Drug calculations

Felistas Chiundira
Child Health Nurse Specialist
 Introduction
• To administer medications safely, you need to have an understanding of
basic mathematics skills to calculate medication doses, mix solutions,
and perform a variety of other activities.
• This is important because medications are not always dispensed in the
unit of measure in which they are ordered.
• Pharmaceutical companies package medications in standard dosages.
• For example, the patient’s clinician can order 20 mg of a medication that
is available only in 40-mg vials.
 Introduction
• Nurses frequently convert available units of volume and weight
to desired doses.
• Therefore be aware of equivalents in all major measurement
systems. You should use equivalents when performing other
nursing actions such as when calculating patients’ intake and
output and IV flow rates.
 SYSTEMS OF MEDICATION
MEASUREMENT
• The proper administration of a medication depends on your
ability to understand medication doses accurately and measure
medications correctly.
• Mistakes in calculating or measuring medications correctly
often lead to fatal errors.
• As a nurse you are responsible for checking calculations
carefully before giving a medication.
 SYSTEMS OF MEDICATION MEASUREMENT
• Three systems of measurement are used in medication
therapy: metric, apothecary, and household
• The apothecary system is used infrequently nowadays
• The metric system is used in Malawi.
• Health care providers usually write prescriptions to be
self administered in household measures for patients.
 CONVERSIONS WITHIN ONE SYSTEM.
• Converting measurements within one system is relatively easy;
simply divide or multiply in the metric system.
• To change milligrams to grams, divide by1000, moving the
decimal 3 points to the left.
• 1000 mg = 1 g
• 350 mg = 0.35 g
 CONVERSIONS WITHIN ONE SYSTEM
• To convert liters to milliliters, multiply by 1000 or move the
decimal 3 points to the right.
• 1 L = 1000 mL
• 0.25 L = 250 mL
• Many actual and potential medication errors happen with the
use of fractions and decimal points.
• Follow practice standards when medications are ordered in
fractions to prevent medication errors .
• For example, to make the decimal point more visible, a leading zero is
always placed in front of a decimal (e.g., use 0.25 not .25).
• Never use a trailing zero (i.e., a zero after a decimal point) because, if a
health care worker does not see the decimal point, the patient may
receive 10 times more medication than that prescribed (e.g., use 5 not
5.0)
 CONVERSION BETWEEN
SYSTEMS
• Nurses frequently determine the proper dose of a medication by converting
weights or volumes from one system of measurement to another.
 DOSE CALCULATION
• Determine the required dose of medication using the following formula:
For pills or capsules:
• Dose ordered/required = Number of capsules or tablets to be given
Dose on stock
• For example: Prescription reads administer Paracetamol 1g orally stat. The available stock
is Paracetamol 500 mg per tablet. To calculate the number of tablets to give, the formula
would be:
• 1000mg = 2 tablets
500mg
 DOSE CALCULATION
• For liquid medication:
• Dose ordered/ required X volume per formulation = mls to give
Dose on stock
• For example: Prescription reads administer Amoxycillin syrup 250 mg orally stat. The
available formulation is 125mg per 5 mls. The formula would be:

• 250mg X 5mls = 10 mls

125 mg
 DOSE CALCULATION
• Example: The prescriber orders morphine sulfate 2 mg IV. The
medication is available in a vial containing 10 mg/mL.
• Estimate the answer
• Calculate
 PAEDIATRIC DOSES
• Calculating children’s medication doses requires caution. Even small
errors or discrepancies in medication amounts can negatively affect a
child’s health
• Most pediatric medications are ordered in milligrams per kilogram
(mg/kg). Therefore ensure that the patient’s weight is expressed in
kilograms