The nurse’s quick guide to

I.V. drug calculations

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By Kelley Miller Wilson, MSN, RN

Assistant Professor • University of Maryland School of Nursing • Baltimore, Md.

Nurses are often intimidated by the math that occurs in Example:

everyday practice. Patient safety depends on the practi- Administer heparin 5,000 units I.V. push. Available is
tioner’s ability to calculate medications correctly and in a heparin 10,000 units/mL. How many mL will you need
timely manner. This article will provide a simple and con- to administer to achieve a 5,000 unit dose?
cise method for accurate computation using basic calcula-
tions (see Quick reference: Universal formulas). 5,000 units (D)
——————— × l mL (V) = X
10,000 units (H)
Doing the math
Even with the programmable I.V. pumps used in many Answer: X = 0.5 mL
clinical settings, it’s advisable for the nurse to verify the
correct dosage by calculation once during the shift; more Calculations in mcg/minute
often if a medication is being titrated or changed. Verifica- Follow these four steps to easily calculate your patient’s
tion of correct dosages with another RN is also a wide- accurate drug dosage.
spread practice among many professionals and some- 1. Find out what’s in your I.V. bottle (drug concentration
times mandatory in institutions. or number of mL of fluid).
Another resource that’s present in many practice set- 2. Determine in which units your drug is measured
tings is the pharmacy. Pharmacists have an abundance of (units/hour, mg/hour, or mcg/kg/minute).
knowledge about medications, as well as an unparalleled 3. Know the patient’s weight in kg if your calculation is
proficiency with drug calculations; utilize their expertise weight based.
if you’re unsure of your computation.
Knowing the therapeutic dosage for the desired effect
is as important as knowing the correct calculations for the
drug. For example, dopamine at doses of 3 to 5 mcg/kg/
Quick reference: Universal formulas
minute provides a gentle dilatation of the renal arteries, Basic dosage calculation
increasing urine output with no effect on BP. At higher
D (desired dose)
doses (up to 20 mcg/kg/minute), dopamine is used for ___________________ × V (volume) = Dose
BP support. Know the medication and what effect you’re H (amount on hand)
attempting to achieve, as well as the maximum recom-
mended safe infusion dosage. I.V. drips in mcg/minute
Next time you have a patient on I.V. medication, try the mg 1,000 mcg mL 1 hour
following simple methods for calculating in a systematic ____ × ___________ × ______ × __________ = mcg/minute
way. Patient medication safety is a goal that all practitioners mL 1 mL 1 hour 60 minute
have in common—it starts with doing the math! (÷ by kg to get mcg/kg/minute)

Basic calculations I.V. drips in units/hour

The universal formula is:
D (desired)
___________ × V (volume) = units/hour (# mL × units/mL = dose)
D (desired amount) H (on hand)
————————— × V (volume) = Dose
H (amount on hand)

Copyright ©2013 Wolters Kluwer Health | Lippincott, Williams & Wilkins. Unauthorized reproduction is prohibited. Nursing made Incredibly Easy! 1
4. Use the universal formula below and then divide your Example:
final answer by the patient’s weight in kg to arrive at Heparin 20,000 units in 500 mL D5W is ordered to run at
mcg/kg/minute. 1,000 units/hour. How will the I.V. pump be set?

mg 1,000 mcg mL 1 hour 20, 000 units

—– × ————– × ——– × ————– = mcg/minute —–———— = 40 units/mL
mL 1 mg hour 60 minute 500 mL

Example: 1,000 units (D)

Dopamine is infusing. The bottle states dopamine 800 mg, —–————— × 1 mL (V) = X
40 units (H)
and it’s mixed in 500 mL of D5W. The I.V. pump in your
patient’s room is set at 15 mL, and the patient weighs Answer: X = 25 mL/hour
60 kg (60,000 g). At how many mcg/kg/minute is the
patient’s dopamine infusing? Example:
Heparin 20,000 units in 500 mL D5W is infusing at
800 mg 1,000 mcg 15 mL 1 hour 20 mL/hour. At how many units/hour is the heparin
—–—— × ————– × –——– × ————– ÷ 60 kg = X
500 mL 1 mg 1 hour 60 minute infusing?

Answer: X = 6.7 mcg/kg/minute 20,000 units

—–———— = 40 units/mL
500 mL
Example:
Dobutamine 200 mg in 250 mL of D5W is ordered to run 40 units 20 mL
at 5 mcg/kg/minute. At how many mL/hour will you —–—— × ———– = X
1 mL 1 hour
set the pump?
Answer: X = 800 units/hour
200 mg 1,000 mcg X 1 hour
—–—— × ————– × ——— × ————– ÷ 60 kg = 5 mcg/kg/minute
250 mL 1 mg 1 hour 60 minute Precisely!
Patient safety depends on accurate I.V. drug dosing;
Answer: X = 22.5 mL/hour precise calculations are essential to this process.
Nurses shouldn’t be apprehensive when I.V. drug
Calculations in units/hour dosages are presented in practice. Use the simple
To arrive at units/hour, the universal formula is: calculations conveyed in this article as a first step! ■
The author has disclosed that she has no financial relationships related to this article.
D (desired)
—–———— × V (volume) = units/hour (# of mL × units/mL = dose)
H (on hand) DOI-10.1097/01.NME.0000426306.10980.65

2 Nursing made Incredibly Easy! Copyright ©2013 Wolters Kluwer Health | Lippincott, Williams & Wilkins. Unauthorized reproduction is prohibited.