INTRODUCTION TO

FORMULAS

Revised by R. Burton-Edwards 2017, R. Rowe 2020

Week 3
OBJECTIVES
At the end of this lab session, students will be able
to:
• Select an appropriate formula for calculating drug
dosages.
• Convert measures to an appropriate system for
calculating drug dosages.
• Calculate various drug dosages using various formulas.

• Read and interpret calibrations

METHODS FOR
CALCULATING ORAL
DRUG DOSAGES (ADULT
AND PEDIATRICS)
KEY TERMS

Basic Formula (BF)

Ratio & Proportion (RP)
Fractional Equation (FE)
Body Surface Area (BSA)
Body Weight (BW)
METHOD 1 – BASIC FORMULA (BF)
 Easy to recall
 Most frequently used

Formula - D x V = A
H
D – the desired dose H – the on-hand dose
V – drug form A – amount for client
METHOD 1 – BASIC FORMULA (BF)
 Example 1
Ordered: Cefaclor (Ceclor) 0.5g PO b.i.d.
Available: Cefaclor (Ceclor) 250mg capsules

Because the unit of measure ordered is in grams and

the unit on the bottle is in milligrams it is important
to convert grams to milligrams to work the problem
METHOD 1 – BASIC FORMULA (BF)
1g = 1000mg
0.5g = X
1gX = 1000mg x 0.5g
X = 500mg

Formula - A= D x V A= 500mg x 1 capsule

H 250mg
A = 2 Capsules
METHOD 1 – BASIC FORMULA (BF)
 Example 2
Ordered: Codeine gr 1 PO STAT
Available: Codeine 30mg/tablet

Grains must first be converted to milligrams

before the drug dose can be calculated.

Standard - grain 1 = 60 mg
A=DxV A = 60mg x 1 tablet
H 30mg
A = 2 tablets
METHOD – RATIO & PROPORTION
(RP)
 Ratio – mathematical expression comparing two
numbers by division 7/15 or 7:15

 Proportion – statement that two ratios are equal e.g. ½ =

5/10

Example: 1:2::5:10 is read “one is to two as five

is to ten.”
METHOD 2 – RATIO & PROPORTION (RP)
 Oldest method currently used in calculating drug
dosages.

 Formula H – drug on hand

H : V :: D : X V – vehicle or drug form

D – desired dose
MEANS
X – unknown amount
EXTREMES
:: - “as” or “equal to”
METHOD 2 – RATIO & PROPORTION (RP)

Rule: In a proportion the product of

the means is equal to the product
of the extremes.

Example: 2 : 3 :: X : 6 = 2 : 3 :: 4 : 6
3X = 12 =12

3 3 =12

X=4
METHOD 2 – RATIO & PROPORTION (RP)
Step 1 – Multiply the means and the extremes
H: V :: D : X
2 : 3 :: 4 : X

Step 2 – Set their products equal (2X = 12)

Step 3 – Divide both sides by the number left of X

2X = 12 = 6
2 2
METHOD 2 – RATIO & PROPORTION (RP)
 Example 1
Ordered: Amoxicillin (Amoxil) 100mg PO q.i.d.
Available: Amoxicillin (Amoxil) 250mg/5mL

H : V :: D : X
250mg : 5mL :: 100mg : X
250X = 500
250X = 500 = 2 mL
250 250
METHOD 3 – FRACTIONAL EQUATION (FE)
 Similar to ratio and proportion (RP)
 Unlike RP it is written as a fraction

 Formula
H = D = dosage on hand = desired dosage
V X vehicle unknown
METHOD 3 – FRACTIONAL EQUATION (FE)
 Example 1
Ordered: Ciprofloxacin (Cipro) 500mg PO q12h
Available: Ciprofloxacin (Cipro) 250mg/tablet

H = D 250mg = 500mg
V X 1tab X tab

Cross multiply and solve for X.

250X = 500
X = 2 tablets of Cipro per dose
METHOD 4- BODY WEIGHT (BW)
 Allows for the individualization of the drug dose.

Steps:
Convert pounds to kilograms if necessary
Multiply drug dose by body weight to get client’s
dose per day
Follow the BF, RP or DA method to calculate the
drug dosage.
METHOD 4- BODY WEIGHT (BW)
 Example 1
Ordered: Fluorouracil (5-FU), 12mg/kg/day IV, not to exceed
800mg/day. The adult weighs 132 Lb.

1. Convert pounds to kilograms by dividing by 2.2 (1kg = 2.2 Lb)

132 Lb / 2.2 = 60kg

2. Mg x Kg = client’s dose
(12 x 60 = 720 mg IV/day)
 METHOD 4- BODY WEIGHT (BW)
 Example 2
Ordered: Cefaclor (Ceclor) 20mg/kg/day in 3 divided
doses. The child weighs 31 Lb
Available: Cefaclor (Ceclor) 125mg/5mL

31 Lb / 2.2 = 14kg
20mg x 14kg = 280mg /day
280mg / 3 divided doses = 93mg /dose
 METHOD 4 – BODY WEIGHT (BW)

A=DxV A = 93mg x 5 ml = 465 = 3.7 ml

H 125mg 125

H : V :: D : X
125mg : 5ml :: 93mg : Xml
125X = 465
X = 3.7 ml
METHOD 4 – BODY WEIGHT (BW)
 Calculatethe dose of ceftriaxone in mLs for
meningitis for a 5-yr-old weighing 18 kg. The
dose required is 100 mg/kg/day given IV once
daily and the drug comes prediluted in a
concentration of 40 mg/mL.
METHOD 5 – BODY SURFACE AREA (BSA)
 Most accurate method to calculate drug dosage for
infants, children, older adults, and clients who are on
anti-neoplastic agents or whose BW is low.

 To calculate the drug dosage using the BSA method,

multiply the drug dosage ordered by the number of
square meters.
METHOD 5 – BODY SURFACE AREA (BSA)

BSA = height (inches) x weight (Lbs)

3131 (constant)
METHOD 5 – BODY SURFACE AREA (BSA)
 Example 1
Melphalon (Alkeran) 16mg/m2 q 2 wks
Client is 68 inches tall and weighs 172 Lb.

√ 68inches x 172 Lb = √ 11696 = √ 3.73 = 1.9m2

3131 3131

Therefore 16mg x 1.9m2 = 30.4mg q2wks or

30mg q2 wks
METHOD 5 – BODY SURFACE AREA (BSA)
 Example 2
Ordeded: cyclophosphamide (Cytoxan) 100mg/m2/day, IV
Available: Cytoxan 200mg IV. Client is 70 inches tall and
weighs 160 Lb.
METHOD 5 – BODY SURFACE AREA
(BSA)
 Example 2. Calculate the dose of vincristine in
mLs for a 4-yr-old with leukemia weighing 37 lb
and is 97 cm tall. The dose required is 2
mg/m2 and the drug comes in 1 mg/mL
concentration.
Order: 15 mg BD x 3/7

What amount should

be given per dose
Order: 2.5mg PO BID X 5/7
How much should be given
in one dose?
 The physician orders Ampicillin 1g P.O q.i.d.
The capsules on hand are labelled Ampicillin
250mg. How many capsules should be
administered for one dose?
 Insulin 8 units S/C is ordered. Available is 10mls
dose vial labeled 100units/ml. How many mls
should be administered?
 MD writes an order for Demerol oral suspension
50 mg by mouth every 6 hours for pain.
Pharmacy dispenses you with 25 mg/ 2 ml. How
many teaspoons will you give per dose?
 The Physician writes an order for Cipro oral
suspension 250 mg every 12 hours for 3 day for
a UTI. Pharmacy dispenses you with 5 gram/100
ml. How many tsp will you administer per dose?
 A doctor orders 200 mg of Rocephin to be taken
by a 15.4 lb infant every 8 hours. The
medication label shows that 75-150 mg/kg per
day is the appropriate dosage range. Is this
doctor's order within the desired range?
INTRODUCTION TO PAEDIATRIC AND
IV CALCULATIONS
PEDIATRIC DOSAGE CALCULATIONS
• Young’s Rule = Age in years x Adult Dose
Age + 12

• Fried’s Rule = Age in month x Adult Dose

150

• Clark’s Rule = Weight in lb x Adult Dose

150
PEDIATRIC DOSAGE CALCULATIONS

Pediatric Dose from Adult Dose

Pediatric Dose = Surface Area (m2) x Adult Dose

1.73m2
 DRIP RATES
 Microdrip – 60 drops (gtt) per ml

Standard IV Set – 15 drops (gtt) per ml

(May range between 10 – 20 gtt/ml depending on the manufacturer)

 Blood Administration Set – 10 drops (gtt) per ml

CALCULATING INTRAVENOUS FLOW
RATES

METHOD 1 : ONE-STEP METHOD

Gtt/min = Amount to be infused x gtt factor

Time (minutes)
CALCULATING INTRAVENOUS FLOW
RATES
METHOD 2 : TWO-STEP METHOD
Ml/Hr = Amount to be infused
Time to administer (hrs)

Gtt/min = Milliliters/Hr x gtt factor

60 minutes

If the milliliters per hour (ml/Hr) is known use step 2 to

determine the drops (gtt) per minute
CALCULATING INTRAVENOUS FLOW
RATES
METHOD 3 : THREE-STEP METHOD
Ml/Hr = Amount to be infused
Time to administer (hrs)

Ml/min = Milliliters per hour

60 minutes

Gtt/min = Milliliters/min x gtt factor

 ABBREVIATIONS OF SOLUTIONS
 5% Dextrose in Water - D5W, 5%DW
 10% Dextrose in Water - D10W, 10%DW
 0.9% Sodium chloride- 0.9% NaCl, N/S
 0.45% Sodium Chloride - 0.45% NaCl, 1/2NS
 5%Dextrose in

0.9% Sodium Chloride - D5NS

 Lactated Ringers - L/R
REFERENCES
 Batastini, P., & Davidson, J. (1985). Pharmacological Calculations for
Nurses: A worktext. USA: John Wiley & Sons Incorporated.

 Kee, J., Hayes, E., McCuistion, L. (2006). Pharmacology: A nursing process

approach 5th(Ed.). Missouri: Elsevier.