MATH COMPUTATIONS IN PHARMACOLOGY

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Three different systems of measurements have

been used in medication administration: the
apothecary, household, and metric systems.

The metric system is the most widely used.

Household measurements are used less often,

the apothecary system, the oldest system of
measurement, not used in current system.
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Medications are generally ordered and
administered based on weight (solids), and
volume (liquids).

METRIC SYSTEM
The basic units of weight and volume in the
metric system are based on the number “10”
as in the decimal system. It uses the basic unit
of GRAM (g) as the unit of weight and LITER
(L) as the unit of volume.
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Parts of the basic units are named by

adding prefixes that describe multiples or
fractions of the standard measure.

Deci = 0.1 (one tenth of one unit)

Centi = 0.01 (one hundredth of one unit)
Milli = 0.001 (one thousandth of one unit)
Micro = 0.000001 (one millionth of one unit)
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WEIGHT Gram (basic g 1g = 1000mg

unit)

milligram mg 1mg = 1000mcg;

0.001g

microgram mcg 1mcg = 0.001mg;

0.000001g

kilogram kg 1kg = 1000g

VOLUME Liter (basic L 1L = 1000ml

unit)

milliliter ml 1ml = (1cc); 0.001L

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RULE: To reduce medication errors, a
zero is always placed before the decimal
point if the unit is less than one whole
unit.
EXAMPLE: 0.78 NOT .78

Extra zeroes to the right of the numbers

at the end of the decimal point should
be deleted.
EXAMPLE: 1.01 NOT 1.01000
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Conversion factors are always in multiples of 10

RULE: To convert from 1 subunit to another you

will either multiply or divide. If converting from
a larger unit to a smaller unit (liter to ml;
kilogram to gram), you multiply by the
appropriate equivalency (1000) or move 3
decimal places to the right

Convert 2 grams to mg
2 x 1000 = 2000 mg OR 2.(000) = 2000mg
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RULE: To convert from a smaller unit (mcg to

mg; mg to g), you divide by 1000, or move
the decimal 3 places to the left.

Convert 4000ml to liters

4000 ÷ 1000 = 4L OR 4.000 = 4L

In order to administer the proper medication

dose you may need to convert dosages
within a system
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HOUSEHOLD SYSTEM
UNIT ABBREVIATION EQUIVALENT
Drop gtt 15 gtt = 1ml
Teaspoon t (tsp) 1 tsp = 5ml
Tablespoon T (tbsp.) 1T = 3tsp; 15ml
Ounce (fluid) Oz 1 0z = 2T; 30ml
Cup cup 1 cup = 8 oz; 240ml
Pint Pt 1pt = 2 cups; 16 oz;
480ml
Quart Qt 1 qt = 4 cups; 2 pts;
960ml
Gallon gal 1 gal = 4 qts
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In order to administer the proper

medication dose you may also need to
convert dosages between the metric and
household systems of measurement.

Know how the measure of a quantity in

one system compares with its measure in
the other system
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RULE: You always convert to the unit of the
medication on hand.

EXAMPLE
Physician orders 2 teaspoons of a medication.
On hand is a bottle containing 20ml of the
medication. The label reads 1 teaspoon = 5ml.
How much would the nurse administer?
Note: Convert teaspoon to ml. Answer would
be in ml.
Answer: 10ml
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As problems get more complex, the need to

perform calculations and all work leading to
answers must be demonstrated on level
computation exams, no matter how simple
the problem.

One more conversion to memorize:

2.2 pounds (lbs) = 1 kg
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RATIO and PROPORTION
A ratio is a comparison of one quantity to
another, can be expressed as a fraction such as
¾ or as ratio 3:4 (stated as 3 is to 4)

A proportion is an equation of 2 ratios that

are equal.

4 quarters = 8 quarters
1 dollar = 2 dollars
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The proportion above can be read as 4
quarters are to 1 dollar as 8 quarters are
to 2 dollars. In a proportion, the products
of cross multiplication are equal. Using
the proportion:
4=8
1=2
4x2=8x1
8 = 8
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4 basic steps to solving problems:

1) Set up a known ratio

2) Set up a proportion with known and
desired units. Use x for the quantity
that is desired or unknown. Label all
terms of the ratio including x.
Be sure the units are the same
horizontally.
3) Cross multiply
4) Solve for the unknown (x)
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EXAMPLE : To solve a proportion problem
such as 3 lbs to ounces.
a. (1 pound = 16 ounces)
b.
1 lb = 3 lbs
16 oz x oz
c. 1 lb(x oz) = 16 oz(3 lbs)
d. Solve for X
X = 48 oz
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REMINDER

When a health care provider orders a

medication, the dosage available (on hand)
may not be in the same measurement unit as
prescribed. You must be able to convert, or
change within and between systems, to set up
the correct ratio and provide the client with
the correct dose.
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FORMULA METHOD
Using a formula method to calculate
dosages requires determining the
components of the formula from the
problem, substituting the information from
the problem into the formula.

NOTE: to perform calculations using

Formula method, you must know the
formula, system of measurements
equivalents and how to do conversions
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5 basic steps to solving the problem

1) Memorize the formula or verify the formula from a resource.
2) Place the information from the problem into the formula in the
correct position, with all the terms in the formula labeled correctly,
including “X”
3) Check that the strength of the drug ordered and the strength of
the drug available are in the same unit of measure. If not, a
conversion must be done before calculating the dosage.
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4) Calculate the dose using the formula:

Dosage ordered X Quantity (form or unit of measure) = dose to give

Dosage available (on hand)

OR
D/H x Q = dose to give
5) Label your answer correctly. Like the quantity, the dose will be stated
in the dosage form
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EXAMPLE 1

Ordered: Drug C 150 mg

Available: Drug C 300 mg/tab
How many tablets should be administered?

Use the formula

150 mg/300 mg x 1 tab = 0.5 tablet

Final answer: 0.5 tablet OR ½ tablet

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EXAMPLE 2

Ordered: Drug C 10,000 units SubQ

Available: Drug C 5,000 units/ml
How many ml should be administered?

Use the formula

10,000 U/5,000 U x 1 ml = 2 ml

Final answer: 2 ml
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DIMENSIONAL ANALYSIS (DA)
Dimensional analysis is considered a
common sense approach to calculating
medication dosages
 To perform calculations using DA, you
must know measurement equivalents and
have an understanding of the dimensional
analysis concept.
 You will need to memorize formulas or
convert depending on your method used
 Dimensional analysis may be used for all
types of calculations
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 The goal is to set up the equation to
cancel out all units of measure (labels)
not needed in the answer (the dose to
be administered)
 In all calculations, the units of measure
in the numerator will cancel out the
same units of measure in the
denominator, and vise versa
 The final calculation results in a clearly
labeled dose to be administered.
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DOSAGE CALCULATION ON PEDIATRICS
Dosages for infants and children are usually less
than the adult dosages for the same medication

The body mass in children is smaller, and their

metabolism is different from adults.

Pediatric dosing is most often based on weight

and safe dose range. Drug manufacturers
sometimes recommend a dosage based on a
child’s weight
2.2 lbs = 1 kg
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2.2 lbs = 1 kg
To convert pounds to kg, divide by 2.2
To convert kg to pounds, multiply by 2.2

EXAMPLE #1
Order: 25 mg/kg of body weight
Available: 5g/20ml
How many ml do you give to 30 lb child?
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RATIO & PROPORTION

1) Calculate the child’s weight in

kilograms (30/2.2 = 13.64 kg)
2) The order reads 25 mg/kg, so multiply
(25 x 13.64 = 341 mg)
3) Set up the ratio and proportion
5 g = 341 mg
20 ml x ml
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4) A conversion must be done because the
order is for mg and the medication is
available in grams. Convert to the unit
on hand (gram). When converting from
milligram to gram, 341 mg becomes
0.341 g.

5) 5g = 0.341 g
20ml x ml

Solution : cross multiply 5x = 20 x 0.341 =

6.82
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6) 5x = 6.82

Solution: Divide by 5 to isolate the x

6.82 / 5 = 1.364 ml or 1.36 ml = 1.4 ml

ANSWER: Give 1.4 ml to the child

weighing 30 lbs
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Formula Method

1) Calculate the child’s weight in

kilograms = 13.64 kg
2) See above. 25 x 13.64 = 341mg

3) Set up the formula D/H x Q = X ml

341 mg x 20ml = X ml
5g
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4) Conversion from mg to gram is
necessary
5) 0.341g x 20ml = X ml
5g
Solution: multiply 0.341 x 20 = 6.82

6) 6.82/5 = X ml
7) Solution: Divide 6.82 by 5 = 1.364 ml =
1.4 ml
8) Give 1.4 ml to the child weighing 30 lbs
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Dimensional Analysis

1) Identify the desired unit needed, and

place on the extreme right (as the
numerator in this case)
2) Fill in the equation with all information
given
3) Cancel out similar labels in numerator
and denominator positions
20 ml 25mg 30lbs ml
5g kg
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4) If cancellations cannot be done, you need to add equivalents in order

for cancellations to be made possible
20 ml 25 mg 30 lbs 1 kg 1g ml = 1.36 or 1.4 ml
5g kg 2.2 lbs 1000mg

5) Multiply all the numerations and divide by the denominators to

obtain your answer. Don’t round any numbers in an equation until
you obtain the final answer

6) Give 1.4 ml to the child weighing 30 lbs

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INTRAVENOUS (IV) FLUID AND
MEDICATION ADMINISTRATION

IV fluids and medications must be closely

monitored

Most large IV fluids and meds administered

in small volumes of fluid (intermittent IV
piggyback) are administered via an
infusion pump – rate of infusion is
expressed in milliliters per hour (ml/hr)
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Occasionally, fluids may be infusing

without and infusion pump or device –
rate of infusion is expressed in drops per
minute (gtts/min)

Calculations of IV fluids and meds can

be done utilizing ratio and proportion
and formula method. Use what is
easiest for you to follow in practice
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In order to calculate an IV rate in
gtts/min you need to know the drop
factor

The drop factor is the number of drops

it takes to equal 1ml with a specific
type of IV tubing. The drop factor is
noted on the tubing package.

IV infusion sets are available as

macrodrips or microdrips.
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The macrodrip sets are calibrated at

10, 15, or 20 gtts/ml

The calibration used at a health care

facility depends on the manufacturer
used by the facility.

Microdrip sets are universally standard

at calibration of 60gtts/ml
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EXAMPLE #1
An IV is ordered to infuse at a rate of 125 ml/hr using a
set calibrated at 10 gtts/ml. Calculate the gtt/min flow
rate.
The ff formula is used in calculating IV drip rates:

1) Volume X drip rate factor (gtts/ml) = gtts/min

Hours (in minutes)
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2) For the above problem, just plug in the known factors:

125 X 10 = 1250 = 20.83
1 (60) 60

3) When calculating gtts/min, round off to the nearest

whole number
ANSWER : 21 gtts/min
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RATIO AND PROPORTION
1) Set up a ratio and proportion:
125 ml = x ml
60 mins 1 min
Be sure the units are the same horizontally

2) Cross multiply
125 ml = x ml
60 mins 1 min
SOLUTION: 60x = 125 X = 2.08 ml/min
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RATIO AND PROPORTION
3) Now you must incorporate the drip rate factor
10 gtts = x drops
1 ml 2.08 ml
Be sure the units are the same horizontally.

4) Cross multiply
10 gtts = x gtts X = 10 (2.08) = 20.8 gtts/min
1 ml 2.08 ml

ANSWER : 21 gtts/min
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DIMENSIONAL ANALYSIS
1) Identify the desired unit needed, and place on the extreme right
gtts
min

2) Fill in the equation with all information given and cancel out similar
labels in the numerator and denominator positions, leaving the labels
required in the answer
125 ml 10 gtts gtts
hr ml min
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3) If any label cannot be cancelled, your need to add equivalents in
order for cancellations to be made possible
1hr 125 ml 10gtts gtts
60 min hr ml min

4) Multiply all the numerators and divide by the denominators to obtain

your answer. Don’t round any numbers in an equation until you
obtain the final answer

5) Answer 20.83 gtts/min = 21 gtts

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EXAMPLE #2

1000 ml of D5 0.9 NaCl is ordered to infuse over 8 hours. An infusion

pump is to be used. At what rate should the nurse set the pump?
Reminder: Infusion pumps are always set at ml/hr

Formula
1000 ml = answer 125 ml/hr
8 hrs
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Ratio and Proportion

1000 ml = x ml
8 hrs 1 hr
8x = 1000
Answer X = 125 ml/hr
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Dimensional Analysis

1000 ml ml
8 hours hr

Answer 125 ml/hr

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CLARK’S RULE

The equation used to calculate pediatric

medication dosage based on the known
weight of a patient and a known adult
dose of medication to be used.

Clark's Rule uses Weight in pounds (lbs),

NEVER in kilograms (kg).
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CLARK’S RULE SAMPLE PROBLEM

A 4-year old patient weighs 17kg. She has

been prescribed a drug that is available
as a 0.5% solution and prepackaged with
an oral dosing spoon embossed with a
milliliter scale. The normal adult dosage
for this medication is 100mg. What
dosage should the child receive if Clark’s
rule is used to calculate it?
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FRIED’S RULE

Similar to Clark's rule is Fried's rule, by which

the formula is modified to be used for
infants.

The formula is nearly identical, except with

the child's weight replaced by the infant's
age in months.
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FRIED’S RULE SAMPLE PROBLEM

Find the 1.5 years old child’s dose of

amoxicillin. Round the answer to the
nearest whole mg. The child is of
normal height for her weight. The
child’s dose is based on the normal
adult dose.

Adult dose: garamycin 40mg

Child’s weight: 41 lbs
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YOUNG’S RULE

equation used to calculate pediatric

medication dosage based on the
patient's age and the known
recommended adult dose.

The child dosage is equal to the adult

dosage multiplied by the child's age in
years, divided by the sum of 12 plus the
child's age.
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 INTRAVENOUS THERAPY
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The therapy that delivers fluids directly into

the vein.
Intravenous cannulation is a technique in
which a cannula is placed inside a vein to
provide venous access.

Venous access allows sampling of blood as well

as administration of fluids, medications,
parenteral nutrition, chemotherapy, and
blood products.
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The choice of fluid, the amount of fluid to be infused, and the rate of
infusion are determined by the indication for fluid therapy.

Types of IV Therapy
For fluids
For blood transfusions
For medications
For nutrition

IV therapy is a common practice for administering fluids to

dehydrated patients, medications, chemotherapy treatments, and
blood transfusions.
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1) PHLEBITIS – inflammation of the vein,

occurs when the cannula is too large for
the vein or if it is improperly secured. To
prevent this, the caregiver should use the
smallest needle possible suitable for the
patient and fluid being administered.

SYMPTOMS
Warmth, swelling, pain, redness around the
vein
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2) EXTRAVASATION – this happens when the liquid

in the IV leaks to the tissue surrounding the vein.
It can also be caused by inserting a cannula that’s
too big for the patient.

SYMPTOMS:
Burning sensation
Swelling around the IV site
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3) AIR EMBOLISM – happens when an air
bubble enters the vein. It could be fatal if
not caught early. The complication can
be avoided by ensuring that the patient is
properly hydrated and resting in a supine
position when injecting and removing the
IV line.

SYMPTOMS
Blue hue of the patient’s skin, difficulty
breathing, low blood pressure
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AIR EMBOLISM
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4) HYPERVOLEMIA – an abnormal increase in blood volume more

likely to happen in pregnant women, young children, elderly
patients, or people with kidney problems.

SIGNS
Tachycardia
Distended neck veins
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5) INFECTION – if the IV line, port or skin on the site of injection are

not properly cleaned prior to inserting the IV, the likelihood of
infection increases. This can be prevented with proper sterilization
and hygiene.

SYMPTOMS
Pain
Swelling
Fever