Drug Calculations

Drug Calculations
Examples
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Converting factors
1 kilogram (kg) 1 pound (lb) 1 kilogram (kg) 1 gram (g or gm) 1 milligram (mg) 1 gram (gm) 1 cc (cubic centimeter) 1 inch (in) 1 grain (gr) 1 (household) cup 8 ounces (oz) 16 ounces (oz) 1 ounce (oz) 1 teaspoon (tsp) 1 dram 1 tablespoon ( T or tbs) 2 tablespoons (T or tbs) 3 teaspoons (tsp) 1 teaspoon (tsp) 1 milliliter (ml) 1 milliliter (ml) 1 liter (L) 37.0 C (Centigrade degrees)
2.2 pounds (lb) 453.6 grams (g or gm) (use 454) 1000 grams (g or gm) 1000 mg (milligrams) 1000 micrograms (mcg, but should always be written out to avoid transcription errors) 1 ml (milliliter) [Preferred term] 1 ml (milliliter) 2.54 cm (centimeters) 60 mg (milligrams) 240 ml (milliliter) 1 (measuring) cup 1 pint (pt) 30 ml (milliliter) 5 ml (milliliter) (not 4-5) 4 ml (milliliter) [archaic use] 15 ml (milliliter) 1 Ounce 1 tablespoon ( T or tbs) 75 gtt (drops) 16 minims (not 15-16) 15 gtt (drops) 1000 ml (milliliter) 98.6 F (Fahrenheit degrees)
Common Abbreviations
a.d. or A.D. a.s. or A.S. a.u. or AU
Right ear Left ear each ear or both ears
HHN
I.D. I.M. or IM I.T.
Hand held nebulizer

Intradermal route Intramuscular route Intrathecal route
I.V. or IV
IVP IVPB NGT
Intravenous route
Intravenous push Intravenous piggyback Nasogastric tube
od or O.D.
os or O.S. ou or O.U. po or P.O. or PO
Right eye
Left eye Each eye or both eyes By mouth
P.R. or PR
SQ, sub q, subcut SL or s.l. S&S V or P.V.
By rectum
Subcutaneous route Sublingual route Swish and swallow Vaginal route
ac ad lib ASAP b.i.d. or BID h.s. or HS NOC pc or P.C. p.r.n. or PRN q or Q
Before meals As desired / needed As soon as possible Twice daily (not the same as q 12 ) At bedtime (hour of sleep) Nighttime [archaic usage] After meals As needed Every
q AM
q hr q.d. or QD q.i.d. or QID q.o.d. or QOD q (Q) 1, 2, 3, 4, 6, 8, or 12, etc
Every morning
Every hour Every day Four times a day Every other day Every 1, 2, 3, 4, 6, 8, 12 hours. (Concept is based on a day and administering on a routine sequential basis to maintain therapeutic blood levels.) Immediately! [not when you can get around to it] Three times daily (not the same as q 8)
stat or STAT t.i.d. or TID
Dosage Forms
amp. cap(s)
Ampule Capsule(s)
DS
elix LA liq sol
Double-strength
Elixir Long-acting Liquid Solution
supp
S.R susp syr tab tinct or tr
Suppository
Sustained release Suspension Syrup Tablet Tincture
ung
Ointment
Solution Measurements
cc or CC gm gr gtt (s) IU kg L mcg or g mg
Cubic centimeter Gram Grain Drop (s) International units (best to write out) Kilogram Liter Microgram (should be written out--safety issue) Milligram
mEq
ml Mn, m oz ss or ss sliver T or Tbs tsp U
Milliequivalent
Milliliter [preferable for volume] Minim [rarely used, except in some math exams] Ounce One-half (archaic use) in NICU, a small slice of a suppository Tablespoon Teaspoon Unit (best to write out)
Miscellaneous Usage in the Hospital
AMA _ c D/C or DC G HO KVO LOC
(Leave) against medical advice with Discontinue Gauge (of needle) House officer (doctor on call) Keep vein open. Laxative of choice (Look for context when written, ie., could be "level of consciousness" when related to neurological exam.) May repeat (x) times [This should be written out due to risk for error.]
MR x _ MOC
FOC NKA N.P.O., NPO, or npo OTC qs Rx _ s __ ss TO TRA VO > <
In peds, mother of child

In peds, father of child (may also be frontal occiputal circumference) (read the context) No known allergies Nothing by mouth Over the counter A sufficient quanity Prescription, sometimes Treatment Right Without (if must abbreviate, use w/o) One-half (should avoid this form) Telephone order (Need to follow the hospital policy re this.) To run at (IV flow rate) Verbal order (What is hospital policy re this?) Greater than Less than
Abbreviations to Avoid
g __ ss or ss
Micrograms should be written out, insist on it! Write out one-half or 1/2 clearly.
OD
Ordered daily? Write out daily. QD, if legible, should be acceptable.
n or N
Nightly? QN? Write out nightly or use hs.
d or D
Daily? Write out how many days.
BT
Ordered at bedtime? Write out bedtime or use the standard hs.
Fishing for answers?
Examples
Example
Doctor's order: 0.25 mg of digoxin p.o. On hand: 0.5 mg tablets
52.0
1 =
1 X 0.25 0.5
Answer
Example
Doctor's order: Give deltasone 7.5 mg PO now. Available : deltasone 2.5 mg tablet.
AVAILABLE
Answer
Example
Doctor's order: Give ranitidine 40 mg PO ABT. Available is ranitidine 20 mg tablet How many tablet you should give? Answer
Example
Doctor's order: Give 7500 i.u of heparin injection S/C . Available:( heparin injection 5000 i.u/ml) How many ml you should give? Answer
Example
Doctor's order: Give 500 cc D5RL to be infused in 6 hrs. You should regulate the I.V at: Answer
Example
Doctor's order: Give 1500 cc normal saline over 4 hrs. You should regulate the I.V at: Answer
Example
Doctor's order: Give 1000 cc dextrose 5% I.V Q 8 hrs. You should regulate the I.V at: Answer
Example
Doctor's order: Give 3 L of I.V fluid 5% D/0.45% normal saline over 24 hrs.(the drop factor is 60 gtt/ml). You should regulate the I.V at: Answer
Example
Doctor's order: Give 3000 cc dextrose 5% I.V Q 6 hrs, drop factor is 20 gtt/m) How many drops should you give per minute? Answer
Example
Doctor's order: Give penicillin 600.000 u I.M stat Available: (penicillin 800.000 u/2 cc) How many ml should you give? Answer
Example
Doctor's order: Give G/S 2000 cc I.V Q 24 hrs, The rate will be how many drop per minute? Answer
Example
The physician orders IV fluids to hydrate a client. The order is written as "D5NS 4 Liters over 24 hours." Looking at the package indicates the drip factor of the tubing is 15 gtt/ml. What is the drip rate?
Answer
Shortcut method when you know the ordered ml/hr:
15 gtt/ml: divide the ml/hr by 4
10 gtt/ml (typically blood products): divide ml/hr by 6
20 gtt/ml: divide ml/hr by 3
175 / 4 175 / 6 175 / 3
= = =
43.75 gtt/min 29.16 gtt/min 58.33 gtt/min
Example
The client's K+ is 2.0 mEq/dl and the physician orders a potassium bolus of 40 mEq of KCl in 200 ml of NS to be delivered at a rate of 10 mEq/hr. What is the drip rate in microdrops? (Ideal, deliver on a pump.)
Answer
Calculating flow rate

Flow rate refers to number of ml of fluid to be infused over one hour (ml/hr).
total # of milliliters (volume) total # of hours
X ml/hr
Example
Order: 500 ml NS bolus over 3 hours
Answer
Example
The nurse makes rounds and notes that the current IV bag contains approximately 450 ml. The IV flow rate is 150 ml/hr. How long will it be before the nurse must hang a new bag?
Answer
exit
Example
Order: Administer 1000 cc at 50 gtt/min.
Answer
exit
Example
John is to receive Cleocin 150 mg IV q 8 hours. The nurse dilutes the medication to a total volume of 30 ml and plans to deliver it via an infusion pump over thirty minutes. What would be the flow rate?
Answer
exit
Example
For the client whose weight is 130 lbs and has dopamine ordered at 8 mcg/kg/min, what rate should the infusion pump be set for a solution of 400 mg dopamine in 250 ml D5W?
Answer
exit
Example
A client is receiving dopamine at 12 ml/hr. The solution hanging indicates "D5W 250 ml/200 mg dopamine". The client weighs 133 lbs. What is the dosage (mcg/kg/min) the client is receiving?
Answer
exit
Example
A client is receiving a heparin drip at 22 ml/hr via an infusion pump. The label on the liter bag of D5W indicates 40,000 U of heparin. How many units of heparin does the client receive per hour?
Answer
Example
The physician becomes concerned about Johns renal function and orders the Vancomycin dose (60 mg) to be infused over 90 minutes instead of the usual 60 minutes. If the Vancomycin dosage is diluted into 60 ml of IV fluid, what will be the flow rate? (Given on an IV pump for control.)
Answer
Example
John's primary IV is running at 34 ml/hr while NPO. When the nurse runs the Vancomycin (250 mg IV q 8 hr) in over 90 minutes [volume is 100 ml--(2 50 ml syringes)], the primary IV is stopped. The ampicillin (395 mg IV q 6 hr) is given concurrently in 10 ml of fluid over 30 minutes. He received 2 boluses of aminophylline (20 ml each over 20 minutes). The IV fluids were stopped while the aminophylline infused. Since microtubing was used for the medications, total flush is negligible (approximately 3 ml). What is Johns total intake for 24 hours?
Answer
exit
Example
Crystal has an IV infusing at KVO (10 ml/hr). She receives an antibiotic in 22.5 ml q 8 concurrently. One ml flush is given after each antibiotic. She is given 30 ml of formula q 3. She had diaper weights of 17 ml, 33 ml, 55 ml, 45 ml, 52 ml, 50 ml, 15 ml, and 36 ml. Calculate her I & O for the past 24 hours.
Answer
Example
John also has an order for ampicillin sodium 395 mg IV q 6 hr. The safe range for his type of infection in the literature is 100-200 mg /kg /day. Is this a safe dose?
Answer
Example
The physician stopped Johns gentamicin and cleocin when the culture report came back. His new orders include Vancomycin 250 mg IV q 8. The literature indicates that the minimal dilution concentration for infusion should be 2.5 mg / ml if given through a peripheral intravenous line (PIV). How many ml of diluent will the nurse need to mix the Vancomycin to meet this safety requirement? Answer
Example
A newborn has an order for 0.15 micrograms of Prostin VR (alprostadil) per hour to maintain patency of the ductus arteriosus. The pharmacy prepared a Prostin drip with 25 mcg alprostadil in 50 ml of D5W. What hourly rate is needed to deliver the dosage of medication as ordered?
Answer
Example
John is to be given an Aminophylline bolus of 30 mg in 20 ml of fluid over 20 minutes. The primary IV is running at 40 ml/hr. The drip factor of the tubing (buretrol) is 60 gtts/cc or minidrip. What is the flow rate needed to deliver the Aminophylline bolus as ordered?
Answer
exit
Example
John is a pediatric client in a hospital in which the policy is to place all children on IV therapy on a buretrol and to only fill the buretrol no more than two-three hours worth of fluid. The nurse fills the buretrol to 90 ml at 10 a.m. If Johns IV is running at 34 ml per hour, how long will it be before the nurse will need to fill it again? Answer
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Drug Calculations

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Drug Calculations

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Drug Calculations

a.d. or A.D. a.s. or A.S. a.u. or AU

Right ear Left ear each ear or both ears

Hand held nebulizer

ac ad lib ASAP b.i.d. or BID h.s. or HS NOC pc or P.C. p.r.n. or PRN q or Q

stat or STAT t.i.d. or TID

cc or CC gm gr gtt (s) IU kg L mcg or g mg

Miscellaneous Usage in the Hospital

AMA _ c D/C or DC G HO KVO LOC

In peds, mother of child

Ordered daily? Write out daily. QD, if legible, should be acceptable.

Nightly? QN? Write out nightly or use hs.

Daily? Write out how many days.

Ordered at bedtime? Write out bedtime or use the standard hs.

Fishing for answers?

Shortcut method when you know the ordered ml/hr:

15 gtt/ml: divide the ml/hr by 4

10 gtt/ml (typically blood products): divide ml/hr by 6

20 gtt/ml: divide ml/hr by 3

175 / 4 175 / 6 175 / 3

43.75 gtt/min 29.16 gtt/min 58.33 gtt/min

Calculating flow rate

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