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Dosage Calculation PDF
Dosage Calculation PDF
CHAPTER
5
Dosage Calculations
L earning Objectives
After completing this chapter, you
should be able to:
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Sig Refresher
The sig portion of the prescription order, meaning signa, is where the instruc-
tions for the patient are written. Pharmacy technicians enter the information
from the prescription order into the computer. The sig is an important value
to remember in order to properly determine pediatric dosages. The following
are some of the more common sigs you will find on prescriptions:
qd = every day
qod = every other day
d = daily bid = twice a day
tid = three times a day
qid = four times a day
q4h = every 4 hr
q6h = every 6 hr
q8h = every 8 hr
q4–6h = every 4–6 hr
prn = as needed
Depending on the workplace, you may also see sigs such as the following:
Dosage Calculations
Dosage calculations include calculating the number of doses, dispensing
quantities, and ingredient quantities; these calculations are performed in the
pharmacy on a daily basis. The pharmacy technician must have a full work-
ing knowledge of how to perform these calculations.
To perform dosage calculations, you will utilize the information and
principles introduced in the previous chapters of this book. You can solve
these calculations by setting up ratios and proportions, keeping like units
consistent, and cross-multiplying.
EXAMPLE 5.1 How many 1-tsp doses are in a 4 oz bottle of Prozac® Liquid
Solution 20 mg/5 mL?
Rx Prozac® Solution
..
TT tsp. po qd
Disp. # 4 oz
The question is simply asking how many doses make up the total amount
being dispensed. The strength of the drug, frequency of dosage and quantity
of the stock bottle have no relevance in performing this calculation.
So now we know that we are working with 1 tsp. doses and a total quan-
tity of 4 oz, but to solve this calculation using a ratio/proportion we have to
have similar units of measure—in this case mL.
We know that 1 tsp = 5 mL and we should also know that 4 oz. = 120 mL,
but if you didn’t that could also be solved by using a ratio/proportion.
1 oz 4 oz
=
30 mL x mL
Cross-multiply and solve the equation for x.
30 * 4 = 120 and 1 * x = (1) x
(1)x = 120
Now that you have both quantities converted to units in mL, we can set
up our ratio/proportion and solve.
1 dose x doses
=
5 mL 120 mL
Cross-multiply
5 * x = 5x and 1 * 120 = 120
Workplace Wisdom Always use the higher dosage amount when perform-
ing dosage calculations on prescriptions that have a range for the dose, as in
Example 5.2. This will provide the most conservative solution and ensure
the most accurate potential for days supply.
Using the information provided, set up the ratio/proportion and solve.
1 dose x doses
=
2 tabs 120 tabs
Cross-multiply
2 * x = 2x and 1 * 120 = 120
Now set up your equation and solve for x.
2x = 120
To solve for x, divide both sides by 2.
2x 120
=
2 2
120 , 2 = 60
x = 60
So, there is a minimum of 60 doses prescribed.
Disp. # 90
2. How many droppersful (a 2.5 mL dosage) are in a 50 mL bottle of
EryPed® Drops? ________________
Disp. # 50
4. How many 1 tsp doses are in each bottle of Zithromax® 200 mg/5 mL as
listed below, when mixed? ________________
Using the information provided in the prescription, you can set up the
calculation as such:
1 2 10 x
dose frequency duration quantity to dispense
1 2 10 20
20 x
Let’s first look at all of the information provided to determine which will
be used in solving the problem:
..
✓ TT tbsp po—the dose
✘ prn—the frequency
✘ 4 oz—the quantity to dispense
✓ Codeine Phosphate Oral Solution 15 mg/mL—the drug name
and strength
✘ 500 mL—the quantity of the stock bottle
Let’s first look at all of the information provided to determine which will
be used in solving the problem:
✓ 400 mg—the dose
✘ 500 mL—the quantity to dispense
✓ Dopamine HCl Injection 80 mg/mL—the drug name and strength
To solve this problem, we must determine how many milliliters of the stock
Dopamine will need to be added to the normal saline IV solution bag.
We must set up a ratio/proportion.
80 mg 400 mg
=
1 mL x mL
Cross-multiply and then set up the equation to solve for x.
1 * 400 = 400 and 80 * x = 80x
400 = 80x
Now divide both sides by 80 to solve for x.
400 80x
=
80 80
x = 5
So, the answer is 5 mL of the stock Dopamine HCl Injection must be
added to the IV solution.
4. Rx—Xanax 0.25 mg
. ..
T -TT TID prn 14d
Pediatric Dosing
Pediatric patients, which include both infants and children, require spe-
cial dosing that is adjusted for their body weight. A number of formulas
have been used throughout the years to determine the best dose for pedi-
atric patients, but the most commonly used method is stated as mg/kg of
body weight.
Young’s Rule
Age of child in years
Child’s dosage = * Adult dosage
Age of child in years + 12
Clark’s Rule
Child’s weight in pounds
Child’s dosage = * Adult dosage
150
Using an age of 1.25 years and the information provided in Example 5.5,
set up the calculation, using Young’s Rule, as follows:
1.25 (Age in years)
Pediatric Dose = * 1000 mg (Adult Dose)
13.25 (Age of child + 12)
1.25
Pediatric Dose = * 1000
13.25
Pediatric Dose = 0.094 * 1000
Pediatric Dose = 94 mg
1 kg = 2.2 lb
Using the weight conversion formula, you divide the patient’s weight,
which in this case is 20, by 2.2 to convert the weight from pounds to kg.
20 , 2.2 = 9.09
So, the infant weighs 9.09 kg.
EXAMPLE 5.13 If a person weighs 180 lb., divide by 2.2 to find weight in
kilograms.
180
2.2 = 81.82 kg
Mg / Kg / Day
When the dose is stated in the manufacturer information as mg/kg/day, this
means we can calculate the patient’s weight in kilograms, multiply the rec-
ommended dose, and take into account the number of times per day the dose
is to be given. The goal is to determine how many milligrams can be given in
each dose.
Using the patient from Example 5.13, an order is given for a dose stated
as 20 mg/kg tid.
Based on his weight, the patient should receive 544 mg of drug per dose.
The patient used in the preceding example weighs 180 lb. and is probably
an adult. The same principles apply to calculating appropriate dosages for a
child based on body weight in kilograms.
SUMMARY
Dosage calculations are varied, and more than likely will be the pharmacy
calculations you perform most often. Dosage calculations include determin-
ing the number of doses, dispensing quantities, and ingredient quantities, for
both adult and pediatric patients.
CHAPTER
5
CHAPTER REVIEW QUESTIONS
MULTIPLE CHOICE 7. How many milligrams are in a 2-mL dose of
prochlorperazine injection 5 mg/mL given IM
1. How many 1-tsp doses are in 1 qt. of lactulose for severe nausea and vomiting?
solution, USP 10 g/15 mL?________________ ________________
a. 32 doses c. 128 doses a. 10 mg c. 2.5 mg
b. 64 doses d. 192 doses b. 5 mg d. 15 mg
2. How many milligrams of estradiol are delivered 8. How many milliliters of chloral hydrate syrup
over 72 hours by one 0.075 mg/day 500 mg/5 mL are required for a dose of
patch?________________ 100 mg?________________
a. 0.225 mg c. 8 mg a. 2.5 mL c. 2 mL
b. 1.6 mg d. 0.075 mg b. 5 mL d. 1 mL
3. You are asked to compound maldroxyl 60 mL, 9. The recommended pediatric dose for promet-
diphenhydramine elixir 60 mL, and viscous li- hazine is 0.25 mg/kg qid. What is the best
docaine 2%, qs to 200 mL. How much viscous dose for a 12-year-old male who weighs
lidocaine 2% will you need to prepare the 95 lb?________________
order?________________
a. 2.5 mg c. 12.5 mg
a. 60 mL c. 80 mL
b. 10 mg d. 15 mg
b. 4 mL d. 200 mL
10. How many total grams of active ingredient are
4. The recommended pediatric dose of ampicillin in five syringes of testosterone 4 g/100 g topical
is 25 mg/kg/day q8h. Your patient is a 4-week- gel containing 3 g of gel each? What is the
old infant who weighs 8.7 pounds. Which is the percent strength of the final product?
best dose for this patient? ________________ ________________
a. 15 mg c. 33 mg a. 15 g, 0.4% c. 2.4 g, 40%
b. 25 mg d. 45 mg b. 0.6 g, 4% d. 60 g, 0.04%
5. How many days will 4 oz. of clemastine fumer-
ate syrup 0.5 mg/5 mL last if the dose is 1/2 tsp
daily?________________ TRUE OR FALSE
a. 24 days c. 30 days 11. When solving dosage calculations, it is helpful
b. 48 days d. 60 days to look for the given. ________________
6. How many grams of drug are in 480 mL of a. true b. false
docusate sodium syrup 60 mg/15 mL? 12. When setting up ratios and proportions to solve
________________ dosage calculations, it is best to keep like units
a. 28.8 g c. 1920 g consistent. ________________
b. 1.92 g d. 2.88 g a. true b. false
13. The unknown, x, will always be located in the 17. Name three types of dosage forms.
upper left corner when setting up dosage ________________ ___________ ___________
calculations. ________________ 18. Which dose is larger, 4 mg/mL or 1 mL of 4%
a. true b. false gel? ________________
14. When choosing the answer in a multiple-choice 19. How many milligrams of drug are in 0.5 mL of
question, you should find the numerical answer a cream that is 4 mg/mL? ________________
regardless of units. ________________ 20. How many milliliters will be required to pro-
a. true b. false vide the necessary dose of albuterol oral syrup
15. You can solve most dosage calculations by 2 mg/5 mL to be given 0.2 mg/kg/day tid for a
cross-multiplying. ________________ patient who weighs 88 lb.? ________________
a. true b. false
SHORT ANSWER
16. Describe why proper dosing of medications is
important to ensure patient safety.
________________