Introduction:

Computing drug dosage is one of the most important skill that every nurse must develop competence to ensure
the safe and adequate delivery of medications to the patients. This handout will provide a basic review of the different
units of measurement. This will also assist the students to develop the appropriate skill through this self directed
material and guide questions which can aid the beginning nurses in doing the computation exercises.

Measuring Systems

Metric system: the most widely used system of measure, based on the decimal system, so all units in the system are
determined as multiples of ten
Apothecary system: a very old system or measure that was specifically developed for use by apothecaries or
pharmacists; it uses the minim as the basic unit of liquid measure and grain as the basic unit measure of solid measure.
Household system: measuring system found in recipe books
Avoirdupois system: older system used by pharmacists to compound medications

MEASURES TO REMEMBER BY HEART!

1 kg = 2.2 lbs
1 g = 1000 mg
1 g = 1,000,000 mcg
1 mL = 10-15-20 gtts (depending n the drop factor)
1 gtt = 4 mcgtts
1 grain = 60 mg
1 inch = 2.54 cm

PARENTERAL DRUG ADMINISTRATION

IDEAL VOLUME TO BE ADMINISTERED:

Intradermal/Intracutaneous
0.01 to 0.1 mL

Intramuscular
Ventrogluteal 1-3 mL
Dorsogluteal 1-3 m; 5 mL for gammaglobulin
Deltoid 0.5-1 mL
Vastus Lateralis - < 0.5mL in infants (maximum of 1 mL)
1 mL pediatrics
1-1.5 mL adults (maximum of 2 mL)

Subcutaneous
0.5 mL to 1.5 mL

** Z-track Injection technique dome to prevent medication from leaking back into the SC tissue. Particularly for
medications that cause visible and permanent skin discoloration.
Ex: iron dextran (Imferon) and hydroxyzine (Vistazine)
Legend:
D desired dose
S stock or on hand dose
V vehicle or drug form in which the drug comes (tablet/capsule)
Q quantity or amount of the solution
A amount of drug calculating to be given to the client

Basic Formula

ORAL DRUG ADMINISTRATION

a. Solid Form

b. Liquid form

PARENTERAL DOSAGE
a. Powder form
b. Liquid form

Q will depend on the route and stock dose, the usual diluents are:
If per IM dilute with 2-3 mL
If per IV stock 500 mg dilute with 5 mL
If per IV stock is 501 mg dilute with 10 mL

Note: refer to the drug insert for actual diluent

INTRAVEOUS FLUID COMPUTATION

a.

b.

c. or

d.
Note: In cases of Incorporations
If incorporating drugs on an IV tubing set, the total volume of the solution must be added to the total
volume if more than 100 mL
If incorporating drugs on an Infusion Pump, the total volume of the solution must be added to the total
volume even if it is less than 100 mL
TITRATION
All intensive care units use potent drugs that have a narrow therapeutic index. These are prescribed by the
physician either by flow rate (ml/hr or gtts/min) or by dosage (mg, mcg, units/kg/min or hour)
Because it is potent it needs to be titrated (adjusted by concentration and administration rate) based on the
clients measurable reaction to the per minute dosage of the medication.
These medications are usually prescribed by a range of dosage with the lower level first set an the infusion
adjusted upward until the desired measurable response is obtained.

Conversions of Drug Dosage having % as stock dose

Ratio and proportion

H2O
(constant) (x)

TITRATION:
IVF in gtts : amount of drug to be :: x : amount of drug to be
Incorporated in IVF in mg delivered per minute

PREPARING A SOLUTION:
note: STOCK is always 100%

FORMULA:

1. Dosage calculation by Body Mass ( 1 kg = 2.2 lbs)

It allows for the individualization of drug dose

2. Dosage Calculation by Body Surface Area (BSA)

This provides a good indication of the distribution, metabolism and excretion of medications
The most accurate way to calculate the drug dose for infants, children, older adults and clients with
antineoplastic agents whose body weight is low
BSA is determined by persons height and weight intersecting the nomogram scale or computed using the
following formula:

BSA (m2) = or

3. Pediatric Dosage using Adult Dosage

4. Pediatric Dosage using Old Methods
Clarks Rule (infant & young children)

Youngs Rule (2 years and older)

:
OR
; :
Ex:

Frieds Rule (infants younger than 1 year)

 DOSAGE CALCULATION EXERCISES
ORAL SOLID
1. Cloxacillin Na 0.5g PO q6. How many capsules will be administered per dose if the stock is 250mg/cap?

0.5 g to mg 5
2
5 5 25

2. Mefenamic acid 500mg PO TID. How many tablets must be administered per dose if the stock is 250mg/tab?

5
2
25

3. Codeine 1/6 gr PO STAT. How many tablets must be prepared if the stock is 5 mg tab?

1/6 gr to mg 5
5


1/6 gr

ORAL LIQUID
4. Ampicillin 125 mg PO QID. How many mL of the drug must be administered if the stock is 250mg/5mL?

25
5 2 5
25
5. Phenytoin suspension 0.1 g PO TID. How many mL of the drug will be administered if the stock is 125mg/mL?
0.1 g to mg

0.8 mL

0.1 g
= 100 mg

PARENTERAL DOSAGE
6. Gentamycin 50mg IM q12h. How many mL of the drug must be administered if the stock is 80mg/2mL?

5
2 25
8

7. Heparin 7,500 units SC OD. How many mL should be administered if the stock is 5,000 units/mL in 5cc vial?
75
5
5

DOSAGE CALCULATIONS BY BODY MASS

8. Cefaclor 50 mg QID. Weight = 15 lbs. Drug Dosage = 20-40mg/kg/day
a) How many cc of the drug should be administered if the stock is 125mg/5mL?

5
5 2
25
 b) Is the drug dosage within the recommended range?
15 lbs to kg 20 mg/kg/day x 6.82 kg = 136.4 mg/day
50 mg x 4 doses = 200 mg/day 40 mg/kg/day x 6.82 kg = 272.8 mg/day

15 lbs
6 82 Yes, it is within the recommended range

9. Fluoroucil 12mg/kg/day IV, not to exceed 800mg/day. The adult weighs 132 lbs. How many mg of the drug should
the client receive per day?

132 lbs to kg
12 mg/kg/day x 60 kg = 720 mg/day

122 lbs
6
DRUG CALCULATIONS BY BODY SURFACE AREA
10. Mustargen 6mg/m2 as a single IV dose. BSA = 1.5 m2. How many mL should be administered per dose if the stock is
10mg/mL?
6 mg/m2 x 1.5 m2 = 9 mg 9

= 0.9 mL

11. Sulfisoxazole 2g/m2/day in four divided doses. Childs height is 50 inches and weighs 60lbs
a) What is the dose/day?

BSA (m2) = 0.98 m2 2g/m2/day x 0.98 m2 = 1.96 g/day

b) How many mL of the drug should be administered per dose if the stock is 500mg/5mL?
1.96 g to mg
96 9 6
5 9 6 4 9
1.96 g

96 5 4

PEDIATRIC DOSAGE
12. Penicillin V BSA: 0.7 m2 Adult dose: 1000mg/day in four divided doses
a) How many mg should the child receive per day?

= 404. 62 mg/day

b) How many mL of the drug should be administered per dose if the stock is 125 mg/5mL?
4 4 62 6
6 5 4 4
4 25

13. The usual adult dose of a certain drug is 50mg. What is the dose for an infant 15 months old?

5 5

14. The average adult dose of a drug is 125 mg. Determine the dose for an 8 month old child?
8
25 6 67
5
15. The average adult dose of penicillin V is 250 mg. Determine the dose for a 6 year old and who weighs 68 lbs.

6 68
25 83 33 25 3 33
6+ 2 5

IVF REGULATION
16. Infuse D5NR 1L for 8 hours. What is the regulation in gtts/min?

gtts/min = 8
3 25 3

17. Infuse D5NSS 1L 40 gtts/min.

a) How many mL of the IVF is the client receiving per hour?

40 gtts/min to mL/hr
40 gtts/min 4 6 6

b) If it is started at 8 am, what time will it be consumed?

c)

6 25 0.25 x 60 mins = 15 mins 8: + 6: 5 4: 5 2: 5
6

18. How many hours will a 1L of D5NM run if it will be infuse at 20 gtss/min?

20 gtts/ min x 4 = 8- mcgtts/min or 80 mL/hr

8
= 12.5 hours

PREPARING SOLUTIONS
19. Prepare 500 cc of a 5% Boric acid solution How many g of Boric acid should be included in the solution?

5% : 100cc :: x (gms) : 1 cc

5
5

20. A client is to have 25% of Ensure for NGT feeding. A 250 mL Ensure is available. How many mL of the water is
needed?
25 25 62 5

250 mL 62.5 = 187.5 mL of H2O

TTRATION
21. Incrporate 5g of MgSO4 to D5W 500 mL to infuse for 8 hours.
a) How many mL of MgSO4 will be incorporated if the stock is 25% in 10 mL ampule?

25 % : 100cc : : x : 1cc 5
2 4
25 25
25
 b) What is the regulation of the IVF?

5 5
5 6
8 6
22. Administer 5 g of MgSO4 deep IM to be divided in 2 buttocks. How many mL of the drug will be injected into each
buttock if the stock is 50% in 10 ampule?

50% : 100cc :: x(gms) : 1cc 5

5
5 2

5

23. Administer 1g of Xylocaine in 250 mL of D5W to deliver 2 mg/min.

a) How many mL of Xylocaine will be incorporated in the IVF if the stock is 1 % in 50 mL vial?

1% : 100cc :: x(gms) : 1cc

b) What is the regulation in mcgtts/min if it is to deliver 2mg/min?

3750 gtts : 1000 mg. :: x : 2mg/min

75

7 5
25 5 375
7 5 4 3