I.

Intravenous Flow Rate Calculation (two methods)

Two Step
Step 1 - Amount of fluid divided by hours to administer = ml/hr
ml/hr x gtts/ml(IV set)
60 min

Step 2 -

= gtts/min

One Step
amount of fluid x drops/milliliter (IV set)
hours to administer x minutes/hour (60)
1000 ml over 8 hrs
IV set = 15 gtts/ml

Example:

Two Step
1000
8

Step 1 125 x 15
60

Step 2 -

= 125
= 31.25 (31 gtts/min)

One Step
1000 x 15
8 hrs x 60

II.

15,000
480

= 31.25 (31gtts/min)

How to Calculate Continuous Infusions

A. mg/min (For example - Lidocaine, Pronestyl)
Solution cc x 60 min/hr x mg/min
Drug mg
Drug mg x cc/hr
Solution cc x 60 min/hr

= cc/hr
= mg/hr

Rule of Thumb
Lidocaine, Pronestyl
2 gms/250 cc D5W
1 mg = 7 cc/hr
2 mg = 15 cc/hr
3 mg = 22 cc/hr
4 mg = 30 cc/hr

D. mcg/min (For example - Nitroglycerin)

Solution cc x 60 min/hr x mcg/min
Drug mcg

= cc/hr

Drug mcg x cc/hr

Solution cc x 60 min/hr

= mcg/hr

Rule of Thumb
NTG 100 mg/250 cc
1 cc/hr = 6.6 mcg/min
NTG 50 mg/250 cc
1 cc/hr = 3.3 mcg/min

G. mcg/kg/min (For example - Dopamine, Dobutamine, Nipride, etc.)

1. To calculate cc/hr (gtts/min)
Solution cc
x 60 min/hr x kg x mcg/kg/min = cc/hr
Drug mcg
Example:
Dopamine 400 mg/250 cc D5W to start at 5 mcg/kg/min.
Patients weight is 190 lbs.
250 cc
x 60 min x 86.4 x 5 mcg/kg/min = 16.2 cc/hr
400,000 mcg

4. To calculate mcg/kg/min
Drug mcg/ x cc/hr
= mcg/kg/min
Solution cc x 60 min/hr x kg
Example: Nipride 100 mg/250 cc D5W was ordered to decrease your patients blood pressure.
The patients weight is 143 lbs, and the IV pump is set at 25 cc/hr. How many mcg/kg/min of
Nipride is the patient receiving?
100,000 mcg x 25 cc/hr
2,500,000
=
= 2.5 mcg/kg/min
250 cc x 60 min x 65 kg
975,000

A. How to calculate mcg/kg/min if you know the rate of the infusion

Dosage (in mcg/cc/min) x rate on pump
Patients weight in kg

= mcg/kg/min

B. For example:
400mg of Dopamine in 250 cc D5W =

1600 mcg/cc
60 min/hr

= 26.6 mcg/cc/min

C. 26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg
in 250 cc of IV fluid. You need this to calculate this dosage concentration first for all
drug calculations. Once you do this step, you can do anything!
D. NOW DO THE REST!
E. If you have a 75 kg patient for example...
26.6 mcg/cc/min x 10 cc on pump
= 3.54 mcg/kg/min
Patientss weight in kg (75 kg)
= 3.5 mcg/kg/min (rounded down)

F. How to calculate drips in cc per hour when you know the mcg/kg/min that is ordered or
desired
mcg/kg/min x patients weight in kg
dosage concentration in mcg/cc/min

= rate on pump

G. For example:
H. 400 mg Dopamine in 250 cc D5W = 26.6 mcg/cc/min
3.5 mcg/kg/min x 75 kg
26.6 mcg/cc/min

= 9.86 cc
= 10 cc rounded up

I. ALWAYS WORK THE EQUATION BACKWARDS AGAIN TO DOUBLE CHECK

YOUR MATH!
J. For example:
10 cc x 26.6 mcg/cc/min
75 Kg
Dosage (in mcg/cc/min) x rate on pump
Patients weight in kg

= 3.5 mcg/kg/min
= mcg/kg/min

L. For example:
M. 400mg of Dopamine in 250 cc D5W = 1600 mcg/cc 60 min/hr = 26.6 mcg/cc/min
N. 26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg
in 250 cc of IV fluid. You need this to calculate this dosage concentration first for all
drug calculations. Once you do this step, you can do anything!
O. NOW DO THE REST!!
P. If you have a 75 kg patient for example

26.6 mcg/cc/min x 10 cc on pump

Patientss weight in kg (75 kg)

= 3.54 mcg/kg/min

Now do some practice exercises to check what you learned

A. Practice Problems:
1. 2.5 liters to milliliters
2. 7.5 grams to milligrams
3. 10 milligrams to micrograms
4. 500 milligrams to grams
5. 7500 micrograms to milligrams
6. 2800 milliliters to liters
7. 165 pounds to kilograms
8. 80 kilograms to pounds
B. Practice Problems: Use the method you have chosen to calculate the amount to give.
1. Order-Dexamethasone 1 mg
Drug available-Dexamethasone 0.5 mg per tablet
2. Order-Tagamet 0.6 gm
Drug available-Tagamet 300 mg per tablet
3. Order-Phenobarbital 60 mg
Drug available-Phenobarbital 15 mg per tablet
4. Order-Ampicillin 0.5 gm
Drug available-Ampicillin 250 mg per 5 ml
5. Order-Dicloxacillin 125 mg
Drug Available-Dicloxacillin 62.5 mg per 5 ml
6. Order-Medrol 75 mg IM
Drug Available-Medrol 125 mg per 2 ml
7. Order-Lidocaine 1 mg per kg
Patients weight is 152 pounds

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?
C. Practice Problems:
1.

Order-1000 ml over 6 hrs

2.

Order-500 ml over 4 hrs

3.

Order-100 ml over 20 min.

IV set 15 gtts/ml
IV set 10 gtts/ml
IV set 15 gtts/ml

D. Practice Problems:
1. Dopamine 400 mg in 250 cc D5W to infuse at 5 mcg/kg/min. The patients weight
is 200 pounds. How many cc/hour would this be on an infusion pump?
2. A Dopamine drip (400mg in 250 cc of IV fluid) is infusing on your 80 kg patient
at 20 cc/hour. How many mcg/kg/min are infusing for this patient?
3. A Nitroglycerin drip is ordered for your patient to control his chest pain. The
concentration is 100 mg in 250 cc D5W. The order is to begin the infusion at 20
mcg/min. What is the rate you would begin the infusion on the infusion pump?
4. A Nitroglycerin drip (100mg in 250 cc D5W) is infusing on your patient at 28
cc/hour on the infusion pump. How many mcg/min is your patient receiving?
5. A procainamide drip is ordered (2gms in 250 cc D5W) to infuse at 4 mg/min. The
patient weighs 165 pounds. Calculate the drip rate in cc/hour for which the
infusion pump will be set at.
6. A Lidocaine drip is infusion on your 90 kg patient at 22 cc/hour. The Lidocaine
concentration is 2 grams in 250 cc of D5W. How many mg/min is your patient
receiving?

Summary
Many nurses have difficulty with drug calculations. Mostly because they dont enjoy or
understand math. Practicing drug calculations will help nurses develop stronger and more
confident math skills. Many drugs require some type of calculation prior to administration.
The drug calculations range in complexity from requiring a simple conversion calculation to a
more complex calculation for drugs administered by mcg/kg/min. Regardless of the drug to
be administered, careful and accurate calculations are important to help prevent medication
errors. Many nurses become overwhelmed when performing the drug calculations, when they

require multiple steps or involve life-threatening drugs. The main principle is to remain
focused on what you are doing and try to not let outside distractions cause you to make a
error in calculations. It is always a good idea to have another nurse double check your
calculations. Sometimes nurses have difficulty calculating dosages on drugs that are
potentially life threatening. This is often because they become focused on the actual drug and
the possible consequences of an error in calculation. The best way to prevent this is to
remember that the drug calculations are performed the same way regardless of what the drug
is. For example, whether the infusion is a big bag of vitamins or a life threatening vasoactive
cardiac drug, the calculation is done exactly the same way.
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.

Answers to Practice Problems

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
4. 10 mL
5. 10 mL
6. 1.2 mL
7. 69 kg = 69 mg
8. 130 mg for 4 doses
C. Practice Problems
1. 41.6 (42)
2. 20.8 (21)
3. 75
D. Practice Problems
1. 17 cc/hr
2. 6.65 mcg/kg/min
3. 3 cc
4. 186.5 mcg/min
5. 30 cc/hr
6. 3 mg/min