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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
Convert the ordered dose and the stock strength to the same unit.
Use desired over have times quantity: (D/H) × Q.
For weight-based doses, multiply by the weight in kg first, then divide the daily dose by the number of doses.
Estimate first and check that the answer is reasonable.
IV infusion rates
Pump rate
mL/h = volume (mL)/time (h)
Drip rate
drops/min = volume (mL) × drop factor / time (min)
Infusion time
time (h) = volume (mL)/rate (mL/h)
Method
Pump rate in mL/h: volume divided by time in hours.
Drip rate in drops/min: volume × drop factor divided by time in minutes.
For time remaining: volume left divided by the rate.
Round as the question or the equipment requires.
Pediatric & critical-care dosing
Daily dose
mg/day = mg/kg/day × weight (kg)
Doses per day
number = 24 h / dosing interval (h)
Pounds to kilograms
kg = lb / 2.2
Infusion concentration
units/mL = units in bag / bag volume
Pump rate
mL/h = dose per hour / concentration
Titrated drip
mL/h = mcg/kg/min × kg × 60 / (mcg/mL)
Dose from pump rate
mcg/kg/min = mL/h × (mcg/mL) / (60 × kg)
Units
1 mg = 1000 mcg
2Practice problems
1.Pharmacy calculationsMedium
A solution has a ratio strength of 1:1000. You need 0.9 mg. Draw up the volume in the 1 mL syringe: what volume V is that?
1:10000.9 mg
V = mL
2.Pharmacy calculationsHard
A vial holds 2000 mg of powder. You add 3.2 mL of diluent, and the powder adds 0.8 mL of volume. The prescription is 1600 mg. Draw up the dose: what volume V do you give?
2000 mg3.2 mL + 0.8 mL1600 mg
V = mL
3.Dosage calculationsMedium
A patient weighs 60 kg and is prescribed 15 mg/kg as a single dose. Find the dose D in mg.
60 kg15 mg/kg
D = mg
4.Dosage calculationsHard
You must prepare 250 mL of a 2.5% (w/v) solution from a 20% (w/v) stock solution. What volume of stock V₁ do you need?
C₁ = 20%C₂ = 2.5%V₂ = 250 mL
V₁ = mL
5.IV infusion ratesMedium
A drip runs at 40 gtt/min through a set of 60 gtt/mL. How many millilitres V does the patient receive in 12 hours?
40 gtt/min60 gtt/mL12 h
V = mL
6.IV infusion ratesHard
A drip runs at 42 gtt/min through a set of 20 gtt/mL. There are 400 mL left in the bag. How many hours t until it is empty? Round to one decimal place.
42 gtt/min20 gtt/mL400 mL
t = h
7.Pediatric & critical-care dosingMedium
Practice exercise (made-up values, not clinical guidance). A practice protocol calls for a heparin bolus of 60 units/kg for a patient who weighs 95 kg. The vial contains 1 000 units/mL. What volume V do you draw up? Round to one decimal place.
60 units/kg95 kg1 000 units/mL
V = mL
8.Pediatric & critical-care dosingHard
Practice exercise (made-up values, not clinical guidance). A bag contains dobutamine 250 mg in 250 mL. The order is 2.5 mcg/kg/min for a patient who weighs 95 kg. At what rate R do you set the pump, in mL/h? Round to one decimal place.
250 mg/250 mL2.5 mcg/kg/min95 kg
R = mL/h
3Solutions
1.Pharmacy calculations
Answer: V = 0.9 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 = 0.9/1 = 0.9 mL
Answer
V = 0.9 mL
2.Pharmacy calculations
Answer: V = 3.2 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
3.2 + 0.8 = 4 mL
C = 2000/4 = 500 mg/mL
Volume
V = 1600/500 = 3.2 mL
Answer
V = 3.2 mL
3.Dosage calculations
Answer: D = 900 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.
Dose
15·60 = 900 mg
Answer
D = 900 mg
4.Dosage calculations
Answer: V₁ = 31.25 mL
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.
Volume of stock
V₁ = 2.5·250/20 = 31.25 mL
Answer
V₁ = 31.25 mL
5.IV infusion rates
Answer: V = 480 mL
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
Rate in mL/h
40·60/60 = 40 mL/h
Volume
V = 40·12 = 480 mL
Answer
V = 480 mL
6.IV infusion rates
Answer: t = 3.2 h
Infusion rates: a pump is set in mL/h = volume/time in hours. A gravity drip is counted in drops per minute: gtt/min = volume (mL) × drop factor (gtt/mL)/time (min). The drop factor is printed on the tubing package: macrodrip sets deliver 10, 15 or 20 gtt/mL (blood sets often 10 gtt/mL in the US, 15 in the UK) and microdrip sets 60 gtt/mL. Always use the drop factor the question or package gives.
Rate in mL/h
42·60/20 = 126 mL/h
Time left
t = 400/126 = 3.175 ≈ 3.2 h
Answer
t = 3.2 h
7.Pediatric & critical-care dosing
Answer: V = 5.7 mL
Heparin and insulin infusions: concentration = units in the bag/bag volume (units/mL). Pump rate (mL/h) = units per hour/concentration, and units per hour = mL/h × concentration. For a weight-based order, units/h = units/kg/h × weight first. A bolus volume = units needed/vial strength. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Units needed
60·95 = 5 700 units
Volume
V = 5700/1000 = 5.7 mL
Answer
V = 5.7 mL
8.Pediatric & critical-care dosing
Answer: R = 14.3 mL/h
Titrated drips: first find the concentration in mcg/mL (mg × 1000/mL). For a weight-based order, mcg/min = mcg/kg/min × weight. Then mL/h = mcg/min × 60/concentration. Working backwards, mcg/kg/min = mL/h × concentration/(60 × weight). The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Concentration
250 mg = 250 000 mcg
250 000/250 = 1000 mcg/mL
Dose per minute and per hour
2.5·95 = 237.5 mcg/min
237.5·60 = 14250 mcg/h
Pump rate
R = 14250/1000 = 14.25 ≈ 14.3 mL/h
Answer
R = 14.3 mL/h
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