Pharmacy Calculations: cram pack

Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.

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1Formulas and methods

Pharmacy calculations

Percentage strength
% w/v = g per 100 mL
Amount in a solution
g = % × mL / 100
Ratio strength
1:X = 1 g in X mL; % = 100 / X
Reconstitution
final volume = diluent + powder volume
Concentration
mg/mL = drug in vial / final volume
Alligation
parts of H = T − L, parts of L = H − T
Water or base
0%

Dosage calculations

Dose from strength
volume = dose / strength
Weight-based dose
dose = mg/kg × body weight
Tablets
number = dose / tablet strength
Units
1 g = 1000 mg, 1 mg = 1000 mcg

Method

  1. Convert the ordered dose and the stock strength to the same unit.
  2. Use desired over have times quantity: (D/H) × Q.
  3. For weight-based doses, multiply by the weight in kg first, then divide the daily dose by the number of doses.
  4. Estimate first and check that the answer is reasonable.

Clinical pharmacokinetics

Rate constant and half-life
k = ln 2/t½ = 0.693/t½
First-order decay
C = C₀·e−kt = C₀·(1/2)t/t½
Two levels
k = ln(C₁/C₂)/Δt
Volume and clearance
Vd = dose/C₀, CL = k·Vd
Loading dose
LD = Vd·C/(S·F)
Maintenance rate
R = CL·Css/(S·F)
Average steady state
Css,avg = S·F·D/(CL·τ)
Steady state
1 − (1/2)ⁿ after n half-lives; ≈ 97% after 5
Infusion
C = (R/CL)(1 − e−kt)
Interval and dose from peak and trough
τ = ln(Cpeak/Ctrough)/k, D = Vd·(Cpeak − Ctrough)
Cockcroft–Gault
CrCl = (140 − age) × kg/(72 × SCr mg/dL), × 0.85 for women
Renal adjustment
dose × CrCl/normal; Dettli Q = 1 − fe·(1 − CrCl/normal)

Method

  1. Convert the half-life to a rate constant: k = 0.693/t½.
  2. Turn per-kg values into totals: Vd (L) = L/kg × weight, CL (L/h) = L/kg/h × weight.
  3. Pick the relation: C = C₀·e−kt, LD = Vd·C/(S·F), maintenance rate = CL·Css/(S·F), τ = ln(Cpeak/Ctrough)/k.
  4. For kidney function, estimate CrCl with Cockcroft–Gault first, then scale the dose or the interval.
  5. Check the result: levels fall by half every half-life, and steady state takes about five half-lives.

2Practice problems

1.Pharmacy calculationsMedium
024681010 mL

A solution has a ratio strength of 1:10 000. You need 0.6 mg. Draw up the volume in the 10 mL syringe: what volume V is that?

1:10 0000.6 mg
V = mL
2.Pharmacy calculationsHard
0123455 mL

A vial holds 2000 mg of powder. You add 1.9 mL of diluent, and the powder adds 0.6 mL of volume. The prescription is 1280 mg. Draw up the dose: what volume V do you give?

2000 mg1.9 mL + 0.6 mL1280 mg
V = mL
3.Dosage calculationsMedium
30 kg30 mg/kg/day2× per dayD = ? mg

A patient weighs 30 kg. The prescribed dose is 30 mg/kg per day, given in 2 equal doses. How many milligrams D are given per dose?

30 kg30 mg/kg/day2× per day
D = mg
4.Dosage calculationsHard
250 mg/5 mLV = ? mL

A child weighing 28 kg is prescribed 12.5 mg/kg per dose of an oral suspension that contains 250 mg in 5 mL. What volume V do you give?

28 kg12.5 mg/kg250 mg/5 mL
V = mL
5.Clinical pharmacokineticsMedium
Vd = 0.7 L/kgC = 15 mg/LLD = ? mg63 kg · S = 0.92 · F = 1

Practice exercise (made-up values, not clinical guidance). A 63 kg patient is to be loaded intravenously with phenytoin sodium to reach a phenytoin level of 15 mg/L. The volume of distribution is 0.7 L/kg and the salt factor is S = 0.92. Find the loading dose LD of phenytoin sodium in mg.

63 kgVd = 0.7 L/kgC = 15 mg/LS = 0.92
LD = mg
6.Clinical pharmacokineticsHard
t (h)C (mg/L)Css​5 hC = ?

Practice exercise (made-up values, not clinical guidance). A theophylline infusion runs at 30 mg/h with no loading dose. The patient's clearance is 2.5 L/h and the half-life is 6 h. What is the level C after 5 h?

R = 30 mg/hCL = 2.5 L/ht½ = 6 ht = 5 h
C = mg/L

3Solutions

1.Pharmacy calculations

Answer: V = 6 mL

Strength to volume: turn the strength into mg per mL first. A w/v percentage is grams per 100 mL, so x% = 10x mg/mL. A ratio strength 1:n is 1 g in n mL. After reconstitution the concentration is the powder's dose over the final volume (diluent + powder volume). Then volume = dose/concentration.

Strength in mg/mL

1000 mg/10 000 mL = 0.1 mg/mL

Volume

V = 0.6/0.1 = 6 mL

Answer

V = 6 mL
2.Pharmacy calculations

Answer: V = 1.6 mL

Strength to volume: turn the strength into mg per mL first. A w/v percentage is grams per 100 mL, so x% = 10x mg/mL. A ratio strength 1:n is 1 g in n mL. After reconstitution the concentration is the powder's dose over the final volume (diluent + powder volume). Then volume = dose/concentration.

Final volume and concentration

1.9 + 0.6 = 2.5 mL
C = 2000/2.5 = 800 mg/mL

Volume

V = 1280/800 = 1.6 mL

Answer

V = 1.6 mL
3.Dosage calculations

Answer: D = 450 mg

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

Total per day

30·30 = 900 mg

Per dose

D = 900/2 = 450 mg

Answer

D = 450 mg
4.Dosage calculations

Answer: V = 7 mL

Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.

Dose from weight

12.5·28 = 350 mg

Volume

V = (350/250)·5 = 7 mL

Answer

V = 7 mL
5.Clinical pharmacokinetics

Answer: LD = 719 mg

Clearance and volume: at steady state the dosing rate equals the elimination rate, so the maintenance rate = CL × Css. A loading dose is LD = Vd × C/(S × F), with S the salt factor (fraction of active drug in the salt) and F the bioavailability (1 for IV). From two levels, k = ln(C₁/C₂)/Δt; for an IV bolus Vd = dose/C₀ and CL = k × Vd. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Volume of distribution

Vd = 0.7·63 = 44.1 L

Amount of active drug needed

Vd·C = 44.1·15 = 661.5 mg

Loading dose

LD = 661.5/(0.92·1) = 719 mg

Answer

LD = 719 mg

In practice the dose is rounded to a convenient amount.

6.Clinical pharmacokinetics

Answer: C = 5.265 mg/L

Designing a regimen: with rapid IV doses the level falls from peak to trough during the interval, so τ = ln(Cpeak/Ctrough)/k and the dose that restores the peak is Vd × (Cpeak − Ctrough). The average steady-state level is Css,avg = S·F·dose/(CL·τ). An infusion rises as C = (R/CL)(1 − e−kt). For a drug cleared by the kidneys, the dose is scaled with the creatinine clearance. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Steady-state level

Css = 30/2.5 = 12 mg/L

Rate constant

k = 0.693/6 = 0.1155 h⁻¹

Level after the given time

C = 12·(1 − e−0.1155·5) = 5.265 mg/L

Answer

C = 5.265 mg/L

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