HISTORY OF PHARMACOLOGY
pharmacology was found in a text entitled
 Herbal Medicine – one of the oldest forms
of healthcare.
 3000 B.C. – The Babylonians recorded the
earliest surviving prescription on clay
tablets.
 2700 B.C. – Chinese recorded the Pen
Tsao (Great Herbal) – compilation of plant
remedies
-> Middle East and China – drugs commonly
used are laxatives and emetics.
• 1500 B.C – The Egyptians wrote their
remedies on a document known as the
Eber’s Medical Papyrus.
-> Egyptian physicians prescribed figs, dates,
or castor oil as laxative, and used tannic
acid to treat burns; opium for pain, moldy
bread for wounds and bruises.
HINDUS – used cannabis and henbane as
anesthetics; used the root of the plant
Rauwolfia Serpentine (contains reserpine)
as a tranquilizer.
 DARK AGES – Pharmacology and
medicine could not advance until the
discipline of science was eventually viewed
as legitimate by the religious doctrines of
the era.
 750 – 1258 A.D. – a school of pharmacy
in Arabia discovered substances effective
against illness, such as burned sponge
(contains iodine) for treatment of goiter.
15th Century (Europe) – Philippus Aureolus
Paracelsus identified the characteristics of
numerous diseases such as syphilis and
used ingredients such as sulfur and
mercury compounds to counter diseases.
1240 A.D – Arab doctors formulated the first
set of drug standards and measurements-
apothecary system (grains, drams,
minims)
131 – 201 A.D – Roman physician GALEN
initiated the use of prescriptions.
th th
17 and 18 Century – Physicians treated
malaria with the bark of cinchona tree
(contains quinine); heart failure with leaves
of foxglove plant (digitalis); scurvy with
citrus fruit.
18th Century – vaccine for small pox; digitalis
from foxglove plant; vitamin C from citrus
fruit.
19th Century – discovery of new drugs such as
morphine and vaccine for rabies; amyl
nitrate for angina; anesthetics such as ether
and nitrous oxide.
The first recorded reference to the word
Pharmacologia sen Manuductio and
Materiam Medicum by Samuel Dale in 1693
1800 – modern pharmacology was thought to
have begun; chemists were able to isolate
the active agents morphine, cocaine,
curare, cocaine, and other early
pharmacological agents from their natural
products.
HEROIN and ASPIRIN – 2 of the first synthetic
drugs created from other elements or
compounds using chemical reactions.
Pharmacologists studied the effects of drugs in
animals and some early researchers used
themselves as test subjects.
FRIEDERICH SERTURNER – first to isolate
morphine from opium in 1805.
1847 – pharmacology was recognized as a
distinct discipline when the first department
of pharmacology was established in
Estonia.
JOHN JACOB ABEL – the father of American
Pharmacology; founded the first
pharmacology department in the US at the
University of Michigan in 1890.
20th Century – isolation of active agents from
scarce natural products is already not
necessary since pharmacologists can now
synthesize drugs in the laboratory.
It became possible to understand how drugs
produced their effects.
20th Century – aspirin from salicylic acid;
phenobarbital, insulin, sulfonamides.
1907 – British biochemist Frederick Hopkins
discover vitamins
1928 – Alexander Fleming discovered
Penicillin
1940’s – Antibiotics (Penicillin,Streptomycin),
antihistamines, cortisone.
1950’s- antipsychotic drugs, anti-hypertensive,
oral contraceptives, polio vaccine
1952 – American physician Jonas Salk
developed the first polio vaccine.
PHARMACOLOGY and THERAPUETICS
PHARMACOLOGY - derived from 2 Greek
words “pharmakon” – medicine or drug;
“logos” – study.
study of medicines; study of biological effects
of chemicals.
THERAPEUTICS – branch of medicine
concerned with the prevention of disease
and treatment of suffering.
PHARMACOTHERAPEUTICS – clinical
pharmacology; the branch of
pharmacology that uses drugs to treat,
prevent, and diagnose disease. It
addresses 2 concerns : the drug’s effects
on the body and the body’s response to the
drug.
TOXICOLOGY – branch of pharmacology that
deals with the undesirable effects of
chemicals on living systems, from individual
cells to humans to complex ecosystems.
CHAPTER 1 – INTRODUCTION to DRUGS
DRUGS – chemicals that are introduced into
the body to cause some sort of change; any
substance that brings about a change in
biologic function through its chemical
actions.
DRUG NAMES:
Chemical Name - describes the drug’s
chemical structure; conveys a clear and
concise meaning about the nature of a
drug.
Generic Name – is the official or non-
proprietary name for the drug.
Brand Name or Trade Name – chosen by the
drug company and is usually a trademark
owned by that specific manufacturer.
POISONS – drugs that have almost exclusively
harmful effects.
TOXINS – defined as poisons of biologic origin,
ie, synthesized by plants or animals, in
contrast to inorganic poisons such as lead
and arsenic.
THE PHYSICAL NATURE OF DRUGS
Drugs may be solid at room temperature
(aspirin, atropine), liquid (nicotine,
ethanol), and gaseous (nitrous oxide).
These factors often determine the best route of
administration.
A number of useful or dangerous drugs are
inorganic elements – lithium, iron, heavy
metals
Many organic drugs are weak bases and acids
– important implications for the way they
are handled by the body.
SOURCES of DRUGS
1.)PLANTS – digitalis products; Riccinus
communis (castor oil); Papaver somniferum
(opium, morphine, codeine).
2.) ANIMAL PRODUCTS – used to replace
human chemicals that are not produced by
the body.
Insulin from pancreas of cows and pigs.
3.) INORGANIC COMPOUNDS – aluminum,
fluoride, gold, iron
4.) SYNTHETIC SOURCES
DRUG EVALUATION – STAGES of DRUG
DEVELOPMENT
1.) PRECLINICAL TRIALS
Chemicals are tested on laboratory animals to
determine whether they have presumed
effects in living tissue and to evaluate any
adverse effects.
Chemicals are discarded if: it lacks therapeutic
activity, is too toxic living animals, highly
teratogenic, and safety margins are so
small.
2.) PHASE I STUDIES – use human
volunteers to test drugs.
Chemicals are discarded at the end of Phase I
studies for the following reasons:
they lack therapeutic effect in humans
they cause unacceptable adverse effects
they are highly teratogenic
they are too toxic
3.) PHASE II STUDIES
Drugs are used in patients who have the
disease that the drug is meant to treat.
Performed in hospitals, clinics, doctors’ offices.
Drugs are discarded if:
- less effective than anticipated
- too toxic when used with patients
- produces unacceptable adverse effects
- has a low benefit-to-risk ratio, and
- it is no more effective than other drugs
already on the market.
4.) PHASE III STUDIES – involve use of drug
in a vast clinical market.
5.) PHASE IV STUDY – continual evaluation
-> Orphan Drugs – drugs that have been
discovered but are not financially viable and
therefore have not been adopted by any
drug company.
-> OTC Drugs – are available without
prescription.
PREGNANCY CATEGORIES
Category A: No risk in human studies (studies
in pregnant women have not demonstrated
a risk to the fetus during the first trimester).
Category B: No risk in animal studies (there
are no adequate studies in humans, but
animal studies did not demonstrate a risk to
the fetus).
Category C: Risk cannot be ruled out. There
are no satisfactory studies in pregnant
women, but animal studies demonstrated a
risk to the fetus; potential benefits of the
drug may outweigh the risks.
Category D: Evidence of risk (studies in
pregnant women have demonstrated a risk
to the fetus; potential benefits of the drug
may outweigh the risks).
Category X: Contraindicated (studies in
pregnant women have demonstrated a risk
to the fetus, and/or human or animal
studies have shown fetal abnormalities;
risks of the drug outweigh the potential
benefits).
Schedules of Controlled Substances
Schedule I (C-I) – high abuse potential and no
accepted medical use (heroin, marijuana,
LSD)
Schedule II (C-II) – high abuse potential with
severe dependence liability (narcotics,
amphetamines, barbiturates)
Schedule III (C-III) – less abuse potential than
schedule II drugs and moderate
dependence liability (nonbarbiturate
sedatives, nonamphetamine stimulants,
limited amounts of certain narcotics)
Schedule IV (C-IV) – less abuse potential than
schedule III and limited dependence liability
(some sedatives, antianxiety drugs, and
non-narcotic analgesics)
Schedule V (C-V) – limited abuse potential.
Primarily small amounts of narcotics
(codeine) used as antitussives or
antidiarrheals.
WEEK 2
PRINCIPLES OF Pharmacokinetics
Principles of drug actions
(three phases)
Pharmaceutic Phase
Pharmacokinetics
Pharmacodynamics
Pharmaceutic phase
• A.) DISINTEGRATION – the breakdown of
a tablet into smaller particles; occurs in the
alkaline environment of the small intestine;
enteric coated resists disintegration in the
gastric acid of the stomach.
• B.) DISSOLUTION – dissolving of the
smaller particles in the GI fluid before
absorption.
Rate Limiting – refers to the time it takes the
drug to disintegrate and dissolve to become
available for the body to absorb it.
Pharmacokinetics PHASE
• PHARMACOKINETICS = The process of
drug movement to achieve drug action
Involves the study of absorption, distribution,
metabolism (biotransformation), and
excretion of drugs.
• CRITICAL CONCENTRATION- the amount
of drug that is needed to cause a
therapeutic effect.
LOADING DOSE- given to cause a fast or
immediate effect; a higher dose than that
usually used for treatment.
Pharmacokinetics
1.) ABSORPTION
Involves moving a drug into the body for
circulation.
Areas of Absorption:
GI Tract – oral, rectal
Mucous membranes
Skin
Lungs
Muscle / subcutaneous
Bioavailability - the percentage of the
administered drug dose that reaches the
systemic circulation.
Drugs that are lipid soluble are absorbed faster
that water-soluble drugs.
Protein-based drugs (insulin and growth
hormones) – destroyed in the small
intestines by digestive enzymes.
Drugs given IM are absorbed faster in
muscles that have more blood vessels
(deltoid).
Subcutaneous tissue has fewer blood vessels
= slower absorption.
Factors that Affect Absorption:
IV (Intravenous) – none
IM (intramuscular), subcutaneous – perfusion,
fat content, temperature
PO (oral) – gastric acidity, length of time in the
stomach
Rectal – perfusion, lesions in the rectum,
length of time retained for absorption
Mucous membranes (sublingual, buccal) –
perfusion, integrity, presence of food or
smoking, length of time
Topical – perfusion, integrity
Inhalation – perfusion, lung integrity, proper
drug administration
2.) DISTRIBUTION
• Involves the movement of a drug to the
body’s tissues.
Factors Affecting Distribution: • PEAK ACTION = the therapeutic effect in
Lipid Solubility its maximum concentration
Ionization • DURATION OF ACTION = the length of
Perfusion of the reactive tissue time the drug has a pharmacologic effect.
Protein binding • THERAPEUTIC INDEX = estimates the
Blood brain barrier margin of safety of a drug
Placenta and Breast milk 1. Low
2. High
3.) BIOTRANSFORMATION (METABOLISM) THERAPEUTIC RANGE = refers to the drug
The process by which drugs are changed into concentration in the plasma between the
new less, active chemicals. MEC and the minimum toxic concentration
First pass Effect – process by which the drug (MTC).
passes to the liver. PEAK DRUG LEVEL = refers to the highest
plasma concentration of drug at a specific
4.) EXCRETION time; indicates the rate of absorption of the
Removal of a drug from the body drug.
Skin, saliva, lungs, bile, feces TROUGH LEVEL = refers to the lowest plasma
Half-life – the time it takes for the amount of concentration of drug at a specific time;
drug in the body to decrease to one-half of indicates the rate of elimination of the drug.
the peak level it previously achieved.; 1. SIDE EFFECTS
important in determining the appropriate 2. ADVERSE EFFECTS / ADVERSE
timing for a drug dose or determining the REACTIONS
duration of a drug’s effects on the body.
FACTORS INFLUENCING DRUG EFFECTS
• Weight
WEEK 3 • Age
• Gender
PRINCIPLES OF PharmacoDYNAMICS Physiological factors:
-Diurnal rhythm
PHARMACODYNAMICS PHASE -Acid-base balance
PHARMACODYNAMICS – the process by -Hydration
which a drug works on the body. -Electrolyte balance
Pathological factors:
DRUG ACTIONS: -GI disorders
1.) To replace or act as substitutes for missing - Vascular diseases
chemicals. - Liver dysfunction
2.) To increase or stimulate certain cellular -Kidney dysfunction
activities. Genetic factors
3.) To depress or slow cellular activities. - Pharmacogenomics / Pharmacogenetics –
4.) To interfere with the functioning of foreign explores the unique differences in response
cells, such as invading microorganisms or to drugs that each individual possesses
neoplasms. Immunological factors
– eg. allergy
• Drug response can cause a PRIMARY or Psychological Factors – patient’s attitude
SECONDARY PHYSIOLOGIC EFFECTS - PLACEBO EFFECT = a psychologic benefit
or both. from a compound that may not have the
POTENCY = strength or power of the drug chemical structure of a drug.
• EFFICACY = the ability of the drug to Environmental Factors
produce a desired response; effectiveness -Temperature
RECEPTOR SITES - react with certain -Light
chemicals to cause an effect within the cell. -Noise
1. AGONISTS Tachyphylaxis – refers to a drug tolerance to
2. ANTAGONISTS a frequently repeated administration of a
DRUG – ENZYME Interactions- drugs cause certain drug
their effects by interfering with the enzyme Cumulation effects
systems that act as a catalysts for various – combined effects of drugs
chemical reactions.

Eg: carbonic anhydrase inhibitor –

acetazolamide (Diamox) WEEK 4

• SELECTIVE TOXICITY- the ability of a drug PRINCIPLES OF therapeutics

to attack only those systems found in
foreign cells. Enhancement of drug effects
• ONSET OF ACTION = the time it takes to
reach the minimum effective concentration Pharmacokinetics interactions
(MEC) after a drug is administered.
1. Drug-to-drug interaction
At the site of absorption
Laxatives increase gastric and intestinal
motility – decrease absorption
Antacids increase gastric ph
Tetracycline when given with dairy products –
decrease absorption
During Distribution
During Biotransformation
Enzyme Inducers – drugs that promote
induction of enzymes leading to increase
metabolism of drugs(eg. Phenobarbital)
Enzyme Inhibitor – decreases the metabolism
of drugs (eg.Cimetidine)
During Excretion
Drugs can increase or decrease renal
excretion and have an effect on the
excretion of other drugs.
Sodium bicarbonate – promotes excretion of
weak acid drugs such as aspirin.
Pharmacodynamics interactions
1.) ADDITIVE DRUG EFFECT
• The sum of the effects of 2 drugs with
similar action.
a.) Desirable – aspirin & codeine; beta blockers
& diuretic for HPN
b.) Undesirable – aspirin & alcohol; 2
vasodilators (hydralazine & nitroglycerine)
2.) SYNERGISTIC DRUG EFFECT
The combined effect of 2 drugs is greater than
the sum of the effect of each drug given
alone.
a.) Desirable – demerol & phenergan
b.) Undesirable – alcohol & diazepam
3.) ANTAGONISTIC DRUG EFFECT
• The drugs cancel each other’s drug effect;
2 drugs in opposing drug categories cancel
drug effects of both drugs.
• Isoproterenol & Propranolol
• Morphine & Naloxone
• Magnesium Sulfate & Calcium
gluconate
• DRUG – FOOD INTERACTIONS
• Food is known to increase,
decrease, or delay drug absorption.
• Tetracycline & dairy
products = decrease plasma
concentration of tetracycline
• MAOI (Monoamine oxidase
inhibitors) & tyramine rich
food = hypertensive crisis
• DRUG – LABORATORY INTERACTIONS
• Abnormal plasma electrolyte
concentrations can affect certain
drug therapies.
- eg. Digoxin & hydrochlorothiazide
Toxic effects of drugs and nursing
management
ADVERSE EFFECTS – undesired effects that
may be unpleasant or even dangerous.
REASONS:
1. The drug may have other effects on the
body besides the therapeutic effects.
2. The patient is sensitive to the drug being
given.
3. The drug’s action on the body causes other
responses that are undesirable or
unpleasant.
4. The patient is taking too much or too little of
the drug, leading to adverse effects.
Importance of Knowing the Adverse Reactions:
1. Can increase the effectiveness of a drug
regimen.
2. Provide for patient safety.
3. Improve patient compliance.
Types:
1.) Primary Actions
– - adverse reactions to the medication from
simple overdosage; the patient is receiving the
normal dose, but is sensitive to the drug so that they
“over-respond” to it. For example: Coumadin &
bleeding, antihypertensive drug and fainting.
2.) Secondary Actions
- effects of the medication besides the desired
effect; i.e. antihistamine for allergies &
drowsiness
3.) Hypersensitivity
* - excessive responsiveness to either the primary
or secondary effects of a drug; may result from
underlying problems such as kidney disease
(decreased kidney function leading to build up
of drug > drug toxicity)
 DRUG ALLERGY– occurs when the body
forms antibodies to a particular drug,
causing an immune response when the
person is re-exposed to the drug.
4 MAIN CLASSIFICATIONS:
1.) Anaphylactic Reaction
- swelling of mucous membranes &
bronchial constriction – leading to
difficulty breathing & possibly
respiratory arrest. Other S & S: hives,
sweating, tachycardia, panic feeling.
Anaphylaxis is a medical emergency!
Treatment is epinephrine 1:1000 0.3 cc
SQ & discontinue the offending drug!
2.) Cytotoxic Reaction
- slower & not obvious; seen as decreased
RBC, WBC, & platelets. Treatment:
discontinue drug
3.) Serum Sickness Reaction
- flu-like symptoms beginning up to a week or
more after starting the drug (itchy rash,
fever, swollen glands, painful joints,
swelling of the face & limbs. Treatment:
discontinue drug, administer anti-
inflammatory and anti-pyretic agents as
prescribed
4.) Delayed Allergic Reaction
- occurs several hours after drug. S & S like
poison ivy! Rash, hives, swollen joints.
Treatment: discontinue drug,
 antihistamines & topical corticosteroids as
prescribed
DERMATOLOGICAL REACTIONS – adverse
reactions involving the skin.
1. Rashes, hives – procainamide
2. Stomatitis – fluorouracil
SUPERINFECTIONS – infections caused by
the usually controlled organisms.
1. Fever, diarhhea, black or hairy tongue,
vaginal discharge, etc.
BLOOD DYSCRASIA – bone marrow
suppression caused by drug effects.
1. Fever, chills, sore throat, weakness, back
pain, dark urine, pancytopenia
TOXICITY – liver injury, renal injury,
poisoning.
ALTERATIONS in GLUCOSE METABOLISM
– hypoglycemia (antidiabetic drugs);
hyperglycemia (ephedrine)
ELECTROLYTE IMBALANCES –
hypokalemia (loop diuretics);
hyperkalemia ( K-sparing diuretics)
SENSORY EFFECTS
Ocular Toxicity – eg. Chloroquine - can
occur when a drug’s molecules are too big
for the tiny blood vessels which end in the
retina
Auditory Toxicity – eg. Macrolides - tiny
vessels and nerves in the 8th cranial
nerve (the auditory nerve), are easily
damaged by certain drugs
NEUROLOGIC EFFECTS
1. General CNS effects
2. Atropine-like or anticholinergic effects –
atropine, antihistamines
3. Parkinson-like syndrome – antipsychotic
and neuroleptic drugs
NEUROLEPTIC MALIGNANT SYNDROME –
general anesthetics
TERATOGENICITY - risk of death or
congenital defects to the developing fetus
Nursing management
ASSESSMENT:
1.) History
a.) Chronic Conditions
b.) Drug Use
c.) Allergies
d.) Level of Education
e.) Level of Understanding of Disease and
Therapy
f.) Social Support
g.) Financial Support
h.) Pattern of Health Care
2.) PHYSICAL ASSESSMENT
a.) Weight
b.) Age
c.) Physical Parameters related to disease or
drug effects
INTERVENTIONS
3 Types:
- Drug Administration - DSRDPTR
- Provision of Comfort Measures - positive
attitude / placebo effect; • Intervene to
manage possible adverse effects; •
Lifestyle adjustment
- Patient / Family Education
10 rights of drug administration
1. The RIGHT CLIENT
2. The RIGHT DRUG
Components of a Drug Order:
-Date and time the order is written
-Drug name
-Drug dosage
-Route of administration
-Frequency and duration of administration
-Any special instructions for withholding or
adjusting dosage based on nursing
assessment, drug effectiveness, or
laboratory results
-Physician’s signature
-Signatures of licensed practitioner taking TO
or VO.
Understanding Drug Labels:
-Drug name – generic and brand name
-Classification
-Medication form
-Dosage Strength
-Volume
-Expiry date
-Manufacturer
-Directions
Components of a Drug Order:
1. STANDING ORDERS – may be an on-
going order or may be given for a
specific number of doses or days; may
have special instructions to base
administration on laboratory values; may
include PRN orders.
2. SINGLE ORDER or ONE-TIME ORDER –
given once and usually at a specific time
Eg. Seconal 100mg HS before surgery
3. PRN ORDER – given at the client’s
requests and nurse’s judgment
concerning need and safety.
4. STAT ORDER – given once, immediately.
3.The RIGHT DOSE
4.The RIGHT TIME
5.The RIGHT ROUTE
Routes of Administration:
1.) ORAL
Tablets, capsule, caplet, lozenge (troche),
pill, aqueous suspension, elixir, syrup.
2.) INHALATION – aerosol spray
3.) INSTILLATION
4.) SUPPOSITORY`
5.) PARENTERAL
Subcutaneous
Intramuscular This system uses the teaspoon as the basic
Intradermal unit of fluid measure and the pound as the
Intravenous basic unit of solid measure.
6.) TOPICAL – cream, gel or jelly, It is not as accurate as metric system.
liniment,lotion, ointment, transdermal patch Spoons, cups, and glasses.
6. THE RIGHT ASSESSMENT
7. THE RIGHT DOCUMENTATION
8. THE RIGHT EDUCATION
9. THE RIGHT EVALUATION
10. THE RIGHT TO REFUSE

COMFORT MEASURES:
Placebo Effect
Managing adverse reactions (AR)
Lifestyle Adjustment

Patient and family education

1.) Name, dose, and drug action
2.) Timing of administration
3.) Special storage and preparation instructions
4.) Specific OTC drugs or alternative therapies
to avoid.
5.) Special comfort or safety measures
6.) Safety measures
7.) Specific points about drug toxicity
8.) Specific warnings about drug
discontinuation

WEEK 5 -Drug calculations

Systems of measurements
1. Metric System
2. Apothecary System
3. Household System

1. Metric system
It is the internationally accepted system of
measurement.
It is a decimal system based on the power of
10.
The basic unit of measures are:
- Gram for weight
- Liter for volume
- Meter for length
Kilo is the prefix used for larger units (e.g.
kilogram).
Milli, centi, and micro are prefixes for smaller
units.
2. Apothecary system
It is a very old system of measurement that
was specifically developed for use by
apothecaries or pharmacists.
Uses roman numerals instead of Arabic
numbers to express the quantity.
The roman numeral is placed after the symbol
or abbreviation for the unit of measure.
The letter “ss” stand for ½ grain.
The unit of weight is the grain (gr).
The units of fluid volume are the ounce, the
dram, and the minim.
3. Household system
It is the measuring system that is found in
recipe books.
EXERCISE
You are caring for a patient at home who must
take magnesium hydroxide/aluminum
hydroxide (Maalox) 30 mL PO. How will you
instruct the patient to measure the dose
using ordinary household measuring
devices? Record your answer to the
nearest whole number.
30 mL = ______ tbsp
30 mL = 2 tbsp
TIME CONVERSIONS
The use of international time or the military
time i.e. 24-hour clock, decreases errors in
administering medications, since no two
times are expressed by the same number.
The use of traditional time, the AM or PM
notation are the only way to distinguish two
times expressed by same number.
International times are read as:
- 0100 = “zero one hundred” (1:00 AM)
- 0000 = “ zero hundreds” (midnight 12:00 AM)
- 2400 = “ twenty four hundred” (midnight)
- 0016 = “zero zero sixteen” (12:16 AM)
To convert traditional time between 1:00PM
and 12:00AM to international time, just ADD
1200 to the traditional time.
Example:
3:00PM to international time
300 + 1200 = 1700 (5:00PM)
To convert international time between 1300 to
2400 to traditional time, just SUBTRACT
1200 from the international time.
Example:
2424 to traditional time
2424 – 1200 = 12:24PM
METRIC CONVERSIONS
Often we need to check the dose of a drug or
solution that is based on the patient’s
weight.
We multiply the prescribed mg dose by the kg
weight of the patient.
Example:
1. Prescribed dose – 25mg per kg
2. Patient’s weight – 66kg
3. Dose required - ???
4. 25mg/kg x 66 kg = 1650mg = 1.65g
EXERCISE
The patient is charted 15mg/kg/day. The
patient weighs 75kg.
1. How much is the total dose per 24 hours?
- 15X75= 1,125 mg/day
2. How much will the patient receive every 8
hours?
- 24hrs/8hrs= 3 hrs
- 1125/3=0.375mg per 8 hrs

Kg  g  mg  mcg DRUG DOSAGE CALCULATIONS

Each of these steps involves the heavier unit
being multiplied by 1000 to bring up the 1. BASIC FORMULA
number of the smaller units for the same DxV=x
weight. H
1. kg  g (1kg x 1000 = 1000g) D= desired dose
2. g  mg (1g x 1000 = 1000mg) H= on hand dose
3. mg  mcg (1mg x 1000 = 1000mcg) V= the vehicle (tablet, capsule, liquid)
x= amount calculated to be given to the client
When we multiply by 1000, we move the
decimal point three places to the right (). 1. BASIC FORMULA
1. 5g = ___ mg -Order: Cefaclor 0.5g PO BID
2. 5g = 5.000. mg () = 5000 mg -Available: Cefaclor 250mg/cap

DxV=x
Kg  g  mg  mcg H
If we are converting from a lighter unit to a
heavier unit, we move the decimal point 500mg x 1 capsule = 2 capsules
three places to the left for each conversion. 250mg
Another way of putting it is we divide by 1000.
1. mcg  mg (1000mcg /1000 = 1mg) 2 cap of Cefaclor 250mg/cap PO BID
2. mg  g (1000mg /1000 = 1g)
3. g  kg (1000g /1000 = 1kg) 2. RATIO AND PROPORTION
When we divide by 1000, we move the decimal KNOWN DESIRED
point three places to the left (). H : V :: D : x
1. 250 mg = __ g
2. 250mg = 0.250. () =0.25 g D= desired dose
H= on hand dose
EXERCISE V= the vehicle (tablet, capsule, liquid)
Digoxin 125mg = _0.125__ g x= amount calculated to be given to the client
DSLR 450mL = _0.450__L
Plain NSS 1.2L = _1,200___mL 2. RATIO AND PROPORTION
Augmentin 1.2g = _1,200,000___mcg Order: Amoxicillin 100mg PO GID
Head circumference 35cm = __0.035__m Available: Amoxicillin 250mg/5mL
H : V :: D : x
When we are converting volumes the process 250mg : 5mL :: 100mg : x Ml
is the same.
1. 1L  1000mL 250mg x = 5mL (100mg)
2. 0.25L  250mL x = 5mL (100mg)
3. 375mL  0.375L 250mg
x = 2mL
ROUNDING OFF: 2mL of Amoxicillin 250mg/5mL PO GID
- Round up if greater than 5 (166.66=167)
- Round down if less than 5 (33.33 = 33) 3. FRACTION AND EQUATION
H = D
Mg/kg CONVERSIONS V x
D= desired dose
H= on hand dose
V= the vehicle (tablet, capsule, liquid)
x= amount calculated to be given to the client

3. FRACTION AND EQUATION

Order: Ciprofloxacin 500mg po q12h
Available: Ciprofloxacin 250mg/tablet
H = D 250mg 500mg cross multiply
V x 1 tab x

250mg x = 1tab (500mg)

x = 1tab (500mg)
250mg
x = 2 tablets
2 tablets of Ciprofloxacin 250mg/tab po, q12h IV SOLUTIONS

EXERCISE
A patient has hypertension is to receive
propranolol 20mg po, qid. The drug comes
in 10mg per tablet. How many tablets
should the patient take?

4. BY BODY WEIGHT
1. Convert the weight from pounds to
kilograms.
2. Calculate the safe dosage in mg/kg/day
by multiplying the mg/kg/day by the
child’s weight in kg equals CLIENT’S
DOSE PER DAY.
3. If the drug is prescribed to be given
more than once a day, client’s dose/day
divided by the # times prescribed to be
given per day equals SINGLE DOSE
(DESIRED DOSE)
4. The client’s dose (single dose)
computed from step 3, use it as the
desired dose then calculate the amount
to give, using either the basic formula,
ratio and proportion, or fractional
equation

 BY BODY WEIGHT
-Order: Cefaclor (Cector) 20mg/kg/day in three
divided doses
-Child’s weight: 31lbs
-Available: Cefaclor 125mg/5mL

1. Convert: 31lb  kg = 31lbs/2.2 = 14kg

2. 14kg x 20 mg/kg/day = 280mg/day

3. 280mg/day divided by 3 (three divided

doses) = 93mg (doctor’s order)

4. D x V = x 93mg x 5mL = 3.7mL

H 125mg

PEDIA DOSES