CALCULATING DOSAGE

Prepared by:

Korir Ronald(UoN BScN Student).

Learning objectives
By the end of the lesson the student will be able to:
1. Understand how to calculate drug dosages.
2. Understand the drug measuring systems.
3. Understand different formulas for calculating drug dosages.
 DRUG DOSAGE
• ‘Dose' is the appropriate amount of a drug needed to produce a certain
degree of response in a patient.
• Dose of a drug has to be qualified in terms of the chosen response, e.g.
the analgesic dose of aspirin for headache is 0.3-0.6 g, its anti platelet
dose is 60-150 mg/ day, while its anti inflammatory dose for rheumatoid
arthritis is 3-5 g per day.
• Q. identify the class of drugs in which aspirin belongs to, its MOA, uses
and side effects?
• There could be a prophylactic dose, a therapeutic dose or a toxic dose
of the same drug.
• The dose of a drug is govern by its potency( the
concentration at which it should be present at the target side)
and its pharmacokinetic characteristics.
 What is dosage calculation?
• Dosage calculation means figuring out the correct dose of a
medication.
• Many times the medication dose prescribed for the patient is
different from the way the medication is supplied.
• For example, an order may be written for the patient to
receive Amoxicillin 500mg, but the medication that comes
from pharmacy is Amoxicillin 250mg per tablet. How many
tablets should the patient take?
• But how about this order: Morphine 15mg injection and the
supplied medication is Morphine 1/2 grain per milliliter. With
this situation, you will need to convert the grain (gr) dosage
to milligrams (mg) and then calculate the correct dosage.
• You will also need to be familiar with the calibrations on
syringes in order to prepare this medication for
administration to the patient.
• The above examples point out some of the factors related to
dosage calculation which you will be learning in this tutorial.
These include:
 Abbreviations used in medication administration.
 Systems of measurement.
Basic mathematical calculations.
Formulas for computing drug dosages.
 DRUG MEASUREMENT SYSTEMS

1.METRIC SYSTEM
• It is a decimal system of weighing and measuring
medications.
• The basic units of metric measures are meter, liter, and gram .
• Meter measures length.
• Liter measures volume(liquids).
• Gram measures weight(solid).
• Common units of measurement in medication dosages are
grams(g), milligrams(mg), micrograms(mcg) and liters(l) and
milliliters(ml).
• Note the relationship between these units of measurement.
• A microgram is a very tiny unit of measurement. It is only
used to measure medicines that are powerful that only a
minute dose is required.
• Because medications are powerful, it is extremely important
that calculations are precise.
• Putting a decimal point in the wrong place could mean that
a patient receives ten times or even a thousand times more
medication than ordered.
• Liter and milliliter are used to measure liquid medication.
 2.The Apothecary System

• The apothecary system is an old measurement system which

is gradually being replaced with the metric system.
• Since some prescribers continue to order medications using
this system, it is necessary to understand and be able to
work with it.
• Grain(gr) is the most frequent unit and is used to measure
weight. Others are minim, dram and ounce which measures
volume.
1 grain = 64.8 milligrams ?
• Because a grain is a powerful unit, dosages of strong
medications are often written as fractions. Example:
Morphine 1/4 grain; Nitroglycerin 1/150 grain.
• It is necessary to think about relationships between the
apothecary and metric systems. Medications may be ordered
in the apothecary system, but supplied in the metric system.
 3.The Household System

• The household system is the least accurate form of

measurement and has generally been replaced with the
metric system.
• Since much patient care is now delivered in the home and
community, patients and families will be using this system.
• It is therefore necessary for nurses to have an understanding
of this system in order to provide care and patient education
in this setting.
• Common measurement units used in the household system
include teaspoon, tablespoon, and ounce. Metric equivalents
for the household measurement units are:
1 teaspoon (tsp) = 5 ml
1 tablespoon (Tbs) = 15 ml
1 ounce (oz) = 30 ml
1 ounce =….tsp?
 Other drug measurement system:

MILLIEQUIVALENT
• Abbreviated mEq.
• Is an expression of the number of grams of a medication contained in
1 ml of a normal solution.
• Example: potassium chloride 25 mEq to minimize GIT discomfort.
UNIT
• Abbreviated as U or u; measures a medication in terms of its action,
not its physical weight
• Examples : heparin sodium, insulin.
 CALCULATION FORMULAS

• There are several ways to calculate dosage.

• This tutorial presents three of the main formulas for dosage
calculation:
1.BASIC FORMULA
• This simple formula is often used and is easy to remember.
• This formula does not include the conversion of differing units
of measurement (example grains and milligrams) so those
conversions must be made before plugging numbers into the
formula.
 Components of the formula are:
D (desired dose): the dose ordered
H (on-hand dose; supplied dose): dose on label of
container .
V (vehicle): form and amount of supplied drug.

The basic formula is:

D × V = amount to give.
H
• Example.
The nurse is required to administer erythromycin 500mg po,
tds, the tablet is 250 mg. what is the amount of tablets the
nurse should give?
 2. Ratio- proportional formula.

• A ratio shows the relationship between numbers; a

proportion contains two ratios.
• You are usually calculating for the quantity of supplied
medication that is equal to the prescribed dosage.
• This formula does not include the conversion of differing
units of measurement, so conversion must be done before
plugging numbers into the formula.
Dose on hand = dose desired
Quantity on hand x( quantity desired)
 3. Dimensional Analysis Formula

• The dimensional analysis method calculates dosages using

three factors:
• 1. Drug label factor: the form of the drug dose (V ) and the
supplied units (H).
• 2. Conversion factor (C): measurement equivalents.
• 3. Drug order factor: the desired dose (D).
• These three factors are set up in an equation which allows
for cross multiplying to solve the problem.
V C(H) D
= amount to administer.
x x
H C(D) 1
• This formula incorporates the conversion of different units of
measurement and also includes the factors noted in the
basic formula. Because of this, many nurses prefer using this
formula.
• Example:
Supply: Erythromycin 250 mg per tablet.
Order: Erythromycin 0.5g orally every 8 hours.
QUESTION 1
Order : doxycycline 100mg po daily.
Supply: doxycycline 0.2 gm per tablet.
How many tablets should the patient receive?
QUESTION 2
Order: prednisolone 40mg po daily.
Supply: prednisolone 5 mg tablet.
 Calculations for Injectables

• Injectable dosages can be calculated using the same formulas.

• Medications for injection will be liquid, so your dosages will
be expressed in milliliters (ml).
Example:
You have an order for Demerol 35 mg IM every 4 hours prn for
pain. The medication is supplied as Demerol 50 mg/ml in a
pre-filled cartridge. How many milliliters will you give?
 ASSIGNMENT.
Read calculation of intravenous medications and drip rates.
QUESTIONS.
Use the three formulas to calculate each of
these questions.
1. Order: Synthroid 200 mcg po daily.
Supply: Synthroid 0.4 mg per tablet. How many tablets will you give?
2. Order: Zoloft 25 mg po twice daily.
Supply: Zoloft 50 mg tablets. How many tablets will you give?
3. A standing order indicates that administer erythromycin syrup 0.75g
po every 6hours. The supply from the pharmacy comes as 250mg/ml
syrup.(a) How many mls will you administer?
(b) you are instructing the patient to take this medicine at
home , how will you advice the patient to take this medicine?
4. Order: Digoxin 0.25 mg po daily.
Supply: Digoxin 0.5 mg tablet .how many tablets will you give?
5. Order: Aspirin 10 gr po every 4 hours prn. Supply: Aspirin 300 mg per
tablet. How many tablets will you administer?
6. Order: Acetominophen 10 gr po every 4 hours prn.
Supply: Acetominophen 300 mg tablets .
(a)How many tablets will you administer?
(b) How will you advice the patient to take this medication following
this drug order?
7. Order: Atropine 0.4 mg IM one hour pre-operatively.
Supply: Atropine 1/150 gr/ml.
How much dose of atropine will you administer?
8. Order: Phenergan 25 mg IM every 4 hours prn
Supply: Phenergan 50 mg/2 ml.
How much dose will you administer?
9. Order: Oxacillin 300 mg IM every 8 hours .
Supply: Oxacillin 2 Gm/5 ml.
How much dose will you administer?
10. Order: Heparin 7500 units sq every 12 hours.
Supply: Heparin 5000 units/ml.
How much insulin will you administer.?
11. Order: Vitamin B-12 30 mcg IM monthly.
Supply: Vitamin B-12 0.05 mg/ml. HOW much will you administer?