Intravenous Dosage Calculations

Dr. Feras Darwish El-Hajji

Part I: Basic Intravenous Therapy Calculations
 I.V Infusions
• I.V infusions are used more frequently today than
I.M injections
• Advantage: minimising multiple injections
(multiple penetrations)
• Intermittent medication therapy can be delivered
through a saline/heparin lock.
 I.V Infusions
• Intermittent medication therapy can be called:
saline lock, hep/heparin lock, intermittent IV
(INT), and intermittent peripheral infusion device
(IPD).
• Advantage: can be used for short-duration
therapy in acute care, long-term care, and home
care.
 I.V Infusions
• Clinical Alert:
• For patient safety, before medication is added to
an I.V solution, always verify compatibility with
the existing I.V solution.

• When the medication and solution are

incompatible, precipitation may result which
could harm the patient.
I.V Calculations

Check I.V orders

Two steps

1. Volume
2. Drop factor
To find out how
To calculate drops /
many milliliters /
min
hour (mL/hr)

Requirement:
Requirement:
infuse the I.V at
infuse the I.V for 24
specified rate (75
hours
mL/hr)
 I.V Calculations
• Rule 1: When the total volume is given 
calculate the mL/hr
Total Volume (TV)
= mL/hr
Total Time (TT) in hours

• Rule 2: When the mL/hr is given  calculate the

drops per minute

Drop Factor or (gtt/ml) (from I.V package)

X Total hourly volume (V/hr) = drops/min
in 1 minute
I.V Calculations

Dose

Concentration

Volume
I.V Calculations

Volume

Time

Infusion rate (ml/hr)

I.V Calculations

Rate

Drop
factor

Drop/min
 I.V Calculations
• Drop factor: number of drops in 1 mL

• Depends on the diameter of the needle where the

drop enters the drip chamber

• Differs from manufacturer to another

• Can be macrodrip (10 drops/ mL) ... To reach

microdrip (60 drops/mL)
 I.V Calculations
• Example 1: Ordered: 2000 mL D5W (dextrose
5% in water) to be infused for 24 hours. The
problem is to find out how many mL per hour the
patient must receive for the 2000 mL to be
infused in 24 hours.

TV 2000
= = 83 mL per hr
TT 24
 I.V Calculations
• Example 2: Ordered: D5W to infuse at 83 mL/hr.
The drop factor (Df) is 10.

Df 10 (Df)
X V/hr = X 83 (V/hr)
Time (min) 60 (min)

10
X 83 = 13.8 or 14 drops per min
60
 I.V Calculations
• Example 3: Ordered: Antibiotic to infuse at 100
mL in 30 minutes. The drop factor is 15.

Df 15 (Df)
X V/hr = X 100 mL
Time (min) 30 (min)

15
X 100 = 50 drops per min
30
 I.V Infusions
• Clinical Alert:
• Check the I.V every hour, even if
an infusion device is used.
Recheck drops per minute rate
frequently because the I.V rate can
vary with position.

• Time taping the I.V has become

importent.
 Common I.V Solutions
Abbreviation I.V solution
NS Normal saline; 0.9% sodium chloride
½ NS 0.45% saline or ½ strength sodium chloride
D5W or 5% D/W Dextrose 5% in water
D5RL Dextrose 5% in Ringer’s lactate solution
RL, LR, or RLS Ringer’s lactate solution, contains: NaCl,
sodium lactate, KCl, and CaCl2
D5NS Dextrose 5% in 0.9% normal saline
D5 and ½ NS (0.45% Dextrose 5% in ½ normal saline or 0.45%
NS) NaCl
 Common I.V Solutions

Tonicity of Solutes
Hypotonic Isotonic Hypertonic
(less than 250 mOsm/L0 (250-375 mOsm/L) (greater than 375
mOsm/L)
Fluid shif-out of Osmolarity equal to that Fluid is drawn into the
intravascular of serum intravascular
compartment, hydrating compartment from the
cells cells
0.45% saline 0.9% saline 5% dextrose and 0.9%
2.5% dextrose in water 5% dextrose in water NaCl
Lactated Ringer’s 5% dextrose and
solution lactated Ringer’s
solution
10% dextrose in water