Methods for Calculation

Midterm week 2
OBJECTIVES

• Select a formula—the basic formula, the ratio-

and proportion method, fractional equation, or
dimensional analysis—for calculating drug dosages.
• Convert all measures to the same system and same unit
of measure within the system before calculating drug
dosage.
• Calculate drug dosage using one of the general formulas.
• Calculate drug dosage according to body weight and
body surface area.
• Discuss meanings for abbreviations used in drug therapy.
INTERPRETING ORAL AND INJECTABLE
DRUG LABELS
• brand name
• generic name
• The dose
EXAMPLE 1 Oral Drug

• Tagamet is the brand (trade) name, cimetidine is the generic name,

and the dose is 200 mg/tablet
Injectable Drug

• brand (trade) name

• generic name,
• dose
Injectable Drug
• EXAMPLE 2 Compazine is the
brand (trade) name,
prochlorperazine is the generic
name, and the dose is 5 mg/mL
injectable.
• Prochlorperazine, formerly sold
under the brand name Compazine
among others, is a medication
used to treat nausea,
schizophrenia, migraines, and
anxiety. It is a less preferred
medication for anxiety. It may be
taken by mouth, rectally, injection
into a vein, or injection into a
muscle.
Four general methods for the calculation of
drug doses

• (1) basic formula,

• (2) ratio and proportion,
• (3) fractional equation,
• (4) and dimensional analysis.
METHOD 1: BASIC FORMULA (BF)
• The basic formula is the following:
D (where D is the desired dose (i.e.,
drug dose ordered by the health • D
care provider),
H is the on-hand dose (i.e., drug dose
• H × V= A
on label of container [bottle, vial]),
V is the vehicle (i.e., drug form in
which the drug comes [tablet,
capsule,
liquid])
A is the amount calculated to be given
to the patient.
METHOD 1: BASIC FORMULA (BF)

Examples
1. Order: cefaclor (Ceclor) 0.5 g PO b.i.d.
Available:
answer:
• To convert grams (large value)
to milligrams (smaller value),
move the decimal point three
spaces to the right
METHOD 1: BASIC FORMULA (BF)

Order: codeine 60 mg PO
STAT
Available:
answer
• Order: codeine 60 mg PO
STAT
• on hand:30mg/tab
METHOD 2: RATIO AND PROPORTION (RP)

• where H is the drug on

hand
• V is the vehicle or drug
form
• D is the desired dose
• x is the unknown amount
to give
• :: stands for “as” or “equal
to.”
• Multiply the means and the
Examples:METHOD 2: RATIO AND PROPORTION (RP)

• .Order: amoxicillin (Amoxil)

100 mg PO q.i.d.
• Available:
METHOD 2: RATIO AND PROPORTION (RP)

• Order: amoxicillin (Amoxil)

100 mg PO q.i.d.
• Available:250mg/ml
METHOD 2: RATIO AND PROPORTION (RP)
• Order: aspirin/ASA 600 (650)
mg q4h PRN
• Available: aspirin 325 mg/tablet
METHOD 3: FRACTIONAL EQUATION (FE)
• The fractional equation method
is similar to ratio and proportion
except it is written as a fraction Cross-multiply and solve for x.

Examples
Order: ciprofloxacin (Cipro) 500
mg PO q12h
Available:
answer

• Examples
• Order: ciprofloxacin (Cipro)
500 mg PO q12h
• Available:250mg
METHOD 4: DIMENSIONAL ANALYSIS (DA)
• is a calculation method known as
units and conversions
• Examples Order: amoxicillin 500 mg
1. Identify the unit/form (tablet, capsule, On the drug label: 250 mg
mL) of the drug to be calculated. per capsule
• If the drug comes in tablet, then tablet
= (equal sign).
2. The known dose and unit/form from
the drug label follows the equal sign.
METHOD 4: DIMENSIONAL ANALYSIS (DA)

3.The mg (250 mg) is the

denominator, and it must match
the next numerator, which is 500
mg (desired dose or order).
• The NEXT denominator would
be1 (one) or blank.
4. Cancel out the mg, 250 and
500. What remains is the
capsule and 2.
examples
• Order: amoxicillin 0.5 g, PO, q8h
• Available: 250 mg = 1 capsule (drug label).
• A conversion is needed between g and mg.
• Remember that 250 mg is the denominator; therefore
1000 mg (conversion factor, which is 1000 mg = 1 g) is
the NEXT numerator, and 1 g becomes the NEXT
denominator.
• The third numerator is 0.5 g, and the denominator is 1
(one) or blank.
Order: amoxicillin 0.5 g, PO, q8h
Available: 250 mg = 1 capsule (drug label).
A conversion is needed between g and mg. Remember
that 250 mg is the denominator; therefore 1000 mg
(conversion
factor, which is 1000 mg = 1 g) is the NEXT numerator,
and 1 g becomes the NEXT denominator. The third
numerator is 0.5 g, and the denominator is 1 (one) or blank.
METHOD 5: BODY WEIGHT (BW)

• The body weight (BW) method of calculation allows for

the individualization of the drug dose and involves the
following three steps:
1. Convert pounds to kilograms if necessary (lb ÷ 2.2 = kg).
2. Determine drug dose per BW by multiplying as follows:
• Drug dose body weight patient s dose per day × = ’
3. Follow the basic formula, ratio and proportion, fractional
equation, or dimensional analysis method to calculate the
drug dosage
Examples

• 1. Order: fluorouracil (5-FU), 12 mg/kg/day IV, not to

exceed 800 mg/day.
• The adult weighs 132 lb.
• a. Convert pounds to kilograms by dividing the number of
pounds by 2.2
answer:METHOD 5: BODY WEIGHT (BW)
METHOD 5: BODY WEIGHT (BW)

Order: cefaclor (Ceclor) 20

mg/kg/day in three divided
doses. The patient weighs
31 lb.
• Available:
METHOD 6: BODY SURFACE AREA (BSA)

• The body surface area (BSA) method is considered the most

accurate way to calculate the drug dose for infants, children, older
adults, and patients who are on antineoplastic agents or whose
BW is low.
• The BSA, in square meters (m2), is determined by where the
person’s height and weight intersect the nomogram scale
• To calculate the drug dosage using the BSA method, multiply the
drug dose ordered by the number of square meters.
 METHOD 6: BODY SURFACE AREA (BSA)

Examples
1. Order: cyclophosphamide
(Cytoxan) 100 mg/m2
/day, IV
Available:

Patient is 70 inches tall and

weighs 160 lb
METHOD 6: BODY SURFACE AREA (BSA)

Examples
1. Order: cyclophosphamide (Cytoxan) 100 mg/m2 /day, IV
a. 70 inches and 160 lb intersect the nomogram scale at
1.97 m2 (BSA)
b. 100 mg × 1.97 = 197 mg.
Answer: Administer cyclophosphamide 197 mg or 200
mg/day
METHOD 6: BSA with the Square Root

• BSA can be calculated by

using the square root and a
fractional formula of height
and weight divided by a
constant.
• this method results in fewer
errors than drawing
intersecting lines on a
nomogram.
METHOD 6: BSA with the Square Root

Examples
Order: melphalan (Alkeran) 16
mg/m2 q2wk. Patient is 68
inches tall and weighs 172 lb.
•a. Use the BSA inches and
pounds formula
•b. 16 mg × 1.9 m2 = 30.4
mg/m2 or 30 mg/m2 every 2
weeks