Pharmaceutical Calculations

ProPharmace: Calculations Master Workbook

Registration Assessment Syllabus
Part II – Pharmaceutical Aspects of Practice
a) Calculations: You must be able to perform
accurately all types of calculations relating to
pharmacy practice

b) Dilutions: You must be able to demonstrate an

understanding of the correct procedures for the
dilution of solid, semi-solid and liquid dosage
forms, including selection of the correct diluent
 Unit Conversions
•  L / dl / ml
•  Kg / g / mg / mcg or µg /ng / pg
•  Km / m / cm / mm
•  Feet / inches
•  Pound / stone
TIPS:
•  Ensure all units are the same before
commencing a calculation
•  Ensure your answer has the correct units
 Unit Conversions Example 1

1.  What is 860,000g expressed in

micrograms?
What do we know?
•  We know that a quantity in grams
multiplied by 1000 = the same quantity in
milligrams
•  A quantity in milligrams multiplied by
1000 = the same quantity in micrograms
Therefore…
•  If we want to get from grams to
micrograms we need to multiply the
quantity by 1000 and by 1000 again
•  860,000g x 1000 = 860,000,000mg

•  860,000,000mg x1000 = 860,000,000,000 mcg

 Unit Conversions Example 2
2. What is 2.5ml expressed in litres?
What do we know?
•  We know that a volume in litres divided
by 1000 = the same volume in millilitres
Therefore…
•  2.5ml /1000 = 0.0025 litres
 Unit Conversions Example 3
3.Mr AF is 6’5’’ tall. What is his height in
metres? Round your answer to two
decimal points.
What do we know?
•  We know that 6’5’’ means 6 foot 5 inches
•  We know that 1 foot is equivalent to 12
inches and 1 inch is equivalent to 25.4mm
•  We know that to convert a length from
mm to m we need to divide by 1000
Therefore…
•  6 foot 5 inches = (6 x 12) + 5 = 77 inches
•  77 inches = 77 x 25.4mm = 1955.8mm
•  1955.8mm / 1000 = 1.9558m
•  Rounding to two decimal points = 1.96m
 Unit Conversions Example 4
4. Mrs AG has come to your pharmacy
requesting for Alli. In order to decide
whether to sell her Alli, you must establish
her Body Mass Index (BMI). She weighs 12
stones and has a height of 170 cm. What is
her BMI? Round your answer to two decimal
points.
BMI can be calculated using the following
formula: Weight (kg) / Height (m2 )
What do we know?
•  We know that 1 stone is equivalent to
6.35 kg
•  We know that to convert a length from
cm to m we need to divide by 100
Therefore…
•  12 stones = (12 x 6.35) = 76.2kg
•  170 cm / 100 = 1.7m
•  Using BMI = Weight (kg) / Height (m2)
= 76.2 / (1.7)2 = 76.2 / 2.89
= 26.36678
= 26. 37 (BMI between 25 and 29.9 – overweight)
 Prescription Quantities
•  Read the question carefully!
•  Write out the steps
–  per dose change
–  per day
–  per interval
then total them up
 Prescription Quantity Example
5. Mr BK presents you with the following prescription
for ciprofloxacin:
Rx: Ciloxan 0.3% ophthalmic solution, apply eye drops to left eye
throughout day and night according to the following regimen:
2 drops every 30 minutes for 6 hours, then hourly for the remainder
of day 1
2 drops every hour on days 2 and 3
2 drops every 2 hours on days 4 and 5
2 drops every 4 hours on days 6 to 14

How many 5ml bottles of Ciloxan 0.3% do you need to

supply? Assume 1ml = 20 drops
What do we know?
•  1ml is equivalent to 20 drops
•  Each bottle is 5ml
•  Frequency of dosing varies each day so
total quantity of opthalmic solution
applied to affected eye varies each day
•  24 hours in a day
Therefore…
•  2 drops every 30 minutes for 6 hours, then hourly for the
remainder of day 1
= 12 x 2 applications in 6 hours + 18 x 2 applications in 18
hours = 60 drops
•  2 drops every hour on days 2 and 3
= 24 x 2 applications in 24 hours + 24 x 2 applications in 24
hours = 96 drops
•  2 drops every 2 hours on days 4 and 5
= 12 x 2 applications in 24 hours + 12 x 2 applications in 24
hours = 48 drops
•  2 drops every 4 hours on days 6 to 14
= (6 x 2 applications in 24 hours ) x 9 days = 108 drops
Therefore…
•  60 + 96 + 48 + 108 = 312 drops
•  20 drops = 1 mL
312 drops = ?
= 15.6 mL
•  5mL = 1 bottle
15.6mL = ?
= 15.6 / 5
= 3.12
= 4 bottles
 Formulation Example
6. If the formula for Ferrous sulphate oral solution
is:

Ferrous sulphate
60mg
Ascorbic acid 10mg
Orange Syrup 0.5ml
Double strength chloroform water 2.5ml
Water for preparations to 5ml
What do we know?
•  We know that the formula is for a 5ml
preparation
•  We know that there is 10mg of ascorbic
acid per 5ml
•  We know that to convert a quantity in mg
to g we must divide by 1000
Therefore…
Using c1 x v1 = c2 x v2
10mg in 5ml
X in 160ml
•  X = 10 x 160 / 5
•  = 320mg
•  = 0.32g
 Parts
Be careful when considering formulae with the
word parts.

Example:
•  1 part with 4 parts = total 5 parts
•  1 part to 4 parts = total 4 parts
 Parts Example
7. This is the formula for a compounded
ointment:
Betamethasone ointment: 1 part
White soft paraffin (WSP): 4 parts

What is the quantity of WSP in 600g of the

above ointment?
 
What do we know?
•  We know that there is a total of 5 parts in
this formula
•  WSP makes up 4/5 of the formulation
•  The total quantity of ointment is 600g
Therefore…
Method 1:
•  Quantity per part = 600/5 = 120g
•  WSP makes up 4 parts therefore quantity in 600g
= 4 x 120 = 480g
Therefore…
Method 2:
•  Because the proportion of WSP in the
formulation is 4/5, the total quantity of WSP in
600g = 600x4/5
•  = 480g
 Percentage Concentrations
% w/v = percentage weight in volume
The weight, in grams of solid in 100ml of solution
%w/w = Percentage weight in weight
The weight in grams of a solid in 100g of product
% v/v = percentage volume in volume
The volume in mL of a liquid contained in 100ml of
product
 Percentage Concentrations
Example 1
8. What is 1 in 80,000 expressed as a percentage?
What do we know?
•  We know that 1 in 80,000 means 1unit in
80,000units
•  We know that a percentage is an amount
out of 100 i.e. 1 in 100 is 1%
There are 2 ways you can tackle this calculation.
Method 1:
c1 x v1 = c2 x v2
1 in 80,000
X in 100
•  X = 1 x 100 / 80,000
•  = 1/800
•  = 0.00125
Therefore the answer is 0.00125%
Method 2:
•  1 in 80,000 divide each side by 8
•  0.125 in 10,000 divide each side by 100
•  0.00125 in 100
•  = 0.00125%
 Percentage Concentrations
Example 2
9. If 500mg of potassium permanganate is
dissolved in 5 litres of water, what is the
strength of the resulting solution?
What do we know?
•  We know that 500mg has been added to
5L of water
•  The units of the answer must be % this
means 1g in 100ml
Therefore…
•  There is 0.5g in 5000ml of water
Method 1:
c1 x v1 = c2 x v2
0.5g in 5000ml
X in 100ml
X = 0.5 x 100 / 5000 = 50/5000
= 1/100 = 0.01 Answer is 0.01%
•  There is 0.5g in 5000ml of water

Method 2: Divide until you get 100ml

E.g. Divide both sides by 5
0.1g in 1000ml
Divide both sides by 10
0.01g in 100ml
Therefore answer is 0.01%
 Concentration Calculations
•  There are a number of ways in which the
concentration of a drug in a preparation
can be expressed
•  For example:
milligrams per millilitre (mg/ml)
millimole per millilitre (mmol/ml)
units/ml
 Concentration Example
10. How much solid must be used to make
up 3.5 litres of a 3.5% w/v solution?
What do we know?
•  We know that the solution we need has
3.5g per 100ml
•  We know that we need 3.5L of this
solution
Therefore…
Method 1
Using c1 x v1 = c2 x v2
3.5g in 100ml
X in 3500ml
X = 3.5 x 3500 / 100
= 122.5g
Therefore…
Method 2
35g in 1000ml
Multiply both sides by 3.5 to get
= 122.5g in 3,500ml
Therefore answer is 122.5g
 Concentration Example 2
11. How much solid must be used to make
up 250ml of 1:8 solution?
What do we know?
•  1:8 means 1 part to 8parts
•  There are a total of 8 parts in 250ml
•  Answer must be in mg
Therefore…
Method 1
Using c1 x v1 = c2 x v2
1g in 8ml
X in 250ml
X = 250/8
= 31.25g
= 31,250mg
Method 2
Solid takes up 1 out of every 8 parts i.e. 1/8 of the
total, therefore…
Quantity of solid = 1/8 x 250ml
= 31.25g
= 31,250mg
 Dilution Calculations
•  Dilution of solutions: weight of active
ingredient remains the same before and
after dilution
• However since the volume changes the
concentration of the solution also
changes
• Therefore you can use the formula
C1 x V 1 = C 2 x V 2
 Dilution Example

12. What volume of a 0.5% w/v stock

solution is needed in order to
produce 1L of a 1 in 8000 solution?
What do we know?
•  We are using stock solution containing 0.5g per
100ml to produce a final solution containing 1g
per 8000ml
•  We only want 1000ml of the final solution
Therefore…
First find out how much active ingredient we
need…
Final solution has 1g in 8000ml, we need 1000ml
of this so we need 1/8g = 0.125g
Stock solution contains 0.5g in 100ml
Method 1 using c1 x v1 = c2 x v2
0.125g in X
X = 0.125 x 100 / 0.5 = 25ml
Method 2
0.5g in 100ml
Divide both sides by 4
0.125g in 25ml
Therefore answer is 25ml
 Chloroform
•  Single Strength Chloroform water = 0.25%
•  Double Strength = 0.5%
= twice as strong as single strength
•  Concentrated Chloroform water = 10%
= 20 times as strong as double strength
and 40 times as strong as single strength
 Chloroform Example
13. You are asked to prepare 200ml of the
following mixture:
Potassium Citrate Mixture BP
Potassium citrate: 3g
Citric acid monohydrate: 500mg
Syrup: 2.5ml
Quillaia tincture: 0.1ml
Lemon spirit: 0.05ml
Double strength chloroform water: 3ml
Water to: 20ml
You have to prepare the double strength
chloroform water from the concentrated
chloroform water that you have in stock. What
volume of concentrated water do you require
to prepare required volume of Potassium
Citrate Mixture BP?
What do we know?
•  We have concentrated chloroform water in
stock
•  We will make double strength chloroform water
from the concentrated chloroform water
•  We need 3ml of double strength chloroform
water per 20ml in the formulation
•  We need a total of 200ml
Therefore…
If there is 3ml in 20ml and we need 200ml total
this means we need 30ml total of double strength
chloroform water (i.e. multiply formula by 10)
Method 1
Concentrated chloroform water is 20 times as
strong as double strength, therefore we only need
30/20 = 1.5ml
Method 2 – using c1 x v1 = c2 x v2
Double strength chloroform water is 0.5%
= 0.5g in 100ml, we have 30ml in the formulation
X in 30ml, X = 0.5 x 30 / 100 = 0.15
Concentrated chloroform water is 10%
= 10g in 100ml
0.15 in Y
Y = 0.15 x 100/10
= 1.5ml
 Mixing Preparations Example 1
14. An ointment contains 1% w/w calamine. What
weight of calamine needs to be added to 200g of
this ointment to produce a 5% calamine ointment?
Round your answer up to two decimal points.
What do we know?
•  We start with 200g of a 1% calamine ointment
•  We want 5% calamine ointment
Therefore…
•  We need to add an amount to our 200g of 1%
ointment to achieve 5%, this translates to…
•  2g in 200g (plus “X” amount of calamine) = 5 g
in 100ml
•  i.e. (2g + X) in (200g + X)
5g in 100ml
Using c1 x v1 = c2 x v2…cross multiply…
(2 +X) x 100 = 5 x (200 + X)
200 + 100X = 1000 + 5X
95X = 800 X = 8.4210… ≈ 8.42g
 Mixing Solutions Example 2
15. If 150 mL is removed from a bag which
contains 500 mL of glucose 5% and replaced with
250 mL of glucose 20%, what is the strength of the
resulting glucose solution?
What do we know?
Step 1:

150ml
glucose 5%
removed

500ml bag of
glucose 5%
What do we know?
Step 2:

Add 250ml
glucose 20%

350ml bag of
glucose 5%
Therefore…
Step 3: work out the total amount of active
ingredient and total volume

250ml of glucose 20%:

20g in 100ml, means 50g in 250ml

350ml of glucose 5%:

5g in 100ml, means 17.5g in 350ml

Total up both sides = 67.5g in 600ml

Final concentration = 11.25g in 100ml = 11.25%
 Mixing Solutions Example 3
16. What volume of 60% ethanol and 20% ethanol
should be mixed together to prepare 1.2L of 30%
ethanol?
What do we know?
We have 2 different concentrations of solution
that need to be mixed to achieve a specific final
concentration and final volume

Conclusion:
We need to use the “Alligation method”
Terminology in the Alligation method
•  Let the stronger product be called product A
and this has a concentration of Ac.
Let the weaker product be called product B and
this has the concentration of Bc

•  Let the final concentration be called Fc.

Parts of product A (Pa) = Fc-Bc
Parts of product B (Pb) = Ac-Fc
Total Parts = Ac-Bc
Therefore…
•  Product A is 60%, product B is 20%
•  Ac = 60, Bc = 20, Fc = 30
•  Parts of product A (Pa) = 30-20 = 10
•  Parts of product B (Pb) = 60-30 = 30
•  Total number of parts = 60-20 = 40
Total volume of final product is 1.2L
•  1200ml/40 parts = 30ml per part
Of the 60% ethanol need 10 parts = 10 x 30ml (300ml)
Of the 20% ethanol need 30 parts = 30 x 30ml (900ml)
(Final check: total of both volumes = 1200ml)
 Molecular Weight
Molecular weight of a drug is the sum of all the
atomic weights of the individual atoms (in grams)

E.g. sodium chloride (NaCl) consists of one atom of

sodium and one atom of chlorine so that its
molecular weight = 23 + 35.5 = 58.5

aluminium chloride (AlCl3) consists of one atom of

aluminium and three atoms of chlorine so that its
molecular weight = 27 + (35.5 x 3) = 133.5g
 Molecular Weight Calculation
17. How many milligrams of lithium are contained
in a 500mg tablet of lithium carbonate?
(lithium carbonate formula: Li2CO3; molecular
weights: lithium = 7, carbon = 12, oxygen = 16)
What do we know?
•  Each molecule of lithium carbonate has 2 atoms
of lithium, one atom of carbon and 3 atoms of
oxygen
•  The total weight of lithium carbonate that we
have is 500mg
Therefore…
•  First calculate the molecular weight:
(2 x 7) + 12 + (3 x 16) = 76g

•  The proportion of lithium in lithium carbonate

is 14g per 74g, therefore the proportion in
500mg should be 14/74 x 500 = 94.59… ≈94.6mg
 Moles
Number of moles = Mass in g
Relative Formula Mass in g

Number of millimoles = Mass in mg

Relative Formula Mass in g
 Moles Calculation Example
18. Which of the following is the volume of a 40
millimolar solution of drug X that could be
made from 3000mg if its relative molecular
mass is 50?
What do we know?
•  40 millimolar solution contains 40 millimoles in
1000ml
•  One mole of drug X weighs 50g
Therefore…
•  One millimole of drug X weighs 50/1000 = 0.05g
•  40 millimoles = 40 x 0.05 = 2g
Method 1: Using c1 x v1 = c2 x v2…
•  2g in 1000ml
3000mg in X = 3g in X
•  X = 3 x 1000 / 2 = 1500ml
Method 2: divide the total weight to be used
with the weight you know the volume for to
calculate the relative proportions.
•  3000mg / 2g = 1.5
•  If 2g is found in 1000ml and we have 3g, the
volume we can make would be 1000ml x 1.5 =
1500ml
 Moles Calculation Example 2
19. Whilst working in the pharmacy aseptic unit
you are asked to add 50mmol of Na ions to a
batch of intravenous fluids. How many
millilitres of sodium chloride injection 0.9%
w/v do you need to add? Round your answer
to the nearest whole number.

Atomic weight of sodium = 23

Atomic weight of chlorine = 35.5
What do we know?
•  We need a total of 50 millimoles of sodium ions
•  We will obtain the sodium ions from sodium
chloride injection 0.9% w/v injection
•  Sodium chloride molecular composition is one
atom of sodium and one atom of chlorine (NaCl)
Therefore…
•  one mole of sodium chloride = 23+35.5= 58.5g
one millimole of sodium chloride = 58.5mg
•  50mmol = 58.5 x 50 = 2925mg = 2.9… grams
Using c1 x v1 = c2 x v2
•  0.9g in 100ml
2.9…g in X
X = 2.9… x 100 / 0.9 = 325ml
 Displacement Volume
•  Volume or quantity of solid occupied by the
powder (of for example an injection) following
the addition of a diluent during reconstitution.

•  Different for different drugs, different

strengths of the same drug and for different
brands.
 Displacement Example
20. Streptomycin is available in 1g vial. A doctor
prescribes streptomycin 750mg IM OD. Each 1g vial
has a displacement value of 0.75ml. The nurse
added 2.25ml WFI to reconstitute the vial. How
many ml of the reconstituted solution must the
nurse administer?
What do we know?
Final volume = DV + volume added
Therefore…
•  Final volume = 0.75ml + 2.25ml = 3ml
Using c1 x v1 = c2 x v2
•  1g vial contains 1g streptomycin in 3ml
750mg in X
0.75g in X
X = 3 x 0.75 / 1
= 2.25ml
 Displacement Example 2
21. You receive a prescription asking you to
prepare 24 Witepsol pessaries (in 2g moulds),
each containing 400mg of drug A. What weights of
base and medicament are required?
(Displacement value of Drug A = 1.2)
What do we know?
•  We need 24 2g pessaries containing Witepsol
and drug A
•  Each 2g pessary contains 400mg of drug A
•  Displacement value of the drug is 1.2
Therefore…
•  Quantity required of drug A: 400mg x 24 = 9.6g

How much Witepsol is displaced?

•  If 1.2g of drug displaces 1g of Witepsol, then
9.6g of drug displaces 9.6/1.2 = 8g of Witepsol

Therefore weight of Witepsol required…

•  (24 x 2g moulds) – 8g = 48 – 8 = 40g
 Pharmacokinetics: Half Life
22. A drug has an elimination half-life of 2 hours.
How long will it take for 75% of the administered
dose to be eliminated?
What do we know?
•  The half-life of a drug is the time it takes for
the initial concentration or amount of drug
administered to the body to be reduced by half
Therefore…
•  If a drug has a half-life of 2 hours then the
after 2 hours half the initial dose is eliminated
i.e. 50%
•  After another 2 hours half of this half dose is
eliminated i.e. a further 25%
•  Therefore a total 75% is eliminated after 4
hours
 Pharmacokinetics:
Volume of Distribution
The Volume of distribution (Vd), is the
theoretical volume that would be needed to
distribute a drug, if it was found at the same
concentration throughout the body as that
measured in the serum.
 Pharmacokinetics: Bioavailability
Fraction of the drug that reaches the systemic
circulation.
Ranges from 0 to 1.
Large first pass effect produces a low oral
bioavailability.
Parenterally administered drugs have a
bioavailability of 1.
Amount of drug = bioavailability x salt fraction x
dose in systemic circulation
 Bioavailability Example 1
23. Mrs WD is admitted to hospital after suffering from a
stroke. She regularly takes digoxin tablets 125 micrograms
daily but as she cannot swallow tablets her doctor wants to
change her to an equivalent dose of digoxin elixir.
What should the daily dose of digoxin be for Mrs WD? The
digoxin elixir you have available is a 50mcg/ml
formulation.

[bioavailabilty of digoxin tablets = 0.7

bioavailabilty of digoxin elixir = 0.8]
What do we know?
•  Digoxin tablets have a bioavailability of 0.7 i.e.
70% of the administered dose is available
Digoxin elixir has a bioavailability of 0.8 i.e.
80% of the administered dose is available
•  Patient used to take 125mcg tablets daily
•  Digoxin elixir is available as a 50mcg/ml
formulation
•  You need an answer in ml
Therefore…
Mrs WD normally receives 0.7 x 125mcg = 87.5mcg
So to maintain Mrs WD on this dose we need the
equivalent amount of digoxin from the elixir:
X x 0.8 = 87.5
X = 87.5 / 0.8 = 109.375mcg
Using c1 x v1 = c2 x v2
50mcg in 1ml of elixir
109.375mcg in V
V = 109.375/50 = 2.1875ml ≈2.2ml
 Bioavailability Example 2
24. A 3-kg infant has been receiving 7.5mg phenytoin sodium
IV bd. If the prescribed formulation is changed to Epanutin
oral suspension (30mg/5ml), how many ml of the suspension
should be given per dose? Round your answer to one decimal
point.

[Conversion factor for phenytoin:

92mg phenytoin base = 100mg phenytoin sodium]
What do we know?
•  There is a difference in bioavailability between
IV phenytoin sodium and phenytoin suspension
(as stated in Section 4.8.1 of BNF/C)
•  92mg phenytoin base = 100mg phenytoin
sodium
•  The patient was receiving 7.5mg phenytoin
sodium in each dose
•  Epanutin oral suspension contains 30mg/5ml
Therefore…
•  dose of phenytoin sodium is 7.5mg
Using c1 x v1 = c2 x v2
•  92mg phenytoin base equivalent to 100mg
phenytoin sodium
? equivalent to 7.5mg phenytoin sodium.
? = 92 x 7.5 / 100 = 6.9mg
•  30mg of phenytoin in 5ml Epanutin suspension
6.9mg in X
X = 6.9 x 5 / 30 = 1.15ml, round to 1DP = 1.2ml
Pharmacokinetics:
Loading Dose
Loading Dose Calculation Example
25. Calculate a suitable oral loading dose for drug
X, given that the doctor wants to obtain a target
plasma concentration of 2 micrograms/L.

Drug X has an oral bioavailability of 0.7, a volume

of distribution of 350L and a salt fraction of 1.
What do we know?
Loading dose
= target concentration x volume of distribution
bioavailability x salt fraction
Therefore…
•  Loading dose = 2mcg/L x 350L / 0.7 x 1
•  = 700mcg / 0.7
•  = 1000mcg
•  = 1mg
 Pharmacokinetics: Clearance
Clearance is the volume of serum that is cleared
of a drug over a set period of time, usually
expressed in litres/hour.
 Clearance Calculation Example 1
26. Mr JT, who weighs 70kg, has taken an
overdose of drug X. His serum concentration of
drug X is 75mg/L and the clearance rate of the
drug is 0.04L/kg/hour.

What is the amount of drug X that will be removed

from Mr JT’s body in 12hrs?
What do we know?
•  Current serum concentration 75mg/L
•  Mr JT weighs 70kg
•  The drug is cleared 0.04L per kg per hour
•  We need to calculate amount cleared in 12hrs
Therefore…
•  Clearance = 0.04 x 70 per hour = 2.8L per hour

There is 75mg of drug X per litre, therefore

•  2.8L x 75mg = 210mg drug cleared per hour

In 12 hours, the amount of drug cleared =

210 x 12 = 2520mg
= 2.52g
 Body Surface Area Example 1
27. Mr GK is 1.8m tall and weighs 80kg. Calculate
his body surface area (m2)
What do we know?
Therefore…
•  Convert height to cm: 1.8m = 180cm
•  Body surface area = √(80 x 180)/3600
•  = √14400/3600
•  = √4
•  = 2m2
 Body Surface Area Example 2
28. Drug X has a recommended dose of 25mg/m2.
Miss AP and Miss LP are twins who have both been
prescribed with Drug X. You measure both their
weights and heights to calculate whether there is
a difference between the doses they need. Miss
AP has a weight of 6.5kg and a height of 0.6m,
Miss LP has a weight of 6.3kg and a height of
0.62m. What would be the difference (if any)
between their doses of Drug X? Round your answer
to two decimal points.
What do we know?

•  Dose of drug 25mg/m2

•  Miss AP weight = 6.5kg, height = 0.6m
•  Miss LP weight = 6.3kg, height = 0.62m
•  Need to convert m to cm for BSA equation
Therefore…
•  Miss AP BSA = √6.5x60/3600 = √0.1083…
= 0.329140…mg
•  Miss LP = √6.3x62/3600 = √0.1085
= 0.329393…mg
Difference: 0.329393…m2 - 0.329140…m2
= 0.0002530…m2
Therefore the difference in dose would be 25mg x
0.0002530… = 0.006326…mg ≈ 6.33mcg
 Infusion Rate Example 1
29. A patient is receiving a diamorphine infusion
over 24 hours. They are currently receiving a dose
of 150mg over a 24 hour period using a syringe
pump that is calibrated to 36mm/24 hours.
You increase the rate of infusion to 54mm/24
hours. What dosage is the patient now receiving?
What do we know?
•  Initially the syringe pump was set to 36mm/
24hrs to deliver 150mg in 24hrs
•  Now you have changed the setting of the pump
to 54mm in 24hrs
Therefore…
Using c1 x v1 = c2 x v2
•  36mm delivers 150mg
54mm delivers X
X = 150 x 54 / 36
= 225mg
Therefore current dose of diamorphine is 225mg
per 24hrs
 Infusion Rate Example 2
30. Master AP is a 10 year old child weighing 32kg.
Having undergone surgery he has been prescribed
diamorphine infusion with the rate of the pump to
be adjusted according to response. If it was
initially set to deliver 75mcg/kg/hr and 2 hours
later was increased by the paediatric nurse to
deliver 0.1mg/kg/hr. How much diamorphine will
he have received within 4 hours?
What do we know?
•  Weight = 32kg
•  Initial rate of infusion = 75mcg/kg/hr
•  2 hours later rate became 0.1mg/kg/hr
•  To calculate total quantity of drug in mg
Therefore…
•  For first 2hrs, Master AP received:
75mcg x 32kg x 2hrs = 4800mcg = 4.8mg of
diamorphine
•  For the next 2hrs, Master AP received:
0.1mg x 32kg x 2hrs = 6.4mg of diamorphine

Therefore over 4 hours he received:

4.8+6.4 = 11.2mg of diamorphine