PHARMACOLOGY

METRIC SYSTEM
The metric system is the most widely accepted and convenient system. The basic units of measurement
are the meter (linear). the liter (volume), and the gram (weight). The metric system is a decimal system, in
which each unit can be divided into multiples of 10 (10, 100, 1000). Calculations in the metric system often
involve moving the decimal point to the right or left.
In the preparation of medications, the nurse usually uses the following metric units: Weight 1 kilogram =
1,000 grams, 1 gram = 1,000 milligrams, 1 milligram = 1,000 micrograms. Volume 1 liter = 1,000 milliliters or
cubic centimeters. It may be necessary to convert drug dosages to a different unit in the metric system. To
convert a larger unit into a smaller unit, move the decimal point to the right (the new number is larger than the
original). To convert a smaller unit into a large unit, move the decimal point to the left (the new number is
smaller than the original).
Example 1: 0.5 g equals how many milligrams? Move the decimal point three places to right; the answer
is 500 mg. Example 2: 900 mg equals how many grams? move the decimal point three places to the left: the
answer is 0.9 g.
 DOSAGE

 Drugs are sometimes prepared and supplied in the amount

ordered by the physician, and the nurse can see when
checking the medication label that no calculation is necessary.
At other times, drugs are not prepared and supplied in the
exact quantities called for in the medication order, and the
nurse must do a dosage calculation to determine what
quantity of medication the patient is to receive.
 DOSAGE

 Several formulas can be used to calculate drug dosages. One such formula consists of ratios to set up a
proportion and can be used to calculate dosages for both solid and liquid preparations. A ratio shows
the relation between numbers. A proportion contains two ratios. The nurse is usually seeking the
quantity of on-hand medication that is equal to the desired dosage (the dosage ordered). The formula
is as follows:
Dose on hand dose desired
Quantity on hand X (quantity desired)
 The dosage must be in the same unit of measurement. This applies to the quantity as well. Dosages are
on the top line of the proportion, quantities on the bottom line. After the numbers are placed in the
proportion, the nurse cross-multiplies to find the desired quantity.
 DOSAGE

Another formula that can be used to calculate drug

dosages is as follows:
Dose desired
X quantity on hand = desired quantity
Dose on hand
This formula can be used for both liquid dosages and
fractions of tablets.
 EXAMPLE

Order: Acetaminophen 500 mg
On hand: Acetaminophen 250 mg in 5 mL
DOSAGE CALCULATIONS BASED ON BODY WEIGHT
Using the formula below, calculate the total required
dosage based on given the body weight.
Weight (kg) x Dosage = Y (Required
Ordered (per kg) Dosage)
Then use this formula:
Dose desired
X quantity on hand = desired quantity
Dose on hand
 EXAMPLE

Medrol 4 mg/kg is ordered for a child weighing

64.8 lb. Medrol is available as 500 mg/4mL.
How many milliliters of medication must the
nurse administer?
 CALCULATION OF INTRAVENOUS DRIP RATES

In these types of calculations, for a given volume, time period, and drop
factor (gtts/mL), the required IV flow rate in drops per minute (gtts/min) is
calculated.
 
Note: Since a fraction of a drop is not possible to give to a patient, it is
usual to round the answers to the nearest whole number.

Volume (mL)
x Drop Factor (gtts/mL) = Y (Flow Rate in gtts/min)
Time (min)
DROP FACTOR

Drop factor the number of drops it takes to make up one

ml of fluid.
Two common sizes are:
• 20 drops per ml (typically for clear fluids)
• 15 drops per ml (typically for thicker substances, such as
blood)
 EXAMPLE

Calculate the IV flow rate for 250 mL of 0.5%

dextrose to be administered over 180 minutes. The
infusion set has drop factor of 30 gtts/mL.
 ACTIVITY

Order: Digoxin 0.25 mg
On hand: Digoxin 0.125 mg tablets
 ACTIVITY

Order: Erythromycin 750 mg
On hand: Erythromycin 250 mg capsules
 ACTIVITY

A doctor prescribes 250 mg of Ceftin to be taken by a

20.5 lb infant every 8 hours. The medication label
indicates that 75-150 mg/kg per day is the desired dosage
range. Is this doctor's order within the desired range?
 ACTIVITY

The infusion set is adjusted for a drop factor of 15

gtts/mL. Calculate the IV flow rate if 1500 mL IV saline
is ordered to be infused over 12 hours.
 ACTIVITY

The total volume to be given is 500 ml. The time over

which this is to be given is 8 hours. The drop factor is 20.
How many drops per minute will be delivered?