Lecture Chapter 6

Dosage Calculations: A Multi-Method
Approach
Second Edition
Chapter 6
Oral Medications
Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Learning Objectives (1 of 2)
6.1 Use the Formula method to calculate dosages.

6.2 Calculate Simple (one-step) problems for oral
medications in solid and liquid form.
6.3 Calculate Complex (multi-step) problems for oral
medications in solid and liquid form.
6.4 Calculate doses for medications measured in
milliequivalents.

Learning Objectives (2 of 2)
6.5 Interpret drug labels in order to calculate doses

for oral medication.
6.6 Calculate doses based on body weight.
6.7 Calculate body surface area.
6.8 Calculate doses based on body surface area.

Simple (One-Step) Problems

Simple (One-Step) Problems (1 of 3)
• In the calculations in previous chapters, all the

equivalents have come from standard tables; for
example, 1 t = 5 mL.
• In this section, the equivalent used will come from the
strength of the drug that is available; for example, 30
mg/mL.

• Medication in Solid Form

– Oral medications are the most common type of
prescription.
– Oral medications are often supplied in a variety of
strengths.
– Whenever possible, it is preferable to obtain the
medication in the same strength as the dose ordered.
▪ If that is not available, choose a strength that
equals a multiple of the prescribed dose.

• Medication in Solid Form

– It is best to administer the fewest number of tablets or
capsules possible.
– In clinical settings, unit-dose medications are usually
supplied by the pharmacist.

Formula Method

Formula Method (1 of 2)
• The formula method is used only for dosage calculation.

• It is not used for unit conversion.
D
Q  X
H

Formula Method (2 of 2)
D
Q  X
H
• D stands for the DESIRED dose that the prescriber
ordered.
• H stands for the amount of the drug on HAND, the
strength available in mg, mL, etc.
• Q stands for the QUANTITY containing the amount of the
drug on hand, the number of tablets, capsules, milliliters,
etc.
• X stands for the UNKNOWN amount to be administered.
Example 6.1 Using Formula Method (1 of 2)
• The order reads butabarbital sodium (Butisol Sodium) 60

mg PO 60 min before surgery.
• Read the drug label shown in Figure 6.1 on the next
slide.
• How many tablets of this preoperative sedative will you
administer to the client?

Figure 6.1 Drug Label for Butabarbital
Sodium (Butisol Sodium)

• D (desired dose) = 60 mg
• H (dose on hand) = 30 mg
• Q (dosage unit) = 1 tab
• X (unknown) = ? tab

• Fill in the formula.

D
Q  X
H
60 mg
 1 tab  ? tab
30 mg

• Cancel.

• Multiply.
2 × 1 tab = 2 tab
• So, you would give 2 tablets by mouth 60 minutes before
surgery.

Example 6.1 Using Dimensional
Analysis (1 of 3)
• The order reads butabarbital sodium (Butisol Sodium) 60

mg PO 60 min before surgery.
• Read the drug label shown in Figure 6.1 on the next
slide.
• How many tablets of this preoperative sedative will you
administer to the client?

Figure 6.1 Drug Label for Butabarbital
Sodium (Butisol Sodium)

Analysis (2 of 3)
• Convert 60 mg to tablets.
60 mg = ? tab
• Cancel the milligrams and calculate the equivalent
amount in capsules.
? tab
60 mg   ? tab
? mg

Analysis (3 of 3)
• Because the label indicates that each tablet contains 30
mg, use the unit fraction
1 tab
30 mg
So, you would give 2 tablets by mouth 60 minutes before

surgery.

• Read the label in Figure 6.3 on the next slide.

• How many tablets of this narcotic analgesic will be
needed for a dose containing 10 mg of hydrocodone
bitartrate and 600 mg of acetaminophen?

Figure 6.3 Drug Label for Vicodin

• Vicodin is a combination drug composed of hydrocodone

bitartrate and acetaminophen.
• Therefore, for computational purposes, you need to only
address the first listed drug (hydrocodone bitartrate).
• Because the dose requires 10 mg of hydrocodone
bitartrate, convert the 10 mg to the appropriate number of
tablets.

• However, before doing any calculations, you should

check to see if the ratios of the amounts of the two drugs
in Vicodin are equivalent in both the prescribed dose and
on the label.
– The hydrocodone bitartrate–acetaminophen ratio in
the dose is 10:600 or 1:60.
– The hydrocodone bitartrate–acetaminophen ratio on
the label is 5:300 or 1:60.
• The ratios are equivalent, and you can now proceed with
the calculations.


D
Q  X
H
10 mg
 1 tab  ? tab
5 mg

• Cancel.

• Multiply.
2 × 1 tab = 2 tab
• Because 2 tablets contain 10 mg of hydrocordone
bitartrate and 600 mg of acetaminophen, 2 tablets would
be needed for this dose.

Analysis (1 of 4)

• How many tablets of this narcotic analgesic will be
needed for a dose containing 10 mg of hydrocodone
bitartrate and 600 mg of acetaminophen?

Figure 6.3 Drug Label for Vicodin

Analysis (2 of 4)
• Vicodin is a combination drug composed of hydrocodone
bitartrate and acetaminophen.
• Therefore, for computational purposes, you need to only
address the first listed drug (hydrocodone bitartrate).
• Because the dose requires 10 mg of hydrocodone
bitartrate, convert the 10 mg to the appropriate number of
tablets.
10 mg = ? tab

Analysis (3 of 4)
• Convert 10 mg to tablets.
10 mg = ? tab
amount in capsules.

Analysis (4 of 4)
• The label indicates that one tablet contains 5 mg of
hydrocordone bitartrate.
• Because 1 tab = 5 mg, the unit fraction is
1 tab
5 mg
Because 2 tablets contain 10 mg of hydrocordone bitartrate and

600 mg of acetaminophen, 2 tablets would be needed for this
dose.
Medication in Liquid Form
• Clients may be unable to swallow medication in tablet

form.
• Sometimes oral medications are ordered in liquid form.
– The label states how much drug is contained in a
given amount of liquid.
• For medications supplied in liquid form, you must
calculate the volume of the liquid that contains the
prescribed drug dosage.
– Medication cups, oral syringes, or calibrated droppers
are used to measure the dose.

Figure 6.5 Measuring drugs in liquid form (calibrated
droppers, oral syringe, and measuring cups) (1 of 2)

Figure 6.5 Measuring drugs in liquid form (calibrated
droppers, oral syringe, and measuring cups) (2 of 2)

• The prescriber orders azithromycin oral suspension 500

mg PO stat, then 250 mg for four days.
• Determine the number of milliliters you will administer to
the client for the stat dose.

Figure 6.7 Drug label for azithromycin


• Q (dosage unit) = 5 mL
• X (unknown) = ? mL

D
Q  X
H
500 mg
 5 mL  ? mL
100 mg

• Cancel.

• Multiply.
5 × 5 mL = 25 mL
• So, you would give 25 mL of this antibiotic by mouth to
the client immediately.

Figure 6.8 Medication cup with 500 mg (25
mL) of azithromycin

Example 6.6 Using Dimensional Analysis
• The prescriber orders azithromycin oral suspension 500

mg PO stat, then 250 mg for four days.
• Determine the number of milliliters you will administer to
the client for the stat dose.

Figure 6.7 Drug label for azithromycin

Analysis (1 of 2)
• Convert 500 milligrams to milliliters.
500 mg = ? mL
amount in milliliters.

Analysis (2 of 2)
• Because the label indicates that every 5 mL of the
solution contains 100 mg of azithromycin, use the unit
fraction
5 mL
100 mg
So, you would give 25 mL of this antibiotic by mouth to the

client immediately.
Figure 6.8 Medication cup with 500 mg
(25 mL) of azithromycin

• Order: potassium chloride 30 mEq PO daily in three

divided doses.
• Determine how many tablets of this electrolyte
supplement you should administer.

Figure 6.11 Drug label for K-Tab

• D (desired dose) = 30 mEq

• H (dose on hand) = 10 mEq

D
Q  X
H
30 mEq
 1 tab  ? tab
10 mEq

• Cancel.

• Multiply.
3 × 1 tab = 3 tab
• Because the order indicates “three divided doses,” you

would administer 1 tablet of K-Tab every 8 hours.

Analysis (1 of 3)
• Order: potassium chloride 30 mEq PO daily in three

divided doses.
• Determine how many tablets of this electrolyte
supplement you should administer.

Analysis (2 of 3)
• Think of the problem this way:

– 30 mEq = x tab (dose)
– 10 mEq = 1 tab (strength)
• One way to set up the proportion is
30 mEq 10 mEq

x tab 1 tab

Analysis (3 of 3)
• Eliminate the units of measurement, cross multiply, and

simplify.
Because the order indicates “three divided doses,” you

would administer 1 tablet of K-Tab every 8 hours.

Complex (Multistep) Problems

Complex (Multistep) Problems (1 of 2)
• Sometimes dosage calculations will require that

multiplication by unit fractions be repeated one or more
times.
• Because you want to find a single unit of measurement,
you must start with a single unit of measurement.

Complex (Multistep) Problems (2 of 2)
• Using Moving the Decimal Point and the Formula Method

– Sometimes, D and H are not in the same units of
measurement.
– To use the formula method, the units of measurement
of D and H must match.
– Also, the units of measurement of Q and X must
match.
– In some instances, you can do this by moving the
decimal point to the right or left, depending on the
order and dose on hand.

• The order is Daypro (oxaprozin) 1.8 g PO once daily

each morning.
• The drug is supplied as 600 mg per caplet.
• How many caplets of this anti-inflammatory drug should
be given to the client?

• D (desired dose) = 1.8 grams

• H (dose on hand) = 600 milligrams
• Q (dosage unit) = 1 caplet
• X (unknown) = ? caplets

• First, you need to convert 1.8 grams to an equivalent

amount of milligrams.

• Move the decimal point 3 places to the right.

D
Q  X
H
1800 mg
 1 cap  ? cap
600 mg

• Cancel.
So, you should give 3 caplets by mouth to the client once a

day in the morning.

Analysis (1 of 6)
• The order is Daypro (oxaprozin) 1.8 g PO once daily
each morning.
• The drug is supplied as 600 mg per caplet.
• How many caplets of this anti-inflammatory drug should
be given to the client?

Analysis (2 of 6)
• Given: Amount of solution: 1.8 grams
• Strength: 1 cap = 600 mg
• Find: Amount of solute: ? cap
• In this problem, you want to convert 1.8 grams to
milligrams and then convert milligrams to caplets.
– 1.8 g = ? mg = ? cap

Analysis (3 of 6)
• You can do this on one line as follows:
? mg ? cap
1.8 g    ? cap
? mg ? mg

Analysis (4 of 6)
• Because 1,000 mg = 1 g, the first unit fraction is
1,000 mg
1g

Analysis (5 of 6)
• Because 1 cap = 600 mg, the second unit fraction is
1 cap
600 mg

Analysis (6 of 6)
• So, you should give 3 caplets by mouth to the client once

a day in the morning.

Dosages Based on the Size of the Client

Dosages Based on the Size of the Client
• Sometimes the amount of medication prescribed is based

on the client’s size.
– A client who is larger will receive a larger dose of the
drug.
– A client who is smaller will receive a smaller dose of
the drug.
• The size of a client is measured by:
– body weight, or;
– body surface area (BSA).

Dosages Based on Body Weight
• When an order is based on the body weight of the client,
the client’s weight is expressed in kilograms.
• Whether you use dimensional analysis, ratio & proportion,
or formula methods to do the following problems, it is best
to start out with Size of the client ×Order to obtain the
Dose.
• The expression 15 mg/kg means the client is to receive 15
milligrams of the drug for each kilogram of body weight.
– Therefore, you will use the equivalent 15 mg (of drug) =
1 kg (of body weight).

• The physician orders Biaxin (clarithromycin) 7.5

milligrams per kilogram PO q12h.
• If the strength is 250 milligrams per 5 mL, how many mL
of this antibiotic drug should be administered to a patient
who weighs 70 kilograms?
– Body weight: 70 kg
– Order: 7.5 mg/kg
– Strength: 250 mg/5 mL
– Find: ? mL

• You want to “change” the body weight of the client (70

kg) to milligrams of drug.
• The order is 7.5 mg/kg, so use the formula
Size of client × Order = Dose
Therefore, the client should receive 525 mg.

• D (desired dose) = 525 milligrams

• H (dose on hand) = 250 milligrams
• Q (dosage unit) = 5 milliliters
• X (unknown) = ? milliliters

• Fill in the formula. D

Q  X
H
525 mg
 5 mL  ?mL
250 mg

• Cancel.

• Multiply.
2.1 × 5 mL = 10.5 mL
• The client should receive 10.5 mL of Biaxin by mouth
every 12 hours.

Analysis (1 of 4)
• The physician orders Biaxin (clarithromycin) 7.5
milligrams per kilogram PO q12h.
• If the strength is 250 milligrams per 5 mL, how many mL
of this antibiotic drug should be administered to a patient
who weighs 70 kilograms?
– Body weight: 70 kg
– Order: 7.5 mg/kg
– Strength: 250 mg/5 mL
– Find: ? mL

Analysis (2 of 4)
• The client’s weight is 70 kg.
• The order is for 7.5 mg/kg.
• Multiply the size of the client by the order to determine
how many milligrams of Biaxin to give the client.
So, the client must receive 525 mg of Biaxin.

Analysis (3 of 4)
• Now, convert the 525 mg of Biaxin to milliliters.
• The strength of the solution is 250 mg/5 mL.
• Think of the problem this way:
– 525 mg = x mL (dose)
– 250 mg = 5 mL (strength)

Analysis (4 of 4)
• One way to set up the proportion is
The client should receive 10.5 mL of Biaxin by mouth every

12 hours.

Dosages Based on Body Surface Area

Dosages Based on Body Surface Area
• Body surface area (BSA) may be used rather than weight

in determining appropriate drug dosages.
–This is particularly true when calculating dosages for
children, those receiving cancer therapy, burn clients,
and clients requiring critical care.
• A patient’s BSA, which is measured in square meters
(m2 ), can be determined by using one of two
mathematical formulas.

BSA Formulas (1 of 2)
• Formula for metric units:
weight in kilograms ´ height in centimeters

BSA =
3,600

BSA Formulas (2 of 2)
• Formula for household units:
weight in pounds ´ height in inches

BSA =
3,131

Example 6.20 (1 of 2)
• What is the BSA of a man who is 5 feet 5 inches tall and

weighs 150 pounds?
• First you convert 5 feet 5 inches to 65 inches.
• Because the example has household units (pounds and
inches), we use the following formula:
weight in pounds ´ height in inches

BSA =
3,131

150  65
BSA 
3,131
 3.11402
 1.7646
2
Therefore, the BSA of this adult is 1.76 m .

• Order: leucovorin calcium 10 mg/m2 PO q6h until serum

methotrexate level is less than 108 M.
• Then calculate how many tablets you will administer to a
client who has a BSA of 1.49 m2 .
• The package information states that these are scored

tablets.

Figure 6.18 Drug Label for Leucovorin
Calcium

• BSA: 1.49 m2 [single unit of measurement]

• Order: 10 mg / m2 [equivalence]
• Strength: 1 tab = 15 mg [equivalence]
• Find: ? tab [single unit of measurement]

• First, multiply the size of the client by the order to

determine how many milligrams of the drug to give the
client.
• Then use the strength to change the resulting milligrams
to tablets.
So, you will administer 1 tablet to the client by mouth every

6 hours.

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Dosage Calculations: A Multi-Method

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

6.1 Use the Formula method to calculate dosages.

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

6.5 Interpret drug labels in order to calculate doses

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• In the calculations in previous chapters, all the

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• Medication in Solid Form

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• Medication in Solid Form

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• The formula method is used only for dosage calculation.

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• The order reads butabarbital sodium (Butisol Sodium) 60

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• Fill in the formula.

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• The order reads butabarbital sodium (Butisol Sodium) 60

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

So, you would give 2 tablets by mouth 60 minutes before

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• Read the label in Figure 6.3 on the next slide.

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• Vicodin is a combination drug composed of hydrocodone

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• However, before doing any calculations, you should

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• Fill in the formula.

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

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• Read the label in Figure 6.3 on the next slide.

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Because 2 tablets contain 10 mg of hydrocordone bitartrate and

• Clients may be unable to swallow medication in tablet

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• The prescriber orders azithromycin oral suspension 500

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Copyright © 2018, 2013 Pearson Education, Inc. All Rights Reserved

• D (desired dose) = 500 mg

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• Fill in the formula.

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