Medication Dosages

Giving the Right Number of Pills

Calculating medication dosages for pills is the most common math you
will be doing in your career. If you plan to work in a hospital setting, you
will give hundreds of thousands of pills over your career.
Is it for You?

How To Do It

Help For
Nursing When a practitioner orders a medication, that specific dosage may not be
Students available to you. While the pharmacy department will do their
calculations, it is your responsibility as the bedside nurse to make
sure your patient get the correct dosage.

Calculating how many pills your patient will need is very easy. It is all
about basic division. Are you ready for it? Here is the only formula you
Travelling, will need for calculating medication dosages in the pill form.
Masters, Oh My

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Here are some Examples

1. The doctor orders 75mg of Toprol XL PO daily. Your pharmacy has only
25mg Toprol XL pills. How many do you give?

OK! Here is another:

2. The doctor orders 5mg of Coumadin PO nightly. You have 10mg

Coumadin pills. Tell me what to give:
A note about splitting pills--Not all pills can be split. Make sure you
check with the pharmacy if you are unsure if it is safe to split a pill or not.
As a general rule, most pills that are scored (indented line in the middle)
can be split safely, but NOT ALL. So again, be on the safe side and
CHECK WITH THE PHARMACIST.

Another Free Example for you!

3. The doctor orders 80mg PO Lasix x1 stat. You have 20mg pills of lasix.
What to do?

Do your PATIENTS a favor here! Most people don’t like swallowing

pills. First, have another nurse double check your calculations anytime
you need to give more than 2 pills or you are unsure of your math. I
STILL do this because patient safety should be a top priority! Second, talk
to your pharmacist about alternatives. In the example above, there may
be 40mg lasix pills available instead of 20mg pills. If so, your patient
would only have to swallow 2 instead of 4. Much better!

Last example:

4. The doctor orders 0.125mg of digoxin PO daily. Your pharmacy has

0.0625mg pills. How much do you give? HINT—DO NOT PANIC b/c OF
DECIMALS. Use the same formula!

GREAT JOB! You can now calculate a medication dosages very easily.
MEMORIZE THE FORMULA and use it for school and then again in your
career.

Click here when you are ready to learn how to calculation liquid
medication doses

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math page

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 Liquid Medication
Giving the Right dose ml by ml
Calculating dosages for liquid medications is also EXTREMELY simple. First, you
should master how to calculate pill dosages. After you are comfortable with that,
we move on to our next formula.
Is it for You?

How To Do It

Help For
Nursing I learned this formula in 12th grade chemistry. It works almost ALL of the time
Students for me, as long as I set it up correctly. You answer should always end with the
units (mg, ml, units, etc.) that you are looking for. Next, remember that units
above and below the line will cancel each other out. Just practice and it will start
to make sense.

Here is my secret formula!

Travelling,
Masters, Oh My 1. Set up your equation. This may take some time to learn, but once you
do, it will become simple
2. Cancel all units that you see on both the bottom AND the top of the
equation. Note that if the unit measure is only present once on the top,
you can only mark it out once on the bottom, and vice versa.
Extras and
3. Now the only math step! Multiply all the numbers on the top, then
Members Area multiply all the numbers on the bottom. Now divide the top number by
the bottom number and WALA you have your answer.

Don’t worry, it is easier than it sounds. Ready? Here is your formula:

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Let’s Jump Right In

1. The doctor orders 5mg of Robitussin PO daily. Your medication bottle from
the pharmacy states 1mg/2ml of Robitussin. There are 30ml in the bottle. How
many do you give?
Try again!

2. You need to give 40meq of KCL PO x1. You have little cups that state KCL
20meq/5ml. How many mL do you give:
Last example!

3. You need to give 10,000 units of swish and spit Nystatin q6h. You have
5,000units/2ml packages of Nystatin. What to do?
If you are having trouble grasping this concept don’t worry. Most people
struggle with it in the beginning. It will just make sense to you one day, at least
that is what happened to me. After practicing and practicing, I just had a
lightbulb moment one day. Now nursing math is simple to me. Learn this
formula before moving on because it is your base and you MUST understand
calculating liquid medication before moving on to IV drip calculations.

If you understand calculation for PO liquid medication, move on to IV liquid

calculations

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 IV Dosage Calculations
They are easier than you think!
IV dosage calculations are of the up most importance if you are planning on
working in a hospital or anywhere else where emergencies could arise.

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How To Do It

Help For For example: Lets say you have to give 80mg of IV lasix STAT x1 so that your
Nursing patient, who is gasping for air and starting to panic more and more by the
Students second, can get some relief from her flash pulmonary edema that just came
on. This is not the time to realize you cannot do calculations!

Luckily for you, you came here, memorized this formula, and helped save your
patient. Bravo! Let's get started. If you already learned how to calculate liquid
PO medications you are already done. Yep, that's right, the formula is exactly
Travelling,
Masters, Oh My
the same.

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Example 1
Life Saving time! Using the scenario from above, your patient is in respiratory
distress. The doctor looks at you and yells (yeah get used to that) "give 80mg
IV lasix stat!" The code cart has 10ml vials of lasix. Each vial says 10mg/1ml
of lasix. What do you give, and remember do it quickly!
Example 2
You are starting a heparin gtt. You have calculated that you need to give a
4200 unit bolus of heparin from your protocol orders. You have a 10ml vial of
heparin that states the concentration as 1000units/1ml. How much is your
bolus in ml?
Last Example
Warning! This one of those multi-step IV dosage calculations. you will need a
conversion table for metric units of measure.

The order states to give 2 grams of magnesium sulfate. You have a bag of
fluid that states 1000mg magnesium sulfate per 100ml of normal saline. How
many ml do you give AND how many bags will you be giving?
As you can see sometimes your dosage calculations will require a little more
 work. Always go back to the 3 basic steps if you get confused!

1. Setup the Equation

2. Mark out like units of measurement

and

3. Multiply Then Divide

Make sure you are very comfortable working with multi-step dosage
calculations. You will do a lot of these in the real world.

Click here when you are ready to learn about IV drip rate calculations

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IV Drip Rate Calculations

Drop by ML by CC
Congratulations! You are now ready to move onto IV drip rate calculations.
If you have not already learned how to give the correct number of pills or
measure the right amount of an IV push medication please go back and do
Is it for You?
 so now.

When patients are admitted to the hospital, it is always a possibility that

they will need an IV drip. It is important that you know how to do these
How To Do It rate calculations, so that you can assure they are not giving too much or
too little of a drug. It is feasible that you can be responsible for serious
harm, or even death, if you do not master this type of calculation.

We will be adding on to the previous formulas you have learned. IV drip

rate calculations may require a few extra steps, however the basic process
is the same as you learned how to calculate liquid medication dosages.

1. Set up the equation

Help For
2. Cancel the like units
Nursing 3. Do your basic multiplication and division
Students
There are a few things to remember when setting up your equations for IV
drip rate calculations.

• Your answers will always be in mL/hr. That is what IV

Travelling, pumps understand
• You may need to add extra column depending on the
Masters, Oh My
information you have. This will be for conversion purposes,
such as minutes to hours or micrograms to milligrams
• If you have a 1 liter bag, automatically change that to 1000
mL
• mcg doses are usually written as mcg/min
Extras and • If your answer seems CRAZY..like 1500ml/hr...You probably
set up your equation wrong, double check all your units!
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Here are your formulas

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Here are your free examples

You have a bottle of Amiodarone with 900mg/500ml. You have given the
loading dose bag and now need to start the gtt at 1mg/min. How fast
should you run the drug?

500 mL X 1 mg X 60 min ═ 54,000 mL ═ 33.3 ml/hr

900 mg 1 min 1 hr 900 hr

And another

Your chest pain patient has an order to start a Nitroglycerin gtt at

15mcg/min. Your bag has 50mg/500ml. How fast should you run your
medication?

500 mL X 1 mg X 15 mcg X 60 min ═ 450,000 mL ═ 9 ml/hr

50 mg 1000 mcg 1 min 1 hr 50,000 hr

Keep Going!

You have vancomycin to give to you patients. Let’s say it is safe to give
500mg over 1 hour. You have a bag of 750mg/500ml to give. At what rate
will you give this bag, and how long will it take the bag to completely
infuse?

500 mL X 500 mg ═ 250,000 mL ═ 333 ml/hr

750 mg 1 hr 750

NOW
How long will that take?

1 hr X 500 mL ═ 500 mL ═ So this should take 1.5 hours

333 mL 1 333

Very soon you will be learning how to calculate weight-based IV drips. Until
that time, continue to practice what you have learned already. I found a
great site that reinforces how to use this method for IV drip rate
calculations.

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IV Drip Rates
For Weight Based Medications
Weight based IV drip rates throw a snag in many nursing students’
Is it for You? confidence in their ability to do nursing math. It is not that hard though. All
you need to do is memorize one little formula.

How To Do It

Help For
Nursing
Students
So put down the paper bag and stop hyperventilating. This is a great way
to learn how to calculate IV drip rates for nursing school. I have seen other
formulas for calculations that I like, however, I find this formula is great in
nursing school because the drip factor is always given to you by your
professor.
Travelling,
Masters, Oh My This is a different formula than that of IV push medications of than that of
IV rate calculations that are NOT weight based.

Here we go! Ready?

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Some Things to Remember

1. In the USA, we still use pounds for a patient’s weight, so you must
FIRST convert pounds to kg. To do this DIVIDE your weight in
pounds by the number 2.2 and you will get the patients weight in
kg.
2. The gtt factor pertains to how many drops equal 1 mL. This will be
on the packaging of your tubing. In school, the teacher will usually
give you this number.
3. Your solution concentration must be in mcg/mL before plugging it
into the equation. So if the concentration is 500mcg/500mL than
the number you would put in the formula is 1. Make sense?

Free Example of IV Drip Rates

You have an order to start a dopamine drip at 5mcg/kg/min. Your patient

weighs 212 lbs. The gtt factor is 60 and the dopamine solution is
400mg/250mL. How fast do you run the drug on the pump?
Your patient is 76kg. You are mixing a dobutamine bag, per orders, with a
500mL bags D5W and a 250mg vial of dobutamine. You need to start the
drip at 2.5mcg/kg/min. Drip Factor = 60. How many mL/hr should you run
the drug?
Start Nipride at 3mcg/kg/min. Patient weighs 110 lbs. Bag of Nipride has
50mg/250mL D5W. Gtt Factor = 60. How fast do you run it per hour?

If you seem to get a wrong answer, double check your setup. Did you
convert pounds to kg? Did you miss a zero in the calculator? Did you round
correctly? Make sure the answer makes common sense. I don’t know if any
drip runs at 500ml/hr besides a fluid bolus, so your answer, by common
sense, should never be that high!

If this doesn’t make sense to you, and another way does---PLEASE use the
way you know. I am confident there are about 20 different ways to do
these calculations. I sometimes use 2 ways just to make sure I get the
same answer. Good way to double check!

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