Medical Dosage Calculation: A Dimensional Analysis Approach

Medical Dosage Calculation
A Dimensional Analysis Approach

Tenth Edition
CHAPTER 9
Parenteral
Medications
Medical Dosage Calculations: A Dimensional Analysis Approach, Tenth Edition Copyright ©2012, ©2008 by Pearson Education, Inc.
June L. Olsen • Anthony P. Giangrasso • Dolores Shrimpton All rights reserved.
Directory
• Classroom Response System Questions

• Lecture Note Presentation
Classroom Response
System Questions
Question #1
The prescriber ordered penicillin G 300,000

unit IM every 12 hours. The label reads
600,000 units per milliliter. How many
milliliters will you administer to the patient?
Question #1 Choices
1. 0.2 mL
2. 0.3 mL
3. 0.4 mL
4. 0.5 mL
Question #1 Response
1. 0.2 mL
2. 0.3 mL
3. 0.4 mL
4. 0.5 mL
Question #2
The prescriber has ordered 4 milligrams of

the analgesic drug, butorphanol tartrate, IM
every four hours PRN. The ampule reads 2
mg per 2 mL. How many milliliters will equal
4 milligrams?
Question #2 Choices
1. 4 mL
2. 5 mL
3. 6 mL
4. 7 mL
1. 4 mL
2. 5 mL
3. 6 mL
4. 7 mL
Question #3
The order: clindamycin 400 mg IM twice a

day for 5 days. The label reads 150 mg/mL.
How many milliliters will you administer to
your patient?
Question #3 Choices
1. 2.4 mL
2. 2.5 mL
3. 2.6 mL
4. 2.7 mL
1. 2.4 mL
2. 2.5 mL
3. 2.6 mL
4. 2.7 mL
Question #4
The order reads: a drug 0.025 g IM three

times a day. If the label states 10 milligrams
per milliliter, how many milliliters will you
prepare for the patient?
Question #4 Choices
1. 2.4 mL
2. 2.5 mL
3. 2.6 mL
4. 2.7 mL
1. 2.4 mL
2. 2.5 mL
3. 2.6 mL
4. 2.7 mL
Question #5
The label on the vial reads: penicillin G

1,000,000 units. The instructions are as
follows: Add 19.6 mL of sterile diluent to
stock solution and 1 mL = 50,000 units. How
many milliliters contain a dose of 100,000
units?
Question #5 Choices
1. 2 mL
2. 3 mL
3. 20 mL
4. 40 mL
1. 2 mL
2. 3 mL
3. 20 mL
4. 40 mL
Lecture Note Presentation
Learning Outcomes
1. Calculate doses for parenteral medications in liquid
form.
2. Interpret the directions on drug labels and package
inserts for reconstituting medications supplied in
powdered form.
3. Label reconstituted multi-dose medication containers
with the necessary information.
4. Choose the most appropriate diluent volume when
reconstituting a multiple-strength medication.
5. Calculate doses of parenteral medications measured in
units.
Figure 9.1 Ampules.
Figure 9.2 Vials.
Parenteral Medications
Supplied as Liquids
Example 1
• The prescriber ordered 3 milligrams of

Dolophine (methadone hydochloride)
subcut stat. The strength is 10mg per mL.
How many milliliters would you administer
to the patient?
3 mg = ? mL
Example 1
• The label reads 10 milligrams per milliliter.

This strength will be used as the unit
fraction
3 mg 1 mL
  ?mL
1 10 mg
3 mg 1 mL 3 mL
   0.3 mL
1 10 mg 10
So, 0.3 milliliter contains 3 milligrams of
methadone, and you would administer 0.3
milliliter of the drug to the patient.
Example 2
• The prescriber ordered 0.002 gram of a

drug IM stat. The strength is 1mg per mL.
Calculate the number of milliliters of this
solution you would administer.
You want to convert 0.002 grams to its equivalent in

milligrams, and then change milligrams to milliliters
0.002 g ? mg ? mL
Example 2
0.002 g = 0 0 0 2 mg = 2 mg
• Because the strength is 1 mg = 1 mL, no

further calculations are needed to
determine that 2mg = 2 mL
• You would administer 2 milliliters of the
solution IM, which would contain 0.002
gram of the prescribed drug.
Example 3
• Determine the quantity of solution to be

withdrawn from the vial if the medication
order reads 250 milligrams of 10% calcium
chloride.
Example 3
• You want to convert 250 milligrams to

milliliters.
250 mg ?g ? mL
2 5 0 gram
So, 250 mg = 0.25 g
Example 3
The strength of “10%” means that 10 grams of
calcium chloride are in 100 milliliters of solution.
So the unit fraction will be 100 mL/10 g
0.25 g 100 mL
  ?mL
1 10 g
0.25 g 100 mL 2.5 mL
 
1 10 g
So, you would withdraw 2.5 mL from the vial.
Heparin
Example 4
• The prescriber ordered:

heparin 5,000 units subcut q12h.
The label on the vial reads 10,000 units
per milliliter. How many milliliters will you
administer to the patient?
Example 4 (continued)
• You want to convert 5000 units to

milliliters.
5,000 units = ? mL
• The label on the vial reads 10,000 units

per milliliter, so the strength is
10,000 units
1 mL
Example 4 (continued)
5,000 units 1 mL
  ? mL
1 10,000 units
1
5,000 units 1 mL 1 mL
 
1 10,000 units 2
2
So, 0.5 milliliter contains 10,000 units of heparin and you

would administer 0.5 milliliter of the solution to the patient
subcutaneously.
Parenteral Medications Supplied
in Powdered Form
Powdered Parenteral Medication
• Some parenteral medications are supplied

in powdered form in sealed vials.The
powder cannot be removed from these
vials. You must add sterile water or saline
(diluent) to the vial and dissolve the
powder to form a solution. You then
withdraw from the vial the liquid volume of
prepared solution that contains the proper
amount of the drug.
Figure 9.38 Drug label for Pfizerpen. (Reg.Trademark of Pfizer Inc.Reproduced with permission.)
Example 5
• The prescriber ordered 150 mg of a drug

IM stat. The directions on the 500 mg vial
read, “Add 9.7 mL NS and the strength will
be 100 mg/mL.” How many milliliters of the
reconstituted solution will you administer?
Example 5
• You want to convert 150 mg to mL. Using

the strength of 100mg/mL.
150 mg 1 mL
  ?mL
1 yr 100 mg
150 mg 1 mL 15 mg
 
1 yr 100 mg 10
So, you would administer 1.5 mL of the solution.
Figure 9.8 Reconstitution of ceftriaxone.
Chapter Summary
• Medications supplied in powdered form

must be reconstituted following the
manufacturer’s directions.
• You must determine the best dosage strength

when there are several options for reconstituting
the medication.
Chapter Summary
• After reconstituting a multiple-dose vial,

label the medication vial with the dates
and times of both preparation and
expiration, storage directions, your
initials, and strength.
Chapter Summary
• When directions on the label are provided

for both IM and IV reconstitution, be sure
to read the order and the label carefully to
determine the necessary amount of diluent
to use.
• Heparin is measured in USP units.
Chapter Summary
• It is especially important that heparin

orders be carefully checked with the
available dosage strength before
calculating the amount to be administered.
• A tuberculin (1 mL) or a 0.5 mL syringe should

be used when administering heparin.
Chapter Summary
• Heparin sodium and heparin flush

solutions are different and should never be
used interchangeably.

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A Dimensional Analysis Approach

• Classroom Response System Questions

The prescriber ordered penicillin G 300,000

The prescriber has ordered 4 milligrams of

The order: clindamycin 400 mg IM twice a

The order reads: a drug 0.025 g IM three

The label on the vial reads: penicillin G

• The prescriber ordered 3 milligrams of

• The label reads 10 milligrams per milliliter.

• The prescriber ordered 0.002 gram of a

You want to convert 0.002 grams to its equivalent in

• Because the strength is 1 mg = 1 mL, no

• Determine the quantity of solution to be

• You want to convert 250 milligrams to

So, 250 mg = 0.25 g

• The prescriber ordered:

• You want to convert 5000 units to

• The label on the vial reads 10,000 units

So, 0.5 milliliter contains 10,000 units of heparin and you

• Some parenteral medications are supplied

• The prescriber ordered 150 mg of a drug

• You want to convert 150 mg to mL. Using

So, you would administer 1.5 mL of the solution.

• Medications supplied in powdered form

• You must determine the best dosage strength

• After reconstituting a multiple-dose vial,

• When directions on the label are provided

• Heparin is measured in USP units.

• It is especially important that heparin

• A tuberculin (1 mL) or a 0.5 mL syringe should

• Heparin sodium and heparin flush

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