The Aga Khan University Hospital

Department of Nursing Education Services

SELF INSTRUCTIONAL PACKAGE

Drug-dosage calculation
INTRODUCTION:
Welcome to the self-instructional package of Medication Certification and Recertification. This
package will help you prepare correct dosage solution/s and administer medicines with accuracy
and ensure safety of patients.
This package consists of:
1. Basic rules for different calculations
2. Dosage calculations of drugs / solutions.
3. Rate of IV administration.
4. IV infusion with specific concentration.
All the above mentioned components have examples and few practice exercise.
______________________________________________________________________________
INSTRUCTIONS:
 You are allowed to work with this package on your own or with an Instructor/ Facilitator.
Practice exercises will assist you to appear in Medication Certification/ Recertification
exam.
 If you complete the certification/ recertification exam with 100% accuracy then only you
will be eligible to administer medications to patients on units.
 If you have some difficulties in securing 100% in certification course then your instructor
will give you more practice and individual tutorials to appear in Retake Exam during
orientation programme, which will be mutually agreed between you and your Instructor.
 If you have some difficulties in securing 100% in recertification course then Clinical Nurse
Instructor (CNI) of your unit will give you more practice and individual tutorials to appear
in Retake Exam, which will be mutually agreed between you and your CNI.
 Please do refer books and seek guidance from Clinical Nurse Instructor on nursing units for
further queries.

Good Luck

I. BASIC RULES / TERMINOLOGIES:

1. Whole number: A number without fractions, example: 5, 17, 438, 10592

2. Decimals:
a) Decimal  Generally used to mean a number which includes a decimal point
example: 6.35, 0.748, 0.002, 236.5
b) Decimal places  Numbers to the right of decimal point. example:
236.5 has 1 decimal place
6.35 has 2 decimal places
0.748 has 3 decimal places
0.0025 has 4 decimal places

3. Multiplication by 10, 100 & 1000

To multiply by Move the decimal point
10 1 place right
100 2 places right
1000 3 places right
For multiplication:
(a) Use zeros to make up places, where necessary.
(b) If the answer is a whole number, the decimal point may be omitted.

Example: (i) 0.36 x 10 = 3. 6 = 3.6 / 0.36  3.6

(ii) 0.36 x 100 = 36. = 36 / 0.36  36

(iii) 0.36 x 1000 = 360. = 360 / 0.36  360

4. Division by 10, 100, and 1000

To divide by Move the decimal point
10 1 place left
100 2 places left
1000 3 places left
For division:
(a) Use zero to make up places, where necessary.
(b) Write a zero before the decimal point (for numbers less than one)

Example: (i) 37.8 / 10 = 3 .7 8 = 3.78 / 37.8  3.78

(ii) 37.8 / 100 = 0. 37 8 = 0.378 / 37.8  0.378

(iii) 37.8 / 1000 = 0. 037 8 = 0.0378 / 37.8  0.0378

 5. Percentages: Number of parts per hundred parts. A percentage may be less than 1%.
Example: 14% means 14 parts per 100 parts.
2.5% means 2.5 parts per 100 parts.

6. Converting metric units:

1 gram (g) = 1000 milligrams (mg)
1 milligram (mg) = 1000 micrograms (μg)
1 liter (L) = 1000 Milliliters (ml)
1 kilogram (kg) = 1000 grams (g)
1 milligram (mg) = 1 cubic centimeter (cc)

7. Rounding-off decimal numbers:

* Method: If the second decimal place is 5 or more, then add 1 to the first decimal place
as it is.
(i) Rounding-off to one decimal place:
Example:
 0.62 = 0.6
 1.75 = 1.8
 3.49 = 3.5
 9.6 = 10

(ii) Rounding-off to two decimal places:

If the third decimal place is five or more then add one to the second decimal place. If the
third decimal place is less than 5 then leave the second decimal place as it is.
Example:
 0.827 = 0.83
 2.145 = 2.15
 0.694 = 0.69
 2.398 = 2.4

(iii) Round off to three decimal places:

If the fourth decimal place is 5 or more then add one to the third decimal place. If the
fourth decimal place is less than 5 then leave the third decimal place as it is:
 0.7854 = 0.785
 0.9705 = 0.971
 1.5968 = 1.597
 1.9999 = 2

8. Dosage calculations should be done in same units.

II. DOSAGE CALCULATION:
The drug may be available in the form of a tablet, powder, granules, capsules, liquid or solution
to be administered. Principles applied in calculating the ordered dosage is same, regardless of the
route of administration and the form it is applied.
A. Correct dosage can be figured out by the use of:
FORMULA:
Desired Dose x Volume (or) Quantity  DD x V/Q
Dose Available DA

Volume is for mls/ cc and Quantity is for tablets/ capsules.

DD and DA must be in same units.

Example: DD = 250mg
DA 125mg

Note: Answer should be in the unit of Quantity or Volume i.e., if ml is given then answer will
be in ml. If tablet is given then answer will be in tablet.

Example (how to put formula in Doctor’s order):

Physician ordered Injection Morphin Sulphate 6mg I/V stat. “Available is 15 mg/ ml, how many
ml/s will you give?
DATA
DD = 06mg
DA = 15mg
V = 01ml
FORMULA
Dosage = DD x V
DA
CALCULATION
= 06 x 01
15
ANSWER = 0.4 ml

PRACTICE EXERCISE # 1:
Medication order states: “Diclofenac Sodium 50mg q8hrly I/M.” Available is 75mg/ 3 ml. How
many ml/s will you administer?
B. If physician orders a dose according to weight then use:

FORMULA:
DD x V x Weight
DA
Example:
Physician ordered for Inj. Lasix 1mg/ kg stat. Patient’s wt is 60kg. Available ampule is 40mg /
2ml.
DATA
DD = 1mg / kg
DA = 40mg
Wt = 60kg
V = 2ml
FORMULA
Dosage = DD x V x wt.
DA
CALCULATION
= 1 x 2 x 60
40
ANSWER = 3ml

PRACTICE EXERCISE # 2 A:
Medication order read: “Give syrup largactil 1.5mg/ kg/ day/ po every 6 hrly”. Available is
50mg/ 2 ml. Child’s weight is 9.5kg Calculate the ml/s patient will receive.

PRACTICE EXERCISE # 2 B:
Medication order states “Give syrup Digoxin 5mcg/ kg Po, stat.” Available is 50 mcg/ ml/s,
patient’s weight is 9 kg. How many ml/s will you give?
III. RATE OF ADMINISTRATION OF I.V FLUIDS:

D.F stands for Drop factor or Set Calibration, that is, drops in one ml of desired set.
 Regular set/ macro chamber = 15 gtt/ml
 Paediatric/ Burretol/ micro chamber = 60 gtt/ml
 Blood = 10 gtt/ml

There are two steps in calculating I.V or Medicated I.V flow rates.

STEP # 01:
Calculate cc/ hr, that is, amount of fluid to be infused over one hour

FORMULA:
Total amount of fluid OR Total Volume
Total Hours Total Hours
Example:
Physician ordered 1000cc 5% D/W to be infused over 12 hours.

Total Volume = 1000cc = 83.33 = 83 cc/ hour

Total hours 12 hours

ANSWER = Patient will get 83cc 5% DW in one hour.

STEP # 02:
Calculate flow rate, i.e., such a drop rate that 83cc is infused over one hour, use:

FORMULAE:

1. Total Volume x D/ F = cc/ hr x D.F

Time in Minutes 60 min

OR

2. Total amount x D.F = T.Vol. x DF

Total hours x 60 Total time x 60

Example:
Calculate rate of 83cc/ hr using regular set.

FORMULA # 01:

Total Volume x D/ F = 83 x 15 = 20.75 = 21

Time in Minutes 60

ANSWER = 21 drops/ minute (round off drops to whole number)

FORMULA # 02:
We can use another formula by using only one step if we are calculating drops/ minute only.

Example:
Calculate 1000cc D/ W in 12 hours.
Total amount x D.F = 1000 x 15
Total hours x 60 12 x 60
= 1000 x 15 = 125 = 20.83
12 x 60 6

ANSWER = 21 drops/min

PRACTICE EXERCISE # 3A:

Give Aminophyline250mg in 500cc of DW in 10 hrs. Calculate cc/ hr and flow rate.

STEP # 03:
Give 1800 units of heparin in 500cc N/S to run over 8 hours.
(a) How many ml/hr will be infused?
Total volume = 500cc
Total hours 8 hrs
ANSWER = 62.5 cc/hour

(b) How many drops/ minute would you give using micro chamber? (60gtts/ ml)
DD x DF = 62.5 x 60 = 62.5 gtts/min
Time in minutes 1 x 60
ANSWER = 63 drops/ min

(c) How many unit of Heparin will the patient get in each hour?
1800 units is going in 8 hours
x units will go in I hour Cross Multiplication

Unit/ hr =
1 x 1800
8
ANSWER = 225 units/ hour

PRACTICE EXERCISE # 3 B:
Give Heparin 1500 units in 500 N/S over 5hours. Calculate cc/hr, units/hr and flow rate using
micro chamber.
1V. CONCENTRATION:

Note: Concentration indicates the strength of drug (mg/ mcg) in 1 cc. It should be in a unit same
as the unit of dose ordered. If ordered dose is in mg, concentration should also be in mg. If it is
in mcg then concentration should be in mcg. To change mg into mcg we use normal value:

FORMULA:
Desired Dose x Drop Factor = DD x 60
Concentration conc.

OR

Desired Dose x Drop Factor x Weight = DD x 60 x wt.

Concentration conc.

Example:
1. Physician ordered Dopamine infusion at the rate of 10 mcg/ kg/ minute. Patient’s wt is 60 kg.
Dilution is made by adding 5 ml of dopamine (200 mg) in 95 ml of D/ W and N/S.

a) How many mcg of Dopamine in 1 ml of above dilution

CONCENTRATION:-
Step 1: 200mg ----------- 100cc
x mg ----------- 1cc .

x = 1 x 200
100
= 1 x 200 = 2 mg
100
Concentration = 2 mg

Step 2: 2 mg x 1000  2000 mcg

Concentration = 2000mcg/ cc

b) How many drops / min will the patient receive? (D.F= 60 gtts/ml)

FORMULA:
Desired Dose x Drop Factor x Weight = DD x 60 x wt
Concentration conc.

10 x 60 x 60 = 18
2000

ANSWER = 18 drops / min

Example:
2. Order states, Administer Dobutamine infusion 20 mcg / kg / min. Patient’s weight is 10 kg.
Add 5 ml Dobutamine (250 mg) in 95 cc N/S.

a) What will be the concentration of dobutamine in 1ml of above dilution?

Step 1: 250 mg ---------100 cc
x mg. --------- 1 cc

x = 1 x 250 = 1 x 250 = 2.5 mg

100 = 100

Step 2: 2.5mg x 1000 = 2500 mcg.

Concentration = 2500 mcg/ cc

b) How many drops / min will be infused? (D/F 60gtts/ml)

FORMULA:
Desired Dose x Drop Factor x Weight = DD x 60 x wt
Concentration conc.

20 mcg x 60 x 10 = 24 = 4.8
2500 5

Answer = 5 drops / min

3) Give Lidocaine 4 mg/ min. Dilution strength is to be made by adding 10 ml of Lidocaine

(200mg) in 90 ml of N/S.

a) How many mcg of Lidocaine in 1 ml of above dilution.

Step 1: 200 mg ------- 100cc
x mg ------- 1cc

x = 1 x 200 = 200 = 2mg

100 100

Concentration = 2 mg/cc

b) What will be the flow rate? (D.F 60 gtts/ml)

Desired Dose x Drop Factor = DD x 60

Concentration conc.
= 4mg x 60 = 240 = 120
2mg 2

ANSWER = 120 drops/ min

PRACTICE EXERCISE # 4:
Medication order states: “Give GTN infusion at the rate of 10mcg/ min. The dilution is to be
made by adding 10ml of GTN (10mg) in 90ml of normal saline.
(a) What will be the concentration of GTN in 1cc solution?
(b) How many drops/ minute will the patient receive? (Use paediatric set)
 SELF TEST EXERCISES
PART 1:
a) Multiply
i. 0.68 X 10
ii. 0.975 X 100
iii. 3.7 X 1000
iv. 5.62 X 10
v. 77 X 100
vi. 825 X 1000
vii. 0.2 X 100
viii. 0.046 X 100
ix. 0.0147 X 1000
x. 0.006 X 10

b) Divide (Write answers in decimal form)

i. 68/10
ii. 2.29/100
iii. 51.4/1000
iv. 916/10
v. 67.2/100
vi. 387/1000
vii. 8.94/10
viii. 0.707/100
ix. 307/1000
x. 7.5/10

c) Change to milligrams
i. 4g
ii. 8.7 g
iii. 0.69 g
iv. 0.035 g
v. 4.28 g

d) Change to grams
i. 6000 mg
ii. 865 mg
iii. 12.5 mg
iv. 70 mg
v. 5 mg

e) Change into microgram

i. 0.195 mg
ii. 0.6 mg
iii. 75 mg
iv. 0.08 mg
v. 0.001 mg
f) Change into milligrams
i. 825 micrograms
ii. 65 micrograms
iii. 9.5 micrograms
iv. 5 micrograms
v. 20.8 micrograms

g) Change into milliliters

i. 30 L
ii. 1.5 L
iii. 1.67
iv. 0.8 L
v. 0.75 L

h) Change into Litres

i. 4000 ml
ii. 10000 ml
iii. 625 ml
iv. 95 ml
v. 5 ml

i) Write each number correct to one decimal place

i. 0.93
ii. 1.22
iii. 0.16
iv. 2.65
v. 8.02

j) Write each number correct to two decimal places

i. 0.333
ii. 1.667
iii. 0.875
iv. 0.833
v. 0.142

k) Write each number correct to three decimal places

i. 9.4863
ii. 1.5288
iii. 0.3113
iv. 2.8585
v. 0.1699
PART 2:
1. The recommended dose of Lasix is 2 mg/kg/day divided q8h. What is the recommended
single q8h dose for a 20 Kg child, when the available is 20mg/ml?
2. Order is to give Calcium Gluconate 400mg IV. Available is 1000mg/10ml. What will be
the dosage?
3. Give syrup Negram 450mg. Available is 250mcg/5ml. How many ml/s will you give?
4. Order is to give Salbutamol nebulizer 2.5 mg q4hrly. Available is 100mg/20ml. How
much dose will you give to patient?
5. Give Largectil 0.5gm/kg/day IV q 6 hrly. Patient weighs 39.5 Kg and available is
500mg/2ml. What dose will you give to patient?
6. Administer erythropoietin 75U/kg. Patient weighs 28 Kg. on hand you have
2000U/0.5ml. How much dose should the patient receive?
7. Administer Temgesic 100 mcg IM stat. If the available drug comes in strength of 0.3
mg/ml, what dose will the patient receive?
8. Order states: Give atropine 600mcg. You have Atropine 1mg/ml. How many ml/s will
you administer to patient?
9. Order states: Give morphine 0.5 mg/kg IV. Available is 15mg/ml and patient’s weight is
20kg. What will be the dosage?
10. Medication order states: Give injection Flagyl 800 mg IV q 8 hrly. Available is 500 mg/
100 ml. How many ml will you give in one dose?

PART 3:
1. The order is to give Mandol 1g q6h IVPB. Recommended dilution is 100cc of compatible
IV fluid. Recommended time of administration is 30 minutes. Using micro chamber,
determine the drops/min needed to give a 100 cc piggyback in 30 minutes.
2. The order is to give Aldomet 250 mg q6h IVPB. The medication is diluted in 100 cc of
5% dextrose. Using 60 drops/cc, Find the rate in drops/min needed to give the
Aldomet over 1 hour.
3. The physician has ordered Garamycin 80 mg q8h. The medication is dissolved in 150 ml
of normal saline. Using 15 drops/cc, find the rate in drops/min needed to give the
medication in 45 minutes.
4. The patient is to receive 100 mg of Vibramycin q12h IVPB dissolved in 500 cc of IV
fluid. The medication is to be infused over 3 hours. Determine the rate of IV in cc/h.
5. A patient is receiving heparin at a rate of 1500 units in 500 cc Normal Saline over 5
hours. Find the rate in cc/h, drops/minute (DF60gtts/ml) and units of
heparin/hour.
6. Give 2 pints packed cells (300 each) over 6 hours. Calculate ml/hr and flow rate (DF 
10 gtts/ml)
7. Dilution contains injection KCl 20meq in 500ml of N/S. Patients has to get 100ml/hr. How
much KCl and mls patient will receive in each hour?
8. Give ampicillin 1400mg q12 hrly. Available is 500mg/5 ml that is further diluted in 250cc
N/S to be given over 1.5 hours. Calculate ml/hr and drops/ min using regular chamber.
9. Order states: Transfuse 20 FFPs (150 each) over 1.5 hrs. Calculate cc/hrs and
drops/min.
10. 10. Give injection Heparin 25000U in 1000ml N/S in 10 hours. Calculate cc/hrs and
drops/min using macro chamber.
PART 4:
1. The order is to give Dobutrex (dobutamine) 250 mg in 250 cc of 5% dextrose at a rate of 6
μg/kg/min. The patient weighs 50 kg. Take out the concentration, and find the rate of
IV in drops/min using 60 gtts/cc.
2. The order is to give Dopamine at a rate of 7 μg/kg/min. The available drug is 200 mg
dissolved in 500 ml. The patient weighs 130 lb. What will be the concentration and
drops/ minute, using the burretol?
3. The order is for Intropin (dopamine) 13 ug/kg/min using 400 mg in 100 cc of normal
saline. The patient weighs 90 kg. Using 60 gtts/cc, find the concentration and gtts/min.
4. The patient is receiving Dopamine at a rate of 25 mg. The weight of the patient is 65 kg.
What will be the concentration of Dopamine (200) mg in 100 ml. Find the drops/
minute, the patient is receiving by using burretol set.
5. A 56 Kg patient is receiving Dobutrex (dobutramine) 4 μg/kg/min through a micro
chamber. The drug is diluted as 350mg in 100cc Normal Saline. Find the concentration
and gtts/min that the patient is receiving.
References:

Curren, M.A., & Munday, D.L. (1990). Math for meds: Dosage and solution. (6th ed.).Chicago;
W.B.Saunders Company.

Brown, M., & Joyce, L.M. (1992).Drug calculations process and problems for clinical
Practice. .(4th ed.).Toronto; Mosby.

Grace, H. (1995). Med.math: Dosage calculation, preparation and administration.

(3rded.). Philadelphia; J.B lippincoth Company.

Shanon, T.M,, & Wilson, A.B. (1997). Dosage calculation: A simplified approach.
(3rd ed.).USA; Applenton&lange Company.

Virginia,P.A. (1992). Programmed mathematics of drug and solutions. (5th ed).Philadelphia;

J.B.Lippincott.