MODULE 1- BASIC CONCEPTS IN
PHARMACOLOGY
COMMON TERMINOLOGIES USED
DRUG
-A substance which has a physiological effect
when ingested or otherwise introduced into the
body (Oxford Dictionary)
PHARMACOLOGY
- The study of the biological effects of chemicals
on living organisms (Karch, 2016).
PHARMACOKINETICS
- The process of drug movement to achieve
drug action. The four processes that completes
pharmacokinetics include: ADME-absorption,
distribution, metabolism and excretion
(McCuistion, et al, 2018)
PHARMACOTHERAPEUTICS
-Also known as clinical pharmacology is the
science which deals with use of drugs in
treatment, prevention and diagnosis of diseases
(Karch 2016).
DRUG CLASSIFICATIONS
-Various categorization of drugs which include
classification of drugs according to: a) body
systems; b) regulation of substance abuse c)
therapeutic use, and d) physiologic or chemical
actions.
MECHANISM OF ACTION
-This explains how the drug provides a
therapeutic effect including the effects that
happen when the drug combines with cellular
drug receptors (Woods,Vaughn, et.al, 2020).
THERAPEUTIC INDICATION
- The disease/s to be treated by the given
medicine and the individuals for which it is
intended (EUPATI, 2020)
CONTRAINDICTION
-The conditions and circumstances which the
drug is undesirable to use and caution must be
given (Woods,Vaughn, et.al, 2020)
SIDE EFFECTS
-Are secondary effects of drugs which may be
predictable resulting to either desirable or
undesirable effects. This reaction may be
different from one patient to another
(McCuistion, et al, 2018).
ADVERSE DRUG REACTIONS (ADRs)
-Are drug effects which is unintentional and/or
unexpected after administration of drug in
normal dosage (McCuistion, et al, 2018).
DRUG TOXICITY
-Occurs when drug exceeds the therapeutic
drug level which may be caused by improper
prescription and administration and/or due to
genetics, age, disease process including co-
morbidities.
NURSING RESPONSIBILITIES
-The use of nursing process in drug
administration using appropriate assessment,
diagnosis, plan of care, intervention and
evaluation (ADPIE).
1
DRUG REGULATION
FDA’s main function:
To protect and promote the right to health of
the Filipino people and to establish and
maintain an effective health products regulatory
system responsive to the country’s health needs
and problems.
SOME OTHER FUNCTIONS OF THE FDA
1. Establishes safety or efficacy standards and
quality measures for foods, drugs and cosmetics
2. Analyzes and inspects health products
3. Helps the public get the accurate, science-
based information needed to use medicines and
foods to maintain and improve their health
4. Helps to speed innovations that make
medicines more effective, safer, and more
affordable
5. Issues certificates of compliance, cease and
desist orders
6. Conducts, supervises, monitors and audits
research studies on health and safety issues of
health products
7. Prescribes standards, guidelines and
regulations with respect to information,
advertisement and marketing
CLASSIFICATION AND EXAMPLES
According to BODY SYSTEMS
CNS drugs, Cardiovascular drugs, Respiratory
drugs, Kidney drugs
According to THERAPEUTIC USE
Antacids, Antibiotics, Antihypertensive,
diuretics, or laxatives
According to CHEMICAL and PHYSIOLOGIC
ACTIONS
Anticholinergics, Beta-adrenergic blockers,
Calcium channel blockers, Cholinergics.
PREGNANCY CATEGORY
CATEGORY A
-Adequate studies in pregnant women have not
demonstrated a risk to the fetus in the first
trimester of pregnancy, and no evidence of risk
in late trimester.
 Example include multivitamins
CATEGORY B
-Animal studies have not demonstrated a risk to
the fetus but there are no adequate studies in
pregnant human, OR;
-Animal studies have shown an adverse effect,
but adequate studies in pregnant humans have
not demonstrated a risk to the fetus in the first
trimester of pregnancy, and no evidence of risk
in late trimester
 Examples include certain antibiotics
such Amoxicillin and Penicillin
CATEGORY C
2
-Animal studies have shown an adverse effect
on the fetus but there are no adequate studies
in humans; the benefits from the use of the
drug in pregnant women may be acceptable
despite its potential risks
 Examples include Aspirin,
Fluoroquinoles, Gentamicin
-Drugs or substances that have a potential for
abuse less than Schedule I or II; currently have
an accepted medical use; abuse may lead to
moderate or low physical and high
psychological dependence. (some sedatives,
anti-anxiety and non-narcotic analgesics)
Classification IV Schedule 4 (S4)

CATEGORY D -Drugs or substances that have a low potential

for abuse relative to those listed in Schedule III;
-There is evidence of human fetal risk, but the
currently have an accepted medical use; abuse
potential benefits from the use of the drug in
may lead to limited physical or psychological
pregnant women may be acceptable despite its
dependence those in schedule III.
potential risks
Classification V Schedule 5 (S5)
 Examples include Tetracyclines,
Chemotherapy drugs, ACE inhibitors -Drugs or substances that have a low potential
for abuse relative to Schedule IV; may not need
CATEGORY X
prescription by a doctor (Over-the-Counter or
-Teratogenic. Evidence of fetal harm is OTC drugs).
established. May cause congenital disease or
death of the fetus.

 Example includes contraceptive drugs

SUBSTANCE ABUSE CATEGORY

Classification I Schedule 1 (S1)

-Drugs or substances that have a high potential

for abuse; no currently accepted medical use
and have a lack of accepted safety for use under
medical supervision. (Heroin, marijuana).

Classification II Schedule 2 (S2) :(Yellow

prescription drugs)

-Drugs or substances that have a high potential

for abuse; currently have an accepted medical
use in treatment but with severe restrictions;
abuse may lead to severe psychological or
physical dependence. (narcotics,amphetamines,
barbiturates). purchaser must be at least 18
years old, and all transactions must be recorded
by the dispensing pharmacist.

Classification III Schedule 3 (S3)

3
DRUG NAMES, FORMS, AND ROUTE
DRUG NAMES
Drugs has several names:
Chemical name - describes the drug’s chemical
structure. used by scientists in studying and
manufacturing the drug
Generic name - is the official or nonproprietary
name for the drug. This is not owned by any
pharmaceutical (drug) company and is
universally accepted. Most drugs are ordered by
generic name. Written in a lowercase letter.
Brand (trade) name - is also known as the
proprietary name, which is chosenby the drug
company and is usually a registered trademark
owned by that specific manufacturer. Always
begin in capital letter
Example: naloxone HCl (Narcan)
C19H21NO4
FORMS AND ROUTES OF DRUG
ADMINISTATION
1. Sublingual – placed under the tongue
2. Buccal – placed between the cheek and gum
3. Oral (tablets, capsules, liquids, suspensions,
and elixirs) –swallowed by mouth
4. Transdermal – patch absorbed in the skin
5. Topical – applied to the skin
6. Instillation (eye drops, ear drops, nose drops
and sprays, and eye ointment)
7. Inhalation - delivered deep into the lungs
with each puff (e.g., Metered-dose inhaler)
8. Nasogastric and gastrostomy tubes –
delivered via feeding tube that enters the
mouth, nose, or abdomen
9. Suppositories –inserted into the rectum,
vagina, or urethra
10. Parenteral forms - administered thru
Intradermal (ID), Subcutaneous (SC),
Intramuscular (IM), intravenous (IV), and
Intraosseous (IO)
A. TABLETS AND CAPSULES
- most common drug forms
- convenient and less expensive and do not
require additional supplies for administration
Nursing considerations:
1. Oral drugs - are not given to patients who are
vomiting, who lack a gag reflex, or who are
comatose. Do not mix a drug with large
amounts of foods or beverages or infant
formula (patients may not consume them)
because they will not get the full dose of
medication.
 Enteric-coated and timed-release capsules
- must be swallowed as a whole so the drug is
released gradually and maintain a therapeutic
drug level. If crushed, the initial excessive drug
release poses a risk of toxicity (e.g., it could lead
to a potentially fatal overdose. Crushing can
also increase the rate of absorption, and could
cause oropharyngeal irritation
4
2. Sublingual drugs (under the tongue)
3. Buccal (between the cheek and gum) routes
should remain in place until fully absorbed,
therefore no food or fluid should be taken while
the medication is in place.
LIQUID
Liquid medication includes elixirs, emulsions,
and suspensions.
- Syrup
- Elixirs are sweetened, hydroalcoholic liquids
used in the preparation of oral liquid
medications. Alcohol and water are used as
solvents when the drug will not be dissolved in
water alone. (eg., diphenhydramine).
- Emulsions are a mixture of two liquids that are
not mutually soluble.
- Suspensions are liquids in which particles are
mixed but not dissolved.
Nursing considerations of Liquid forms:
• Read the labels to determine whether diluting
or shaking is required.
• Make sure your facility has plastic dosing cups
that measure in milliliters (mL).
• To avoid mix-ups, it is always best to measure
the prescribed dose of liquid medication in a
syringe calibrated mL and then squirt the
medication into the oral measuring cup.
According to the U.S. Pharmacopeial convention
a proposed change is required for all facilities to
supply dosing cups with legible markings in
metric units
4. TRANSDERMAL
-Transdermal drugs provide more consistent
blood levels than oral and injectable forms and
avoid GI absorption problems associated with
oral products. Absorbed locally then
transported to systemic circulation
• Transdermal medication is stored in a patch
placed on the skin and is absorbed through the
skin to produce a systemic effect.
• A patch may be left in place for as little as 12
hours or as long as 7days depending on the
drug.
Nursing considerations
• To prevent skin breakdown, transdermal
patches should be rotated to
different sites and should not be reapplied over
the exact same area every time.
• Area should be thoroughly cleansed before
administration of a new transdermal patch.
• Perform hand hygiene and apply gloves when
administering medicated patches to prevent
transfer of medication; advise the patient to do
the same for self-administration.
• Never cut the patch in half.
5. TOPICALS
-Topical medications are most frequently
applied to the skin by painting or spreading the
medication over an area and applying a moist
dressing or leaving the area exposed to air. This
produces local effect
Nursing considerations
• Medications can be applied to the skin in
several ways:
• Using a glove,
5
• Using tongue blade, or cotton-tipped
applicator.
Note: Nurses should never apply a topical
medication without first protecting their own
skin. This is to protect from transferring the
action of the drug to the nurses systemic
circulation.
6. INSTILLATION
-Instillations are liquid medications usually
administered as drops, ointments, or sprays in
the following forms:
Nursing considerations
prescribed asthma and bronchitis drugs to the
lower respiratory tract via inhalation. MDIs act
faster than drugs taken by mouth, and fewer
side effects occur because the drug goes right to
the lungs and not to other parts of the body
Nursing considerations
• Explain what a metered dose is, how it is
being administered, and warn the patient about
overuse and side effects of the drug
• Teach patients to rinse their mouth after using
an MDI. This is especially important when using
a steroid drug. Rinsing the mouth helps to
prevent irritation and secondary infection to
oral mucosa. Advise patients to avoid smoking.

- Eyedrops - Gently pull down on the skin below

the eye to expose the conjunctival sac. Apply
drops to the middle third of the sac, and apply
gentle pressure over the lacrimal duct after
administration
7. NASOGASTRIC AND GASTROSTOMY TUBES
• Administration of drugs through a feeding
tube that enters the mouth, nose, or abdomen

- Eye ointments - Squeeze a ¼-inch–wide strip Nursing considerations

of ointment into the conjunctival sac
- Eardrops - Straighten the external ear canal by
pulling the auricle down and back in children
under 3 years of age. In patients older than 3
years of age, including adults, pull the auricle
upward and outward
- Nose drops - Advise patients to tilt the head
back for drops to reach the frontal sinus and to
tilt the head to the affected side to reach the
ethmoid sinus
-Nasal sprays - to reach the sinuses, proper
head position is with the patient looking down
at the feet with the spray tip aimed toward the
eye
• Before administering drugs, always check for
proper tube placement, and always assess the
gastric residual
• Return any aspirated gastric fluid to the
stomach. (Check the agency’s policy for tube
placement and residual)
• Make sure the drug is crushable when
administering it through tube feeding
• Ensure to place patient in a high fowler
position or elevate the head of bed at least 30
degrees to avoid aspiration
• Flush with 10 to 15 mL of water in between
each administration to maintain patency of the
tubing

8. INHALATIONS

-Metered-dose inhalers (MDIs) are handheld

devices used to deliver a number of commonly

6
9. SUPPOSITORIES
• A suppository is a solid medical preparation
that is cone- or spindleshaped for insertion into
the rectum, globular or egg-shaped for use in
the vagina, or pencil-shaped for insertion into
the urethra.
• Suppositories are made from glycerinated
gelatin or high-molecular weight polyethylene
glycols and are common vehicles for a variety of
drugs. A suppository is a useful route in babies,
in uncooperative patients, and in cases of
vomiting or certain digestive disorders
RECTAL SUPPOSITORIES
-Medications administered as suppositories or
enemas can be given rectally for local and
systemic absorption. The numerous small
capillaries in the rectal area promote
medication absorption.
VAGINAL SUPPOSITORIES
-Vaginal suppositories are like rectal
suppositories. They are generally inserted into
the vagina with an applicator supplied with the
medication; gloves should be worn. The patient
should be in the lithotomy position. Advice
patient to remain lying for a period of time to
allow medication absorption; times vary
depending on medication. After insertion,
provide the patient with a sanitary pad.
Nursing Considerations
• The foil around the suppository is removed,
and the suppository may be lubricated before
insertion. When medications such as antipyretic
or bronchodilators are given, the patient must
be reminded to retain the medication and not
expel it.
• Suppositories tend to soften at room
temperature and therefore must be
refrigerated before use
• Explain the procedure to the patient and
provide privacy.
• Use glove for insertion.
• Instruct the patient to lie on the left side and
breathe through the mouth to relax the anal
sphincter.
• Apply a small amount of water-soluble
lubricant to tip of unwrapped suppository, and
gently insert the suppository beyond the
internal sphincter.
• Have patient lie on the side for 20 minutes
after insertion.
• If indicated, teach patients how to self-
administer suppositories, and observe a return
demonstration for teaching effectiveness.
10. PARENTERAL- administered via injection.
• Intradermal (ID) - Administered for skin
testing (e.g., tuberculin screening, allergy
testing and testing for other drug sensitivities,
some immunotherapy for cancer).
• Subcutaneous (subcut) - Systemic effect,
sustained effect; absorbed mainly through
capillaries; usually slower in onset than with the
intramuscular (IM) route.
• Intramuscular (IM) - Systemic effect, Usually a
more rapid effect of drug than with a subcut
route, Used for solutions that are more viscous
and irritating for adults, children, and infants,
IM injections are associated with many risks, so
accurate, careful technique when administering
an IM injection is necessary
• Intravenous (IV) - Systemic effect, More rapid
than IM or subcutroutes
• Intraosseous (IO) - drug administration
involves the infusion of medication directly into
the bone marrow
7
SAFETY AND QUALITY DRUG Note: Medication order must only be prescribed
by:
ADMINISTRATION
a. medical doctor, dentist podiatrist
SIX RIGHTS OF MEDICATION
ADMINISTRATION b. certified nurse practitioner, advanced
practice registered nurse
1. RIGHT PATIENT
2. RIGHT DRUG c. physician assistant, veterinarian,
3. RIGHT DOSE chiropractor, and optometrist.
4. RIGHT ROUTE d. medical clinical psychiatrists and
5. RIGHT TIME pharmacists have prescriptive authority
6. RIGHT DOCUMENTATION with strict guidelines set by the state.
7. RIGHT ASSESSMENT
8. PATIENTS RIGHT TO EDUCATION Prescriptions may be done by handwritten,
9. RIGHT TO EVALUATE telephone order or verbal order, or directly
10. RIGHT TO REFUSE entered the patient’s EHR.

1. Right patient – determining patient
identification is an integral part of ensuring
patient safety.
Two important ways of identifying the patient:
1. Full name
2. birth date.
Then compare with the patient’s
• to ensure accuracy All T/O or V/O are either
handwritten by the nurse taking the order or
entered directly into a computer and “read
back” before affixing signature.
• If controlled drugs, 2 nurses are required to
listen and affix their signature.
• After dictating a verbal order, the provider
must sign it within 24 hours.

A. identification (ID) band and the medication Note: Nursing students are not allowed to
administration record (MAR). accept or take provider orders.

B. Electronic health records (EHRs) that allow
the nurse to directly scan the bar code from the
ID band.
• If the patient is an adult with a cognitive
disorder or a child, verify the patient’s name
with a family member. If family member is
unavailable, a photo ID on the band with the
patient’s name and birth date could be affixed
to the band.
2. Right Drug - The nurse must accurately
determine the right drug prior to
administration.
The components of a drug order are as follows:
1. Patient name and birth date
2. Date the order is written
3. Provider signature or name if an electronic
order, T/O, or V/O
4. Signature of licensed staff who took the T/O
or V/O, if applicable
5. HCPs who wish to prescribe controlled drugs
must register with the Drug enforcement
agency (DEA) or FDA. When prescribing
controlled substances, the HCP’s DEA/FDA
number must be on the prescription.

8
6. Drug name and strength dose vial, it should be properly disposed
according the sanitation or hospital policy.
7. Drug frequency or dose (e.g., once daily)

8. Route of administration
9. Duration of administration (e.g., × 7 days, × 3
doses, when applicable)
10. Number of pills to be dispensed
11. Any special instructions for withholding or
adjusting dosage based on nursing assessment,
drug effectiveness, or laboratory results
4. Right Time – includes the time the
prescribed dose is ordered to be administered.
To maintain therapeutic level of the drug in the
blood plasma level, a daily prescribed order
should have specified intervals.
Example of specified intervals for the drug
order includes:

To avoid medication errors, the drug label 1. once a day

should be read three times: 2. twice a day (bid) or every 12 hours

1. When you pick up the medication and 3. three times a day (tid) or every 8 hours
remove it from the drug cabinet
4. four times a day (qid), or every 6 hours (every
2. As you prepare the drug for administration 6hrs)
Note: Use of military time (24-hour clock) is
3. When you administer the drug
recommended in the healthcare facility rather
than the standard time because it reduces
administration errors.
3. Right Dose - administration of correct
amount of drug ordered that it is safe for the
patient. The right dose must be based on the
patient’s physical status including the patient’s
weight

- Always recheck the drug calculation if the dose

is within a fraction or if it is an extremely large
dose. Consult another nurse or the pharmacist
when in doubt.

Method of dispensing the drug:

1. Automated dispensing cabinets – the use of
computerized drug storage cabinet that stores
and dispense medications near the point of care
2. Unit dose (single dose) - has reduced dosage
errors because no calculations are required
5. Right Route - is necessary for adequate or
appropriate absorption. It is ordered by the
health care provider and indicates the
mechanism by which the medication enters the
body.

3. Multidose vial - requires calculations to

withdraw an exact amount of drug according to
the dose required. If something left in the multi-

9
6. Right Assessment - requires the collection
of appropriate baseline data before
administration of a drug.
Example of right assessment
1. taking a complete set of vital signs
2. checking lab levels prior to drug
administration
3. Identify high-risk patients so precautions to
reduce risk could be given (e.g., patients with
medication allergies, diabetic patients, cardiac
and pulmonary patients, and the elderly and
pediatric populations).
7. Right Documentation - requires the nurse
to record immediately the appropriate
information about the drug administered.
Method of documenting drug administration:
1. Paper medication administration record
(MAR) - is the commonly used method specially
in the Philippines as per observation
2. Computerized charting - nurse enters a
personal identification and password to get
access into the system.
Note: • A drug that is given but not
documented is considered not given and a drug
that is not given but documented is considered
given. It is important that nurses must
remember that drugs should be signed
immediately after the drug is administered
8. Right to Education - The nurse should
accurately and thoroughly inform the patient
about the drugs they are taking and how each
drug relates to their condition. Teaching also
includes:
• Why the patient is taking the drug, what is the
expected result of the drug, its possible good
/therapeutic effects, side effects and adverse
effects, and if there are any dietary restrictions
or requirements.
• Laboratory test result monitoring and the
necessary skills of drug administration with
return demonstration before discharge. This
facilitates continuity of care at home upon
discharge.
9. Right Evaluation - determines the
effectiveness of the drug based on the patient’s
response to the drug.
• The nurse should ask the patient whether the
medication improve the present health
condition.
• The nurse should evaluate the therapeutic
effect of the medication by assessing the
patient response to the drug.
Example: Patient response to an antiemetic,
antihypertensive, and antihistamine
10.Right to Refuse - patient has the right to
refuse the medication.If the patient refuse the
medication:
• The nurse’s is responsible to determine the
reason for the patient refusal to medication
• The nurse should explain to the patient the
“risks involved with refusal”, and reinforce the
important benefits of and reasons for taking the
medication.
10
• When a medication is refused, the refusal
must be documented immediately, and follow-
up is always required. The primary nurse and
health care provider should be informed
because the omission may pose a specific threat
to the patient (e.g., a change in the lab values
with insulin and warfarin).
Nurses six rights of administering
medication:
1. the right to a complete and clear order (e.g.,
nurses may clarify a HCP order that is not clear
because it is not legibly written or a verbal or
telephone order that are sounds like or sounds
alike.
2. the right to have the correct drug, route
(form), and dose dispensed
3. the right to have access to information
4. the right to have policies to guide safe
medication administration
5. the right to administer medications safely
and to identify problems in the system
6. the right to stop, think, and be vigilant when
administering medication
The Joint Commission National Patient Safety
Goals (TJC)
Two important goals that have already become
standards for all TJC
1. “Do not use” abbreviations - orders that
should be written to avoid misinterpretation
2. List of acceptable abbreviations - are
abbreviations that are frequently used in drug
therapy and must be known by the nurse
DISPOSAL OF MEDICATION
• Appropriate disposals of used drugs are
important to decrease the amount of controlled
substances released into the environment,
especially into water and sewage system.
Unless instructed, do not flush drugs down the
toilet so not to pollute environment and danger
human and animals. List of drugs that could be
flushed were listed in your reference book pp.
80 (e.g., Abstral, Demerol, and etc)
• Facilities may contract with an independent or
local collection program company authorized by
the state and the FDA/DEA.
• The drugs are disposed in a receptacle that
must comply with strict security and record-
keeping requirements as established by the
FDA/DEA. The company then incinerate the
waste.
SHARPS SAFETY/ NEEDLE-STICK INJURY
Nurses should not risk their lives every time
they use a sharp object or needle.
• Sharps safety prevent incidents of blood-
borne related disease such as the HIV/AIDS or
Hepatitis B.
11
• The Needle-stick Safety and Prevention Act
(NSPA) requires that employers implement
safer medical devices for their employees,
provide a safe and secure workplace
environment with educational opportunities,
and develop written policies to help prevent
sharps or needle-stick injuries. This will include
a flowchart of pre-post exposure management.
• Use puncture-proof containers to dispose of
sharps and needles. Containers must be closed,
puncture resistant, leak proof, color coded, and
emptied routinely to prevent overfilling
SAFETY RISK WITH MEDICATION
ADMINISTRATION
1. Tablet splitting - some patients are cutting
their pills in half. However, this is not
recommended by the FDA. The only time tablet
splitting is advisable is when it is specified by
the pharmacist on the label
2. Buying drugs over the Internet - precautions
must be taken because drugs sold online may
be too old, too strong, or too weak to be
effective and are unsafe to use with other
medications
3. Dosage Forms: To Crush or Not to Crush - Do
not crush any extended- or sustained-release
drugs because this will change the
pharmacokinetic phase of the drug. Although
some drugs can be used crushed, some should
not be crushed. Always consult with the
pharmacist or, when possible, the health care
provider prior to crushing a patient’s drug.
4. High-Alert Medications - can cause
significant harm to the patient. If a highalert
medication is given in error, it can have a major
effect on the patient’s organs such as cardiac,
respiratory, vascular, and neurologic systems.
Examples of high alert drugs:
1. epinephrine
2. Insulin (all forms)
3. magnesium sulfate injection
4. opium tincture
5. potassium chloride concentrates for injection
Lists to reduce risk of errors in administering
high alert medication:
1. Simplify the storage, preparation, and
administration of high-alert drugs
2. Write policies concerning safe administration
3. Improve information and education
4. Limit access to high-alert medications
5. Use labels and automated alerts
6. Use redundancies (automated or
independent double-checks)
7. Closely monitor the patient’s response to the
medication (possibly the most important step)
 Look-Alike and Sound-Alike Drug Names
• Nurses should be aware and give emphasis
that certain drug names sound alike and are
spelled similarly is prone to medication error
and should not be practiced in the clinical
settings.
Example:
1. glypizide (Glucotrol) with glyburide
(Glyceron)
2. Glimepiride (Amaryl) with galantamine
(Reminyl).
Note: To prevent this incident, nurses should
always practice the Six plus 4 Rights of
medication administration.
12
13
DOSAGE CALCULATIONS  Grams ( g, mg, kg, mcg)
 Liters (l, ml, )
TERMINOLOGIES
 Meter (m, cm, km)
POSOLOGY- the study of dosage of medicines.
2. Apothecary system:
1. Minimum dose – the least dosage amount of
- Apothecaries means pharmacist
a drug that can be given to achieve a
- an old system used for measuring and
therapeutic effect (in a day)
weighing drugs and solutions by use of
2. Maximum dose – the highest dosage amount fractions
that can be given in a day, if it exceeds, toxic
➢ Ounce ➢ Grains
effect may occur
➢ Pound ➢ Dram
3. Daily dose – the total dosage amount that is
given to a patient in a day to achieve ➢Quart ➢Pint
therapeutic effect
➢Minim ➢Gallon
4. Maintenance dose – the total dosage amount
that must be given to maintain a state of
wellness 3. Household system

5. Single dose – the dosage amount that is given Teaspoon Tablespoon

only once
Fluid ounces Cups
6. Loading dose -the amount of drug which is
Pints Quarts
given more than the usual dose because the
drug action is needed quickly Gallon

7. Toxic dose - the amount of drug which when Other systems:

given will cause danger to the patient and
A. Milliequivalent (mEq):
possible death
 refers to the ionic activity of the drug
8. Lethal dose - the amount of drug which when
 measures electrolytes
given will cause imminent death to the patient
B. International Units (IU):

THREE MEASURING SYSTEM  Measures certain vitamins or enzymes

M-A-H

1. Metric system

2. Apothecary system

3. Household system

1. Metric system- an internationally

agreed decimal system of measurement

14
Calculation Methods
Three methods can be used:
1. Basic Formula
2. Ratio-Proportion calculation (R/P)
3. Dimensional analysis (D/A)
 These methods are used to calculate most
enteral and parenteral drugs dosages.
Formula 1: Weight conversion
1 kg = 2.2 lbs
1. Pounds (lbs) to Kilogram (Kg)
→ Use DIVISION
→ ____lbs. / 2.2lbs = ____ kgs.
2. Kilogram (kg) to Pounds (lbs)
→Use MULTIPLICATION
→ ____kgs x 2.2 lbs. = ____ lbs
Convert:
1. 45 lbs to kgs → 45 lbs / 2.2 lbs → 20.45 kgs
2. 126 lbs to kgs → 126 lbs / 2.2 lbs → 57.27 kgs
3. 10 kgs to lbs → 10 kgs X 2.2 lbs → 22 lbs
4. 69 kgs to lbs → 69 kgs X 2.2 lbs → 151.8 lbs
Calculation by weight
Required Dose = Weight in kgs X Dosage per kg
Practice computation: Answer
1. Give Tramadol 2 mg/kg of body weight.
Weight of patient is 125 lbs.
Answer:
RD = wt. in kg x dosage/kg
125lbs/2.2 = 56.81kg x 2mg = 113.63mg
2. Give Acetaminophen 12.5 mg/kg every 4
hours for pediatric patient weighing 14 kgs.
Answer
RD = wt. in kg x dosage/kg
14 kg x 12.5 mg = 175 mg every 4 hours
3. Give Tamiflu 3mg/kg/day divided into 2 doses
for infants weighing 9.8 kgs.
Answer
RD = wt. in kg x dosage/kg
9.8 kg x 3mg = 29.4 mg / day
14.7 mg / dose
PEDIATRIC DOSAGE
Reason is:
Immaturity of child’s organ
 Pharmacokinetics (ADME) is different from
adult
 Smaller dose to achieve comparable critical
concentration
 Research cannot be done to children for
ethical reasons
 Dosage calculation allows to identify
recommended dose
15
Pediatric dose calculation YOUNG’S RULEALWAYS use AGE

Calculation of pediatric dose

Clark’s rule Pediatric dose: Fried’s rule

Child’s dose = infant’s age (in months) X average adult dose
Adult Dose X (Weight ÷ 150)
150 months
Young’s rule

Adult Dose X (Age ÷ (Age+12))

Exercise #1
Fried’s rule
Adult dose = 500 mg every 8 hours
infant’s age (in months) X Average adult dose
Infant’s age = 2 months
__________________
Exercise #2
150 months
Adult dose = 500mg every 6 hours

Infant’s age = 6 months

Pediatric dose: Clark’s rule
FRIED’S RULE
Adult Dose X (Weight ÷ 150) = Childs Dose
Younger than 1 year of age
Exercise #1

Adult dose = 500 mg every 8 hours

Body Surface Area (BSA)
Child’s weight = 46 lbs
BSA (m2) using west nomogram (inches and lbs
Exercise #2 or cm and kg) and square root (height in cm X
Adult dose = 500mg every 6 hours weight in kg)

Child’s weight = 31 kgs Pediatric dose:

CLARK’S RULE ALWAYS in POUNDS (lbs) Drug dose ordered x BSA using square root
(most precise).

Pediatric dose: Young’s rule

Adult Dose X (Age ÷ (Age+12)) = Child's Dose

Exercise #1

Adult dose = 500 mg every 8 hours

Child’s age = 10 y/o

Exercise #2

Adult dose = 500mg every 6 hours

Height (cms) and Weight in kgs
Child’s age = 7 y/o

16
Example 1:  1 Kilogram= 1000 Grams
 1 Gram= 1000 Milligram
Desired dose = 100mg/m2
 1 Milligram= 1000 Micrograms
Height = 72cms Weight= 7 kgs  1 kg= 2.2 lbs
 1 lbs= 454 gm
Answer: 72 x 7 = 504/3600 = 0.14 = 0.37m2 x
 1 oz= 30 gm
100 mg = 37.41mg
 16 oz= 1 lb
Example 2:  1 inch = 2.54 cms (length)

Desired dose = 5mg/m2 Conversion of units

BSA - 1.5 m2 Two methods can be used:

Answer: 5mg / m2 x 1.5m2 = 7.5 mg 1. Dimensional analysis (D/A)

2. Ratio-Proportion calculation (R/P)

Dosage Conversion
NON-PARENTAL MEDICATIONS Method #1 : CONVERSION

1. Dosage calculation of solid form Dimensional Analysis

2. Dosage calculation of liquid form QUESTION: 0.6 g is how many milligrams?

X = conversion unit asked X Given dose

Conversion of units: volume basic equivalent value

 1cc= 1 mL Example:
 5mL= 1 tsp X = 1,000mg X .6 grams
 15mL= 1 tbsp
 30mL= 1 oz 1 gram
 480 mL= 1 pt X = 600 mg
 1 cup = 0.5 pint **
 3785 mL= 1 gal
 3 tsp= 1 tbsp Method #2: Ratio & proportion (R/P)
 2 tbsp= 1 oz
 1 tsp = 60 drops (gtts) QUESTION: 0.6 g is how many milligrams?
 16 oz= 1 pt given dose : X :: basic unit : basic equivalent
 2 pt= 1 qt
 4 qt= 1 gal given in unit asked
 1 grain = 64.8 mg .6 grams: _X_mg :: 1 gram : 1,000mg
 1 Liter= 1000 ml (metric)

TIPS:
Conversion of units: weight

17
1. Know what is asked.

2. Know the doctor’s order = DESIRED

3. Know the available = STOCK

4. Know the CONVERSION UNITS

5. Know which method to use

6. Write LEGIBLY & NEATLY

7. Be careful in entering numbers

Conversion of dosage

Two methods can be used:

1. Basic Formula

→ Dimensional analysis (D/A)

2. Ratio-Proportion calculation (R/P)

→ Fractional Analysis

Sample problem:

A doctor orders 200 mg of Rocephin to be taken

by a 15.4 lb infant every 8 hours. The
medication label shows that 75-150 mg/kg per
day is the appropriate dosage range. Is this
doctor's order within the desired range?

18