6

SECTION I

PHARMACEUTICAL PRACTICE

Example:

Example:

How much sodium chloride is needed to adjust the

following prescription to isotonicity? (E value [sodium
chloride equivalents] for zinc sulfate is 0.15)
Zinc sulfate 2%
NaCl
q.s.
Purified water q.s. 60 mL
Make isotonic solution

How much calcium chloride (CaCl22H2O) is required to

prepare 100, 1 mL ampules containing 10 mEq per mL?
(mw 147)

Solution:

100 mL  10 mEq=mL 1000 mEq

1 mEq

Solution:

1 mEq
1000 mEq

73; 500 mg
73:5 mg
X

If sodium chloride is only being used to provide the 60 mL

isotonic solution: 60 mL  0.9% 0.54 g (or 540 mg)
Step 1: 60 mL  2% 1.2 g (or 1200 mg) of zinc sulfate
required to fill the prescription
Step 2: 1200 mg is equivalent to 1200  0.15 180 mg
of sodium chloride
Step 3: 540 mg  180 mg 360 mg (or 0.36 g), answer

ELECTROLYTE SOLUTIONS
Electrolyte solutions are used to treat fluid and electrolyte
disturbances. They may be prepared as oral solutions,
syrups, dry granules intended to be dissolved in water or
juice to make an oral solution, or oral tablets or capsules, and
they are also commonly prepared as intravenous infusions.
To convert electrolytes in solution (expressed as
milliequivalents [mEq] per unit volume to weight per unit
volume or vice versa), the following calculation may be used:
mg  Valence
mEq
Atomic; molecular; or formula weight
mg

mEq  Atomic; molecular; or formula weight

Valence

Table 2-1

Valences and Atomic Weights of Select Ions

Ion

Formula

Aluminum
Ammonium
Acetate
Bicarbonate
Calcium
Carbonate
Chloride
Citrate
Ferrous
Ferric
Gluconate
Lactate
Lithium
Magnesium
Phosphate
(mono)
Phosphate (di)
Potassium
Sodium
Sulfate

Al3
NH4
C2H3O2
HCO3
Ca2
CO32
Cl

C6H5O73
2
Fe
Fe3
C6H5O3
C3H5O3
Li
Mg2
H2PO4
HPO42
K
Na
SO42

Atomic/Formula
Weight

Valence

27
18
59
61
40
60
35.5
189
56
56
195
89
7
24
97

3
1
1
1
2
2
1
3
2
3
1
1
1
2
1

96
39
23
96

2
1
1
2

From Zatz J: Pharmaceutical Calculations, ed 4, Hoboken, NJ,

2005, John Wiley & Sons, Inc., p. 267.

147 mg
73:5 mg
2

X 73:5 g, answer

TPN CALCULATIONS
Total parenteral nutrition (TPN) provides all of the
patients daily nutritional requirements and generally
contains dextrose (carbohydrate), amino acids (protein
source), vitamins, trace minerals, electrolytes, and fat
emulsions. TPN solutions may also include insulin and
occasionally therapeutic drugs. The amount of protein,
dextrose, and fat are calculated based on the patients
daily kcal (calories) needed and available stock solutions.
Other ingredients do not contain calories.

Example:
A patient needs 1600 kcal/day. The physician has
ordered that the patient receive 65% of the daily calories
(kcal) from carbohydrates, 10% from protein, and 25%
from fat.
Calculate the amount (volume) needed to supply the
dextrose, protein, and fat calories from these pharmacy
stock solutions:
Dextrose 65%, amino acid 10%, fat 25%
First, determine how many kcal the patient needs from
each component:
1600 kcal  65% 1040 kcal from dextrose
1600 kcal  10% 160 kcal from protein
1600 kcal  25% 400 kcal from fat
Next, convert these kcals into grams:
1040 kcal  1 gram=3:4 kcal 305:9 grams dextrose
160 kcal  1 gram=4 kcal 40 grams protein
400 kcal  1 gram=9 kcal 44 grams fat
Then, calculate how many milliliters are needed from
each stock solution:
305.9 grams  100 mL/ 65 grams 470.6 mL from
dextrose 65%
40 grams  100 mL/ 10 grams
400 mL from amino
acid 10%
44.4 grams  100 mL/ 25 grams 177.6 mL from fat 25%
NOTE:
Carbohydrate contains 3.4 kcal/g
Amino acid contains 4 kcal/g
Fat contains 9 kcal/g

CALCULATION OF DOSES
There are a variety of ways to determine doses of drugs
including by age, body weight, surface area, creatinine
clearance, and other pharmacokinetic parameters.