Drug Dosages and Solutions

By:

M.V. Immaculata,MAN.RN
Objectives
At the end of the discussion, the learner will be able to:
1. Review the commonly used intravenous solutions.
2. Review the Roman and Arabic systems of numbers.
3. Demonstrate proficiency in performing conversion of
medication problems using the Household and metric
systems.
4. Demonstrate proficiency in calculation of drug dosage
and intravenous flow rate.
 Basic Formula

D X V
_______ = amount(in ml)to administer
H
D : desired dose (i.e. dose ordered by the primary care provider)
H : dose on hand (i.e. dose on label of bottle, vial, ampule)
V : Vehicle (i.e. form in which the drug comes, such
as tablet or liquid)
 Formula: D/H x Q = ml(amount in ml to be given)
Doctors order: D (Desired Dose) Stock dose: H (Available Stock/Hand)
Metronidazole 200 mg IV q 8 hrs ANST Metronidazole 500 mg /100 ml vial

Example: Example:
Long Method Short Method
Stock dose:Metronidazole Stock dose: Metronidazole
500 mg /100 ml vial 500mg/100ml = 5 mg /ml

200 mg 200 mg
_____ X 100 ml = 40 ml _____ = 40 ml
500 mg
5 mg
 Fluid Compartments of the Body
(water distribution in 3 compartments)
1. Intravascular Compartment arteries, veins,
capillaries.
2. Intracellular Compartment
3. Interstitial Compartment spaces between the
cells, outside the vascular compartment.
EXTRACELLULAR compartment composed of
Intravascular and Interstitial
compartments. = contains 1/3 of TBW
INTRACELLULAR compartment contains 2/3 of TBW
 Important Terms

Intravenous Terms Intravenous Abbreviations

gtts: drops D: Dextrose
Drop Factor: Number of drops per W: Water
volume of IV fluid. Varies depending on
the tubing used. Usually measured in S: Saline
gtts/mL. NS: Normal Saline (0.9%
Flow Rate: Measure of the flow of
NaCl)
liquid from an IV. Usually measured in
gtts/minute (how many drops are RL or LR: Lactated
released every minute) or in mL/hour Ringer's
(how many mL flow through each
hour). gtts/minute is used for
manually regulating an IV while
ml/hour is used when utilizing an
electronic IV regulator.
 Commonly Used Drop Factors

Microdrops(ugtts) Macrodrops (gtts)

60 ugtts/ml 10 gtts/ml
15 gtts/ml
20 gtts/ml

Ratio ugtts : gtt

60 ugtts /10 gtts = 6 ugtts: 1 gtt
60 ugtts /15 gtts = 4 ugtts: 1 gtt
60 ugtts /20 gtts = 3 ugtts: 1 gtt
 Volume/Time - IV Drop Rate
FORMULA

Volume (mL)
__________ X Drop Factor (gtts/ml) = Y (Flow Rate in gtts/min)
Time (min)

Drop factors (Common) : 10,15, 20 macrodrops/ml

60 microdrops/ml
Commonly Used Intravenous Solutions
Isotonic Hypotonic Hypertonic
0.9% NaCl Na Cl 0.2 % or Parenteral
Lactated 0.45% Nutrition
Ringers (LR) In general solutions
Dextrose 5% with Lower osmolality than with greater than
0.2% Na Cl the serum. Contains 600-700 mOsm/L
fewer electrolytes and should not be
more free water. administered in
Ideal for replacement Useful in cellular
for patients with an peripheral veins.
dehydration. Must be
intravascular fluid
deficit (e.g., acute Too rapid administered
blood loss from administration might
cause a sudden shift of
through central
hemorrhage, GI infusion lines
bleeding, or from an fluids being drawn
from the interstitial where the solution
accident) can be rapidly
space to the other
Hypovolemic, compartments diluted by large
Hypotensive to
volume to support BP.
volumes of rapidly
flowing blood -SVC
 Volume/Time - IV Drop Rate

Example:
Calculate the IV flow rate for 1000 mL of Plain NSS
to be infused in 8 hours. The infusion set is calibrated
for a drop factor of 20 gtts/ml.
 Volume/Time - IV mL Rate

FORMULA

Volume (mL)
__________ = Y (Flow Rate in ml/hr)
Time (hr)
 Volume/Time - IV mL Rate

Example:

D5W IV 1 L to infuse in 20 hours by infusion pump.

 Volume/Time - IV mL Rate

COMPUTATION:

Infuse PNSS 1ml for 1 hour

 Volume/Time - IV Drop or ml Rate

1 ml 60 ugtts /ml 60

____ X _________ = ___ = 1ugtt /min.

1 hr 60 min. 60
 Volume/Time - IV Drop or ml Rate

Therefore:

1 uggt /min = 1 ml/hr

or
1 ml/hr = 1 ugtt/min.
Conversion of drops/min. to ml/hr
If 1 uggt/min. = 1 ml/hr

What if ? the flow rate is

1 gtt(macro)/min.
How many ml/hr?
Consider the drop factor..........
 Commonly Used Drop Factors

Microdrops(ugtts) Macrodrops (gtts)

60 ugtts/ml 10 gtts/ml
15 gtts/ml
20 gtts/ml

Ratio ugtts : gtt

60 ugtts /10 gtts = 6 ugtts: 1 gtt
60 ugtts /15 gtts = 4 ugtts: 1 gtt
60 ugtts /20 gtts = 3 ugtts: 1 gtt
Exercise
1. D5W 500 ml to regulate at 1. How many ml/hr is being
10 ugtts(microdrops)/min. infused?
Exercise
1. D5W 500 ml to regulate at 1. How many ml/hr will be infused?
10 gtts(macrodrops)/min. 2. Convert 10 gtts(macro)/min. to
ugtts(micro)/min.
3. USING the Drop Factor Ratio
Drop factor: 20 gtts/ml 60 ugtts /10 gtts = 6 ugtts: 1 gtt
60 ugtts /15 gtts = 4 ugtts: 1 gtt
60 ugtts /20 gtts = 3 ugtts: 1 gtt
4. FR of 10 gtts/min = 30
ugtts/min.
5. 30 ugtts/min = 30 ml/hr

Answer: 30 ml/hr
 ROMAN NUMERALS Key Symbols

1 through 50 1 through 1000

I=1 C = 100
V=5
X = 10 D = 500
L = 50 M = 1000
 Unit Conversion

Mass Volume
mcg mg g kg
mcL mL L ko
( by 1,000 ) ( by 1,000 )
mcg mg g kg
( x by 1,000 ) mcL mL L kL
( x by 1,000 )
lb kg
( by 2.2 )
lb kg
( x by 2.2 )
 Systems of Measurements
(Calculation, Preparation, and Administration of medicines)

Common Household Equivalents Common Metric Equivalents

1 quart = 4 cups 1 milliliter(ml) = 1 cubic

1 pint = 2 cups
1 cup = 8 ounces
1 teacup = 6 ounces
1 tablespoon = 3 teaspoons
1 teaspoon = approx. 5 ml
1000 milliliters(ml) = 1 Liter(L)
= 1000 cubic centimetrs(cc)
1000 milligrams(mg) = 1 gram(g)
1000 micrograms(mcg) = 1 gram(g)
1000 grams(g) = 1 Kilograms(kg)
 Convert the following:
Mass
lb kg Answer

44 lb kg
44 lb 2.2 = 20 kg
 Convert the following:
Volume
L mcl Answer

0.003 L mcl 0.003 L x 1,000 = 3 mL

3 mL x 1,000 = 3,000 mcL

 References
Clayton, Stock, Harroun (2007)Basic Pharmacology for Nurses
DosageHelp.com
Thank you for listening

MVI 2014