Chapter 5:

Dosage Calculations

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Responsible Parties
 The prescriber who orders the drug
 The pharmacist who dispenses the drug
 The nurse who administers the drug

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Dosing Considerations
 Packaging
 Sex
 Weight
 Age
 Physical Condition
 Other drugs that the patient is taking

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Measuring Systems
 Metric System
 Apothecary System
 Household System
 Avoirdupois System

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Metric System
 Solids: Gram (g)
o 1 milligram (mg) = 0.001 g
o 1 microgram (mcg) = 0.000001 g
o 1 kilogram (kg) = 1000 g
 Liquids: Liter (L)
o 1 milliliter (mL) = 0.001 L
o 1 mL = 1 cubic centimeter = 1 cc

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Apothecary System
 Solids: Grain (gr)
o 60 gr = 1 dram (dr)
o 8 dr = 1 ounce (oz)
 Liquids: Minim (min)
o 60 minim = 1 fluid dram (f dr)
o 8 (f dr) = 1 fluid ounce (f oz)

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Household System
 Solids: Pound (lb)
o 1 lb = 16 ounces (oz)
 Liquids: Pint (pt)
o 2 pt = 1 quart (qt)
o 4 qt = 1 gallon (gal)
o 16 oz = 1 pt = 2 cups (c)
o 32 tablespoons (tbsp) = 1 pt
o 3 teaspoons (tsp) = 1 tbsp
o 60 drops (gtt) = 1 tsp

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Other Systems #1
 Avoirdupois System
o Older system
o Ounces and grains
 Other Systems
o Measures may reflect chemical activity or biological
equivalence
 Unit
 Milliequivalents
 International units

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Other Systems #2

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Question #1
Tell whether the following statement is true or false.

The avoirdupois system is a system of measurement that

uses ounces and grains.

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Answer to Question #1
True

Rationale: The avoirdupois system is another older system

that was very popular when pharmacists routinely had to
compound medications on their own. This system uses
ounces and grains, but they measure differently than
those of the apothecary and household systems. The
avoirdupois system is seldom used by prescribers, but
may be used for bulk medications that come directly from
the manufacturer.

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Calculating Dosage
 Oral Drugs
 Parenteral Drugs
 Intravenous Solutions

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Ratio Proportion Conversion Between
Systems oral and parental

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Example

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Examples

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Calculating IV Drip Rate

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Differences Between Children and Adults
 Children absorb, distribute, metabolize, and excrete
drugs differently than adults
 Children’s organs are not as developed as an adult’s
organs

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Pediatric Dosage Calculation
 Fried’s Rule
 Young’s Rule
 Clark’s Rule
 Surface Area Calculation- Most used

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Fried’s Rule

This rule assumes that an adult dose would be appropriate

for a child who is 12.5 years (150 months) old

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Young’s Rule

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Clark’s Rule
Uses the child’s weight to calculate the appropriate dose
and assumes that the adult dose is based on a 150-lb
person

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Surface Area Calculation #1

Determine the child’s surface area with the use of a

nomogram (the height and weight of the child are
taken into consideration in this chart)

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Surface Area Calculation #2

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Question #2
What is the most accurate calculation for drug dosage in a
child?
A. Fried’s rule
B. Young’s rule
C. Clark’s rule
D. Surface area calculation

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Answer to Question #2
D. Surface area calculation

Rationale: These rules are not usually used today. The

nonogram, which uses body surface area, is more
accurate for determining dosages

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