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
00.10.20.30.40.50.60.70.80.911 mL

A solution has a ratio strength of 1:1000. You need 0.85 mg. Draw up the volume in the 1 mL syringe: what volume V is that?

1:10000.85 mg
V = mL
2.Pharmacy calculationsHard
30%hydrogen peroxide+0%water? mL3%250 mL

Practice exercise (made-up values, not clinical guidance). You must prepare 250 mL of 3% hydrogen peroxide from a 30% stock and purified water. How many mL V of water do you need? Round to the nearest whole mL.

30%0%3%250 mL
V = mL
3.Dosage calculationsMedium
1%20 mLm = ? mg

How many milligrams of drug m are in 20 mL of a 1% (w/v) solution?

1% w/v20 mL
m = mg
4.Dosage calculationsHard
00.10.20.30.40.50.60.70.80.911 mL

The prescription is 790 units of a drug that comes as 1000 units/mL. Draw up the dose in the 1 mL syringe: what volume V do you give?

790 units1000 units/mL
V = mL
5.Clinical pharmacokineticsMedium
VCss​ = 2.5 mg/LR = ? mg/minCL = 700 mL/min

Practice exercise (made-up values, not clinical guidance). A patient has a lidocaine clearance of 700 mL/min. What infusion rate R in mg/min keeps the steady-state level at 2.5 mg/L?

CL = 700 mL/minCss = 2.5 mg/L
R = mg/min
6.Clinical pharmacokineticsHard
t (h)C (mg/L)Css​15 hC = ?

Practice exercise (made-up values, not clinical guidance). A theophylline infusion runs at 25 mg/h with no loading dose. The patient's clearance is 2.5 L/h and the half-life is 8 h. What is the level C after 15 h?

R = 25 mg/hCL = 2.5 L/ht½ = 8 ht = 15 h
C = mg/L

3Solutions

1.Pharmacy calculations

Answer: V = 0.85 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/1000 mL = 1 mg/mL

Volume

V = 0.85/1 = 0.85 mL

Answer

V = 0.85 mL
2.Pharmacy calculations

Answer: V = 225 mL

Alligation: to mix a higher strength H and a lower strength L into a target strength T, take (T − L) parts of H and (H − T) parts of L. The parts are crossed: each stock gets the distance from the target to the other stock. Water or a plain base counts as 0%. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.

Alligation parts

30%: 3 − 0 = 3 parts
0%: 30 − 3 = 27 parts
total: 30 parts

Water

V = 250·27/30 = 225 mL

Answer

V = 225 mL

Check: 25 mL of 30% contains 7.5 g of drug, which is 3% of 250 mL.

3.Dosage calculations

Answer: m = 200 mg

Solution strengths: a percentage strength is grams per 100 mL, so 1% = 1 g/100 mL = 10 mg/mL. A ratio strength 1:1000 means 1 g in 1000 mL = 1 mg/mL; 1:10 000 is 0.1 mg/mL. For a dilution the amount of drug stays the same: C₁·V₁ = C₂·V₂.

Concentration

1% = 1 g/100 mL = 10 mg/mL

Mass of drug

m = 10·20 = 200 mg

Answer

m = 200 mg
4.Dosage calculations

Answer: V = 0.79 mL

Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.

Volume

V = 790/1000 = 0.79 mL

On the syringe

On this 1 mL syringe every small line is 0.01 mL.

Answer

V = 0.79 mL
5.Clinical pharmacokinetics

Answer: R = 1.75 mg/min

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.

Clearance in L/min

700 mL/min = 0.7 L/min

Infusion rate

R = 0.7·2.5 = 1.75 mg/min

Answer

R = 1.75 mg/min
6.Clinical pharmacokinetics

Answer: C = 7.274 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 = 25/2.5 = 10 mg/L

Rate constant

k = 0.693/8 = 0.08664 h⁻¹

Level after the given time

C = 10·(1 − e−0.08664·15) = 7.274 mg/L

Answer

C = 7.274 mg/L

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