle of a 20% solution and asks that you mix it with sterile water to make as much 12% solution as possible. How much sterile water will you use ? A. 525mL B. 800mL C. 1000mL D. 1250mL

Another way to do this problem is to use the formula:

C1 X V1 = C2 X V2
C1= V1= C2= V2= Concentration 1 Volume 1 Concentration 2 Volume 2

1) First, plug it all in:


(.20)(1500ml) = (.12)( X )
(Volume 2 is unknown or "X")

2) Do the multiplication
300ml = .12X

3) Do the division to isolate X

300ml .12X

.12 .12

4) Now you have the larger volume.


(but, this is not the final answer)

2500mL = X

5) Figure out the difference between the Smaller


and larger volumes. (this is the final answer)

2500mL - 1500mL --------

1000mL - would be added to the solution. The answer is C.


If you want to cross check your answer, you could by taking this new information and doing an Alligation. This type of pharmacy tech math may be more difficult for those who have not taken algebra in school or pharmacy dilution math before.

Want to see the proper algebra way to do this problem in text?

Question: The pharmacist hands you a 1.5L bottle of a 20% solution and asks that you mix it with sterile water to make as much 12% solution as possible. How much sterile water will you use ? A. 525mL B. 800mL C. 1000mL D. 1250mL

Organize your known information: % Qty decimal Set-up sol. 1 20% 1500ml .20 1500(.20) sol. 2 0% X .00 .00(X) Want

12% 1500 + X .12 (1500 + X)(.12)

1) The Equation Set-up:

1500(.20) + X (0.00) = (1500 + X).12

2) Do the math:

1500(.20) + X (0.00) = (1500 + X).12 300 = 180 + .12X 120 = .12X

3) Isolate for "X":

120
=

.12x

.12 .12

4) Solution:

1000 = X You would need to add 1000ml of sterile water. Answer = "C"

x Supplied Units (strength) = Amount you give Supplied Dose (have)


Some people find the mnemonic NHS useful to remember the drug formula Rules for using the formula

1. 2. 3. 4.

Get the dose units the same Work out units for answer (remember missing or incorrect units means an incorrect answer) "crunch" numbers Look at the answer "Is it reasonable?"

Worked Example
1 The prescription

DRUG Gentamicin

DOSE

ROUTE

Start Date

Valid Period

20mg

IV

Today

x 3 doses

12

SIGNATURE

Pharmacist

14

A Prescriber

18

Additional Instructions

22

2 The drug

3 - Setting out the calculation

Since the units are the same - Rule 1 has been met

The units for the answer is mL (I am giving a volume)

Now by "crunching" the numbers (I did the red step before the blue step) I get the answer mL or 0.5 mL Finally I look at the answer - it seems reasonable i.e. the prescribed dose is less than the supplied dose and my answer is less than the amount supplied. Finally I look at the answer - it seems reasonable i.e. the prescribed dose is less than the supplied dose and my answer is less than the amount supplied.

Changing between multiples of units (Rule 1)


Healthcare uses the Systme Internationale (SI) measurement system. That is packages of units increase or decrease by steps of 1000; thus 1 gram is 1000 milligrams. Put another way each time you open a gram you get 1000 smaller pieces or 1000 milligrams. Thus to turn grams into milligrams you times the number by a thousand. You could do this by doing a times sum but a simpler method is to move the decimal point three places to the right. It is usually easier to change the larger unit to the smaller unit giving you whole numbers irrespective of whether the prescribed dose or the supplied dose has the larger unit.

Activity
Try these examples
Convert 1.2 g to milligrams Change 0.5 milligrams to micrograms How would 0.25 litres be expressed in millilitres?

Check your answers


1200 mg or 1200 milligrams 500 micrograms 250 mL or 250 millilitres Remember a number without the correct units is wrong

Various ways of presenting drug strength


Most of us are familiar with drugs expressed as the weight of the drug in a given number of millilitres e.g. 80 mg/2mL but drug strength may also be expressed as:

The number of units of the drug in a number of millilitres e.g. insulin 100 units/mL A percentage e.g. 2%. The number tells you the weight (in grams) of the drug available in 100 millilitres. A ratio e.g. 1:1000. The first number in the ratio tells you the weight (in grams) of the drug available while the second number tells you the volume (in millilitres)

Although the information may look different the same drug formula is still used to calculate the amount the patient receives.

Activity

Try these examples


Give Heparin 2500 units, pharmacy has supplied 5000 units / 5 mL Prescribed 50 g Glucose, Infusion bag states 20% Glucose Ordered 1 mg Adrenaline, Information on ampoule 1:10000 Adrenaline

Check your answers


Heparin 2500 units 50 g Glucose 1 mg Adrenaline give 2.5 mL give 250 mL give 10 mL

Workings out