DRUG CALCULATION REVIEW

LEVEL 2
ENTERING 330, 340 & 360
THINGS TO KNOW
Conversion factors (pp 6 -7)
Pounds to kilograms
Teaspoon & tablespoon to milliliters
Ounces to milliliters
Within the metric system
Ex. Micrograms to milligrams
THINGS TO KNOW
Rounding rules
How to set up conversion equations (pp 9 -13)
Also known as DIMENSIONAL ANALYSIS
Start with known quantity and units
Then add conversion factors
How to check for reasonableness (pp 17 -18)
GETTING STARTED
An everyday occurance
You are driving to school. You live 20 miles from
school and average speed limit is 40 miles per
hour. How many minutes will it take you to get to
school?
What do you know?
Distance: 20 miles
Rate: 40 mph
SET UP THE EQUATION
Distance: 20 miles
Rate: 40 mph
SET UP THE EQUATION
Distance: 20 miles
Rate: 40 mph
SOLVE THE EQUATION
SOLVE THE EQUATION
ORAL MEDICATIONS
LETS TRY ONE
Order: Administer Augmentin
1000 mg by mouth three times a
day. How many tablets will you
give per dose?
What do you know?
Order: Administer Augmentin
1000 mg by mouth three times a
day. How many tablets will you
give for each dose?
What do you know?
Order: Administer Augmentin
1000 mg by mouth three times a
day. How many tablets will you
give for each dose?
ORDERED: 1000 mg
AVAILABLE: 500 mg/tablet
SET UP THE EQUATION
Order: Administer Augmentin
1000 mg by mouth three times a
day. How many tablets will you
give for each dose?
ORDERED: 1000 mg
AVAILABLE: 500 mg/tablet
SET UP THE EQUATION
Order: Administer Augmentin
1000 mg by mouth three times a
day. How many tablets will you
give for each dose?
ORDERED: 1000 mg
AVAILABLE: 500 mg/tablet
SOLVE THE EQUATION
SOLVE THE EQUATION
Is two tablets a reasonable answer? Yes.
If you answer 0.2 tablets, is that reasonable? No.
How about 2000 tablets? No.
Calcuation tests will only have reasonable answers.
ORAL SOLUTION
ORDER: Amoxil 175 mg by
mouth four times a day. How
many milliliters will you give
each dose?
WHAT DO YOU KNOW?
ORDER: Amoxil 175 mg by
mouth four times a day. How
many milliliters will you give
each dose?
WHAT DO YOU KNOW?
ORDER: Amoxil 175 mg by
mouth four times a day. How
many milliliters will you give
each dose?
ORDERED: 175 mg
AVAILABLE: 125 mg/5 ml
SET UP THE EQUATION
ORDER: Amoxil 175 mg by
mouth four times a day. How
many milliliters will you give
each dose?
ORDERED: 175 mg
AVAILABLE: 125 mg/5 ml
SET UP THE EQUATION
ORDER: Amoxil 175 mg by
mouth four times a day. How
many milliliters will you give
each day?
ORDERED: 175 mg
AVAILABLE: 125 mg/5 ml
SOLVE THE EQUATION
Is your answer reasonable?
SOLVE THE EQUATION
WHAT IF THE ORDER
IS WEIGHT BASED?
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WHAT DO YOU KNOW?
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WHAT DO YOU KNOW?
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WEIGHT: 62 lbs
ORDERED: 10 mg/kg
SET UP THE EQUATION
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WEIGHT: 62 lbs
ORDERED: 10 mg/kg
SET UP THE EQUATION
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WEIGHT: 62 lbs
ORDERED: 10 mg/kg
SOLVE
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WEIGHT: 62 lbs
ORDERED: 10 mg/kg
Is your answer reasonable?
SOLVE
ORDER: Amoxil 10 mg per kg by mouth four
times a day. Your patient weighs 62 lbs.
How many mg will you give each dose?
WEIGHT: 62 lbs
ORDERED: 10 mg/kg
WHAT IF THE ORDER IS WEIGHT BASED?
PART 2
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
WHAT DO YOU KNOW?
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
WHAT DO YOU KNOW?
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
ORDERED: 10 mg/kg
PT WEIGHT: 62 lbs
AVAILABLE: 125 mg/ml
SET UP THE EQUATION
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
ORDERED: 10 mg/kg
PT WEIGHT: 62 lbs
AVAILABLE: 125 mg/ml
SET UP THE EQUATION
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
ORDERED: 10 mg/kg
PT WEIGHT: 62 lbs
AVAILABLE: 125 mg/ml
SOLVE THE EQUATION
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
ORDERED: 10 mg/kg
PT WEIGHT: 62 lbs
AVAILABLE: 125 mg/ml
SOLVE THE EQUATION
ORDER: Amoxil 10 mg per kg by
mouth four times a day. Your patient
weighs 62 lbs. How many ml will you
give each dose?
ORDERED: 10 mg/kg
PT WEIGHT: 62 lbs
AVAILABLE: 125 mg/ml
TRY ONE ON YOUR OWN
ORDER: Potassium chloride 30
mEq by mouth now.
How many milliliters will you give?
Remember:
What do you know?
Set up equation.
Solve equation.
Is it reasonable?
TRY ONE ON YOUR OWN
ORDER: Potassium chloride 30 mEq
by mouth now.
How many milliliters will you give?
ORDERED: 30 mEq
AVAILABLE: 20 mEq/15ml
SET UP
SOLVE
Is your answer reasonable?
TRY ONE ON YOUR OWN
ORDER: Potassium chloride 30 mEq
by mouth now.
How many milliliters will you give?
ORDERED: 30 mEq
AVAILABLE: 20 mEq/15ml
SET UP
SOLVE
IV FLUIDS & DRIP RATES
A SIMPLE PROBLEM
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
WHAT DO YOU KNOW?
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
WHAT DO YOU KNOW?
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
ORDERED: 1000 mL in 6 hours
SET UP THE EQUATION
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
ORDERED: 1000 mL in 6 hours
SET UP THE EQUATION
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
ORDERED: 1000 mL in 6 hours
SOLVE THE PROBLEM
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
ORDERED: 1000 mL in 6 hours
Is your answer reasonable?
SOLVE THE PROBLEM
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
ORDERED: 1000 mL in 6 hours
WHAT IF ITS ON A PUMP?
ORDERED: NS 1000 mL over 6 hours.
What is the rate in ml/hr?
ORDERED: 1000 mL in 6 hours
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
ANOTHER SIMPLE RATE PROBLEM
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
WHAT DO YOU KNOW?
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
WHAT DO YOU KNOW?
ORDERED: 100 ml in 30 minutes
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
SET UP THE EQUATION
ORDERED: 100 ml in 30 minutes
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
SET UP THE EQUATION
ORDERED: 100 ml in 30 minutes
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
SOLVE THE EQUATION
ORDERED: 100 ml in 30 minutes
Is your answer reasonable?
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
Calculate the ml/hour.
SOLVE THE EQUATION
ORDERED: 100 ml in 30 minutes
BUT THERES NO PUMP!!!!!!
SO YOULL HAVE TO USE (GASP) THE DREADED DROP FACTOR
REMEMBER
A drop factor tells you the number of drops
per milliliter of fluid
Ex. A drop factor of 15 means there are 15 gtts/ml
And, YES, facilities still use drop factors to
figure the rate because
They dont have enough pumps
Emergency/disaster situations occur
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
You have a drop factor of 15 gtt per mL.
Calculate the rate in gtt per minute.
BACK TO ORIGINAL PROBLEM
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
You have a drop factor of 15 gtt per mL.
Calculate the rate in gtt per minute.
WHAT DO YOU KNOW?
ORDERED: 100 ml in 30 minutes
DROP FACTOR: 15 gtt/ml
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
You have a drop factor of 15 gtt per mL.
Calculate the rate in gtt per minute.
SET UP THE EQUATION
ORDERED: 100 ml in 30 minutes
DROP FACTOR: 15 gtt/ml
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
You have a drop factor of 15 gtt per mL.
Calculate the rate in gtt per minute.
SET UP THE EQUATION
ORDERED: 100 ml in 30 minutes
DROP FACTOR: 15 gtt/ml
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
You have a drop factor of 15 gtt per mL.
Calculate the rate in gtt per minute.
SOLVE THE PROBLEM
ORDERED: 100 ml in 30 minutes
DROP FACTOR: 15 gtt/ml
Is your answer reasonable?
Erythromycin 250mg in 100mL D5W to infuse in 30 minutes.
You have a drop factor of 15 gtt per mL.
Calculate the rate in gtt per minute.
SOLVE THE PROBLEM
ORDERED: 100 ml in 30 minutes
DROP FACTOR: 15 gtt/ml
LETS DO ANOTHER!
ORDERED: 600 mL NS over 6 hours.
DROP FACTOR: 10 gtt per mL
Calculate rate in gtt per minute.
SET IT UP
ORDERED: 600 mL NS over 6 hours.
DROP FACTOR: 10 gtt per mL.
Calculate rate in gtt per minute
SET IT UP
ORDERED: 600 mL NS over 6 hours.
DROP FACTOR: 10 gtt per mL.
Calculate rate in gtt per minute
SOLVE
ORDERED: 600 mL NS over 6 hours.
DROP FACTOR: 10 gtt per mL.
Calculate rate in gtt per minute
Is your answer reasonable?
SOLVE
ORDERED: 600 mL NS over 6 hours.
DROP FACTOR: 10 gtt per mL.
Calculate rate in gtt per minute
OH NO!!!
Can you have a partial drop?
NO!!!!
Round up or down to a whole drop.
So, the correct answer is
17 gtt/min
INJECTABLES
READING SYRINGES
If the plunger is beveled, read at the
point indicated in the above illustration.
READING SYRINGES
If the plunger is flat, read at the point
indicated in the illustration.
READ THE SYRINGE
READ THE SYRINGE
The correct answer is 1.2 mL
READ THE SYRINGES
READ THE SYRINGES
0.8 mL
1.3 mL
2.2 mL
Calculating injectables is just the same
as calculating oral medications.

HOWEVER!!!!!!
If you have to calculate the dosage
after reconstituting a medication, be
sure to use the reconstituted
concentration and NOT the amount of
fluid used to reconstitute in your
calculations.

FOR EXAMPLE
For IM administration use 2.1 mL
of solution to reconstitute.
HOWEVER the resulting
concentration is 350 mg/mL!!!!!
For IV administration use 9.6 mL
of solution to reconstitute.
HOWEVER the resulting
concentration is 100 mg/mL!!!!!!





READ LABELS CAREFULLY AND KNOW WHAT
YOU NEED TO SOLVE THE PROBLEM
SO, LETS DO A PROBLEM
Administer Rocephin 500 mg IM now.
How many mL will you give?
WHAT DO YOU KNOW?
Administer Rocephin 500 mg IM now.
How many mL will you give?
WHAT DO YOU KNOW?
Administer Rocephin 500 mg IM now.
How many mL will you give?
ORDERED: Rocephin 500 mg IM
AVAILABLE (once reconstituted): 350 mg/mL
SET UP THE EQUATION
Administer Rocephin 500 mg IM now.
How many mL will you give?
ORDERED: Rocephin 500 mg IM
AVAILABLE (once reconstituted): 350 mg/mL
SET UP THE EQUATION
Administer Rocephin 500 mg IM now.
How many mL will you give?
ORDERED: Rocephin 500 mg IM
AVAILABLE (once reconstituted): 350 mg/mL
SOLVE THE PROBLEM
Administer Rocephin 500 mg IM now.
How many mL will you give?
ORDERED: Rocephin 500 mg IM
AVAILABLE (once reconstituted): 350 mg/mL
Is your answer reasonable?
SOLVE THE PROBLEM
Administer Rocephin 500 mg IM now.
How many mL will you give?
ORDERED: Rocephin 500 mg IM
AVAILABLE (once reconstituted): 350 mg/mL
SO, WHATS THE ROUNDING RULE?
For parenteral medications
If greater than 1 mL round to the 10ths
Ex. 1.42857 round to 1.4 mL
If less than 1 mL round to the 100ths
Ex. 0.42857. round to 0.43 mL
The correct answer is 1.4 mL

Lets Practice!!!!!
1. Heparin 6500 units IV push has been ordered. It is available as 15,000
units/ml. How many mls should be given?
1. Heparin 6500 units IV push has been ordered. It is available as 15,000
units/ml. How many mls should be given?
2. Your patient weighs 130 lb. You are ordered to administer
15mg/Kg/24hrs of a medication in divided doses every 8hrs. How many mg
of the medication would you give per dose?

2. Your patient weighs 130 lb. You are ordered to administer
15mg/Kg/24hrs of a medication in divided doses every 8hrs. How many mg
of the medication would you give per dose?

3. A medication order is to give 500mg I.M. q 12 hr. Available is
0.5grams/2ml. How many ml would be administered per dose?

3. A medication order is to give 500mg I.M. q 12 hr. Available is
0.5grams/2ml. How many ml would be administered per dose?

4. A medication is available in 500mg tablets. The physician has ordered 0.5
grams. How many tablets should be given?
4. A medication is available in 500mg tablets. The physician has ordered 0.5
grams. How many tablets should be given?
5. Order-Dexamethasone 1 mg
Drug available-Dexamethasone 0.5 mg per tablet
How many tablets will you give?



5. Order-Dexamethasone 1 mg
Drug available-Dexamethasone 0.5 mg per tablet
How many tablets will you give?
6. Order-Tagamet 0.6 gm
Drug available-Tagamet 300 mg per tablet
How many tablets will you give?
6. Order-Tagamet 0.6 gm
Drug available-Tagamet 300 mg per tablet
How many tablets will you give?
7. Order-Phenobarbital 60 mg
Drug available-Phenobarbital 15 mg per tablet
How many tablets will you give?

7. Order-Phenobarbital 60 mg
Drug available-Phenobarbital 15 mg per tablet
How many tablets will you give?

8. Order-Ampicillin 0.5 gm
Drug available-Ampicillin 250 mg per 5 ml
How many mL will you give?

8. Order-Ampicillin 0.5 gm
Drug available-Ampicillin 250 mg per 5 ml
How many ml will you give?

9. Order-Dicloxacillin 125 mg
Drug Available-Dicloxacillin 62.5 mg per 5 ml
How many ml will you give?

9. Order-Dicloxacillin 125 mg
Drug Available-Dicloxacillin 62.5 mg per 5 ml
How many ml will you give?

10. Order-Medrol 75 mg IM
Drug Available-Medrol 125 mg per 2 ml
How many ml will you give?

10. Order-Medrol 75 mg IM
Drug Available-Medrol 125 mg per 2 ml
How many ml will you give?

11. Order-Lidocaine 1 mg per kg
Patients weight is 152 pounds
How many mg will you give?

11. Order-Lidocaine 1 mg per kg
Patients weight is 152 pounds
How many mg will you give?

12. Order- 520 mg of a medication in a 24 hour period. The
drug is ordered every 6 hours.
How many milligrams will be given for each dose
12. Order- 520 mg of a medication in a 24 hour period. The
drug is ordered every 6 hours.
How many milligrams will be given for each dose
13. Order-1000 ml over 6 hrs, IV set 15 gtts/ml
How many gtt per min will you give?
13. Order-1000 ml over 6 hrs, IV set 15 gtts/ml
How many gtt per min will you give?
14. Order-500 ml over 4 hrs, IV set 10 gtts/ ml
How many gtt per minute will you give?

14. Order-500 ml over 4 hrs, IV set 10 gtts/ ml
How many gtt per minute will you give?

ORDER: Give Lasix 15 mg IV now.
ORDER: Give Lasix 15 mg IV now.
ORDER:Give Cleocin 400 mg IM three times a day.
How many mls will you give for each dose?
ORDER:Give Cleocin 400 mg IM three times a day.
How many mls will you give for each dose?
Your patient is ordered Ceftriaxone IV. The medication is reconstituted as
directed resulting in 100 ml of solution. What is the final concentration?
Your patient is ordered Ceftriaxone IV. The medication is reconstituted as
directed resulting in 100 ml of solution. What is the final concentration?
The final concentration is 100mg/ml
Using the previous concentration and dilution, if you administer the
antibiotic in 30 minutes, what is the rate in ml/hour?
Using the previous concentration and dilution, if you administer the
antibiotic in 30 minutes, what is the rate in ml/hour?