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Methods of Calculation
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 the method that you prefer
to become proficient in calculating drug dosages.
Remember: Before doing the calculation, convert units of measurement to one system.
D (Desired dose)
H (Dose on hand)
V (Vehicle-tablet or liquid)
D
x V = Amount to Give
H
50 250
x5= = 2 ml
125 125
Known Desired
H : V :: D : X
Means
Extremes
HX = DV
DV
X=
H
IX. H=250 mg
X. V=1 capsule
250 : 1 :: 1000 : X
1000
X=
250
XII. X = 4 capsules
H D
=
V X
HX = DV
DV
X=
H
0.125 0.25
=
1 X
0.25
X=
0.125
XXI. X = 2 tablets
Two Step
One Step
amount of fluid x drops/milliliter (IV set)
hours to administer x minutes/hour (60)
Two Step
1000
Step 1 - = 125
8
125 x 15
Step 2 - = 31.25 (31 gtts/min)
60
One Step
1000 x 15 15,000
= = 31.25 (31gtts/min)
8 hrs x 60 480
Drug mg x cc/hr
= mg/hr
Solution cc x 60 min/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
Rule of Thumb
NTG 50 mg/250 cc
Solution cc
x 60 min/hr x kg x mcg/kg/min = cc/hr
Drug mcg
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
Example: Nipride 100 mg/250 cc D5W was ordered to decrease your patient’s blood pressure.
The patient’s 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?
B. For example:
1600 mcg/cc
400mg of Dopamine in 250 cc D5W =
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!
F. How to calculate drips in cc per hour when you know the mcg/kg/min that is ordered or desired
G. For example:
3.5 mcg/kg/min x 75 kg
= 9.86 cc
26.6 mcg/cc/min
= 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
= 3.5 mcg/kg/min
75 Kg
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!
A. Practice Problems:
3. 10 milligrams to micrograms
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
Patient’s 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:
D. Practice Problems:
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?
Summary
Many nurses have difficulty with drug calculations. Mostly because they don’t 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.
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
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