DRUG

COMPUTATION
Prepared by: Mariflor Rimas Ocampo
Revised/Updated by: Group 35 BSN II-3
lEARNING OBJECTIVES
Calculate the correct dose of a drug when given
examples of drug orders and available forms of the
drugs ordered.
 12 rights of
medication
administration
 RIGHT PATIENT
1. Always check patient’s 2. Ask patient to state their
identification bracelet. name and birth date.

3. Compare medication 4. Verify patient’s allergies

order to identification with chart and with
bracelet and patient’s patient.
stated name and birth
date.
 RIGHT MEDICATION
1. Perform a triple check of 2. Always check the
the medication’s label. medication label with the
When retrieving the physician’s order.
medication
When preparing the
medication
3. Never administer
medication prepared by
Before administering
another person.
medication to patient
RIGHT DRUG PREPARATION
1. Check the medication 2.
orders, only administer
drug from a complete
and legible order
Nurses must adhere exactly to the
type of drug preparation indicated
by the doctor because different
types of preparation could produce
potent or delayed or unwanted
expalled results.
 RIGHT DOSE
1. Check the label for 2. Compare prepared dose
medication concentration with medication order

3. Triple all medication 4. Check all medication

calculations calculations with another
nurse

5. Verify that dosage is within

appropriate dosage range for
patient and medication
 RIGHT TIME
1. Verify schedule of 2. Check last dose of
medication with order medication given to
Date patient
Time
Specified period of
time
3. Administer medication
within 30 minutes of
schedule
 RIGHT ROUTE
1. Verify medication route 2. Medication may only be
with medication order administered via route
before administering specified in order.
 RIGHT Reason
1. Should know the rationale 2. Should know the the action,
behind the doctor’s order pharmacokinetics and possible
for the drug. side effects of any of the drug
being administered through a
detailed drug study
 RIGHT EDUCATION
1. Inform patient of 2. Inform patient of desired
medication being effects of medication.
administered.

3. Ask patient of side effects 4. Ask patient if they have

of medication. any known allergies to
medication.
 RIGHT ASSESSMENT
1. Properly assess patient 2. If deemed unsafe or
tests to determine if inappropriate, notify
medication is safe and ordering physician and
appropriate. document notification.
3. Document that
medication was not
administered and the
reason that dose was
skipped.
 RIGHT to refuse
1. The legally responsible
party for patient’s care
has the right to refuse
any medication.
3. Verify that responsible
party understands all of
these consequences.
2. Inform responsible party
of consequences of
refusing medication.
4. Notify physician that
ordered medication and
document notification.

5. Document refusal of medication

and that responsible party
understands consequences.
 RIGHT EVALUATION
1. Assess patient for any 2. Assess patient for
adverse side effects effectiveness of medication

3. Compare patient’s prior 4. Document patient’s

status with post response to medication
medication status
RIGHT DOCUMENTATION
1. Never document before 2. Document:
medication is Medication
administered Dosage
Route
Date and Time
Signature and credentials
( when appropriate,
signature of other nurse
checking medication)
Routes OF
DRUGS
 oral drugs
Frequently, tablets or capsules for oral administration
are not available in the exact dose that has been
ordered.
Pain reliever = 1 tablet
Give 250 mg of pain reliever.
The easiest way to determine dose is to set up a ratio
and proportion.
oral
 PARENTERAL
Parenteral nutrition (PN) refers explicitly to administering liquid
nutrition intravenously to an individual unable to use their
digestive system. The term parenteral translates to "outside of the
digestive tract” and allows an individual to bypass the usual
process of eating and digestion.
 PARENTERAL
ROUTE: There are four potential routes of parenteral injections,
including intradermal (IM), subcutaneous (SQ), intramuscular
(IM), and intravenous (IV).

EXAMPLES:
IV infusion
Chemotherapeutic drugs
Botox injection
PARENTERAL ROUTE
 inhalation
Inhaled medicines, or medicines that you breathe directly into the
lungs, are an important part of treatment for chronic lung disease.
A variety of medicines are available in an inhaled form. When
inhaled, the medicine quickly reaches the airways and less is
absorbed into the bloodstream.
 inhalation
ROUTE: Must be in a mist and inhaled deeply; inhalation through the
mouth must be atomized into smaller droplets than those
administered by the nasal route
EXAMPLES:

metered dose inhalers (MDIs)

dry powder inhalers (DPIs)
soft mist inhalers (SMIs)
INHALATION ROUTE
 EYE
The medicines in this section include those which act on the eyes,
usually given as eye-drops or ointments.

ROUTE: EXAMPLES:
Azithromycin eye drops (Azyter)
the topical route is the most
Ofloxacin eye drops (Exocin)
commonly used
Aciclovir eye ointment
EYE ROUTE
forms OF
DRUGS
 VIAL DRUGS
Vial Medications are used to store liquid medicines. We carry a
variety of glass and plastic vials, like glucagon, solu-medrol,
adenosine, magnesium sulfate and more.
 VIAL DRUGS
ROUTE:
Intramuscular, Intradermal,
Intravenous, Subcutaneous

EXAMPLES:

Vial of vaccine and syringe

Sterile single-use vial of eye drops
VIAL drugs
 AMPULE
A small container, usually made of glass or plastic containers
containing a drug that will be used for an injection.

EXAMPLES:
epinephrine
fentanyl citrate
lidocaine hydrochloride
 AMPULE
ROUTE:
Intramuscular (into a muscle, abbreviated as
IM)
Subcutaneous (below the dermis and epidermis,
abbreviated as subcut or SC)
Intradermal (a shallow injection under the
dermis, abbreviated as ID)
Intravenous (into a vein, abbreviated as IV)
Intrathecal (into the cerebrospinal fluid)
Intracardiac (into the heart muscles or
ventricles)
Intra-articular (into a joint)
AMPULE drugs
 DRUG
CLASSIFICATION
 SOLID DRUGS
solid dose formation is a hard tablet made by compressing
medicine in a powder form

Route:
oral, buccal, sublingual, rectal, topical, inhalational
 EXAMPLE

Oral- Biogesic
Buccal- Prochlorperazine Maleate
Sublingual- Zolpidem tablet
Rectal- Bisacodyl
 LIQUID DRUGS
Liquid medications include products such as elixirs, solution,
suspensions, and syrups.

Route: Examples:
Oral and Cutaneous Lagundi Syrup
Digoxin
EXAMPLE
 POWDER DRUGS
A drug composed of a solid dry substance in the form of finely
divided particles used for external and internal use in the form of
dosage is termed a pharmaceutical powder. These powders are
used in doses and can be obtained through processes like crushing
and grinding.

Route:
Oral, Pulmonary/Inhalation, Cutaneous
 TYPES OF POWDER
1. Bulk Powder 2. Dusting Powder
The bulk powder is a These are pharmaceutical
finely powdered powders that contain
substance that single medical agents
consists of medical applied as dusting agents.
drugs and can be These powders are
used for internal and frequently used a
external uses. medicinal powder drug
and protect against skin
irritation.
 TYPES OF POWDER
3. Douche Powder 4.
A powder drug that is
used for the cleaning
solutions of intimate
body parts for hygiene.
It is sometimes called
douches. These
powders are prepared
for cleaning vaginal
problems.
Insufflations
These are extremely
small fine solid
particles of the
pharmaceutical
powder used to
inject into the body.
 TYPES OF POWDER
5. Divided Powders 6. Powder Sprays
A single dose of A better alternative
medicine in than dusting
powdered form powder as it is
packed in individual dispensed with high
packages is known pressure and
as divided powder, uniform distribution
generally known as in the targeted
a chart. place.
 TYPES OF POWDER
7. Efflorescent Powder
These types of pharmaceutical powders are those
powders that are composed of crystallized powders
such as atropine, citric acid, codeine, alums and
caffeine. This type of pharmaceutical Powder would
become sticky if exposed to a low-humidity
environment as the water gets liberated from the
Powder.
 DRUG
COMPUTATIONS
 GENERAL FORMULA

DESIRED X QUANTITY
STOCK
 EXAMPLE #1
An order is written for 10 grains of aspirin
(gr x, aspirin). The tablets that are available
each contains 5 grains. How many tablets
should the nurse give?
 Solution
DESIRED X QUANTITY
STOCK

10 (gr)(tablets)
X= 5 (gr) X = 2 Tablets
 EXAMPLE #2
An order is written for 0.05 g Aldactone
(spironolactone) to be given orally (PO).
The Aldactone is available in 25-mg tablets.
How many tablets would you have to give?

50 mg/25mg x 1 = 2 tablets
 Solution
1) Convert gram to milligram

0.05 gram X 1000 mg

1 gram
= 50 mg
 Solution
DESIRED X QUANTITY
STOCK
50 (mg) (tab)
X= 25 mg X = 2 Tablets
 EXAMPLE #3
A patient has a bottle of warfarin (Coumadin) 5
mg tablets at home. After his most recent
international normalized ratio (INR), the doctor
calls and tells him to take 7.5 mg/day. How
many tablets (scored) should the patient take?
ANSWER
D: 7.5 mg
S: 5 mg
Q: 1 tablet
A: 1.5 or 1 1/2 tablets
 EXAMPLE #4
The physician orders alprazolam (Xanax) 0.5
mg PO. You have on hand Xanax 0.25 mg
tablets. How many tablet(s) will you give?
ANSWER
D: 0.5 mg
S: 0.25 mg
Q: 1 tablet
A: 2 tablets
 EXAMPLE #5
You need to administer 250 mg of erythromycin
(Erythrocin) PO. You have on hand 0.5 g tablets.
How many tablet(s) will you give?
ANSWER
D: 250 mg
S: 500 mg
Q: 1 tablet
A: 1/2 tab
 EXAMPLE #6
You have available lorazepam (Ativan) 0.5 mg
tablets, and you need to administer 1 mg PO. How
many tablet(s) will you administer?
ANSWER
D: 1 mg
S: 0.5 mg
Q: 1 tablet
A: 2 tablets
 EXAMPLE #7
An order has been written for 250 mg of
sulfisoxazole. The bottle states that the solution
contains 125 mg/5 mL. How much of the liquid
should you give?
 Solution
DESIRED X QUANTITY
STOCK

250 mg 5 mL
125 mg X X = 10 mL
 EXAMPLE #8
The physician writes a “now” order for codeine 45
mg IM for a patient with a vertebral compression
fracture. You have on hand codeine 60 mg/2 mL.
How many milliliters should you give?
ANSWER
D: 45 mg
S: 60 mg
Q: 2 mL
A:
 EXAMPLE #9
You have an order to administer 40 mg of
methadone (Dolophine) SC for opioid detoxification.
You have on hand 30 mg/mL. How much should you
draw into the syringe?
ANSWER
D: 40 mg
S: 30 mg
Q: 1 mL
A: 1.3 mL
ampule
DESIRED X QUANTITY
STOCK
Doctor’s order: 450 mg IV
450 mg 2 mL
300 mg X

X = 3 mL
 drip rates for
rate gtts/min or
ugtts min
Volume in milimeter
Drip Rate =
Time in hours
 drip rates in
drops per min.
Drip Rate = Volume in ml X Drop factor ( drops/ml)
Time to run in hrs. 60( minutes/hrs.)

MACRO DROP FACTOR = 15 drops per ml ( gtts/ ml)

MICRO DROP FACTOR = 60 micro drops per ml ( ugtts/
ml)
 EXAMPLE #1
A adult patient is ordered to receive 1000 mL of
intravenous fluids to run for 8 hours. Calculate
the drip rate.
 solution
FR= Vol. in ml x DF
time(60 min.)

1000 ( 15gtts/ml) = 15000 gtts = 31.25gtts/min or 31-32 gtts/min

8 hours ( 60 mins.) = 480 mins.
 EXAMPLE #2
A patient is to receive 1 liter of PNSS over the
next 12 hours. What is the rate of infusion in
drops per minute, if the drop factor is 60 drops
per milliliter.
 solution
METHOD 1: get the ml/hr then get the ml/min and then the DPM
ml/hr= volume in ml = 1000ml = 125 ml/hr
hours 8 hour

ml/min= ml/hr = 125 ml/hr= 2.08 ml/ min

60 mins 60 mins
FR or DPM= ml/min (DF)= 2.08 ml/min (15 gtts/ml) =31.25 or 31 gtts/min
31-32gtts/min
 solution
METHOD 2: get the ml/hr
ml/hr= volume in ml = 125 ml
6 hours

DPM= ml/hr (DF)= 125ml/hr (15gtts/ml) =31.25 0r 31 gtts/min

60 60
 solution
Drip Rate = Volume in ml X Drop factor ( drops/ml)
Time to run in hrs. 60( minutes/hrs.)

= 1000 ml X 60 drops / ml
12 hours 60 minutes / hour

83.33 drops / min

Thank you for
listeninG!