Means
Many nurses are weak with drug calculations of all sorts. This article will help to review
Extremes
the major concepts related to drug calculations, help walk you through a few exercises, and
provide a few exercises you can perform on your own to check your skills. There are many III. Left side are known quantities
reference books available to review basic math skills, if you find that you have difficulty IV. Right side is desired dose and amount to give
with even the basic conversion exercises. V. Multiply the means and the extremes
HX = DV
DV
X=
Common Conversions: H
Example: Order-Keflex 1 gm p.o. BID
1 Liter = 1000 Milliliters Drug available-Keflex 250 mg per capsule
1 Gram = 1000 Milligrams VIII. D=1 gm (note: need to convert to milligrams)
1 Milligram = 1000 Micrograms 1 gm = 1000 mg
1 Kilogram = 2.2 pounds IX. H=250 mg
X. V=1 capsule
25
: 1 :: 1000 : X
Methods of Calculation 0
Any of the following three methods can be used to perform drug calculations. Please
review all three methods and select the one that works for you. It is important to practice XI. 250X = 1000
the method that you prefer to become proficient in calculating drug dosages.
1000
X=
Remember: Before doing the calculation, convert units of measurement to one system. 250
Lidocaine, Pronestyl A. How to calculate mcg/kg/min if you know the rate of the infusion
2 gms/250 cc D5W
Dosage (in mcg/cc/min) x rate on pump
= mcg/kg/min
1 mg = 7 cc/hr Patient’s weight in kg
2 mg = 15 cc/hr
3 mg = 22 cc/hr B. For example:
4 mg = 30 cc/hr
1600 mcg/cc
400mg of Dopamine in 250 cc D5W =
D. mcg/min (For example - Nitroglycerin) 60 min/hr
Solution cc x 60 min/hr x mcg/min = cc/hr = 26.6 mcg/cc/min
C. 26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 1. 2.5 liters to milliliters
400 mg in 250 cc of IV fluid. You need this to calculate this dosage 2. 7.5 grams to milligrams
concentration first for all drug calculations. Once you do this step, you can do 3. 10 milligrams to micrograms
anything! 4. 500 milligrams to grams
D. NOW DO THE REST! 5. 7500 micrograms to milligrams
E. If you have a 75 kg patient for example... 6. 2800 milliliters to liters
7. 165 pounds to kilograms
26.6 mcg/cc/min x 10 cc on pump 8. 80 kilograms to pounds
= 3.54 mcg/kg/min B. Practice Problems: Use the method you have chosen to calculate the amount to
Patients’s weight in kg (75 kg)
give.
= 3.5 mcg/kg/min (rounded down) 1. Order-Dexamethasone 1 mg
Drug available-Dexamethasone 0.5 mg per tablet
F. How to calculate drips in cc per hour when you know the mcg/kg/min that is 2. Order-Tagamet 0.6 gm
ordered or desired Drug available-Tagamet 300 mg per tablet
3. Order-Phenobarbital 60 mg
mcg/kg/min x patient’s weight in kg Drug available-Phenobarbital 15 mg per tablet
= rate on pump 4. Order-Ampicillin 0.5 gm
dosage concentration in mcg/cc/min
Drug available-Ampicillin 250 mg per 5 ml
5. Order-Dicloxacillin 125 mg
G. For example: Drug Available-Dicloxacillin 62.5 mg per 5 ml
H. 400 mg Dopamine in 250 cc D5W = 26.6 mcg/cc/min 6. Order-Medrol 75 mg IM
Drug Available-Medrol 125 mg per 2 ml
3.5 mcg/kg/min x 75 kg 7. Order-Lidocaine 1 mg per kg
= 9.86 cc Patient’s weight is 152 pounds
26.6 mcg/cc/min
= 10 cc rounded up 8. Order- 520 mg of a medication in a 24 hour period. The drug is ordered
every 6 hours.
How many milligrams will be given for each dose?
I. ALWAYS WORK THE EQUATION BACKWARDS AGAIN TO DOUBLE C. Practice Problems:
CHECK YOUR MATH! 1. Order-1000 ml over 6
J. For example: hrs IV set 15 gtts/ml
2. Order-500 ml over 4
10 cc x 26.6 mcg/cc/min hrs IV set 10 gtts/ml
= 3.5 mcg/kg/min 3. Order-100 ml over 20
75 Kg
Dosage (in mcg/cc/min) x rate on pump min.
= mcg/kg/min IV set 15 gtts/ml
Patient’s weight in kg
Many facilities use monitors to calculate the infusion rates, by plugging the numbers in the
computer or monitor with a keypad and getting the exact infusion titration chart specifically
for that patient. If you use this method for beginning your infusions and titrating the
infusion rates, be very careful that you have entered the correct data to obtain the chart.
Many errors take place because erroneous data is first entered and not identified. The
nurses then titrate the drugs or administer the drugs based on an incorrect chart. A method
to help prevent errors with this type of system is to have another nurse double check the
data and the chart, or to do a hand calculation for comparison. The use of computers for
drug calculations also causes nurses to get “rusty” in their abilities to perform drug
calculations. It is suggested that the nurse perform the hand calculations from time to time,
to maintain her/his math skills.
A. Practice Problems
1. 2500 mL
2. 7500 mg
3. 10,000 mcg
4. 0.5 gm
5. 7.5 mg
6. 2.8 L
7. 75 kg
8. 176 lbs
B. Practice Problems
1. 2 tablets
2. 2 tablets
3. 4 tablets