Learners - Guide 3pctb

PTCB Study Session Three
Learner’s Guide
May 2010 Course Code #203063

PTCB Study Session Three: Learner’s Guide
Table of Contents
Introduction ........................................................................................................................... 2
Math Basics ........................................................................................................................... 4
Measurement Systems ......................................................................................................... 6
Pharmacy Calculations....................................................................................................... 10
Dosing Calculations............................................................................................................ 10
Flow Rates ........................................................................................................................... 15
Percent Solution Calculations ........................................................................................... 18
Dilutions and Concentrations ............................................................................................ 21
Alligation Calculations ....................................................................................................... 24
Children’s Dosing ............................................................................................................... 27
Self Quiz............................................................................................................................... 29
Conclusion........................................................................................................................... 34
Appendix # 1........................................................................................................................ 35
Appendix # 2........................................................................................................................ 36
Appendix # 3........................................................................................................................ 39
Appendix # 4........................................................................................................................ 40
Appendix # 5........................................................................................................................ 43
Appendix # 6........................................................................................................................ 48
Appendix # 7........................................................................................................................ 50
Appendix # 8........................................................................................................................ 51
Appendix # 9........................................................................................................................ 54
Appendix # 10...................................................................................................................... 55
Appendix # 11...................................................................................................................... 57
Page i
NOTES
Agenda
Course Duration: 3 hours
Topic Duration Description

Discuss the objectives and the
20 agenda
Introduction
minutes Discuss questions from homework
and pre-work assignments
Complete initial pre-test to assess
Learner’s understanding of basic
20
Math Basics math concepts
minutes
Further review of these concepts if
necessary
Review relationships between four
Measurement 20
measurement systems used in
Systems minutes
pharmacy practice
Discuss steps to completing
pharmacy calculations
o Dosing calculations
Pharmacy 90 o Flow rates
Calculations minutes o Percent solution calculations
o Dilution calculations
o Alligations
o Children’s Dosing
20 Allow learners to complete self quiz
Self Quiz
minutes individually
Summarize course content, review
10
Conclusion learning objectives, and identify
minutes
next steps
1
NOTES
Introduction
Duration: 20 minutes
Description: The introduction consists of three key

sections: getting to know each other; benefits of PTCB
certification; and a review of the learning objectives and
agenda.
Reviewing Learning Objectives
The role of the Pharmacy Technician is to help licensed

Pharmacists provide medication and other healthcare products to
patients. The benefits of becoming a Nationally Certified Technician
include increased trust from patients and pharmacists, improved
patient care, and greater opportunities for professional growth
within CVS. This program is designed to complement your practice
experience with a higher level of competence to aid in obtaining
national certification
In this training session, you will build upon what you have learned
in PTCB Study Sessions One & Two.
Upon completing this course, you will be able to:

Demonstrate a deeper understanding of basic mathematical
skills
Demonstrate an understanding of the relationships between the
different measurement systems used in pharmacy practice
Accurately complete pharmacy calculations including:
Dosage Calculations
Flow Rates
Percent Solutions
Dilution Calculations
FACILITATOR NOTES Alligations
III. Reviewing Learning Objectives Children’s Dosing
Review the learning objectives.
REMEMBER: These guides are

intended to SUPPLEMENT the text
books, The Pharmacy Technician
and Complete Math Review for the
Pharmacy Technician. Learners
should not be attending sessions 2
unless they have completed the pre
work assigned for the session.
NOTES
Introduction, continued
Reviewing Learning Objectives, continued
As you move through the activities in this training, think about how
you can enhance your skills as a Pharmacy Technician and help
create exceptional experiences for your customers at CVS.
As part of this section, your Trainer will:
Review the work that you completed in the Complete Math
Review for the Pharmacy Technician.
Homework and Pre-Work Review
As part of this section, your Trainer will review the Chapter Self-
Tests you completed in The Pharmacy Technician for homework
and the pre-work that you completed in Complete Math Review for
the Pharmacy Technician. Discuss any questions you may have
had while completing the homework and pre-work assignments.
3
NOTES
Math Basics
Pretest
Description: Review of basic math concepts covered

in Complete Math Review for the Pharmacy
Technician.
Recall what you learned in the Complete Math Review for the
Pharmacy Technician. This pretest is designed to assess your
understanding of basic math principles. Complete the following
calculations without a calculator.
1. XXIV + CL = ______________
2. 156.26 + 35.12 = _____________
3. 156.26 x 35.12 = ______________
4. Which of the following has the greatest value?

a. 1/200
b. 1/300
c. 1/500
d. 2/500
5. Express each of the following in Arabic numerals

a. IX
b. VIII
c. DXV
d. CDXLV
e. LXVI
6. Change 2/3 into a percentage. ________________
7. 12+13.24+42.541+82.005+0.2= _______________
4
NOTES
Math Basics, continued
8. 1/2 x 3/8 = ______________
9. 3/8 ÷ 3/4= _______________
10. Convert the following into decimals:

a. 5/10 _______
b. 2 1/3 _______
c. 4/9 _______
d. 16/25 _______
e. 1 4/6 _______
11. Convert the following to fractions (lowest terms or mixed

fraction)
a. 1.1 _______
b. .86 _______
c. .20 _______
d. 1.64 _______
e. .45 _______
12. Convert the following to ratios

a. 8/24 _______
b. 10/105 _______
c. 19/109 _______
d. .3 _______
e. .002 _______
f. .55 _______
13. Solve for X

a. 1:X = 3:12 __________
b. 20:10 = 100:X __________
c. 14:2 = 21: X __________
d. 5:35 = X:28 __________
e. 6:24 = 16: X __________
14. IV:XII = ?: XLVIII __________
15. 7 ÷ 2/3= ___________
5
NOTES
Measurement Systems
Discussion # 1
Description: This section will include a review of

four measurement systems: Metric system,
Apothecary System, Avoirdupois System, and Household
measurements, and a discussion of common conversions between
systems.
Metric System
Today, the metric system is the most commonly used measurement
system for pharmaceutical calculations.
Basic Metric Units

Gram (g) weight
Liter (l) volume
Meter (m) length
Prefix Symbol Meaning Conversion

Micro- mc or μ One millionth basic unit x 1,000,000
Milli- m One thousandth basic unit x 1,000
Centi- c One hundredth basic unit x 100
Deci- d One tenth basic unit x 10
Basic Unit (g, l, or m)
Hecto- H One hundred times basic unit x 0.01
Kilo- K One thousand times basic unit x 0.001
Conversion Example
÷ 1,000 ÷ 1,000 ÷ 1,000

(x0.001) (x0.001) (x0.001)
Micrograms Milligrams Grams Kilograms
x1,000 x1,000 x1,000
6
NOTES
FACILITATOR NOTES
Measurement Systems, continued

Apothecary System
The apothecary system is less common than the metric system,
however some medications are still prescribed using apothecary
weights. The apothecary system has units of measure for weight
and volume but none for length. Because the apothecary system
and the metric system both have units of measure for weight and
volume, it is simple to convert these measurements from one
ASK: Ask learners to convert system to the other.
each unit of volumetric measure
into minims
Answers: Unit of Measure Conversion
Fluidram: 60 minims Volume
Fluid ounce: 480 minims Minim
Pint: 7,680 minims
Quart: 15,360 minims Fluidram 60 minims
Gallon: 61,440 minims Fluidounce 8 fluidrams
Pint 16 fluidounces
ASK: Ask learners to convert
each unit of weight measurement
Quart 2 pints (32 fluidounces)
into grains Gallon 4 quarts (8 pints)
Answers: Weight
Scruple: 20 grains Grain
Dram: 60 grains
Ounce: 480 grains
Scruple 20 grains
Pound: 5760 grains Dram 3 scruples
Ounce 8 drams (24 scruples)
TIP: Discuss with Learners Pound 12 ounces
different medications they may
see in the pharmacy that are
measured in grains.
(Phenobarbital and Amour Avoirdupois System
Thyroid) The avoirdupois system is a measurement system for weights only.
The system contains three units of measure; two of which are
commonly used in everyday life, the pound and the ounce, and one
which is rarely used outside the pharmacy, the grain.
Note: Inform Learner’s that the Unit of Measure Conversion

grain in the Avoirdupois system Grain*
is the same as the grain in the
Apothecary system. However the Ounce 437.5 grains
ounce and pound are NOT the Pound 16 ounces
same
7
NOTES
Measurement Systems, continued

Household Measurements
Household measurements are regularly used in pharmacy practice,
as they are easiest for the patients to understand.
Unit of Measure Conversion

Volume
Teaspoonful (tsp)
Tablespoonful (Tbsp) 3 tsp
Fluid ounce * 2 tbsp
Cup 8 fluid ounces
Pint 2 cups
Quart 2 pints
Gallon 4 quarts
Weight
Ounce
Pound* 16 ounces
Intersystem Conversions
As a pharmacy technician, it is essential that you are able to
convert measurements within and between systems.
Volume:
16.23 minim= 1 ml
1 fluidram= 5 ml = 1 teaspoonful
1 teaspoonful= 5ml
1 tablespoonful= 15ml
1 fluid ounce= 30 ml
33.8 fluid ounces= 1 L
1 pint= 16 fluid ounces= 480 ml
1 quart= 2 pints= 960 ml
1 gallon= 4 quarts= 3840ml
Weight:
1 grain= 65mg
15.4 grains= 1g
1 ounce = 30 g
1 ap pound= 5760 grains= 373.2 g
1 av pound= 7000 grains= 454 g
2.2 lbs= 1 kg
8
NOTES
Activity # 1
Duration: 5 minutes
Directions: Complete the following conversions.
1. 34.6g= ___________mg
2. 735mg= ___________g
3. 3400ml= ___________L
4. 1.5L= ___________ml
5. 10dL= ___________L
6. 300Hg= ___________mg
7. 7.48Kg= ___________g
8. 4.27ml= ___________L
9. 25cL= ___________L
10. 15Km= ___________m
11. 24 fl oz= ___________pints
12. 40gr= ____________scruples
13. 16tsp= ___________ml
14. 12 ounces= ___________ap. pounds
15. 6.5 tbsp= ___________tsp
16. 8 quarts= ___________gal
17. 1 oz= ___________g
18. 35ml= ___________tsp
19. 105ml= ___________tbsp
20. 3 fluidrams= ___________ml
21. 120 lbs= ___________Kg
22. 8 fl oz= ___________ml
23. 7lbs 4 oz= ___________g
24. 100mg/dL= __________mg/ml
25. 1 mg/L= ___________mcg/ml
26. 50 mcg/ml= ___________mg/dL
9
NOTES
Pharmacy Calculations
Discussion # 2
Description: This section will include instructions for

completing important pharmaceutical calculations. As a
technician, you should be able to accurately calculate
dosages, flow rates, percent solutions, dilutions, alligations, and
children’s doses. In addition to these pharmaceutical calculations,
you should be familiar with basic business math.
Dosing Calculations
There are a variety of ways dosing calculation questions can be
asked, including, but not limited to, overall total dose, total daily
dose, total number of tablets/mls/teaspoons, and daily number of
tablets/mls/teaspoons. You may also encounter questions that
require you to calculate the regimen or duration of therapy.
Total Dose Calculations

When calculating the total dose, there are four elements to
consider:
Dosage (mg) or concentration (mg/ml)
Quantity (#)
Regimen (ie. QD)
Duration (ie. 10 days)
10
NOTES
Pharmacy Calculations, continued
Calculating overall total dose

1. Identify or calculate total dose quantity
[For liquids convert dose quantity to mls]
2. Multiply dose quantity by dosage (mg) or concentration (mg/ml)
Examples:
Biaxin 500 mg bid x 7 days
1. 2 doses a day
2 doses x 7 days= 14 doses
day
2. 14 doses x 500mg= 7000 mg total
dose
Amoxil 250mg/5ml; 10 ml QID x 10 days

1. 4 doses a day
4 doses x 10 days= 40 doses
day
40 doses x 10ml= 400ml
dose
2. 400 ml x 250mg = 20,000 mg total
5ml
Calculating total daily dose

1. Using regimen, identify dose quantity for one day
[For liquids, convert dose quantity to mls]
2. Multiply daily dose quantity by dosage (mg) or concentration
Examples:
Biaxin 500 mg bid x 7 days
1. bid= 2 doses a day
2. 2 doses x 500 mg= 1000mg/day
day dose
Amoxil 250mg/5ml; 10 ml QID x10 days

1. 4 doses a day
4 doses x 10ml = 40ml/day
day dose
2. 40 ml x 250 mg = 2,000mg/day
day 5 ml
11
NOTES
Other Dose Calculations
Calculating total number of tablets/mls/teaspoons

Solving these problems requires one more piece of information; it is
essential that we are given the strength of dosage form given.
Steps:
1. Calculate overall total dose (follow steps from above)
a) Identify or calculate total dose quantity
[For liquids convert dose quantity to mls]
b) Multiply dose quantity by dosage (mg)
2. Divide by strength of dosage form
Examples:
Biaxin 500 mg bid x 7 days; strength given 250mg/tab
1. a. 2 doses x 7 days= 14 doses
day
b. 14 doses x 500mg= 7,000 mg total
dose
2. 7,000mg ÷ 250mg =
tablet
7,000mg x 1 tablet = 28 tablets
250 mg
Amoxil 500mg QID x 10 days; strength given: 250mg/5ml

1. a. 4 doses x 10 days= 40 doses
day
b. 40 doses x 500mg= 20,000 mg total
dose
2. 20,000mg ÷ 250mg =
5ml
20,000mg x 5ml = 400 ml
250 mg
12
NOTES
If you look back to our calculation for the total dose of Amoxil you
will see we already knew the total dose required 400 ml. There is
another way of calculating the total number of dosage forms without
first calculating the total dose.
Another way to calculate the total number of tablets/mls/teaspoons:

1. Calculate the number of tablets/mls/teaspoons per dose.
2. Using regimen and duration calculate total dose quantity
[for liquids convert dose quantity to mls]
3. Multiply total number of doses (step1) by dose quantity
(step 2)
Amoxil 500mg QID x 10 days; Strength given: 250mg/5ml

1. 500mg x 5 ml = 10 ml/dose
dose 250 mg
2. 4 doses x 10 days = 40 doses
Day
40 doses x 10ml = 400 mls
dose
3. 400 ml x 250mg = 20,000 mg total
5ml
Use the information we have discussed so far to determine the

steps to solving for the regimen and duration of therapy.
Calculating regimen for therapy:

1.
2.
Calculating duration of therapy:

1.
2.
13
NOTES
Activity # 2
Directions: Solve the practice problems individually,

discuss answers as a class.
Dosage calculation problems can come in variety of forms. Be

sure you are able to answer any style dosage calculation by
completing the following problems. Practice using
ratios/proportions to solve unfamiliar problem styles.
1. Calculate the total number of tablets dispensed for a

prescription of Decadron 1.5mg po bid x10days. You only
have 750mcg tabs in stock.
2. Calculate the total amount of solution dispensed for a

prescription of Theophylline 10 mg bid x 7 days. You have
100mg/5ml solution in stock.
3. You are filling a prescription for Amoxicillin 500mg po bid.

The prescription calls for a number of 34 capsules, strength
500mg. What is the duration of this therapy?
4. How many 30 mg lansoprazole capsules will you need to

make a 2 week supply of lansoprazole oral solution for a
prescription of 30mg bid?
5. What is the total dose for the prescription in the previous

question?
6. How many 25 mg tablets do you need to produce a 30 day

supply of 1mg/5ml solution prescribed as 1.5 tsp po bid?
7. If a patient is talking 2 tsp po tid of 100mg/5ml Augmentin,

what is the daily dose in milligrams?
14
NOTES
Flow Rates
The flow rate is the rate at which IV solutions are infused. Flow
rates can be calculated using ratios and proportion equations. They
are usually recorded as volume measurement/ unit time, for
example L/hour or ml/min. These questions may require you to
calculate the IV administration rate in various forms. You may also
need to determine the amount of time it will take for an IV bag to
empty.
There are three (sometimes four) pieces of information to be

considered for IV administration:
Total volume of fluids administered
Total time of infusion
Flow rate of fluids
Drop factor of administration set (also known as calibration)
Flow rate= Total volume

Total time
This equation will provide an answer in unit volume/unit time

format, such as ml/min. However, if the question requires an
answer in drops/min you will need the drop factor or calibration of
the equipment to complete the calculation. This equation will
provide you with an answer in drops/min.
Flow rate= Total Volume x Calibration

Total time
Calculating Flow rate:

1. Identify or calculate total volume
2. Identify or calculate total time of administration
3. Divide total volume by total time
1. total volume
2. total time
3. total volume = volume Flow
total time unit time rate
15
NOTES
Calculating Flow rate (in drops):

2. Identify or calculate total time of administration
3. Divide total volume by total time
4. Multiply the quotient from step 3 by the drop factor
1. total volume
2. total time
3. total volume = volume
total time unit time
4. Volume x drops = drops Flow

Unit time volume unit time rate
Calculating total time of administration:

2. Identify or calculate flow rate
3. Divide total volume by flow rate
1. Total volume
2. Flow rate: Volume
time
3. Total Volume x time = total time
Volume
Calculating total Volume for administration:

1. Identify or calculate total time
2. Identify or calculate flow rate
3. Multiply flow rate by total time
1. Total time
2. Flow rate: Volume
time
3. Total Time x Volume = Total Volume
time
** for all calculations the last step will be to convert to the desired units**
16
NOTES
Activity # 3
Duration: 15 min
Directions: Individually solve the practice problems, and then

discuss answers as a class.
1. A physician orders 2 L of a solution to be administered over

8 hours. What should the administration rate be in ml/min?
2. The administration set from question one is calibrated at 10

gtts/ml, what is the administration rate in gtts/min?
3. 1L of normal saline is administered over 3 hours. Calculate

the flow rate in ml/min.
4. 1L of solution is to be administered at a rate of 100ml/hr.

What is the duration of the infusion?
5. 300ml of D5W is to be administered over 1.5 hours. The

drop factor is 15 gtts/ml, what is the flow rate in gtts/min?
6. 500ml of solution is administered at 25ml/hour begins at

2:00pm, when will the bag be empty?
7. 1200 units of Novolin is to infuse into 1L NS over 10 hours

with a drop rate of 10 gtts/ml. What is the infusion rate of the
insulin?
8. 1.8L NS is to be administered over 6 hours. There are two

administration sets available, with drop factors of 10gtts/ml
and 12 gtts/ml. What will be the difference in administration
rate if you use the first administration set compared to the
second?
9. You receive a medication order for 510mg of

methylprednisolone in 150 ml of NS to infuse over 2 hours at
a drop rate of 20gtts/ml. What is the administration rate in
mg/min?
10. 1.2L of Ringers Lactate runs for 10 hours. The flow rate is 60
gtts/min. Calculate the drop factor.
17
NOTES
Percent Solution Calculations
Types of percents
Weight-in-weight
W/W percentage expresses the “parts” of drug in 100 “parts” of a
mixture by weight. “Parts” can be any unit of weight measurement
(mg, g, lb, gr., etc)
Xg active
Xg active +Yg inactive
Volume-in-volume
V/V percentage expresses the “parts” of active drug in 100 “parts”
of solution. “Parts” in v/v percentage can be any unit of liquid
measurement (ml, L, fluidram,etc)
Xml active
Xml active +Yml inactive
Weight-in-volume
W/V percentage expresses the number of grams of active drug in
100 ml of mixture.
Xg active
100 ml solution
18
NOTES
Percent Solution Calculations, continued

There are four elements involved in solving percentage solution
problems:
Amount of active ingredient in mixture
Total Amount of mixture
Amount of active ingredient in 100 units of mixture (%
strength)
100 units of mixture
Amount of active ingredient

Amount of active ingredient = in 100 units of mixture
Total amount of mixture 100 units of mixture
This ratio formula can be used to calculate:

the percent solution
the amount of active ingredient in a given amount of mixture
the amount of inactive ingredient that must be added to
active ingredient to create a certain percent solution
the amount of total mixture necessary to create a certain
percent solution
19
NOTES
Activity # 4
Duration: 15 min
Directions: Complete Advance Practice Problems from Chapter 8

in Complete Math Review for Pharmacy Technicians. Page 115;
36-40.
20
NOTES
Dilutions and Concentrations
Diluting Sock Solutions

Stock solutions are highly concentrated solutions used to create
weaker solutions for human use. Pharmacists can create large
amounts of drug product by diluting a small amount of stock
solution with inactive ingredients.
To answer questions about dilution of stock solutions, the following

formula is used:
OV x O% = NV x N%
OV= Old Volume (or stock volume)

O%= Old percent (or stock concentration)
NV= New Volume (or desired volume)
V%= New percent (or desired concentration)
Remember:
Both sides of the equation will provide the same amount of
active drug product
The volume of the concentrated stock solution will always be
less than that of new desired solution
A dilutant will always need to be added to the volume of
stock solution (OV) to equal the desired volume for the new
solution (NV)
Calculating volume of stock needed to compound a certain

volume of desired concentration solution:
1. Determine total amount of drug product needed (multiply the
desired concentration by the desired volume)
2. Divide by concentration of stock solution
NV x N%
O%
21
NOTES

Dilutions and Concentrations, continued
Calculating concentration of new solution:
1. Determine total amount of drug product used (multiply the stock
concentration by the volume of stock used)
2. Divide by volume of new solution
OV x O%
NV
Calculating total volume of new solution needed to create

desired concentration:
1. Determine total amount of drug product used (multiply the stock
concentration by the volume used)
2. Divide by desired concentration
OV x O%
N%
Calculating amount diluent needed:

1. Determine both OV and NV using formula
2. Subtract OV from NV
NV-OV= diluent needed
22
NOTES
Activity # 5
Directions: Complete the following stock solution

dilution questions individually. Discuss answers as a
class.
1. A 100ml bottle of solution contains 50mg/ml of medication.

What is the total weight of the medication in the vial?
2. How much of a 25mg/ml stock solution would be needed to

prepare 100 ml of a 2.5mg/ml solution?
3. How much water would need to be added to the stock

solution calculated in the pervious question?
4. You are given a solution of 1M sodium chloride (NaCl), you

are asked to take 1.5ml and add to it 8.5ml of a 0M “filler”.
What is the new NaCl concentration?
5. What is the final volume of a 10mg/ml solution made with

50ml of 100mg/5ml stock solution?
6. A medication order for 1L of 0.3% NaCl solution arrives at

the pharmacy. You have 15% NaCl solution on hand. How
many ml of stock will you use? How many ml of solvent
(water) will you need?
7. How many fluid ounces of 5mcg/ml stock medication will be

used to create 15ml of 10mcg/ml dilution?
23
NOTES

Allegation Calculations
In the previous section, we diluted a stock solution with a diluent

that contained 0% active drug product. That is, we mixed a strong
stock solution with enough “filler” to bring the concentration of the
stock solution down to the desired level. In this section, we will
discuss how to create a solution with a desired concentration using
two stock solutions of different strengths. That is to say, our diluent
now contains some concentration of active drug product.
Set up:
High %
Desired %
Low %
The easiest way to set up an allegation calculation is using a “tic-

tac-toe” method.
Steps for set up:

1. Draw a tic-tac-toe grid
2. In top left place higher concentration of components
being mixed
3. In bottom left place lower concentration of components
being mixed
4. In center place desired concentration
5. In top right place the difference of the desired
concentration and the lower concentration
6. In bottom right place difference of higher concentration
and desired concentration
High % Desired% - Low% = # of parts of high %
Desired %
Low % High % - Desired%= # of parts of low %
24
NOTES

Allegation Calculations, continued
Steps for solving:

1. Add parts from steps 5 and 6 of set up to determine total
parts of new product
2. Set up proportion
Total Parts = Parts of High% .
Total desired amount ? (volume of high% needed)
3. Solve proportion for amount of high % component
4. Subtract amount of high% component from total desired
amount to calculate amount of low % component.
Example:
How much 1% hydrocortisone ointment and 2.5% hydrocortisone
ointment do you need to prepare 150g of 2% hydrocortisone
ointment?
Set up:
Solution:
25
NOTES
Activity # 6
Directions: Complete the following stock solution

dilution question individually. Discuss answers as a
class.
1. Use 0.25% and 0.1% triamcinolone creams to create 90g of

0.05% triamcinolone cream.
2. How much of a 2.5% ointment and a 0.5% ointment are

needed to create 50g of 1% ointment?
3. Prepare 1L of 20% solution using 90% and 10%

components.
4. How many ml of 90% solution should you add to 25ml of

10% solution to create a 30% solution?
5. You have 45 g of benzocaine 10% ointment, how much

benzocaine 2% ointment should you add to create 4oz of 5%
ointment.
26
NOTES
Children’s Dosing
There are multiple ways to calculate dosing for children. The most
common is to calculate the specific dose based on a child’s weight.
Other ways include using formulas such as Young’s rule and
Clark’s rule.
For exact dosing instructions, medication can be dosed on a

milligram per kilogram basis (mg/kg). This means based on the
specific weight of the patient (in kilograms) you can calculate
exactly how many milligrams of medication they should be given.
Calculation:
1. Convert lbs to kg (2.2lb=1kg)
2. Multiply by mg/kg
For less specific dosing calculations, information about a child

combined with the normal adult dose can be used to calculate the
child’s medication dose.
Young’s Rule:
Young’s rule calculates dose by the age of the patient.
Age of child x Adult dose= Child’s dose

Age of child +12
Clark’s Rule:
Clark’s rule calculates the dose by relating the weight of the child
to that of a 150lb adult.
Adult dose x Weight of child(in lbs) = Child’s Dose

150
Example:
Bobby and Jason are both 4 years old. Bobby weighs 30lbs and
Jason weighs 40 lbs. The standard dose for keflex is 3.5mg/kg or
250 mg for an adult. Calculate both children’s doses using all three
methods.
27
NOTES
Activity # 7
Directions: Complete the following Children’s Dosing question

individually. Discuss answers as a class.
1. An adult dose of Phenobarbital is 120mg. Calculate the dose

for a 25lb child.
2. A child weighs 65 lbs and is prescribed cloxacillin 250mg

QID. The label states the safe dose of cloxacillin is
50mg/kg/day. Is the prescribed dose safe?
3. You have a medication order for caffeine citrate 5mg/kg what

is the correct dose for an infant weighing 5000g?
4. Use both Clark’s rule and Young’s rule to calculate the dose
of Cephalexin 250mg for an 8 year old weighing 50lbs.
5. You have a medication order for Garamycin 20mg/kg. You

have Garamycin 300mg/ml in stock, how much do you
dispense for an 88 pound child?
28
NOTES
Self Quiz
Instructions: In this activity, choose the one best answer for each
of the following questions.
1. How many grams of 5% hydrocortisone cream can be made

with 20g of hydrocortisone powder?
a. 400g
b. 4000g
c. 0.1g
d. 100g
2. How many grams of medication are needed to compound

250ml of a 45% solution?
a. 45g
b. 112.5g
c. 11,250g
d. 250g
3. How many 40 mg doses of Gentamicin can be made from

20ml of 40mg/ml stock solution?
a. 20 doses
b. 1 dose
c. 80 doses
d. 100 doses
4. How much Spironolactone is in 10ml of a 1:10,000 solution?

a. 1mg
b. 1g
c. 0.1g
d. 10mg
5. The children’s dose for Phenytoin is 50mg/kg, what dose

should be administered to a 38 pound child?
a. 433mg
b. 863mg
c. 85mg
d. 4180mg
29
NOTES
Self Quiz, continued
6. What is the ratio of 0.9% stock solution and sterile water, you
will use to compound 0.225% NaCl?
a. 1:1
b. 1:2
c. 1:3
d. 4:1
7. A medication order for penicillin 1g IV every 4 hours was

started at 6:00 am. What times will the next two doses be
given?
a. 12:00am, 6:00pm
b. 10:00am, 2:00pm
c. 9:00 am, 1:00pm
d. 8:00am, 12:00pm
8. How many milligrams are in 1/5 grain?

a. 13mg
b. 20mg
c. 25mg
d. 65mg
9. How many 30mg tablets will you need to compound a

prescription for Spironolactone 1mg/5ml, 1.5 tsp bid for 30
days?
a. 1
b. 2
c. 3
d. 4
10. Using Young’s rule, find the dose of acetaminophen for a 4-

year old child when the adult dose is 500mg.
a. 125mg
b. 166.7mg
c. 1300mg
d. 250mg
11. You are filling a prescription that reads 2gtt od tid. How many
drops will the patient use per day?
a. 12
b. 8
c. 6
d. 3
30
NOTES
12. What volume of 100mg/10ml Furosemide solution will contain

60 mg Furosemide?
a. 0.6ml
b. 6ml
c. 60ml
d. 600ml
13. A 70kg adult requires a dose of 0.7mg/kg/hr of Aminophylline.

The concentration of the solution available is 250mg/250ml.
What is the correct flow rate?
a. 0.7ml/hr
b. 24.5ml/hr
c. 49ml/hr
d. 490ml/hr
14. You receive a medication order for a TPN which includes

4.5mEq/L. The stock solution on hand contains 45mEq/100ml.
What volume of stock will you need to prepare 2500ml TPN?
a. 11.25ml
b. 2.5ml
c. 250ml
d. 25ml
15. How many mls will a patient take a day for a prescription that
reads 3/4 tsp tid?
a. 15ml
b. 34ml
c. 2.25ml
d. 11.25ml
16. An order for 1 lb of 2% zinc oxide cream is to be prepared

using 6% zinc oxide cream and 1% zinc oxide cream. How
much of each is needed?
a. 90.8g of 6%, 363.2g of 1%
b. 363.2g of 6%, 90.8g of 1%
c. 75.7g of 6%, 378.3g of 1%
d. 378.3g of 6%, 75.7g of 1%
31
NOTES
17. A solution contains 30g of NaCl in 1000ml of solution. What is

the final concentration?
a. 30%
b. 15%
c. 1.5%
d. 3%
18. A medication order is written for 2L of D50.45NS with 40mEq
of KCl over 12 hours. What is the flow rate?
a. 83ml/hr
b. 166.7ml/hr
c. 42ml/hr
d. 50ml/hr
19. A physician writes a prescription for 4 fl oz of a solution that

contains equal parts of 3 medications. How much of each
medication will you add?
a. 30ml
b. 40ml
c. 15ml
d. 10ml
20. How many milligrams of 50% magnesium sulfate solution
should be added to a TPN to create 2% magnesium sulfate in
1L of TPN?
a. 10ml
b. 20ml
c. 30ml
d. 40ml
21. What volume of 0.9% solution can be made from 40ml of

22.5% NaCl stock solution?
a. 78ml
b. 2L
c. 1L
d. 39ml
22. What is the average adult weight used in Clark’s Rule for
children’s dosing?
a. 70lbs
b. 150lbs
c. 150kg
d. 170lbs
32
NOTES

23. How much medication is in 0.75ml of a 5mg/ml solution?
a. 3.75mg
b. 4.5mg
c. 7mg
d. 35mg
24. A medication order is written for 0.9%NS 500ml with 200 units
of regular insulin infused at 10U/hr. The drop factor is 60.
Calculate the flow rate (gtts/min)
a. 25 gtts/min
b. 20 gtts/min
c. 60 gtts/min
d. 8.5 gtts/min
25. In what ratio should a pharmacy technician mix 20% and 5%

dextrose solutions to obtain a 12.5% solution?
a. 2:1
b. 1:3
c. 1:1
d. 1:2
33
NOTES
Conclusion
Description: Summary of course content and discussion

regarding next steps.
The rapid growth of the pharmaceutical industry has led to an

increase in opportunities for well-trained technical personnel. The
Pharmacy Technician is responsible for a variety of duties in the
pharmacy. In addition, the Technician plays an important role in
patient care by assisting the Pharmacist. Maintaining a complete
understanding of pharmacy calculations will enhance your skills as
a Pharmacy Technician.
Instructions:
The topics and content we have discussed today will help you to
pass the PTCB exam. Write down any key points that you would
like to remember in the space below.
Next Steps
Now that you have completed PTCB Study Session Three, you are
ready to begin preparing for Session Four. The next session will
consist of a questions and answers session and a practice exam.
Before the next session, you will have an opportunity to apply what
you have learned in this session by completing the Advanced
practice Questions at the end of each chapter in Complete Math
Review for the Pharmacy Technician.
For the next class, complete the Post Test in the Complete Math
Review for the Pharmacy Technician the Practice Exam and
Calculations Practice in The Pharmacy Technician . Flag any
questions you have difficulty with for discussion during the next
session. Note: If you are sharing books with other store
colleagues, do not write your answers in the book. Record your
answers on a separate piece of paper.
34
Appendix #1 11. a. 1 1/10

b. 43/50
1. 24+ 150= 174=CLXXIV c. 1/5
d. 1 16/25
2. 156.26 e. 9/20
+ 35.12
191.38 12. a. 1 : 3
b. 2 : 21
3. 156.26 c. 19 : 109
x 35.12 d. 3 : 10
5,487.8512 e. 1 : 500
f. 11 : 20
4. a. 1/200= 0.005
b. 1/300= 0.0033 13. a. 1 = 3 = 12= 3x X= 4
c. 1/500= 0.002 x 12
d. 2/500= 0.004
b. 20 = 100 = 1000= 20x X= 50
5. a. 9 10 x
b. 8
c. 515 c. 14 = 21= 42= 14x X= 3
d. 445 2 x
e. 66
d. 5 = x = 35x= 140 X= 4
6. 66.67% 35 28
7. 12.00
+ 13.240 e. 6 = 16 = 384 = 6x X= 64
+ 42.541 24 x
+ 82.005
+ 00.200 14. 4:12 :: x:48
149.986 X= 16= XVI
8. 3/16 15. 7 ÷ 2/3= 7 x 3 = 21= 10 1/2

1 2 2
9. 3/8 ÷ 3/4= 3/8 x 4/3= 12/24= 1/2
10. a. 0.5
b. 2.33
c. 0.44
d. 0.64
e. 1.667
- 35 -
PTCB Study Session Three: Facilitator’s Guide
Appendix #2
1. 34.6g x 1000mg = 34600mg
1g
2. 735mg x 1g = 0.735g
1000mg
3. 3400ml x 1 L = 3.4L
1000ml
4. 1.5 L x 1000ml = 1500ml

1L
5. 10dL x 1L = 1L
10dL
6. 300Hg x 100g x 1000mg =30,000,000 mg * this can also be answered in one step
1Hg 1g
7. 7.48Kg x 1000g = 7480 g

1 Kg
8. 4.27ml x 1 L = 0.0047 L
1000ml
9. 25cL x 1L = 0.25L
100cL
10. 15Km x 1000m = 15,000m

1Km
11. 24 fl.oz x 1 pint = 1.5 pints

16 fl.oz
12. 40 grains x 1 scruple= 2 scruples

20 grains
13. 16 tsp x 5ml = 80ml

1tsp
14. 12 ounces x 1 ap. pound= 1 ap. pound

12 ounces
36
Appendix #2, continued
15. 6.5 tbsp x 3 tsp = 19.5 tsp

1 tbsp
16. 8 quarts x 1 gal = 2 gallons

4 quarts
17. 1 oz x 30g = 30g

1 oz
18. 35ml x 1 tsp = 7 tsp

5 ml
19. 105ml x 1 tbsp = 7 tbsp

15 ml
20. 3 fluidrams x 5 ml = 15 ml
1 fluidram
21. 120lbs x 1Kg = 54.55 Kg

2.2 lbs
22. 8 fl.oz x 30ml = 240 ml

1 fl.oz
23. 4 oz x lb = 0.25lbs
16 oz
0.25lbs + 7 lbs= 7.25lbs
7.25 lbs x Kg x 1000g = 3,295.5 g

2.2 lbs 1Kg
OR
7.25lbs x 454.5 g= 3295.1 g * 1 Kg x 1000g = 454.5g/lb
1 lb 2.2lbs 1Kg
24. 100mg x 10 dL = 1mg/ml

dL 1000ml
37

25. 1mg x 1000mcg x 1L = 1 mcg/ml
L 1 mg 1000ml
26. 50 mcg x 1 mg x 1000ml = 5 mg/dL

ml 1000mcg 10dL
38
Appendix #3
1.
1. 2 doses x 10 days = 20 doses 5.
total 1. 1 dose= 30 mg
Day 30 mg x 2 dose = 60 mg/day
20 doses x 1.5 mg= 30 mg total dose day ．．．．．．．
．．．
．． dose ．．．．．．．．． 2. 60 mg x 14 days= 840 mg total
2. 30 mg total x 1 tablet= 40 tablets Day
0.75mg
6.
2. 1. 1 dose= 1.5 tsp
1. 1 dose= 10mg 1.5 tsp x 2 doses= 3tsp/day
10 mg x 2 doses = 20 mg/day dose day
Dose day 3 tsp x 30 days= 90 tsp
20mg x 7 days = 140 mg total day
day ．．． 5 ml x 90tsp = 450 ml total
2. 140mg x 5ml = 7ml tsp
100 mg 450ml x 1 mg = 90 mg
5 ml ．．．．．．．．．．
．．
2. 90mg x 1 tab = 3.6 ~4 tablets
3. 25mg
．．．．．．
1. total quantity= 34 capsules
2. 34 caps x 1 day = 17 days
2 caps 7.
1. tid= three doses a day
1 dose= 2 tsp
4. 2tsp x 3 dose = 6tsp/day
1. 1 dose= 30 mg dose day
30 mg x 2 dose = 60 mg/day 6 tsp x 5ml = 30 ml/day
dose day day tsp ．．．．．．
．．．
60 mg x 14 days= 840 mg total 2. 30 ml x 100mg = 600mg/day
day ．．．．．．．．．． Day 5 ml
2. 840 mg x 1 cap = 28 capsules
30mg
39
Appendix #4
1. A physician orders 2 L of a solution to be administered over 8 hours. What should the

administration rate be in ml/min?
1. Total volume= 2L
2. Total time= 8 hours
3. 2L x 1000ml x 1 hr = 4.2 ml/min
8 hours L 60 min
2. The administration set from question one is calibrated at 10 gtts/ml, what is the administration
rate in gtts/min?
1. Total volume= 2L
3. 2 L x 1000ml x 1 hr = 4.2 ml/min
8 hours L 60 min
4. 4.2 ml x 10 gtts = 42 gtts/min
min ml
3. 1L of normal saline is administered over 3 hours. Calculate the flow rate in ml/min.
1. Total volume= 1L
3. 1 L x 1000ml x 1 hr = 5.6 ml/min
3 hours L 60 min
4. 1L of solution is to be administered at a rate of 100ml/hr. What is the duration of the infusion?

1. Total volume= 1L
2. Flow rate: 100ml/hr
3. 1L x 1000ml= 1000ml
1L
1000ml ÷ 100ml = 1000ml x 1 hr = 10 hrs
1 hr 100 ml
5. 300ml of D5W is to be administered over 1.5 hours. The drop factor is 15 gtts/ml, what is the
flow rate in gtts/min?
1. Total volume= 300 ml
2. Total time= 1.5 hrs
3. 300 ml x 1 hr = 300ml
1.5 hr 60 min 90 min
4. 300ml x 15 gtts= 4500gtts = 50gtts/min
90 min ml 90 min
40

6. 500ml of solution is administered at 25ml/hour begins at 2:00pm, when will the bag be empty?
1. Total volume= 500ml
2. Flow rate: 25 ml/hour
3. 500ml ÷ 25ml= 500ml x 1 hr = 20 hours
1 hr 25ml
4. 2:00pm + 20 hours= 10:00 am the next day
7. 1200 units of Novolin is to infuse into 1L NS over 10 hours with a drop rate of 10 gtts/ml. What
is the infusion rate of the insulin?
1. Total amount= 1200 units
3. 1200 units= 120 units x 1 hr = 2 units/min
10 hours 1 hr 60 min
8. 1.8L NS is to be administered over 6 hours. There are two administration sets available, with
drop factors of 10gtts/ml and 12 gtts/ml. What will be the difference in administration rate if you
use the first administration set compared to the second?
1. Total volume= 1.8L
3. 1.8L x 1000ml x 1 hr = 5 ml/min
6 hr 1L 60 min
4. Set 1: 5 ml x 10 gtts = 50 gtts
min ml min
Set 2: 5ml x 12 gtts = 60 gtts
min ml min
5. 60gtts – 50 gtts= 10 gtts/min
min min
9. You receive a medication order for 510mg of methylprednisolone in 150 ml of NS to infuse

over 2 hours at a drop rate of 20gtts/ml. What is the administration rate in mg/min?
1. Total volume= 150ml
3. 150ml x 1 hour= 150 ml
2 hours 60 min 120 min
4. 150ml x 510 mg = 4.25mg/min
120min 150 ml
41

10. 1.2L of Ringers Lactate runs for 10 hours. The flow rate is 60 gtts/min. Calculate the drop
factor.
1. Total volume= 1.2 L
3. 1.2 L x 1000ml x 1 hr = 2ml/min
10 hr 1L 60 min
4. 60 gtts ÷ 2ml = 60 gtts x 1 min= 30 gtts/ml
Min min min 2 ml
42
Appendix #5
1. The concentration of a pesticide in animal feed is 6 ppm.

a. How many kilograms of animal feed would contain 1mg of pesticide?
6ppm= 6mg/1,000,000mg
1. Set up ratio:
6mg = 1mg
1,000,000mg ? mg
2. Cross multiply:
6mg⋅?mg = 1,000,000mg⋅mg
3. Divide:
? mg = 1,000,000mg⋅mg = 166,667mg
6 mg
4. Convert Measurement units:

166,667 mg x 1g x 1kg = 0.16667 kg
1000 mg 1000g
b. Express the concentration of pesticide in animal feed as a ratio strength.

6ppm= 6mg = 1 mg = 166,667mg
1,000,000mg ? mg
ratio: 1:166,667
43

2. Rx Potassium permanganate solution 1:1000, 3 liters
a. How many tablets containing 0.5g of potassium permanganate would be required to prepare
this prescription?
1:1000= 1g:1000ml
1. Set up ratio:
1g = ?g
1000ml 3000ml
2. Cross multiply:
1gx3000ml= ?gx1000ml
3000ml·g= ?gx1000ml
3. Divide:
?g= 3000ml·g = 3g
1000ml
4. Calculate number of tablets:
3gx 1 tablet= 6 tablets
0.5g
b. What will be the percent strength of the solution if you incorrectly used 60 of the 0.5g
tablets?
Calculate total strength of medication:
60 tablets x 0.5g = 30g total
tablet
Identify total volume:
3 Liters = 3000ml
Calculate w/v% strength (g/ml):
30g = 1g = 1%
3000ml 100ml
44

3. Rx Resorcinol lotion 10%
a. How many ml of resorcinol monoacetate should be used in preparing ½ L of lotion?
1. Set up ratio:
?ml = 10ml
500ml 100ml
2. Cross Multiply:
?mlx100ml= 500mlx10ml
?mlx100ml= 5000ml·ml
3. Divide:
?ml= 5000ml·ml = 50 ml
100ml
b. What is the ratio strength of 8.35ml of lotion

10% the ratio strength does not change based on volume
4. Pediatric atropine sulfate has a concentration of 0.05mg/ml

a. Express this concentration as a mg%
1. Set up ratio:
0.05mg = ? mg
1 ml 100ml
2. Cross multiply:
0.05mgx100ml = ?mgx1ml
5mg·ml = ?mg·ml
3. Divide
?mg= 5mg·ml = 5mg
Mg
4. write as mg%: 5mg/100ml= 5mg%
45

b. How many mcg of atropine would be in a 5-ml syringe?
1. Set up ratio:
0.05mg = ? mg
ml 5ml
2. Cross multiply:
0.05mgx5ml = ?mgx1ml
0.25mg·ml = ?mg·ml
3. Divide:
?mg = 0.25mg·ml= 0.25mg
ml
4. Convert measurement units:
0.25mg x 1000mcg = 250mcg
1mg
5. Bupivacaine hydrochloride 0.5% and epinephrine 1:200,000 injection is available as a 30ml single
dose vial and is used for nerve block and caudal and epidural anesthesia.
a. How many milligrams of Bupivacaine are contained in a vial of the solution.
1. Set up ratio:
0.5%= 0.5g/100ml
0.5g = ? g
100ml 30ml
2. Cross multiply:
0.5gx30ml = ?gx100ml
15g·ml= ?gx100ml
3. Divide:
?g= 15g·ml = 0.15g
100ml
4. convert to mg:
0.15g x 1000mg= 150mg
1g
46

b. How many micrograms of epinephrine are contained in 1 ml of the solution.
1. Set up ratio:
1:200,000= 1g/200,000ml
1g = ?g
200,000ml 1ml
2. Cross multiply:
1gx1ml = ?gx200,000ml
1g·ml= ?gx200,000ml
3. Divide:
?g= 1g·ml = 0.000005g
200,000ml
4. convert to mcg:
0.000005g x 1000mg x 1000mcg = 5mcg
1g 1mg
47
Appendix #6
1. A 100ml bottle of solution contains 50mg/ml of medication.
What is the total weight of the medication in the vial?
Calculating amount of medication:

50mg x 100ml= 5,000mg
1 ml
2. How much of a 25mg/ml stock solution would be needed to prepare 100 ml of a 2.5mg/ml
solution?
Calculating volume of stock needed:
1. Total drug product needed: 2.5 mg x 100 ml = 250mg
ml
2. 250mg ÷ 25mg = 250 mg x ml = 10ml of stock solution

ml 25 mg
3. How much water would need to be added to the stock solution calculated in question one?
Calculating amount of diluent needed:
1. OV needed= 10ml
Total NV= 100ml
2. 100ml-10ml= 90ml water
4. You are given a solution of 1M sodium chloride (NaCl), you are asked to take 1.5ml and add to it
8.5ml of a “filler”. What is the new NaCl concentration?
Calculating concentration of new solution
1. Total amount of drug product used: 1M x 1.5ml = 1.5M⋅ml
2. 1.5M⋅ml ÷ [8.5ml + 1.5ml]= 0.15M
5. What is the final volume of a 10mg/ml solution made with 50ml of 100mg/5ml stock solution?
Calculating total volume of new solution
1. Total amount of drug product used: 100mg x 50ml= 1,000mg
5 ml
2. 1000 mg ÷ 10mg = 1000mg x 1 ml = 100ml

ml 10 mg
48

6. A medication order for 1L of 0.3% NaCl solution arrives at the pharmacy. You have 15% NaCl
solution on hand. How many ml of stock will you use? How many ml of solvent (water) will you need?
Calculating amount of stock needed:
1. Total drug product needed: 0.30% x= 0.3g
1ml
0.3g x 1000ml = 300 g
1ml
2. 300g ÷ 15g = 300g x 1ml = 20 ml of stock
1ml 15g
Calculating amount of diluent needed:

1. 100ml total – 20 ml stock= 80 ml diluent
7. How many fluid ounces of 5mcg/ml stock medication will be used to create 15ml of 10mcg/ml
dilution?
Calculating amount of stock needed:
1. Total drug product needed: 10mcg x 15ml = 150mcg
ml
2. 150mcg ÷ 5mcg = 150mcg x 1ml = 30ml
ml 5mcg
3. 30ml x 1fluid ounce= 1 fluid ounce
30 ml
49
Appendix # 7
Example:
How much 1% hydrocortisone ointment and 2.5% hydrocortisone ointment do you need to prepare
150g of 2% hydrocortisone ointment?
Set up:
2.5% (2 – 1)= 1 part
2%
1% (2.5 – 2)= 0.5 parts
Solution:
1. Total parts= 1 part + 0.5 parts= 1.5 parts
2. Proportion:
1.5 total parts = 1 part of 2.5% (high %)
150g desired amount ?
3. 1.5 parts x ? = 150g x 1 part
1.5 parts x ? = 150g·parts
1.5 parts x ? = 150g·parts
1.5 parts 1.5 parts
? = 100g of 2.5%
4. 150g desired total amount-100g of 2.5%= 50g of1%
Alternate solution:
1. Total parts= 1 part + 0.5 parts= 1.5 parts
2. Ratios:
1 part 2.5% and 0.5 parts 1%
1.5 parts total 1.5 total parts
3. Amount of 2.5%: 1 x 150g = 100g

1.5
Amount of 1%: 0.5 x 150g = 50g

1.5
50
Appendix #8
1. Use 0.25% and 0.1% triamcinolone creams to create 90g of 0.05% triamcinolone cream.
0.25 0.2
0.05
0.1 0.05
1. 0.2+0.05= 0.25 total parts

2. proportion:
0.25 parts = 0.2
90g ?
0.25parts x ? = 18g·parts
?= 72 g 0.25%
3. 90g-72g= 18g 0.1%
1%: 30g
0.25%: 60g
2. How much of a 2.5% ointment and a 0.5% ointment are needed to create 50g of 1% ointment?
2.5% 0.5
1%
0.5% 1.5
1. 0.5+1.5= 2.0 total parts

2. proportion:
2 parts = 0.5
50g ?
2parts x ? = 25g·parts
?= 12.5 g 2.5%
3. 50g-12.5g= 37.5g 0.5%
2.5%: 12.5g
0.5%: 37.5g
51

3. Prepare 1L of 20% solution using 90% and 10% components.
90% 10
20%
10% 70
1. 70+10= 80 total parts

2. proportion:
80 parts = 10 parts
1L ?
80 parts x ? = 10L·parts
?= 0.125L or 125 ml 90%
3. 1L - 0.125L = 0.875L or 875ml 10%
90%: 125ml
10%: 875ml
4. How many ml of 90% solution should you add to 25ml of 10% solution to create a 30% solution.
90% 20
30%
10% 60

2. proportion:
80 parts = 60 parts
? 25ml
2000ml·parts = 60parts x ?
?= 33.33ml total
3. 33.33ml total - 25ml 10%= 8.33ml
90%: 8.33ml
52

5. You have 45 g of benzocaine 10% ointment, how much benzocaine 2% ointment should you
add to create 4oz of 5% ointment.
10% 3
5%
2% 5

2. proportion:
8 parts = 5 parts
120g ?
8parts x ? =600g·parts
?= 75g
2%: 75g
53
Appendix #9
Example:
Bobby and Jason are both 4 years old. Bobby weighs 30lbs and Jason weighs 40 lbs. The standard
dose for keflex is 3.5mg/kg or 250 mg for an adult. Calculate both children’s doses using all three
methods.
Mg/kg method:
Bobby Jason
1. 30lbs x 1kg = 13.64kg 1. 40lbs x 1kg = 18.18kg
2.2lb 2.2lb
2. 13.64kg x 3.5mg = 47.74 mg 2. 18.18kg x 3.5mg = 63.63 mg
Kg kg
Young’s Rule:
Bobby Jason
1. 250mg x 4 yrs = 62.5mg 1. 250mg x 4 yrs = 62.5mg
4yr +12 4yr +12
Clark’s Rule:
Bobby Jason
1. 250mg x 30lbs = 50mg 1. 250mg x 40lbs = 66.66mg
150 lbs 150lbs
54
Appendix #10
1. An adult dose of Phenobarbital is 120mg. Calculate the dose for a 25lb child.
Answer: You must use Clark’s rule because you are only given the adult dose and weight of child.
Adult dose x Weight of child = child dose
150lbs
120mg x 25lbs = 20mg

150lbs
2. A child weighs 65 lbs and is prescribed cloxacillin 250mg QID. The label states the safe dose of
cloxacillin in 50mg/kg/day. Is the prescribed dose safe?
Answer: Convert pounds to kilograms
65lbs x 1 kg = 29.55kg
2.2kg
Calculate mg/kg dose given

250mg = 8.46mg/kg
29.55kg
Calculate total daily dose

8.46mg/kg x 4 doses = 33.84 mg/kg/day
Dose day
33.84mg/kg/day <50 mg/kg/day = SAFE
3. You have a medication order for caffeine citrate 5mg/kg what is the correct dose for an infant
weighing 500mg?
Answer:
5000mg x 1kg = 5 kg
1000mg
5mg x 5kg= 25mg

kg
55

4. Use both Clark’s rule and Young’s rule to calculate the dose of Cephalexin 250mg for an 8 year
old weighing 50lbs.
Answer:
Clark’s Rule: Adult dose x Weight of child = child dose

150lbs
250mg x 50lb = 83.33 mg

150mg
Young’s Rule: Adult dose x Child’s age = child’s dose

Child’s age + 12
250mg x 8 = 100mg
20
5. You have a medication order for Garamycin 20mg/kg. You have Garamycin 300mg/ml in stock,
how much do you dispense for an 88 pound child?
Answer: Convert pounds to kg
88lbs x 1 kg = 40kg
2.2 lbs
Calculate total dose

20mg x 40 kg= 800 mg
Kg
Calculate volume that contains 800mg

800mg x 1 ml = 2.67 ml
300mg
56
Appendix #11
1. How many grams of 5% hydrocortisone cream can be made with 20g of hydrocortisone powder?
Percent Solution Calculation (use ratios)
5% hydrocortisone = 5g hydrocortisone
100g cream
1. Set up ratio
5g = 20 g
100g ? g
2. Cross multiply
5g x ?g = 20g x 100g
5g x ?g = 2000g·g
3. Divide
?g = 2000g·g
5g
?= 400g
Note: For percent solution calculations, the type of solution will not be explicitly indicated. That is, it
will not say w/w, v/v, or w/v. The other information in the question will reveal the type of solution. For
example in this problem it states that 20g of powder will be used as the solute and the options for the
solvent are all given in grams, therefore we are looking at a w/w solution.
2. How many grams of medication are needed to compound 250ml of a 45% solution?
Percent Solution Calculation (use ratios)
45% solution= 45 mg medication

100ml
1. Set up ratio
45g = ? g .
100ml 250ml
2. Cross multiply
45g x 250ml = ?g x 100ml
11250g·ml= ?g x 100ml
3. Divide
?g = 11250g·ml
100ml
?= 112.5g
Note: Here we used w/v percent solution because we knew the final solution would be a liquid
“compound 250ml” and all answer options were expressed in mg.
57

3. How many 40 mg doses of Gentamicin can be made from 20ml of 40mg/ml stock solution?
Dosing Calculation
Calculating number of doses
1. Calculate overall strength
20ml x 40mg= 800mg
ml
2. Divide by strength per dose:
800mg ÷ 40mg = 800mg x dose = 20doses
dose 40mg
Note: We never discussed how to calculate a problem exactly like this, however Learners should be
prepared to see unfamiliar calculations on the PTCB exam. They may not have seen a problem
exactly like this, but they have learned the information needed to solve it.
4. How much Spironolactone is in 10ml of a 1:10,000 solution?

Percentage Solution calculation (use ratios)
1:10,000= 1g Spironolactone
10,000ml solution
1. Set up ratio
1g = ?g
10,000ml 10ml
2. Cross multiply
1g x 10ml = ?g x 10,000ml
10g·ml = ?g x 10,000ml
3. Divide
?g = 10g·ml =0.001g
10,000ml
Convert to milligrams:
0.001g x 1000mg= 1mg
58

5. The children’s dose for Phenytoin is 50mg/kg, what dose should be administered to a 38 pound
child?
Children’s Dosing
1. Convert lbs to kg
38lbs x 1kg = 17.3kg
2.2lbs
2. Multiply by dosage
17.3kg x 50mg= 865mg
kg
6. What is the ratio of 0.9% stock solution and sterile water, you will use to compound 0.225%
NaCl?
Dilution Calculation (OV x O% = NV x N%)
Calculating volume of stock needed
1. Determine total drug product needed
NV x N%
100ml x 0.225g= 0.225g
100ml
2. Divide by stock concentration
0.225g ÷ 0.9g= 0.225g x 100ml = 25ml stock solution
100ml 0.9g
Calculating amount of diluent needed

1. 100ml total- 25ml stock= 75 ml water
Ratio:
25:75 = 1:3
Note: use 100ml as total solution for easy calculation.
7. A medication order for penicillin 1g IV every 4 hours was started at 6:00 am. What time will the
next two doses be given?
6:00am + 4 hours= 10:00am

10:00am + 4 hours= 2:00 pm
8. How many milligrams are in 1/5 grain?
1 grain= 65 mg
65mg ÷ 5= 13mg
59

9. How many 30mg tablets will you need to compound a prescription for spironolactone 1mg/5ml,
1.5tsp bid for 30 days?
Dosage Calculation
Calculating overall total dose
1. Calculate total dose quantity:
1.5 tsp x 5 ml= 7.5 ml/dose
Dose tsp
7.5ml x 2 dose= 15ml/day

Dose day
15ml x 30 days = 450ml

Day
2. Multiply by dosage
450ml x 1 mg = 90 mg
5ml
Now the new question becomes, how many 30 mg tablets will you need to compound a prescription
for 90mg.
90mg x 1 tablet = 3 tablets

30mg
10. Using Young’s rule, find the dose of acetaminophen for a 4-year old child when the adult dose is
500mg.
Children’s dosing
Young’s rule: Age of child x Adult dose = Child’s dose
Age of child +12
4 x 500mg = 125mg
4+12
11. You are filling a prescription that reads 2gtt od tid. How many drops will the patient use per day?
Dosage Calculation
Calculating daily number of drops:
OD= right eye= 2 gtts/dose
Tid= 3 doses/day
1. 2 gtts x 3 dose = 6 gtts/day

Dose day
60

12. What volume of 100mg/10ml Furosemide solution will contain 60 mg Furosemide?
Percentage Solution Calculation (use ratios)
1. Set up ratio
100mg = 60mg
10ml ?ml
2. Cross multiply
100mg x ?ml = 10ml x 60mg
100mg x ?ml = 600ml·mg
3. Divide
?ml = 600ml·mg
100mg
? = 6ml
13. A 70kg adult required a dose of 0.7mg/kg/hr of Aminophylline. The concentration of the solution
available is 250mg/250ml. What is the correct flow rate?
Flow Rate
1. Total volume
70kg x 0.7mg = 49mg
Kg
49mg x 250ml= 49 ml
250mg
2. Total time: 1 hour
3. Flow rate= 49ml/hour
14. You receive a medication order for a TPN which includes 4.5mEq/L. The stock solution on hand
contains 45mEq/100ml. What volume of stock will you need to prepare 2500ml TPN?
NV x N%
2500ml x 4.5mEq= 11.25mEq
1000ml
11.25mEq ÷ 45mEq= 11.25mEq x 100ml = 250ml stock solution
100ml 45mEq
61

15. How many mls will a patient take a day for a prescription that reads 3/4tsp tid?
Dosage Calculation
Calculating ml per day
3/4=0.75
0.75tsp x 5 ml = 3.75ml/dose
Dose tsp
3.75ml x 3 dose= 11.25ml/day

Dose day
16. An order for 1 lb of 2% zinc oxide cream is to be prepared using 6% zinc oxide cream and 1%
zinc oxide cream. How much of each is needed?
Alligation Calculation
Set up:
6% (2 – 1)= 1 part
2%
1% (6 – 2)= 4 parts
Solution:
5. Total parts= 1 part + 4 parts= 5 parts
6. Proportion:
5 total parts = 1 part of 6% (high %)
454g desired amount ?
7. 5 parts x ? = 454g x 1 part
5 parts x ? = 454g·parts
5 parts x ? = 454g·parts
5 parts 5 parts
? = 90.8g of 6%
8. 454g desired total amount-90.8g of 2.5%= 363.2 of 1%
62

Alternate solution:
4. Total parts= 1 part + 4 parts= 5 parts
5. Ratios:
1 part 6% and 4 parts 1%
5 parts total 5 total parts
6. Amount of 6%: 1 x 454g = 90.8g

5
Amount of 1%: 4 x 454g = 363.2g

5
17. A solution contains 30g of NaCl in 1000ml of solution. What is the final concentration?
Percentage Solution Calculation
Weight/Volume solution= Xg/ 100ml
1. Set up ratio:
? g = 30 g
100ml 1000ml
2. Cross multiply
?g x 1000ml = 30g x 100ml
?g x 1000ml= 3000g·ml
3. Divide
?g = 3000g·ml
1000 ml
?= 3g
Concentration:
3g/100ml = 3%
18. A medication order is written for 2L of D50.45NS with 40mEq of KCl over 12 hours. What is the
flow rate?
Flow Rate
1. Total Volume: 2L= 2000ml
2. Total Time: 12 hours
3. Flow rate: 2000ml = 166.7ml/hour
12hr
Note: Advise Learners to be cautious of irrelevant information. This questions appears complicated
but is actually a simple division problem.
63

19. A physician writes a prescription for 4 fl oz of a solution that contains equal parts of 3
medications. How much of each medication will you add?
4 Fluid ounces x 30 ml = 120ml

fl oz
120ml ÷ 3 products= 40 ml of each
20. How many milligrams of 50% magnesium sulfate solution should be added to a TPN to create
2% magnesium sulfate in 1L of TPN?
NV x N%
1000ml x 2g = 20g
100ml
20g ÷ 50g= 20g x 100ml = 40ml stock solution
100ml 50g
21. What volume of 0.9% solution can be made from 40ml of 22.5% NaCl stock solution?
Calculating volume final solution
3. Determine total drug product used
OV x O%
40ml x 22.5g = 9g
100ml
4. Divide by desired concentration
9g ÷ 0.9g= 9 g x 100ml = 1000ml = 1L of solution
100ml 0.9g
22. What is the average adult weight used in Clark’s Rule for children’s dosing?
Clarks rule:
Adult dose x Weight of child(in lbs) = Child’s Dose
150
64

23. How much medication is in 0.75ml of a 5mg/ml solution?
Dosage Calculation:
Use ratio:
1. set up ratio
? mg = 5 mg
0.75ml ml
2. Cross multiply
?mg x 1ml = 0.75mlx 5 mg
?mg x 1ml = 3.75ml·mg
3. Divide
?mg = 3.75ml·mg
1ml
?= 3.75mg
24. A medication order is written for 0.9%NS 500ml with 200 units of regular insulin infused at
10U/hr. The drop factor is 60. Calculate the flow rate (gtts/min)
Flow Rate
1. Total volume: 500ml
2. Total time:
200 units ÷ 10 units= 200 units x 1 hour = 20 hours
Hr 10 units
3. 500ml = 25ml/hr
20 hr
Convert ml/hr to gtts/min

25ml x 1 hour x 60 gtts = 25 gtts/min
Hr 60 min ml
Alternate way to solve:

1. Find unit concentration: 200 units in 500ml NS
200 units= 0.4untis/ml
500 ml
2. Divide unit flow rate by unit concentration
10 units ÷ 0.4 units = 10 units x 1 ml = 25ml/hr
Hr ml hr 0.4 units
Convert ml/hr to gtts/min
25ml x 1 hour x 60 gtts = 25 gtts/min
Hr 60 min ml
65

25. In what ratio should a pharmacy technician mix 20% and 5% dextrose solutions to obtain a
12.5% solution?
Set up:
20% (12.5 – 5)= 7.5 part
12.5%
5% (20 – 12.5)= 7.5 parts
Ratio
7.5 :7.5 = 1:1
66

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PTCB Study Session Three

May 2010 Course Code #203063

Math Basics ........................................................................................................................... 4

Measurement Systems ......................................................................................................... 6

Flow Rates ........................................................................................................................... 15

Percent Solution Calculations ........................................................................................... 18

Dilutions and Concentrations ............................................................................................ 21

Alligation Calculations ....................................................................................................... 24

Children’s Dosing ............................................................................................................... 27

Topic Duration Description

Description: The introduction consists of three key

Reviewing Learning Objectives

The role of the Pharmacy Technician is to help licensed

Upon completing this course, you will be able to:

REMEMBER: These guides are

PTCB Study Session Three: Learner’s Guide

Description: Review of basic math concepts covered

2. 156.26 + 35.12 = _____________

3. 156.26 x 35.12 = ______________

4. Which of the following has the greatest value?

5. Express each of the following in Arabic numerals

6. Change 2/3 into a percentage. ________________

PTCB Study Session Three: Learner’s Guide

Math Basics, continued

8. 1/2 x 3/8 = ______________

9. 3/8 ÷ 3/4= _______________

10. Convert the following into decimals:

11. Convert the following to fractions (lowest terms or mixed

12. Convert the following to ratios

13. Solve for X

14. IV:XII = ?: XLVIII __________

15. 7 ÷ 2/3= ___________

PTCB Study Session Three: Learner’s Guide

Description: This section will include a review of

Basic Metric Units

Prefix Symbol Meaning Conversion

÷ 1,000 ÷ 1,000 ÷ 1,000

Micrograms Milligrams Grams Kilograms

x1,000 x1,000 x1,000

Measurement Systems, continued

Note: Inform Learner’s that the Unit of Measure Conversion

PTCB Study Session Three: Learner’s Guide

Measurement Systems, continued

Unit of Measure Conversion

PTCB Study Session Three: Learner’s Guide

Directions: Complete the following conversions.

PTCB Study Session Three: Learner’s Guide

Description: This section will include instructions for

Total Dose Calculations

PTCB Study Session Three: Learner’s Guide

Pharmacy Calculations, continued

Calculating overall total dose

Amoxil 250mg/5ml; 10 ml QID x 10 days

Calculating total daily dose

Amoxil 250mg/5ml; 10 ml QID x10 days

PTCB Study Session Three: Learner’s Guide

Pharmacy Calculations, continued

Other Dose Calculations

Calculating total number of tablets/mls/teaspoons

Amoxil 500mg QID x 10 days; strength given: 250mg/5ml

PTCB Study Session Three: Learner’s Guide

Pharmacy Calculations, continued