Chapter 9

Parenteral Medication Labels

and Dosage Calculation

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 Parenteral Routes
• IV
– Most common
• IM
• Subcutaneous
– Second most common
• Intradermal
– Least common

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 Packaging
• Parenteral medications available in
ampules, vials, prefilled syringes, bag
solutions, and bottled solutions

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 IM Solutions
• Manufactured so average adult dosage
contained in volume between 0.5 mL and 3
mL
• Most dosages prepared using 3 mL syringe

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 Subcutaneous Solutions
• Manufactured so average adult dosage
contained in volume between 0.5 mL and 1
mL
• Most dosages prepared using 3 mL or TB
syringe

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 IV Medication Preparation
• Administration usually two-step procedure:
1. Prepare dosage
2. Dilute in IV fluids

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 Solution Labels
• Metric/SI examples:
– Morphine sulfate 4 mg/mL
– Digoxin 75 mcg/mL
– Cefazolin 1 gram/50 mL

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 Solution Labels
• Percent examples:
– 1% lidocaine
– 10% calcium gluconate
– 0.45% sodium chloride

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 Solution Labels
• Ratio examples:
– 5000 : 1 heparin
– 2500 : 1 heparin
– 1000 : 1 epinephrine

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 Solution Labels
• International unit examples:
– Heparin: 5000 international units
– Factor VIII: 4550 international units
– Factor IX: 2300 international units
• mEq examples:
– 20 mEq potassium chloride (KCl)
– 50 mEq sodium bicarbonate (NaHCO3)

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 Safety Point
• Labels of most parenteral solutions quite
small
– Read with particular care

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 Example 1
• Prescription for atropine 1/150 grains
subcutaneously
• Atropine vial labeled 0.4 mg/mL
• How many mL should be administered
subcutaneously?

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 Example 1
• Convert 1/150 grains to 0.4 mg
• Use basic formula
0.4 mg
1 mL  1 mL
0.4 mg

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 Example 2
• Prescription for heparin 5,000 units
subcutaneously
• Heparin vial labeled 10,000 : 1 mL heparin
• How many mL should be administered
subcutaneously?

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 Example 2
• Use basic formula
5, 000 units 1 mL  0.5 mL
10,000 units

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 Example 3
• Prescription for morphine sulfate 2 mg IV
• Morphine sulfate prefilled syringe contains
4 mg/mL
• How many mL should be administered
intravenously?

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 Example 3
• Use basic formula
2 mg
1 mL  0.5 mL
4 mg

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 Example 4
• Prescription for promethazine sulfate 25 mg
IV bolus
• Promethazine sulfate vial labeled 25 mg/mL

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 Example 4
• IV drug resource states each 12.5 mg of
promethazine sulfate should be diluted with
5 mL normal saline for injection prior to
administration via IV bolus
• How many total fluid and medication bolus
mL should be administered intravenously?

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 Example 4
• Each 12.5 mg requires 5 mL normal saline
dilution
• To dilute 25 mg requires 10 mL of normal
saline
• 10 mL normal saline + 1 mL (25 mg)
medication = 11 mL total volume

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 Example 5
• Prescription for 2550 international units
Factor IX concentrate intravenously each
day
• Pharmacy supplies Factor IX in
concentration of 250 international units/5
mL
• How many mL should be administered per
intravenous bolus?

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 Example 5
• Use basic formula
2550 units  5 mL  10.2 mL
250 units

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