DOSE CALCULATIONS

By Osman A. khairdon
 Introduction
• Dose is the amount of drug administered or taken by a
patient for the intended medicinal effect.
• Dose may be expressed as single dose, daily dose .
• Drug doses vary greatly between drug substances;
some drugs have small doses, other drugs have
relatively large doses.
 Dose Measurement
• In the institutional setting, doses are measured and
administered by professional personnel.
• A variety of measuring devices :
– Calibrated cups for oral liquids
– Syringes and intravenous sets for parenteral medication
• In the home setting, the adult patient or a child's parent
generally measures and administers medication.
Exceptions occur when home health care personnel are
involved in a patient's care.
– Liquid dosage is usually measured in "household" terms, most
commonly by the teaspoonful and tablespoonful.
…cont…
• An oral dispenser finds use in administering calibrated
quantities of liquid medication to children

Calibrated cup oral dispenser

 Teaspoon and Tablespoon
• In calculating doses, pharmacists and
physicians accept a capacity of 5 mL for the
teaspoonful and 15 mL for the tablespoonful.
– The capacities of household teaspoons may vary
from 3 to 7 mL and those of tablespoons may vary
from 15 to 22 mL
– Factors such as viscosity and surface tension of a
given liquid can influence the actual volume held
by a household spoon.
 Calculating the number of tablets or capsules
required
A formula :
number required = amount prescribed/amount in each tablet or capsule

Example 1: A patient is prescribed 75mcg of levothyroxine sodium

(thyroxine sodium) but the strength of the tablets available is 25
mcg. How many tablets are required?

Example 2: A patient is prescribed 2 g of flucloxacillin to be given

orally but it is available in 500mg capsules. How many capsules
should you give?
 Exercise
1. 500 mg is prescribed and the tablets are 250 mg each.
How many tablets will you give?
2. How many milliliters of a liquid medicine would provide
a patient with 2 tablespoonfuls twice a day for 8 days?
3. How many milliliters of a mixture would provide a
patient with a teaspoonful dose to be taken 3 times a day
for 16 days?
4. You receive a prescription with the sig: Amoxil® 500mg
1tab PO TID X10D. How many tablets are needed to fill
this order ? 
Drug dosage based on body weight
• The usual doses for drugs are considered generally
suitable for 70-kg (154-lb) individuals.
• The ratio between the amount of drug administered
and the size of the body influences the drug
concentration at its site of action.
• Useful equation for the calculation of dose based on
body weight is:
patient ' s dose ( mg )  drug dose ( mg )  patient ' s weight ( Kg )

• This equation is based on drug dose in mg/Kg and

patient’s weight in Kg.
 Example
1. The usual initial dose of chlorambucil is 150 ug/kg
of body weight once a day. How many milligrams
should be administered to a person weighing 154 lb?
2. The usual dose of sulfisoxazole for infants over 2
months of age and children is 60 to 75 mg/ kg of
body weight. What would be the usual range for a
child weighing 44 lb?
Calculation involving inject able medication

IV infusions are sterile, aqueous preparations

administered intravenously in relatively large
volumes.
– They are used to extend blood volume and /or
provide electryltes, nutrients or medications.
– They come in plastic solution bags and glass
bottles ranging from 50 mL to 1000 mL or more.
 Cont…

• Administration set used to deliver the fluid from IV

bottle or bag to patient’s vein.
– The sets may be standard (macrodrip) or pediatric
(microdrip).
• The passage of solution into patient’s vein may be
assisted by gravity, or by electronic volumetric
infusion pumps.
• IV drugs are usually added to bags of fluid for direct
infusion into the body.
 Example
1. A physician orders midazolam hydrochloride
(VERSED) 2 mg IV Stat. A pharmacist delivers a vial
containing midazolam hydrochloride 5 mg/mL. How
many milliliters should be administered?
2. A physician orders enalaprilat (VASOTEC IV) 2 mg
IVP for a hypertensive patient. A pharmacist delivers
several 1-mL injections, each containing 1.25 mg of
enalaprilat. How many milliliters of the injection
should be administered?
Common Intravenous Solutions and their
abbreviations
Abbreviation Solution Component
D Dextrose
W Water
S Saline
NS Normal Saline (0.9% NaCl)
NaCl Sodium Chloride
RL Ringer’s Lactate
LR Lactated Ringer’s
D5W 5% Dextrose in water
D5LR 5% dextrose in Lactated Ringers
Reading label – Drop Factor (gtt per mL)
• The IV fluid is labeled using special
abbreviations and notations.
• Labeled
– Letters – solution components
– Numbers – concentration
 Calculation of IV Flow rates
• Flow rates (gtt/min) = Number of drop per 1
minutes.
• In most cases, we start with Drop Factor =
gtt/mL
– Rounding off to nearest whole number
because you can watch-count only whole
drops.
• Formula for IV flow rate for manually
regulated IVs ordered in mL per hour or for
minutes
Cont…
 Examples
• A client is to receive 1000 mL of D5W IV that
is to be infused in 8 hours. The available IV set
has a drop factor of 10 gtt per mL. How many
drops per minute would deliver the ordered
flow rate?
 Cont…

2. An intravenous fluid of 1000 mL of Ringer’s

Injection was started in a patient at 8:00 A.M. and
was scheduled to run for 12 hours. At 3:00 P.M. it
was found that 800 mL of the fluid remained in
the bottle. At what rate of flow should the
remaining fluid be regulated using an IV set that
delivers 15 drops per mL in order to complete the
administration of the fluid in the scheduled time?
 Exercise
• The physician's order reads ‘‘1000 cc D5W IV
in 24 hours.'' How many drops per minute
should the IV infusion run if a microdrop
administration set is used? The microdrop set
delivers 60 gtt/mL
 IV Flow Rate: mL per hour
 Regulate an IV volume by electronic infusion
pump or controller calibrated in mL per hour
Total mL ordered
 mL/h (rounded to a whole number)
Total h ordered
 Exercise
1. You receive a physician’s order for D5W
250mL IV over the next 2 hours by infusion
pump. What is the mL/h?
2. Order of medication is Lidocaine 2g in
500mL D5W IV to run at 4mg/min. Calculate
the flow rate per infusion pump.
• Thanks