PHARMACY CALCULATIONS

RATE OF FLOW OF INTRAVENOUS SOLUTIONS

A very common route of administration, commonly found in the

hospital scenario, are IV infusions. This involves the drug being
introduced directly through a vein as a sterile aqueous solution,
over a period a time. Not to be confused with injections, which are
administered all in one go. In order to ensure the drug is
administered into the patient at a constant rate, a device is used to
control the flow rate of the infusion. It may be necessary to
calculate the volume of solution that is delivered over a period of
time or the volume of solution that will deliver a known quantity of
drug.

EXAMPLE 1:
Mr Jones is a 54 year old man, weighing 70 kg. He has been
prescribed IV sodium valproate at a dose of 30 mg/kg to be
administered over 5 minutes. The sodium valproate injection that
will be used contains 100 mg/mL.

Calculate the rate in mL/min at which the sodium valproate

injection should be administered?

Step 1:
Firstly, we would need to work out the total quantity of drug that
has been prescribed to Mr Jones. He has been prescribed 30 mg/kg.
We therefore would multiply his weight of 70kg by 30mg.
30 x 70 = 2100mg
Therefore, Mr Jones has been prescribed a total of 2100mg of
Sodium Valproate.
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Step 2:
The question is asking us for the rate of infusion of drug into Mr
Jones in mL/min. We therefore need to calculate the volume
required to carry out the infusion. This can be done using the
quantity of drug calculated above, and the information provided to
us about the nature of the sodium valproate injection being used.
The injections come in a concentration of 100mg/mL, and so to
work out the total volume of IV solution required, we would need to
divide total amount of drug by concentration of the injection.

2100
= 21𝑚𝑙
100

Therefore, we require 21ml of drug solution for the infusion.

Step 3:
Finally, the question is asking about the rate of infusion over a 5
minute period in ml/min. We therefore need to divide our total
volume of drug solution by the time of infusion.

21
= 4.2 𝑚𝑙/𝑚𝑖𝑛
5

Therefore, the drug is to be administered at a rate of 4.2 ml/min.

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EXAMPLE 2:
20 mL of Addiphos solution and 10 mL of multivitamin infusion
are added to 500 mL of glucose 5% solution. The resultant solution
is to be administered over 4 hours. The administration set is
calibrated to 20 drops/mL.

Calculate the number of drops per minute to be given if the

patient is to receive all of the solution in the specified time.

Step 1:
Firstly, we would need to calculate the total volume of the infusion
solution:
20ml + 10ml + 500ml = 530ml

Step 2:
As we have been given an administration time of 4 hours, but a
infusion rate of dops/ml, we would then need to convert the
administration time into minutes also.
4 hours x 60 = 240 minutes

Step 3:
The administration set is calibrated to 20 drops/mL. Therefore we
need to convert our total volume into ml:
530 x 20 = 10600 drops

Step 4:
We have been asked to calculate the rate of infusion in drops per
minute, over the administration time provided. We can do this by
dividing the total volume,in drops, by the total time of infusion in
minutes.
100600/240 = 44.17

The infusion fluid should be administered at 44 drops per minute.

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EXAMPLE 3:
A 56-kg female patient requires amphotericin by IV infusion at a
dose of 250 micrograms/kg. The concentration of the final
solution must not be more than 100 micrograms/mL. A vial of
amphotericin contains 50 mg. Calculate the dose of amphotericin
and the volume of IV solution required by the patient if the
solution contains the maximum concentration. If the solution has
to be delivered in 2.5 hours, what is the rate in mL/minute? →

If a 50-mg vial is used to prepare the IV solution, what is the total

volume of the solution prepared?

Step 1:
Firstly, we would need to calculate the total dose of drug prescribed
to the patient. We can do this multiplying the dose of 250
micrograms/kg by the patient’s weight of 56kg.
250 x 56 = 14000 mcg

Step 2:
The question then asks to calculate the volume of IV solution
required by the patient if the solution contains the maximum
concentration of 100 mcg/ml. We therefore need to divide our total
dose of 14000 by 100mcg.
14000/100 = 140ml

Step 3:
The question then asks the rate of infusion in ml/min, to deliver
140ml of the infusion solution in 2.5 hours.
2.5 hours = 150 minutes
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We would then divide the total volume of infusion solution by the

time of 150 minutes.
140ml/150 = 0.93 ml/min

Step 4:
Lastly, The total volume to contain the amphotericin at a
concentration of 100 micrograms/mL needs to be calculated. We
would need to convert 50mg into mcg.
50mg = 50000 mcg

We then to calculate the total volume of vehicle required to contain

the drug at a concentration of 100mcg/ml. To do this, we would
need to divide the total amount of drug in the vial, by the
concentration of 100 mcg/ml.
50000 mcg / 100 = 500ml

Therefore, the 50 mg needs to be dissolved in up to 500 mL of

solvent.

Tip; This question may seem confusing, as only 140ml of infusion solution
is required for administration. Although, this question is concerned with
the preparation of the infusion solution, in the scenario where only vials
containing 50mg of drug compound are available. Of this prepared
solution, only 140ml of the prepared solution will be administered to the
patient.
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EXAMPLE 4:
Phenytoin has a recommended dose of 18 mg/kg of body weight to
be infused at a rate not exceeding 50 mg/minute. Assume that the
patient is a woman weighing 50 kg. The prescriber would like an
infusion volume of 100mL and a dose rate of 25mg/minute. How
much 0.9% saline would be required to make up the injection to
100ml and what is the flow rate per minute?

Step 1:
Firstly, we would need calculate the total dose of drug being
administered to our patient.
18mg x 50kg = 900mg

Step 2:
The injection contains 50mg/ml,
900/50 = 18 ml
We therefore require 18ml of solution.
100ml – 18ml = 82ml
We therefore require 82ml of 0.9% saline to make up the solution.

Step 3:
We are then required to calculate the flow rate per minute. The
prescriber would like a dose rate of 25mg/min, and so we will need
to calculate the volume of infusion solution which contains 25mg of
Phenytoin. We know that in our prepared solution, we have a total
of 900mg in 100ml.

𝑥 100
= 𝑥 = 2.78
25 900

Therefore, 2.78 mL contains 25 mg of phenytoin. Thus the flow rate

of the infusion should be set at 2.78 mL/minute.
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EXAMPLE 5:
The required dose of furosemide by slow IV infusion is 50 mg at a
rate not exceeding 4 mg/minute. Furosemide injection contains
10mg furosemide in 1mL. Calculate the volume of furosemide
injection required and the infusion rate, i.e. mL/minute, if the
patient is to receive the correct dose.

Step 1:
Firstly, we are asked for the volume of Furosemide injection
required. The Furosemide injections contain 10mg in 1ml.
Therefore:
50mg / 10mg/ml = 5ml

Therefore, we require 5ml of Furosemide injection.

Step 2:
We are then asked to calculate the infusion rate in ml/minute.
Firstly, we need to divide the total dose of drug by the maximum
rate of infusion.
50mg / 4mg/min = 12.5 minutes

Therefore, it would take 12.5 minutes to administer all the injection

solution at 2mg/min.

Step 3:
Lastly, to calculate the infusion rate, we need to divide the
administered 5ml of drug solution by the infusion time calculated
of 12.5 minutes.
5/12.5 = 0.4 ml/min

Therefore, the drug solution needs to be administered at a rate of

0.4ml/min in order to deliver the correct dose of drug.