DOSAGE CALCULATIONS

APOTHECARY MEASUREMENTS
 The apothecary system, originated as the system of HOUSEHOLD EQUIVALENTS
weights and measures for dispensing and prescribing  Commonly used in the household
medications.  First originated in the US
 Date back; used back then in England  Not as accurate as the metric system
 Originated in London  Lacks standardization
 Roman numerals were used instead of the Arabic Number  More of approximation
to express the quantity.  The use of household measurements is considered
inaccurate because of the varying sizes of cups, glasses,
DRY WEIGHTS FLUID VOLUME and eating utensils, and this system generally has been
Larger Smaller Larger Smaller replaced with the metric system.
Units Units Units Units  However, as patient care moves away from hospitals,
480 grains which use the metric system, and into the community, it is
1 ounce (oz) 1 quart (qt) 2 pints (pt)
(gr) once again necessary for the nurse to have an
16 fluid understanding of the household measurement system to
1 ounce (oz) 8 drams 1 pint ounces (ft be able to use and teach it to clients and families.
oz)
60 grains 8 fluid dram 1 measuring cup 8 ounces (oz)
1 dram 1 fluid ounce
(gr) (fl dr) 1 medium-sized glass
8 ounces (oz)
60 minims (tumbler size)
1 scruple 20 grains 1 fluid dram
(min, m) 6 ounces (oz); varies with
1 coffee cup
1 minim 1 drop (gtt) size
1 ounce (oz) 2 tablespoons (T), 30 cc (ml)
EXAMPLE #1 1 tablespoon (T) 3 teaspoons (t), 15 cc (ml)
 Convert 5 pints to fluid ounces (fl oz). 1 teaspoon (t) 60 drops (gtts), 5 cc (ml)
 5 pints = 80 fl oz 1 drop (gtt) 1 minim (min, m)
 1 pint = 16 fl oz
BODY SURFACE AREA
 Most accurate way to calculate the drug dose for infants,
children, older adults, and clients who are on
antineoplastic agents or whose body weight is low.
 In physiology and medicine, the body surface area is the
measured or calculated surface area of a human body.
 This body surface area calculator estimates the surface
area of a person's body based on body weight and height.
 Low Body Weight = Underweight & possibly malnourished

NOMOGRAM
 Also called as nomograph
 Used particularly on pediatric patients
EXAMPLE #2  Find patient’s weight in the right column and the height in
 Convert 80 fl oz to pints the left column.
 80 fl oz = 5 pints  Place a straight edge on the nomogram so the weight and
height are connected.
 The point where the straightedge crosses the center
column denotes the patient’s body surface area in square
meters.
 Calculating chart with scales that contain values of three
or more mathematical variables, widely used in medicine,
engineering, industry, and the biological and physical
sciences.

METRIC SYSTEM
 Was developed in the late 18th century
 In the present, it is the one that we recognize and is an
internationally accepted measurement system
 A system based on the power of 10  In getting the patient’s BSA, we need a ruler or something
 Once we are measuring for the larger unit, we are using with a straight edge and the nomogram chart or
the kilo. nomograph.
 You will see that there are 3 vertical lines, or 3 columns.
Names and columns at both ends represents the weight and the height
Unit Measurements
Abbreviations of the patient.
1 kg 1,000 g  It’s on either side, and in the middle, the center vertical
1,000 mg 1g line/column represents the surface area in sq meters.
Gram (Weight)
1,000,000 mcg 1g  So what we will do, is find the patient’s weight and height.
1,000,000,000 ng 1g  Mark and place a straightedge on the nomogram, so the
1 kL 1,000 L weight and height are connected.
Liter (Volume)
1L 1,000 mL

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 The point where the straightedge crosses the center Example:
column denotes the patient’s body surface area in sq  The child is weighing 50 lbs and adult dose of the drug is
meters. 30 drops, 3x a day.
ANTINEOPLASTIC AGENTS 50lbs X 30 drops

 Medications that are used to treat cancer.
150
 Also known as anti-cancer, chemotherapy, etc.
 1500/150
 Comes in many forms; liquid, liquid that's injected, pills
 10 drops, 3x a day
 Examples:
 Cycloposphamide FRIED’S RULE
 All well known to cause direct hepatoxicity when given in  Use for infants (up to 1 year old)
moderate to high doses.  This rule is a method of estimating the dose of medication
 Particularly, when it's used, there's myoloabration for a child by dividing the child's age in months by 150 and
 It is a severe form of myolosuppresion which is a multiplying the result by the adult dose.
condition wherein bone marrow activity is  150 is constant.
descreased; due to this, it results to fewer RBC, o Average standard weight of an adult.
WBC, and platelets  Formula:
 Contain chemicals that kill cells that divide rapidly such as age∈months x AD
cancer cells 
150
SAMPLE QUESTION
 Order:
YOUNG’S RULE
 Methotrexate (Mexate) 50 mg weekly.  Used for those above 1 year
 Child’s height is 155 cm and weights 80 lbs.  An equation used to calculate pediatric medication dosage
 Child’s drug dosage: 25-27 mg/m2/week based on the patient's age and the known recommended
 Child’s height and weight intersect at 1.3 m2 adult dose.
(BSA)  The definition of Young's Rule is the age of the patient,
 Is the prescription safe? divided by the age added to twelve, all multiplied by the
 Remember: Safe if within 50 mg. recommended adult dose.
 Answer:  Formula:
 Multiply the BSA, 1.3 m2 by the minimum and age∈ years x AD
maximum doses. 
 25 mg x 1.3 m2 = 32.5 mg age ∈years +12
 27 mg x 1.3 m2 = 35.1 mg
 Dosage is considered safe within the parameters
according to the child’s BSA.

GENERAL FORMULA FOR DRUG CALCULATION

 Formula:
desired strength
 A= x stock volume
stock on hand
PEDIATRIC DOSAGES  Wherein:
 Pediatric dosing is important because pediatric patients  DS = amount of drug in the dosage or the unit of
experience unique differences from the adult population in dosage; ex. 500 mg per capsule
pharmacokinetic parameters and, consequently, require  Stock on hand = available
individualized dosing.  Stock volume = number of shares
 Proper dosing of the pediatric patient depends on a
number of factors, including the patient's age and weight.
 Different Rules in Pediatric Dosages
1. Clark’s Rule
2. Fried’s Rule
3. Young’s Rule

CLARK’S RULE
 Weight of the child is needed.
 Clark's rule is a medical term referring to a mathematical
formula used to calculate the proper dosage of medicine
for children aged 2–17.
 Clark's rule equation is defined as the weight of the patient
in pounds divided by the average standard weight of 150
pounds (68 kg) multiplied by the adult dose of a drug
equals the pediatric medication dose.
 Formula:
weight ∈lbs x AD

150
IV SET
 IV stands for Intravenous
 Intra = Inside
 Meaning “inside the vein”
 IV sets are used for the controlled infusion of medications,
typically over long periods of time.
 IV sets are used to connect the medication to the needle
inserted into the patient. IV extension sets are also used to
extend IV lines without risk of contamination.

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 When using IV administration sets you can adjust the flow
rate to be faster or slower depending on the medication
you are infusing and the prescription orders.
 If you are using a mechanical pump or infusion pump, you
can set more rapid infusion or slow infusion rates with
extreme precision. while
 With gravity pumps, roller clamps are the parts of the IV
set that control the flow rate.
 Basic IV Set or Standard Gravity Drip includes:
 Infusion Set
 Fluid Container
 Drip Chamber
 Roller Clamp
CALCULATING ADMINISTRATION RATES
May include drip chamber, tubing, roller  2 Components to Remember Before Using the Formulas:
Infusion Set 1. Drop Factor of the IV Administration Rate
clamp, and connection to cannula
Fluid Container Bottle or bag which holds the fluid 2. Amount of Solution to be Infused over 1 Hour
Physically counting drips gives
Drip Chamber
indication of flow rate
Roller Clamp Adjustable for different flow

IV DRIP TUBING AND DROP FACTOR

 IV drip tubing comes in a variety of sizes called drop
factors.
 The drop factor is the number of drops in one mL of
solution using gravity IV tubing.
 The drop factor is printed on the IV tubing package.
 Macrodrip tubing includes tubing with drop factors of 10,
15, or 20 drops per mililiter and is typically used to deliver
general IV solutions to adults.
 Microdrip tubing includes tubing with a drop factor of 60
drops per milliliter.
 It is typically used to deliver precise amounts of
medication in small drops to children and infants.
 At a very basic level, microdrip tubing is used for people
who are receiving smaller amounts of IV medication.
Macro drip tubing is much larger, so is better for delivering
larger doses of fluid.

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