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Methods of Calculation Any of the following three methods can be used to perform drug calculations. Please review all three methods and select the one that works for you. It is important to practice the method that you prefer to become proficient in calculating drug dosages. Remember: Before doing the calculation, convert units of measurement to one system. I. Basic Formula: Frequently used to calculate drug dosages.
D (Desired dose) H (Dose on hand) V (Vehicle-tablet or liquid) D x V = Amount H to Give D = dose ordered or desired dose H = dose on container label or dose on hand V = form and amount in which drug comes (tablet, capsule, liquid) Examp Order-Dilantin 50 mg p.o. le: TID Drug available-Dilantin 125 mg/5ml D=50 mg 50 H=125 mg V=5 ml
25 x5 0 =2 12 = 12 ml 5 5
o.II. D=1 gm (note: need to convert to milligrams) 1 gm = 1000 mg H=250 mg V=1 capsule 25 0 : 1 : : 10 00 : X XI. X. Left side are known quantities Right side is desired dose and amount to give Multiply the means and the extremes HX = DV D X V = H Examp Order-Keflex 1 gm p. IV. BID le: Drug available-Keflex 250 mg per capsule VIII. Ratio & Proportion: Oldest method used in calculating dosage. V. 250X = 1000 . Know n : : Desire d H : V D : X Means Extremes III. IX.
25 = 0.12 V=1 tablet .25 X 0.2 = 5 5 1 X XX.125X = 0. XIII.12 0.o.125 mg per tablet D=0.25 mg le: p. X = 4 capsules Fractional Equation H =D V X XIV. 0. H =D V X HX = DV D X V = H Examp Order .100 X 0 = 250 XII.25 mg H=0.0. QD Drug Available .Digoxin 0. Cross multiply and solve for X.125 mg 0.
XXII.0 15 = = 31.25 (31 15 2gtts/min) 60 One Step 1000 x 15.5 XXI.25 00 8 hrs x (31gtts/min) 480 60 XXIII. X = 2 tablets Intravenous Flow Rate Calculation (two methods) Two Step Step 1 .Lidocaine. Pronestyl) Solution cc x 60 min/hr x = mg/min = gtts/mi n . How to Calculate Continuous Infusions A. mg/min (For example .Amount of fluid divided by hours to administer = ml/hr ml/hr x Step gtts/ml(IV set) 260 min One Step amount of fluid x drops/milliliter (IV set) hours to administer x minutes/hour (60) Examp 1000 ml over le: 8 hrs IV set = 15 gtts/ml Two Step 100 Step = 0 1125 8 125 x Step = 31.
mcg/min (For example .Nitroglycerin) Solution cc x 60 min/hr x = mcg/min cc/hr Drug mcg Drug mcg x cc/hr = Solution cc x 60 mcg/hr min/hr Rule of Thumb NTG 100 mg/250 cc 1 cc/hr = 6.Drug mg Drug mg x cc/hr = Solution cc x 60 mg/hr min/hr cc/hr Rule of Thumb Lidocaine. Pronestyl 2 gms/250 cc D5W 1 mg 2 mg cc/hr 3 mg cc/hr 4 mg cc/hr = 7 cc/hr = 15 = 22 = 30 D.6 .
To calculate mcg/kg/min Drug mcg/ x cc/hr Solution cc x 60 min/hr x kg = mcg/kg/mi n Examp Nipride 100 mg/250 cc D5W was ordered to decrease your le: patient’s blood pressure. How many mcg/kg/min of Nipride is the patient receiving? 100. Dobutamine.mcg/min NTG 50 mg/250 cc 1 cc/hr = 3. Nipride. 250 cc 400. and the IV pump is set at 25 cc/hr.4 x 5 mcg/kg/min = 16.5 975. etc. =000 = 2. Patient’s weight is 190 lbs.2 cc/hr 4.000 mcg x 60 min x 86. To calculate cc/hr (gtts/min) Solution cc x 60 min/hr x kg x Drug mcg/kg/min = cc/hr mcg Examp Dopamine 400 mg/250 cc D5W to start at le: 5 mcg/kg/min.000 mcg x 25 cc/hr 250 cc x 60 min x 65 kg 2.500.3 mcg/min G. mcg/kg/min (For example .) 1. The patient’s weight is 143 lbs.00 mcg/kg/min 0 A.Dopamine. How to calculate mcg/kg/min if you know the rate of the infusion .
. For example: H.6 mcg/cc/min 3. NOW DO THE REST! E. 26. If you have a 75 kg patient for example. Once you do this step..5 mcg/kg/min (rounded down) F.6 mcg/cc/min x 10 cc on pump = 3. 26. You need this to calculate this dosage concentration first for all drug calculations.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg in 250 cc of IV fluid.54 mcg/kg/min Patients’s weight in kg (75 kg) = 3. How to calculate drips in cc per hour when you know the mcg/kg/min that is ordered or desired mcg/kg/min x patient’s weight in kg dosage concentration in mcg/cc/min G. 400 mg Dopamine in 250 cc D5W = 26. you can do anything! D.86 cc 26.6 mcg/cc/min = 10 cc = rate on pump .6 mcg/cc/min C. For example: = mcg/kg/mi n 400mg of Dopamine in 250 1600 mcg/cc cc D5W = 60 min/hr = 26.5 mcg/kg/min x 75 kg = 9.Dosage (in mcg/cc/min) x rate on pump Patient’s weight in kg B.
5 liters to milliliters 2. 7. 400mg of Dopamine in 250 cc D5W = 1600 mcg/cc 60 min/hr = 26. For example: M. You need this to calculate this dosage concentration first for all drug calculations. you can do anything! O.5 mcg/kg/min = mcg/kg/mi n Dosage (in mcg/cc/min) x rate on pump Patient’s weight in kg L. ALWAYS WORK THE EQUATION BACKWARDS AGAIN TO DOUBLE CHECK YOUR MATH! J. 2800 milliliters to liters . NOW DO THE REST!! P. 7500 micrograms to milligrams 6. 2.6 mcg/cc/min x 10 cc on pump = 3.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg in 250 cc of IV fluid. 10 milligrams to micrograms 4. 26.6 mcg/cc/min 75 Kg = 3.54 Patients’s weight in kg mcg/kg/min (75 kg) Now do some practice exercises to check what you learned A.5 grams to milligrams 3. 500 milligrams to grams 5. For example: 10 cc x 26. Practice Problems: 1.rounded up I. If you have a 75 kg patient for example 26. Once you do this step.6 mcg/cc/min N.
Practice Problems: IV set 15 gtts/ml IV set 10 gtts/ml IV set 15 gtts/ml 1. D. The patient’s weight is 200 pounds. Practice Problems: Use the method you have chosen to calculate the amount to give. Order-Dicloxacillin 125 mg Drug Available-Dicloxacillin 62.7. Order-Ampicillin 0. Dopamine 400 mg in 250 cc D5W to infuse at 5 mcg/kg/min. Order-Tagamet 0. 165 pounds to kilograms 8.6 gm Drug available-Tagamet 300 mg per tablet 3. Order-Dexamethasone 1 mg Drug available-Dexamethasone 0. 1. Order-Lidocaine 1 mg per kg Patient’s weight is 152 pounds 8. Order. How many cc/hour would this be on an infusion pump? .5 mg per tablet 2. Order-100 ml over 20 min. Order-1000 ml over 6 hrs 2. Practice Problems: 1.5 gm Drug available-Ampicillin 250 mg per 5 ml 5. The drug is ordered every 6 hours.520 mg of a medication in a 24 hour period. How many milligrams will be given for each dose? C. 80 kilograms to pounds B. Order-Phenobarbital 60 mg Drug available-Phenobarbital 15 mg per tablet 4. Order-500 ml over 4 hrs 3.5 mg per 5 ml 6. Order-Medrol 75 mg IM Drug Available-Medrol 125 mg per 2 ml 7.
6. A Dopamine drip (400mg in 250 cc of IV fluid) is infusing on your 80 kg patient at 20 cc/hour. Practicing drug calculations will help nurses develop stronger and more confident math skills. It is always a good idea to have another nurse double check your calculations. Regardless of the drug to be administered. A Lidocaine drip is infusion on your 90 kg patient at 22 cc/hour. Many nurses become overwhelmed when performing the drug calculations. Many drugs require some type of calculation prior to administration. The best way to prevent this is to remember that the drug calculations are performed the same way regardless of what the drug is. For example. when they require multiple steps or involve life-threatening drugs. the calculation is done exactly the same way. The Lidocaine concentration is 2 grams in 250 cc of D5W. The concentration is 100 mg in 250 cc D5W. What is the rate you would begin the infusion on the infusion pump? 4. Mostly because they don’t enjoy or understand math.2. The drug calculations range in complexity from requiring a simple conversion calculation to a more complex calculation for drugs administered by mcg/kg/min. A Nitroglycerin drip (100mg in 250 cc D5W) is infusing on your patient at 28 cc/hour on the infusion pump. How many mg/min is your patient receiving? Summary Many nurses have difficulty with drug calculations. whether the infusion is a big bag of vitamins or a life threatening vasoactive cardiac drug. How many mcg/min is your patient receiving? 5. . How many mcg/kg/min are infusing for this patient? 3. A procainamide drip is ordered (2gms in 250 cc D5W) to infuse at 4 mg/min. Sometimes nurses have difficulty calculating dosages on drugs that are potentially life threatening. The patient weighs 165 pounds. The order is to begin the infusion at 20 mcg/min. A Nitroglycerin drip is ordered for your patient to control his chest pain. The main principle is to remain focused on what you are doing and try to not let outside distractions cause you to make a error in calculations. This is often because they become focused on the actual drug and the possible consequences of an error in calculation. Calculate the drip rate in cc/hour for which the infusion pump will be set at. careful and accurate calculations are important to help prevent medication errors.
7500 mg 3.2 mL . be very careful that you have entered the correct data to obtain the chart.5 gm 5. Practice Problems 1. The nurses then titrate the drugs or administer the drugs based on an incorrect chart. If you use this method for beginning your infusions and titrating the infusion rates. 75 kg 8. 2500 mL 2. 10 mL 5. 2 tablets 2. 176 lbs B.000 mcg 4. 0. by plugging the numbers in the computer or monitor with a keypad and getting the exact infusion titration chart specifically for that patient.5 mg 6. or to do a hand calculation for comparison.8 L 7. 4 tablets 4. 1. A method to help prevent errors with this type of system is to have another nurse double check the data and the chart. to maintain her/his math skills. 7. 10. Practice Problems 1. Answers to Practice Problems A. 2. The use of computers for drug calculations also causes nurses to get “rusty” in their abilities to perform drug calculations. It is suggested that the nurse perform the hand calculations from time to time. 10 mL 6. 2 tablets 3. Many errors take place because erroneous data is first entered and not identified.Many facilities use monitors to calculate the infusion rates.
5 mcg/min 5. 17 cc/hr 2. 3 cc 4. Practice Problems 1. 130 mg for 4 doses C.7.6 (42) 2. 3 mg/min . 6.65 mcg/kg/min 3. 41. 186. Practice Problems 1. 69 kg = 69 mg 8. 75 D.8 (21) 3. 30 cc/hr 6. 20.