Calculations

 Desired Dose:
 Desired Frequency: (per dose, per day) (If the question does not specify dose or
day then you may assume it is dose)
 Have: (Dose you have, include form (concentration)):
 Equivalency: (Desired Dose and Have)
 Desired Form: x (tab, cap, mL etc)
 Set up the problem using the formula you always use.


 Or


 What dose do you want (include unit of measure)?

 What dose/form do you have?
 What do you know regarding the relationship between the unit of measure of
dose wanted and have (equivalency)?
 What form do I want (tab, cap, mL, tsp, tbsp, oz)?
 What is the answer (amount and unit of measure) or (how many and form)?
 Drug A 0.01 g po is ordered at HS. Have Drug
A 5 mg/tablet. How many tablet(s) should
the nurse give?
 Step 1: Desired Form and Frequency (what is
question asking for?):

 Step 2: Have:

 Step 3: Equivalency Between have and desired

doses:

 Step 4: Desired Dose and Frequency?

 Step 1: Desired Form and Frequency (what is
question asking for?): tablet(s)/dose

 Step 2: Have: 5 mg/tablet

 Step 3: Equivalency Between have and desired

doses: 1 g = 1000 mg

 Step 4: Desired Dose and Frequency? 0.01 g; q HS

 Step 1: Desired Form and Frequency (what is question asking for?: tablet(s) /dose
 Step 2: Have: 5 mg/tablet
 Step 3: Equivalency Between have and desired doses: 1 g = 1000 mg
 Step 4: Desired Dose and Frequency? 0.01 g; HS

 X tablet = 1 tab/5 mg x 1000 mg/1 g x 0.01 g/HS

 1 tab x 1000 x 0.01 = 10
 5x1 5 = 2 tablets

 Is this logical?

 Check your answer by replacing answer and desired

dose and see if you come up with 0.01 g.
 With each of the following problems fill in the
questions:

 Step 1: Desired Form and Frequency (what is question

asking for?):
 Step 2: Have:
 Step 3: Equivalency Between have and desire doses:
 Step 4: Desired Dose and Frequency?
 Set up the problem using the formula you
consistently use and calculate the correct
answer.

 Question if the answer is logical.

 Check your work.

 Your patient is to receive Drug A 25 mg PO daily. The pharmacist dispenses Drug Z 50 mg
scored tablets. How many tablet(s) should your patient take?

 Your order reads Drug B 100mcg PO every morning. You have Drug B 0.05 mg tablets. How
many tablet(s) should you administer?

 Your order reads Drug C 225,000 units PO daily. You have on hand Drug C 50,000 unit tablets.
How many tablet(s) do you administer?

 Your order reads Drug D 15 mg PO every morning. You have on hand Drug D 10 mg tablets.
How many tablet(s) will you administer?

 Ordered: Drug E 90 mg PO tid for a patient with hypertension. It is supplied as Drug E 60 mg

scored tablets. How many tablet(s) should you administer?

 You have Drug F 0.25 mg tablets, and you need to administer Drug F 125 mcg PO. How many
tablet(s) should you administer?
 How are you doing?

 Should we move on?

 Drug A suspension 180 mg PO bid is ordered for a patient
who cannot swallow pills. It is supplied as 125 mg/5 mLs.
How many milliliter(s) should you administer?

 Step 1: Desired Form and Frequency (what is question

asking for?):

 Step 2: Have:

 Step 3: Equivalency Between have and desired doses:

 Step 4: Desired Dose and Frequency?

 Step 1: Desired Form and Frequency (what is
question asking for?): milliliter(s)/dose

 Step 2: Have: 123 mg/5 mLs

 Step 3: Equivalency Between have and desired

doses: same

 Step 4: Desired Dose and Frequency? 180 mg;

bid
 Step 1: Desired Form and Frequency (what is question asking
for?): milliliter(s)/dose
 Step 2: Have: 123 mg/5 mLs
 Step 3: Equivalency Between have and desired doses: same
 Step 4: Desired Dose and Frequency? 180 mg; bid

X milliliter(s): 5 mLs/123 mg X 180 mg/bid

5 mL x 180 = 900 = 7.3170731mLs (round to 10th) = 7.3 mLs

123 x 1 = 123
 You are caring for a patient at home who must take Drug A 30 mL PO. How will you instruct the
patient to measure the dose using ordinary household measuring devices?

 A patient is instructed to take Drug B liquid (elixir) 650 mg qid. Have Drug B 160 mg/5 mL. How
many mL(s) should the patient take?

 A homebound patient must take Drug C 400,000 units po every 4 hours, to swish in the mouth
and then swallow. Available: Drug C 100,000 units/5 mL. The patient has only household
measuring spoons. How should the patient be instructed to take the dose?

 Your patient is receiving Drug D 500 mg oral suspension po q 6 hours. Label: Drug D
250 mg/5 mL, and the bottle contains 100 mL. How many mL(s) should you give?

 Your patient needs Drug E 400 mg oral suspension. Label: Drug E 200 mg/5 mL. How many mL(s)
should you give?

 The doctor orders Drug F 100 mg oral suspension po t.i.d. for your patient. Have: Drug F125
mg/5 mL. How many mL(s) should you give?
 Do you have it yet?

 Moving on.

 Weight base questions are common, lets try

some.
 One additional step needs to be added:
additional information required to calculate
correctly in this case you will need to add is lbs
or kg.
 Drug A 0.001 mg/kg PO per day. It is
supplied as 0.075 mg tablets. The patient
weighs 196 pounds. How many tablet(s)
should you give?
 Step 1: Desired Form and Frequency (what is
question asking for?): tablet(s)/dose

 Step 2: Have:0.075 mg tablet

 Step 3: Equivalency: 1 kg /2.2 lb

 Step 4: Desired Dose and Frequency? 0.001 mg/kg;

day

 Step 5: Added information: 196 lb

 Step 1: Desired Form and Frequency (what is question asking for?): tablet(s)
/dose
 Step 2: Have:0.075 mg tablet
 Step 3: Equivalency : 1 kg/2.2 lb
 Step 4: Desired Dose and Frequency? 0.001 mg/kg; day
 Step 5: Additional information: 196 lbs

X tablet(s) = 1 tablet/0.075 mg X 0.001/ 1 kg X 1kg/2.2 lbs X 196 lbs/day

=

1 tab x 0.001 x 196 = 0.196 = 1.1878787 tab (round rule) = 1 tablet

0.075 x 2.2 0.165
 You have on hand Drug A 4 mg/mL. You need to administer Drug Z 0.015
mg/kg to a patient who weighs 150 pounds. How many mL(s) should you
administer?

 The doctor orders a single dose of Drug B 20 mg/kg/dose oral suspension

for a toddler who weighs 20 lb. What’s the dose in milligrams?

 The doctor orders Drug C oral suspension 56 mg/kg/day in four divided doses
for a patient who weighs 55 lb. The suspension that’s available is Drug C 125
mg/5 ml. What volume should you administer for each dose?

 The doctor orders Drug C 35 mg/kg/dose po to sedate a 3 kg neonate for an

electroencephalogram. On hand dosage Drug C 75 mg/mL for sedation prior to
a procedure. How many mL(s) will you give.
 Do you have it?

 Try safe dose.

 Difference: for have put the safe range
 In the additional information you will have to
add wt or kg.
 The practitioner orders Drug A 10 mg po q 4-
6 hr prn, nausea. The child weighs 44 lbs.
The drug resource indicates that the usual
po dosage is 0.5 mg to 1mg/kg/dose every
4-6 hrs as needed. Is this a safe dose?
 Step 1: Desired Form and Frequency (what is
question asking for?):

 Step 2: Have:

 Step 3: Equivalency :

 Step 4: Desired Dose and Frequency?

 Step 5: Added information:

 Step 1: Desired Form and Frequency (what is
question asking for?): mg/dose

 Step 2: Have: 0.5 mg to 1 mg/kg/dose

 Step 3: Equivalency: 1 kg = 2.2 lbs

 Step 4: Desired Dose and Frequency? 10 mg q 4-6 hr

 Step 5: Added information: 44 lbs

 Step 1: Desired Form and Frequency (what is question asking for?): mg/dose
 Step 2: Have: 0.5 mg to 1 mg/kg/dose
 Step 3: Equivalency: 1 kg = 2.2 lbs
 Step 4: Desired Dose and Frequency? 10 mg q 4-6 hr
 Step 5: Added information: 44 lbs
Must calculate the range and determine if dose is safe.
Safe?
X mg = 0.5 mg/1 kg X 1 kg/2.2 lbs X 44 lbs/dose
0.5 mg X 1 X 44 = 22 = 10 mg/dose
1 x 2.2 = 2.2

X mg = 1 mg/1 kg X 1 kg/2.2 lbs X 44 lbs/x

1 mg X 1 X 44 = 44 = 20 mg/dose
1 X 2.2 = 2.2
Order was for 10 mg/dose: is it safe? YES
 The doctor orders Drug A 100 mg po tid. The child weighs 33 lb. The recommended dosage on
the drug label, “Usual dose: Children, 20 mg per kg a day… in three divided doses.” Is this
dosage safe?

 Suppose the physician orders Drug B 200 mg po q 8hr for a child who weighs 22 lb. The label
describes the recommended dosage as, “usual child dosage: 20-40 mg/kg/day in divided
doses every 8 hours.” Is this dosage safe?

 The physician orders Drug C 2.1 g po q 8 hr. The child weighs 95 lb. The drug reference
indicates that the usual po dosage for infants and children in 50-100 mg/kg/day divided every
8 hours; maximum dosage is 6 g/day. This means that regardless of how much the child
weighs, the maximum safe allowance of this drug is 6 g per 24 hours. Is the order safe?

 The order reads Drug D 40 mg po q 6hr PRN, temp > 101.6º. The 7-month-old baby weighs 17
½ lb and has a temp of 102.6º. The drug reference manual states “Children: 6 months-12
years: Temperature < 102.5ºF - 5 mg/kg/dose; temperature> 102.5ºF - 10 mg/kg/dose; given
every 6-8 hr; Maximum daily dose: 40 mg/kg/day. Is the order safe?

 Prescribed Drug E10 mg/kg po q 12 hr. The patient weighs 50 kg. Recommended safe dose is
50-75 mg/kg/day. Is the prescribed dose safe?
 Do you have it?

 Reconstitution is next.
 Your patient needs Drug A 25 mg po now. The label
says to add 1.3 mLs water to yield 50 mg/1.5 mLs.
How many mL(s) of reconstituted solution should
you give the patient?

 Take a look is this any different than the basic

po or liquid calculations?

 Does not matter if it is oral liquid or injectable

or IV, it is still the same math problem.
 Step 1: Desired Form and Frequency (what is
question asking for?):

 Step 2: Have:

 Step 3: Equivalency Between have and desired

doses:

 Step 4: Desired Dose and Frequency?

 Step 1: Desired Form and Frequency (what is
question asking for?): mL(s)/ dose

 Step 2: Have:50 mg/1.5 mL

 Step 3: Equivalency Between have and desired

doses: same

 Step 4: Desired Dose and Frequency? 25 mg;

now
 Step 1: Desired Form and Frequency (what is question asking for?):
mL(s)/ dose
 Step 2: Have:50 mg/1.5 mL
 Step 3: Equivalency Between have and desired doses: same
 Step 4: Desired Dose and Frequency? 25 mg; now

X mL(s) = 1.5 mL/50 mg X 25 mg/dose

1.5 mLs X 25 = 37.5 = 0.75 mL (rule) 0.8 mL

50 X 1 = 50
 Break time

 Parenteral meds are next

 Is setting up the problem any different?