DRUG DOSAGE CALCULATIONS

TERMS
FLOW RATE: volume per unit time usually expressed as ml/hr. can be ml/min or
ml/sec
DRIP RATE: number of drops per unit time usually expressed as drops/min(dpm)
DOSE: amount of drug per unit time given to the patient expressed as mg/min,
g/hr or IU/min
CONCENTRATION: amount of the drug in a given volume usually expressed as
mg/ml, g/l or mIU/ml
DROP FACTOR: number of drops per unit volume. Expressed as drops/ml
TITRATION: adjustment of the IV medication dosage within prescribed
parameters to achieve a desired effects.
Measurement Systems
Three main types (Refer to your text book)
– Apothecary
– Household
– Metric
DRUG CALCULATION METHODS
Various methods are used for solving medication calculation. The most common
methods are:
 Formula,
 Proportion
 Dimensional Analysis
No one method is best for solving every type of problem. Several good approaches
are available, however and one of the best is dimensional analysis
Rule #1 in drug calculations – BETTER STICK TO ONE METHOD!
Routes of Drug administration
 IM– Intramuscular
 IO– Intraosseous
 IV– Intravenous
 IVP– Intravenous Push
 ID – Intradermal
 IN – Intranasal
 IP – Intraperitoneal
 IT – Intrathecal
 IVPB – Intravenous piggyback
 p.o – By mouth
 SC / SubQ – Subcutaneous
 SL – Sublingual
 top. – Topical
 vag. – Vaginally
Measurements
 Kg – Kilogram
 gm – gram
 mg – milligram
 mcg – microgram
 mEq - milliequivalent
 L – litre
 mL – millilitre
 µg – microgram
 gtt – drop
 µgtt – micro drop
 tbsp – tablespoon
 tsp – teaspoon
 mg/dL – milligrams per decilitre
BODY SURFACE AREA

Use either a Normogram chart to fine the Body Surface Area or

Body surface area (BSA) = √ 𝑤𝑒𝑖𝑔ℎ𝑡 (𝑘𝑔) ×ℎ𝑒𝑖𝑔ℎ𝑡(𝑐𝑚)
3600

Recommended Volume for Administration Per Sites:

Intradermal = 0.1 - 0.5 ml (allergy testing)
Subcutaneous injection = 0.5 - 1.0 ml per site
Intramuscular injection = 2.5 - 3.0 ml per site (1 ml in the deltoid)
IV injection (IV push) = 1 – 60 ml
CONVERSIONS
Solid Conversions Liquid Conversions
gr 1 = 60 mg 30 mL = 1 oz
gr 15 = 1 g 1 tsp = 5 mL
2.54 cm = 1 in 1 standard measuring cup
2.2 lb. = 1 kg = 240 mL
Mass
mcg ← mg ← g ← kg ( x by 1,000 )mcg → mg → g → kg ( ÷ by 1,000 )
lb ← kg ( x by 2.2 )
lb → kg ( ÷ by 2.2 )
Volume
mcL ← mL ← L ← kL ( x by 1,000 )
mcL → mL → L → kL ( ÷ by 1,000 )
Time
min ← hr ( x by 60 )
min → hr ( ÷ by 60 )
Temperature Conversions

Medication orders often use Centigrade temperature.

The relationship of Centigrade ᴼC and Fahrenheit ᴼF degrees is
To convert from Fahrenheit to Centigrade, use this formula:
°C = (°F − 32) ÷ 1.8
°C = (°F − 32) ÷ 9/5

To convert from Centigrade to Fahrenheit, use this formula:

°F = (°C × 1.8) + 32
°F = (°C × 9/5 ) + 32
Calculating Dosages of Tablets

In calculating tablet dosages, the following formula is useful

Number of tablets = 𝐷𝑒𝑠𝑖𝑟𝑒𝑑 𝑑𝑜𝑠𝑎𝑔𝑒
S𝑡𝑜𝑐𝑘 𝑠𝑡𝑟𝑒𝑛𝑔𝑡ℎ
Example:-
Orders 1,500 mg of calcium carbonate for the patient.The drug is available in 250
mg tablets. How many tablets should be given to the patient?
Number of tablets = 1500 𝑚𝑔
250 𝑚𝑔
= 6 tablets
Calculating Mixtures and Solutions

The following formula is useful in calculating Mixtures and Solutions:

Amount of solution to be given = 𝐷𝑒𝑠𝑖𝑟𝑒𝑑 𝑑𝑜𝑠𝑎𝑔𝑒
S𝑡𝑜𝑐𝑘 𝑠𝑡𝑟𝑒𝑛𝑔𝑡ℎ x Stock volume

The order is 375 mg of Inj.Cefuroxime for the patient. The drug is available
in 750 mg vial. You plan to dilute it in 10 mL of sterile water. How much should
you give to your patient?
Amount of solution to be given = 375 𝑚𝑔 x 10 ml
750 𝑚𝑔
= 0.5 mg x 10 ml
= 5 ml
Calculate IV Rate – mL per hour and minute

It is easy to calculate the running rate of IV fluids in terms of mL per hour or mL

per minute:
ML per hour or minute = Total IV Volume
Time (Hour or Minute)

Start venoclysis with D5 0.9 NaCl 1L to be infused for 16 hours. How many mL of
the IV fluid should you infuse per hour?
1L ÷ 16 hours = mL per hour
[1L x 1,000] = 62.5 mL per hour
16 hours
Calculate IV Rate – drops per minute
Calculating for drops per minute is simple with the following formula:
Drops Per Minute = Total IV Volume x Drop Factor
Time (Minute)
Example
The physician orders to start venoclysis with D5 0.3 NaCl 1L solution. The IV fluid
will be infused for 14 hours and the drop factor of the macro drip used is 20. It
should be regulated to how many drops per minute?
Drops Per Minute = [1 L x 1,000] x 20
[14 hours x 60]
= [1,000 mL ÷ 840 minutes] x 20 = drops per minute
= 1.19 x 20 = 23 to 24 drops per minute
Calculate IV Rate – Remaining Time of Infusion

Calculating for the remaining time of infusion for a certain IV fluid is possible with
the following formula:
Minutes Remaining = Volume remaining (in ml) x Drop Factor
Drops per minute
Example
A patient has 350 mL of Plain 0.9 NaCl solution as IV infusion regulated at 20
drops per minute. Drop factor 10 was used for the patient’s macro drip set.
Considering the IV fluid level of the patient, for how many minutes will it run?
Minutes Remaining = 350 mL x 10
20 Drops per minute
= 175 minutes or 3 hours
Paediatrics Drug Calculation
Calculation on Proportion to age
A. Young’s formula
D𝑜𝑠𝑒 f𝑜𝑟 𝑎 𝑐ℎ𝑖𝑙𝑑 = A𝑔𝑒 (𝑦𝑒𝑎𝑟𝑠) × A𝑑𝑢𝑙𝑡 𝑑𝑜𝑠𝑒
𝑎𝑔𝑒 + 12
The above formula is used for calculating the doses for children less than 12 years of age
(1-12 years)
B. Dilling’s formula
D𝑜𝑠𝑒 for 𝑎 𝑐ℎ𝑖𝑙𝑑 = A𝑔𝑒 (𝑦𝑒𝑎𝑟𝑠) × A𝑑𝑢𝑙𝑡 𝑑𝑜𝑠𝑒
20
The above formula is used for calculating the doses of a child in between 4 -20 years of
age
C. Fried’s formula
D𝑜𝑠𝑒 f𝑜𝑟 𝑎 𝑐ℎ𝑖𝑙𝑑 = A𝑔𝑒 𝑖𝑛 𝑚𝑜𝑛𝑡ℎ x Adult dose
150
1. Calculation based on body surface area
A. Catzel rule:
𝐷𝑜𝑠𝑒 f𝑜𝑟 𝑡ℎ𝑒 𝑐ℎ𝑖𝑙𝑑 = S𝑢𝑟f𝑎𝑐𝑒 𝑎𝑟𝑒𝑎 𝑜𝑓 𝑐ℎ𝑖𝑙𝑑 × A𝑑𝑢𝑙𝑡 𝑑𝑜𝑠𝑒
S𝑢𝑟f𝑎𝑐𝑒 𝑎𝑟𝑒𝑎 𝑜𝑓 𝑎𝑑𝑢𝑙𝑡
The average body surface area for an adult = 1.73 m2
Hence, 𝐷𝑜𝑠𝑒 f𝑜𝑟 𝑡ℎ𝑒 𝑐ℎ𝑖𝑙𝑑 = S𝑢𝑟f𝑎𝑐𝑒 𝑎𝑟𝑒𝑎 𝑜𝑓 𝑐ℎ𝑖𝑙𝑑 × A𝑑𝑢𝑙𝑡 𝑑𝑜𝑠𝑒
1.73𝑚2
1. Calculation based on body weight:
A. Clark’s rule
𝐷𝑜𝑠𝑒 = w𝑡 𝑖𝑛 𝑙𝑏 × A𝑑𝑢𝑙𝑡 𝑑𝑜𝑠𝑒(𝑚𝑔)
150 𝑙𝑏
𝐷𝑜𝑠𝑒 = 𝑤𝑡 𝑖𝑛 𝑘𝑔 × A𝑑𝑢𝑙𝑡 𝑑𝑜𝑠𝑒(𝑚𝑔)
70 𝑘𝑔
The rule is applicable only when child’s dose is less than 150 lb or 70 kg
FLUID THERAPY
In fluid therapy maintenance is calculated using 4, 2, 1 formula
(Holliday - Segar’s Formula): This was standard looking at maintenance daily fluid requirement of healthy
children
4ml/kg/hr. for first 10 kg,
2ml/kg/hr. for next 10 kg
1ml/kg/hr. for remaining kilogram weight
This can be simplified by using formula,
Maintenance fluid requirement (ml/hr) = {60+ (Weight kg-20)} ml/hr for weight ≥20 kg

Example: 65 kg women who is nil per Oral will require,

Fluid required = 60 + (65-20)
60+45
105ml/hr of intravenous infusion
Similarly, 70 kg who had fasted over (night) 8hrs for elective surgery will have deficit of,
Fluid deficit = 60 + (70-20)
= 60 +50 ml
= 110 ml/hr
References
 Finkel, R., Clark, M. A., Cubeddu, L. X., Harvey, R.A., & Champe, P. C. (2009).
Lippincott’s illustrated reviews : pharmacology. Lippincott Williams & Wilkins,
Cop.
 Rosenfeld, G. C., & Loose, D. S.(2014). Pharmacology. Lippincott Williams &
Wilkins.
 Clayton, B. D., & Willihnganz, M. J. (2017). Basic pharmacology for nurses.
Elsevier.

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