Chapter 3 –

MEDICATIONS &
CALCULATIONS
SYSTEM OF
MEASUREMENT WITH
CONVERSION
 Metric System
• METRIC SYSTEM is a decimal system
based on the power of 10 (degree of
magnitude is always multiple of 10)
• Developed in the late eighteenth century;
• Is the internationally accepted system of
measurement
• The basic units of measure are:
 Gram (gm, G) for weight
 Liter (L) for volume
 Meter (m) for linear measurement or
length
Conversion within the Metric System

•Metric units most frequently used:

1g= 1000 mg
1L= 1000 ml
1mg= 1000 mcg
Metric Conversion
• When converting LARGER units to
SMALLER units in the metric system,
move the decimal point one space to the
RIGHT for each degree of magnitude
change
• Example: Change 1 gram to milligrams

1g=1.000mg or 1g=1000mg
 Metric Conversion
• When converting SMALLER units to
LARGER units, move the decimal point
one space to the LEFT for each degree
in magnitude
• Example: Change 1000 mg to 1gram

1000mg=1000.g or 1000mg=1g
NOTE:
 When changing LARGER units to smaller units, move
the decimal point to the RIGHT
 When changing smaller units to larger units, move the
decimal point to the LEFT
Practice Problem
 Larger to Smaller units
1. Change 2 g to mg ____
2. Change 0.5 g to mg ____
3. Change 2.5 L to ml ____
 Smaller to Larger Units ____
4. Change 1500 mg to g ____
5. Change 3 g to kg ____
6. Change 500 ml to L ____
Household System
• Is not as accurate as the metric
system because of the lack of
standardization of spoons, cups and
glasses
• Likely to be used by the patient at
home where hospital measuring
devices are not available
• Measurements are approximate
Household System
• Example:
 a teaspoon (t) is considered to
be equivalent to 5ml
 Three teaspoons equal 1
tablespoon (T)
 Milliliters (ml) is the same as
cubic centimeters (cc) in value
Household Equivalent in Fluid Volume

1 coffee cup (c) 6 ounces (oz)

1 medium size glass 8 ounces (oz)
1 ounce (oz) 2 tablespoons (T)
1 tablespoon (T) 3 teaspoons (t)
1 teaspoon (t) 60 drops (gtts)
 Household Conversion
• To change LARGER units to SMALLER
units, MULTIPLY the requested number
of units by the basic equivalent value
• To change SMALLER units to LARGER
units, DIVIDE the requested number of
units by the basic equivalent value
 Practice Problem
• Larger to Smaller Units
1. 3 oz to T ____
2. 5 T to t ____
3. Change 3 coffee cups to oz ____
• Smaller to Larger units ____
4. 3 T to oz ____
5. 16 oz to measuring cup ____
6. Change 12 t to T ____
METHODS FOR
CALCULATION
Methods for Calculation
 Four general methods for the
calculation of drug doses are:
Basic formula
Ratio and Proportion
Fractional equation
Dimensional analysis
Methods for Calculation
 These methods are used to calculate
oral and injectable drug doses
 Keep in mind that the goal is to
prepare and administer medications in
safe and correct manner
Methods for Calculation
 Before calculating drug doses, all units
of measure must be converted to a
single system
 If the drug ordered in grams (g,G) and
the drug label gives the dose in
milligrams (mg), the convert grams to
milligrams
Interpreting Oral and
Injectable Drug Labels
 Pharmaceutical companies usually
label their drugs with the brand name
of the drug in large letters and generic
name in small letters
 The dose per tablet, capsule or liquid
is printed on the drug label
Example no. 1
Example no. 2
Methods for Calculation
 The following recommendations are
offered:
Think
Read accurately
Picture the problem
Identify an expected range for the answer
Seek help when unsure of the calculation
Method 1: BASIC FORMULA
• The basic formula is easy to recall and is most
frequently used in calculating drug dosages
•Formula:
• D xV = A
H
• Where:
 D is the desired dose (desired dose
ordered by the physician)
 H is the on-hand dose (drug dose on label
of container)
 V is the vehicle (drug form in which the
drug comes)
 A is the amount calculated to be given to
the client
EXAMPLE no. 1

Order: cefaclor (Ceclor) 0.5 g PO bid

Example no. 2
 Order: Codeine 60 mg PO STAT
 Available:
Method 2:
RATIO & PROPORTION
• Is the oldest method currently used in the
calculation or drug dosages
• formula:
• H : V :: D : x
• Where:
 H is the drug on hand
 V is the vehicle or drug form
 D is the desired dose
 X is the unknown amount to give
• Note: Multiple the means and the extremes; solve
for x; x is the divisor
EXAMPLE no. 1
Order: amoxicillin (Amoxil) 100 mg PO q.i.d
Method 3:
FRACTIONAL EQUATION
• Similar to Ratio and Proportion except it is
written as a fraction
• Formula: H = D
V x
 H is the dosage in hand
 V for vehicle
 D desired dose
 X unknown

• Note: Cross multiply and solve for x

EXAMPLE
Order: ciprofloxacin (Cipro) 500 mgPOq12h
Method 4:
DIMENSIONAL ANALYSIS
• Is a calculation method known as
units and conversions
• Advantage: it decreases number of
steps required to calculate a drug
dosage
STEPS:
1. Identify the unit/form (tab., cap) of the drug to be
calculated then place equal sign
2. The known dose and unit/form from the drug label
follows the equal sign
e.g. Order: Amoxicillin 500mg, Available: 250/ capsule
capsule = 1 cap
250 mg
3. The mg (250 mg)is the denominator and it must
match the next numerator, which is 500mg (desired
dose)
capsule = 1 cap x 500 mg
250 mg x 1
4. Cancel out the mg, 250 and 500 mg. what remains is
the capsule and 2. answer 2 capsules
Example
Order: Amoxicillin 0.5g PO q8h
 Body Weight
 The body weight (BW) method of
calculation allows for the individualization
of the drug dose and involves the following
three steps
1. Convert to kilograms if necessary (lb /
2.2 = kg)
2. Determine the drug dose per BW by
multiplying as follows:
Drug dose x body weight = Client’s dose per day
3. Follow the basic formula
 Example no. 1
1. Order: Fluorouracil (5 –FU), 12 mg/kg/day
IV, not to exceed 800 mg/day, the adult
weighs 132 lbs
a. Convert pounds to kilograms by directing
the number of pounds by 2.2 (1 kg = 2.2 lbs)
o132/ 2.2 = 60 kg
b. mg x Kg = client’s dose
o12 x 60 = 720 mg IV/day
Answer: Fluorouracil 12mg/kg/day = 720mg
Example no. 2
 Order: cefaclor (Ceclor) 20 mg/kg/day in
three divided doses; the child weighs 31 lb
 Available:
Answer
a. Convert lbs to kg
31/2.2 = 14kg

b. 20 mg x 14g = 280/day
280 mg/3 divided doses = 93mg/dose

c. D x V = 93mg x 5 = 3.7ml
H 125mg
Practice Problems
Oral and Injectable dosage calculation
 Solve the problem and determine the
drug dose given the following:
1. Order: cimetidine (Tagamet) 0.4g PO, q6h
Available:

How many tablet (s) of Tagamet should the

patient receive? _____
Answer
a. Convert gm to mg by moving the decimal
point three spaces to the right.
0.4g = 400mg

b. D x V = 400mg x 1 tablet = 1 tablet

H 400mg
Practice Problems
Oral and Injectable dosage calculation
2. Order: doxycycline hyclate (Vibra Tab)
PO, initially 200 mg, then 50mg PO bid
Available:

a. How many tablets would you give as the initial

dose? _____
b. How many tablets would you give for each
dose after the initial dose? ____
Answer
a. Initially
D x V = 200mg x 1 = 2 tablets
H 100mg

b. Daily
D x V = 50mg x 1 = ½ tablet
H 100mg
Practice Problems
Oral and Injectable dosage calculation
3. Order: Azithromycin (Zithromax) 250
mg, PO, daily
Available:

How many ml should the patient receive

per day? ____
Answer
a. D x V = 250mg x 5ml = 6.25 ml
H 200mg
Practice Problems
Oral and Injectable dosage calculation
4. Order heparin 7500 units SQ
Available:

How many ml should the patient receive?

_____
Answer
a. D x V = 7500 units x 1ml = 0.75 ml
H 10,000 units
Practice Problems
Oral and Injectable dosage calculation
5. Order: atropine sulfate 0.5 mg subQ
Available:

How many ml should the patient receive?

_____
Answer
a. D x V = 0.5mg x 1ml = 1.25ml
H 0.4mg
Practice Problems
6. Order: oxacillin 250 mg IM q6h
Available: (Drug label states to add 2.7 ml
of sterile water = 3ml of drug solution)

How many ml should be given? ____

Answer
a. D x V = 250mg x 3ml = 1.5ml
H 500mg