DRUG PREPARATIONS AND EQUIPMENT TO MEASURE  Tinctures in drops

DOSES (Ma’am Dedal)  Fluid extracts is the most concentrated

DRUG PREPARATIONS SOLUTIONS

• Oral route  Clear liquids that contain a drug dissolved in water
• Parenteral route
• Topical route SUSPENSIONS
 Solid particles dispersed in liquid
ORAL ROUTE: TABLETS  Resuspend
 Made from powdered drugs compressed into  Shake
 molded shape
 Easiest MAGMAS
 Most convenient  Large, bulky articles

TABLETS: NURSING RESPONSIBILITY GELS

 Crush plain tablets for patients with difficulty in  Small particles
swallowing
EMULSIONS
SCORED TABLETS  Creamy, white suspension of fats or oils
 line across the center
POWDERS
COATED TABLETS  Dry, finely ground drugs
 smooth and easy to swallow  In liquid form, becomes oral suspension
 Write: date, time, your initials, and the solution
ENTERIC-COATED TABLETS
 protect the drug from being inactivated in the PARENTERAL ROUTE : INTRADERMAL
stomach  “by injection”
 dissolve in the intestine  Solutions, suspensions, and powders

PROLONGED RELEASE OR EXTENDED-RELEASE TABLETS TOPICAL ROUTE: AEROSOL POWDERS OR LIQUIDS

 XL = extended length  Combined with a propellant, sprayed to the skin
 CD = controlled dose  Nebulizers and inhalers = mucus membranes of the
 SR = sustained release respiratory tract
 Disintegrate slowly
POWDERS
SUBLINGUAL TABLETS  Dry form, may be applied to the skin
 Dissolve quickly
 Absorbed through the capillaries CREAMS
 Semisolid
CODED TABLETS  Apply to the skin or mucus
 Contains a number, a letter, or both
OINTMENTS
CAPSULES  Semisolid in petroleum or lanolin base
 Gelatin containers  “ophthalmic” if for the eye
 Avoid opening capsules
 Do not open spansule, timespan, time release, or PASTES
sustained release  Thick ointments
 absorb secretions and softens the skin
LOZENGES
 Small, solid tablets SUPPOSITORIES
 Dissolve slowly in the mouth  Molded with a firm base such as cocoa butter, that
melts in body temperature
SYRUPS  Rectum, vagina, and urethra
 Sugar in water
 Maybe contraindicated for DM TRANSDERMAL MEDICATIONS
 Drug molecules in polymer patch
ELIXIRS  Slowly released or absorbed in the skin
 Hydrochloric liquids that are sweetened
 Maybe contraindicated in alcoholism and DM TOPICAL DROPS
 Eye drops, nose drops, or ear drops
FLUID EXTRACTS AND TINCTURES
 Alcoholic, liquid concentration of a drug EQUIPMENT TO MEASURE DOSES
 Small amounts Measure liquid accurately:
2 practices D = desired dose (order)
 Pour liquids to a line H = on hand or have
 Pour liquids at eye level and on a flat surface S = supply
Meniscus – some liquids have depressed area or curved
liquid, lowest point Proportion Expressed as Two Fractions
 Set up proportions so that unlike units are across from
MEDICINE CUP each other. The first fraction is known equivalent
1tablet
SYRINGES  To express “one tablet is equal to 50 mg” write 50mg
 1 ml precision syringe  The second fraction is the unknown, the desired (order)
dose
ROUNDING OFF NUMBERS IN LIQUID DOSES:
xtablets
 When the last number is 5 or more, add 1 to the
previous number Example: x tablets is equal to 100 mg written as: 100mg
- Example: 1.55 becomes 1.6
 When the number is 4 or less, drop the The completed proportion looks like
numbers S x Supply x
 
- Example: 0.33 becomes 0.3 H D Have Desire

ROUNDING OFF NUMBERS IN LIQUID DOSES: For the previous example, it would be like this:
 If using a 3-ml syringe, carry out decimals to 1tablet xtablets
two places and then round off to the nearest 
50mg 100mg
tenth for milliliters
- Example: .76 ml becomes .80 ml Next solve for x:
 If using the 1-ml precision syringe, carry out Example 1
decimals three places and round off to the 1tablet xtablets
nearest hundredth and then to the nearest 
50mg 100 mg
tenth
- Example: .465 ml becomes .470 ml, then .50 ml
1tablet xtablets
Insulin syringe 
50mg 100mg
LOW DOSE INSULIN SYRINGE: 50 units
100 x 1 = 50 x
NEEDLES FOR INTRAMUSCULAR AND SUBCUTANEOUS
INJECTIONS 100 x1 50 x

 Gauge = needle’s diameter or width 50 50
 Low-dose insulin = smallest diameter, finest
 needle 100 50 x
 16- gauge needle = transfuse blood 
50 50
CHOOSING THE RIGHT NEEDLE 100
x
 Route of administration 50
 Size and condition of the patient Answer: 2 tablets = x
 Amount of adipose tissue present at the site
Proportions Expressed as Two Ratios
NEEDLE LENGTH  Set up ratio by using colon
 Intradermal = 3/8-5/8 (1 to 1.5cm)  Double colons separate the two ratios ::
 Subcutaneous = 5/8 to 7/8 (1.5cm to 2 cm)  The first ratios is the known equivlents
 Intramuscular = 1” to 3” (2.5 to 7.5 cm)  The second ratio is the desired (ordered) dose
 Intravenous = 1” to 3” long, have long bevels, and are Example:
25G to 14 G S:H: :x:D Supply : Have : x : Desire
For the previous example, ratio would look like: 1 tablet : 50
Calculation of Oral Medications - Solids and Liquids mg: : x100 mg
Ma’am Dedal
Next solve for X:
In dosage calculation, start with 3 pieces of information: 1. 1 tablet : 50 mg : : x : : x : 100 mg
 The doctor’s or healthcare provider’s order - cross multiply
 The quantity or strength of drug on hand; and 1 x 100 = 50 x
 The solid or liquid form of the supply drug (I.e., the form 100 50 x
the drug arrives in) 
50 50
100
X or x = unknown amount (answer of drug to administer x
50
Answer: 2 tablets = x When the numerator and denominator in D/H are decimals,
add zeros to make the number of decimal places the same.
Formula Method Then drop the decimal points
D Desire Added
xS  x  Supply  x 0.50 mg numerator
H Have
0.25 mg denominator or divisor
Oral Solids
Rule: Formula Method Problem 2
Desire Order: Lanoxin (digoxin) 0.125 mg po every day
 Supply  x Supply: Read the Label
Have
Rule: Proportion Expressed as Two Ratios
Supply : Have : : x: Desire
Rule: Proportion Expressed as Two Fractions
Supply x

Have Desire

Problem 1
Order: Carvedilol 6.25 mg po bid
Supply: Read the label above Formula Method
D
xS  x
Desire: The order. In this example, the desired is 6.25 mg H
Have: The strength of the drug supplied in the container. In 0.125mg
1tablet  x
the example, the label says that each tablet contains 12.5 mg 0.250mg
Supply: The unit form in which the drug comes. Carvedilol 1/2 or 0.5 = x
comes in tablet form. Because tablets and capsules are single
entities, the supply for the oral solid drugs is always one Ration Method
Amount: How much supply to give. For oral solids the answer 1 tablet: 0.25 mg :: x : 0.125 mg
will be the number of tablets or capsules to administer 0.125 0.250

0.250 0.250
Example
1/2 or 0.5 tab = x
Desire: carvedilol 6.25 mg po
Have: 12.5 mg
Fraction Method
Supply: 1 tablet
1 x
Formula Method 
D 0.250 0.125
xS  x 1/2 or 0.5 tab = x
H
6.25mg
1tablet  X Problem 3
12.5mg Order: Amoxicillin 1 g po q6h
1/2 tablet = X Supply: 1 capsule equals 500 mg

Proportion Expressed as Two Ratios Fraction Method

S:H::x:D 500mg
1 tablet : 12.5 mg : : x : 6.25 mg 1
6.25 x 1 = 12.5 X 1000mg
6.25 2
x x
12.5 X=2
Answer: 1/2 tabler = X
Ratio Method
Proportion Expressed as Two Fractions 1 tab : 1000 mg :: x : 500 mg
Supply x 500 mg : 1000 mg

Have Desire X = 2 tablets
1tablet x

12.5mg 6.25mg Formula Method
6.25 mg x 1 = 12.5 X 1000mg
2
6.25 500
x
12.5 X = 2 tablets
Answer: 1/2 tablet = X
Problem 4
Clearing Decimals when Using the Formula Method Order: Synthroid (levothyroxine) 75 mcg po every day
 Supply x

Have Desire

Fraction Method
75mcg
1
75mcg
= 10 mL
= 1 tablet

Fraction Method
1tab x

75mcg 75mcg

X table (5 mcg) = 75 mcg (1 tablet)

75 mcg tablet x = 75 mcg/tablet)/(75 mcg mg) = 1
X = 1 tablet

Ratio Method
1 tablet : 75 mcg :: x : 75 mcg
75mcg
x
75mcg
X = 1 tablet

Formula Method
75mcg
1tablet
75mcg

Special Types of Oral Solid Orders

 Drugs that contain a number of active ingredients are
ordered by the number to be administered and do not
require calculation
 Over-the-counter (OTC) medications are often ordered
by how many are to be administered
 Order: Vitamin B Complex tablets 1 po every day
 Interpret as: Give 1 tablet by mouth every day

Oral Liquids
Same methods as for oral solids, except that the supply will
include a liquid measurement, usually milliliters (mL)

Formula Method
D
xS  x
H
Proportion Expressed as Two Ratios
Supply : Have : : x: Desire
Proportion Expressed as Two Fractions