Pharmacy Calculations

Justin Cornewell, PharmD

Objectives
1. Given a prescription or order: Calculate the correct quantity of medication to dispense, administer, or
compound
2. Calculate the concentration of an IV product
3. Calculate an IV rate in mL/hour
4. Calculate a drip rate in drops per min
5. Calculate mEq
6. Calculate number of grams in a solution given percentage strength
7. Calculate mEq given grams
8. Convert a percentage strength to parts per million (PPM)
9. Calculate ratio strength given a percentage strength
10. Convert a ratio strength to percentage strength
Pharmacy Calculation Tips
1. Double check all calculations
2. Attention to detail
3. Answer the question(s) asked
4. Read the question again after solving the problem
5. Round at the end
6. Most calculations on the NAPLEX will be case based
Objective 1
Prescription: Vicodin 5mg-325 mg

Take 1 tablet PO Q4-6H PRN pain for 2 days.

How many hydrocodone/acetaminophen 5 mg-325 mg tablets should be

dispensed?

A. 6 tablets
B. 8 tablets
C. 12 tablets
D. 18 tablets
E. 24 tablets
Objective 1
Prescription: Bactrim DS tablets

Take 2 tablets PO BID x 14 days

How many tablets should be dispensed?

A. 7 tablets
B. 14 tablets
C. 28 tablets
D. 56 tablets
E. 72 tablets
Objective 1
Order: cephalexin 300 mg PO x 1 dose

Product: Cephalexin 250 mg/5 mL

How many mL should be dispensed?

A. 4 mL
B. 5 mL
C. 6 mL
D. 7 mL
E. 10 mL
Objective 1
Prescription: cephalexin 300 mg PO Q6H x 10 days

Product: cephalexin 250 mg/5 mL 200 mL bottle

How many bulk bottles should be dispensed to the patient?

A. 1
B. 2
C. 3
D. 4
E. 5
Objective 1
Compound omeprazole 2 mg/mL suspension

Total volume 200 mL

How many 20 mg omeprazole capsules should be used?

A. 5
B. 10
C. 15
D. 20
E. 25
Objective 1
Compound the following

Hydrocortisone-eucerin cream 1:1

QS AD 100 g

How many grams of hydrocortisone cream should be added?

A. 50 g
B. 50 mg
C. 100 g
D. 100 mg
Objective 1
Compound the following:

Hydrocortisone-eucerin cream 1:1

QS AD 100 g

How many grams of eucerin cream should be added?

A. 50 g
B. 50 mg
C. 100 g
D. 100 mg
Objective 1
Order: Add 500 mg of sodium bicarbonate per L to each peritoneal dialysis bag.

Dialysis brings two, 5000 mL bags

How many mg of sodium bicarbonate should be added to

each bag?

A. 500 mg
B. 1000 mg
C. 1500 mg
D. 2000 mg
E. 2500 mg
Objective 1
Order: Add 500 mg of sodium bicarbonate per L to each peritoneal dialysis bag.

Dialysis brings two, 5000 mL bags

How many mL of sodium bicarbonate should be added to each bag, using a 50

mEq/50 mL vial (84 mg/mL)?

A. 30 mL
B. 29.8 mL
C. 19.8 mL
D. 12.5 mL
E. 50 mL
Objective 1
Order: Add 500 mg of sodium bicarbonate per L to each peritoneal dialysis bag.

Dialysis brings two, 5000 mL bags

How many mEq of sodium bicarbonate will be added to each bag, using a 50
mEq/50 mL vial (84 mg/mL)?

A. 30 mEq
B. 29.8 mEq
C. 19.8 mEq
D. 12.5 mEq
E. 50 mEq
Objective 2
Calculate the concentration in mCg/mL of norepinephrine 8 mg in 250 mL of NS?
Assume total volume equals 250 mL.

A. 0.032 mCg/mL
B. 0.32 mCg/mL
C. 3.2 mCg/mL
D. 32 mCg/mL
E. 320 mCg/mL
Objective 2
Calculate the concentration in mCg/mL of norepinephrine 32 mg in 250 mL of NS?
Assume total volume equals 250 mL.

A. 1.28 mCg/mL
B. 12.8 mCg/mL
C. 128 mCg/mL
D. 1280 mCg/mL
E. 32 mCg/mL
Objective 3
Calculate the IV rate in mL/hour for a patient weighing 75 kg for the following:

Norepinephrine 8 mcg/kg/min.

Product: norepinephrine 8 mg in 250 mL of NS

Do you see any problems with this order?

Objective 4
Patient: JW Age: 64 Weight: 220 pounds Height: 6’ 6”

Order: heparin 12 units/kg/hr (max dose 1000 units per hour)

Product: heparin in D5W 25000 units/ 250 mL

Problem: Calculate the drip rate (drops/min) assume 15 drops per mL. Round to
nearest whole number.
Objective 5
How many mEq of potassium chloride are present in a 12 mL dose of a 10% (w/v)
potassium chloride (M.W.=74.5). Round to 1 decimal place.

A. 16.1 mEq
B. 12.4 mEq
C. 13.1 mEq
D. 20 mEq
E. 40 mEq
Objective 6
How many grams of NaCl are in 1L of NS? Hint: NS=0.9% NaCl

A. 9g
B. 90 g
C. 900 g
D. 0.9 g
E. 99 g
Objective 7
How many mEq of Na are in 1L of NS? (MW of NaCl=58.4 g/mol)

A. 77 mEq
B. 154 mEq
C. 308 mEq
D. 616 mEq
E. 9 mEq
Objective 8
Express 0.00022% (w/v) as PPM. Round to nearest tenth

A. 22.2 ppm
B. 222 ppm
C. 2.2 ppm
D. 0.2 ppm
E. 1 ppm
Objective 9
Express 0.04% as a ratio strength
Objective 10
Express 1:4000 as a percentage strength
Compounding Problem 1
Calculate how many mL of epinephrine 1:1000 should be drawn up to make a 8
mg in NS 250 mL drip?

A. 4 mL
B. 8 mL
C. 16 mL
D. 0.8 mL
E. 0.4 mL
Compounding Problem 2
Calculate the final concentration in mg/mL of epinephrine 8 mg in 250 mL of NS

A. 0.016 mg/mL
B. 0.032 mg/mL
C. 0.16 mg/mL
D. 0.32 mg/mL
E. 0.08 mg/mL
Compounding Problem 3
How many 1 mL ampules of epinephrine 1:1000 should you obtain to compound
epinephrine 8 mg in NS 250 mL?

A. 4 ampules
B. 6 ampules
C. 8 ampules
D. 16 ampules
E. 32 ampules
Compounding Problem 4
Order: D12.5% 500 mL

Compound using D70% and SWFI

Hint: Alligation method

Compounding Problem 5
An order is received for phenytoin IV. A loading dose of 15 mg/kg is to be infused
at 0.5 mg/kg/min for a 33 pound child. The pharmacy has phenytoin IV solution 50
mg/mL in a 5 mL vial. The pharmacy will compound the IV in 50 mL of NS. Over
how many minutes should the dose be administered? Round to nearest whole
number.
Compounding Problem 6
A mouth rinse contains 1/12 % (w/v) of chlorhexidine gluconate. How many grams
of chlorhexidine gluconate should be added to prepare 18 liters of mouthwash?
Round to the nearest whole number.
Community Pharmacy Problem 1
How many HumalogⓇ U-100 KwikPens should be dispensed for a 30 day supply,
given the following prescription:

HumalogⓇ U-100 KwikPen 10 units subcutaneously before meals

HINT: Each pen is 300 units/3mL

A. 1 pen
B. 3 pens
C. 6 pens
D. 9 pens
E. 30 pens
Community Pharmacy Problem 2
A pharmacist receives a prescription for VigamoxⓇ 0.5%. Dispense 3 mL with the
directions of 1 gtt tid ou x 7 days.

How many drops per day will the patient use?

A. 3 drops
B. 6 drops
C. 9 drops
D. 12 drops
E. 15 drops
Community Pharmacy Problem 3
A pharmacist receives a prescription for VigamoxⓇ 0.5%. Dispense 3 mL with the
directions of 1 gtt tid ou x 7 days.

What is the correct days supply using 20 drops per mL?

A. 7 days
B. 10 days
C. 14 days
D. 21 days
E. 30 days
Community Pharmacy 4
A patient is using HumulinⓇ R U-500 insulin. They forgot their U-500 syringes at
home while on vacation. The local pharmacy only has U-100 syringes. If the
patient takes 100 units with meals, to which mark (on the U-100 syringe) would
you instruct the patient to draw the syringe up to?

A. 10 units
B. 20 units
C. 50 units
D. 80 units
E. 100 units
Community Pharmacy Problem 5
Prescription: TMP/SMX 40-200 mg/5 mL

1 tsp PO BID x 10 days until all taken

If the pharmacist dispensed 3 ounces, how many days of therapy will the patient
be short? Use 30 mL for 1 fluid ounce. Round to nearest whole number.

A. 10 mL
B. 90 mL
C. 1 day
D. 3 days
E. 9 days
Community Pharmacy Problem 6
Prescription. Amoxicillin 200 mg/5 mL suspension

Take 800 mg PO BID

Product: Amoxicillin 200 mg/5 mL suspension (TV=100 mL)

The pharmacist mistakenly adds too much water and discovers the total volume to
be 110 mL. The pharmacy has no other other bottles of amoxicillin. How many mL
should the patient take twice daily to receive the correct dose?