DRUGS & DOSAGE CALCULATION

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OBJECTIVES
At the end of this presentation Candidates will be able to:
Explain the concepts of metric conversion system. Demonstrate conversion from one metric system to another metric system. Explain the concepts of Tablet Dosage Calculations Calculating the number of tablets or capsules to administer to a patient Explain the concepts for calculating fluid dosages. Demonstrate for calculating fluid dosages. Explain the concepts for intravenous drug calculations Practice for intravenous drug calculations
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METRIC CONVERSIONS SYSTEM

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How to do metric conversions:

Basic measures or units

Quantity length mass volume time

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Unit metre gram litre second

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Symbol m
Small s

g l s
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CLASS ACTIVITY
Question: What are the Quantities of the following Symbols ? Symbol m g l s
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Quantity length mass volume time

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Question: What are the units of the following Symbols ? Symbol m g l s
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Unit metre gram litre second

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How to do metric conversions:

Large and small quantities of these units often have a prefix (beginning word) to make writing quantities more compact For example 0.000001g may be written as 1 mcg or 1g.
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Prefix
mega kilo hecto deka Unit deci centi milli micro

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Multiplication Factor M 1,000,000 k 1,000 h 100 da 10 e.g. g, m, l or s 1 d 0.1 c 0.01 m 0.001 mcg or 0.000001
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Symbol

CLASS ACTIVITY
Question: What are the SYMBOLS of the of the following Prefixes ?

Prefix mega kilo hecto deka

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Symbol M k h da
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CLASS ACTIVITY
Question: What are the SYMBOLS of the of the following Prefixes ?

Prefix deci centi milli micro

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Symbol d c m mcg or
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CLASS ACTIVITY
Solve the following equation

2+2X2 2X2+2
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06 GOOD JOB
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Rule of Mathematic

Always multiply or divide first then add or abstract Example: CORRECT 2X2+2 =6 2+2X2 =8 WRONG
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What is decimal?
Point () placement in number is called decimal. Example:

0.1 00.1 1000

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Decimal
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MNEMONICS TO LEARN
M - - k h da _____ d c m - -
Left--------Decimal Place-------- Right

Easy to learn: Maa - - Ka haat daal ( ) dahi chawal mircha - - uthao

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Moving decimal Placement

CONVERTING A NUMBER FROM ONE METRIC UNIT TO ANOTHER INVOLVES MOVING THE DECIMAL PLACE TO THE LEFT OR THE RIGHT. 1. Identify the two units (e.g g to mg.) in the problem 2. Count the number of units from the unit given to the unit desired 3. Move the decimal point the number of places from the given unit to the desired unit
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Example 1
Convert 0.1 grams to milligrams. The decimal place is moved 3 places to the right.

Mg - - kg hg dag g dg cg mg - - g

10 0 0

0.1 g = 100 mg
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Example 2
Convert 375 millilitres to litres. The decimal place is moved 3 places to the left.

Ml - - kl hl dal l dl cl ml - - l

0.0 0 1
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375 ml = 0.375 l
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Class Activity
M --k h da ( UNIT )d c m - -
1. Convert 93074 milligrams to grams. Answer= (93.074) 2. Convert 0.090113 millilitres to microlitres. Answer=(90.113) 3. Convert 0.056915 metres to micrometres. Answer=(56915) 4. Convert 64343 millilitres to litres. Answer=(64.343) 11/12/2012 NomiWG-ACI

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Class Activity

M --k

5. Convert 0.008781 millilitres to microlitres Answer= 8.781 6. Convert 97.196 micrograms to milligrams. Answer= 0.097196 7. Convert 91.765 grams to milligrams. Answer= 91765 8. Convert 0.056244 milligrams to micrograms. Answer= 56.244
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)d c m - -

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Class Activity
M - - k h da ( UNIT )d c m - - 9. Convert 0.027342 millilitres to microlitres. Answer= 27.342 10. Convert 16.961 micrograms to milligrams. Answer= 0.016961 11. Convert 70.906 microlitres to millilitres. Answer= 0.070906 12. Convert 9.707 litres to millilitres. Answer= 9707
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Class Activity

M --k

h da ( UNIT

)d c m - -

13. Convert 0.089292 metres to micrometres. Answer= 89292 14. Convert 91.103 microlitres to millilitres. Answer= 0.091103 15. Convert 0.070223 litres to microlitres. Answer= 70223 16. Convert 0.073969 litres to microlitres Answer= 73969
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Class Activity
M --k h da ( UNIT )d c m - -

17. Convert 46704 micrometres to metres. Answer= 0.046704 18. Convert 97599 milligrams to grams. Answer= 97.599 19. Convert 45232 milligrams to grams. Answer= 45.232 20. Convert 14.805 micrograms to milligrams. Answer= 0.014805
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Software fro

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Software fro

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Tablet Dosage Calculations

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How to calculate tablet dosages:

Required Dose Stock Dose

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Number of = tablets to be given

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Note: Units (e.g. g, mg.) for required dose and stock dose must be the same

Example 1:
A client is ordered 150mg of aspirin. 300 mg aspirin tablets are available. How many tablets would you give?

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150 mg ------------------ = 1/2 tablet 300 mg

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Example 2: How many tablets containing 62.5 mcg will be required to give a dose of 0.125 mg?
STEP 1 : CONVERT TO SAME UNITS
(0.125 mg to mcg) or (62.5mcg to 0.125 mg)

STEP 2: CALCULATE
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STEP 1 : CONVERT TO SAME UNITS (0.125 mg to mcg)

Convert 0.125 mg to mcg. The decimal place is moved 3 places to the right. 1 00 0 Mg - - kg hg dag g dg cg mg > > g 0.125 mg = (0.125 * 1000 mcg) = 125 mcg
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STEP 2: CALCULATE

125 mcg ------------------ = 2 tablets 62.5 mcg

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OR
Convert 62.5 mcg to mg. The decimal place is moved 3 places to the left. Mg - - kg hg dag g dg cg mg < < g (0.001) 62.5 mcg = (62.5 * 0.001 mg) = 0.0625 mg STEP 2: CALCULATE 0.125 mg ------------------ = 2 tablets 0.0625 mg
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CLASS ACTIVITY
1.A client is ordered 50 milligrams of Amitriptyline. 25 milligram tablets are available. How many tablets will you give? 50 milligrams ---------------------------------- = 2 tablets 25 milligrams 2.A client is ordered 37.5 milligrams of Dothiepin. 75 milligram tablets are available. How many tablets will you give? 37.5 milligrams ---------------------------------- = 0.5 tablets 75 milligrams
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CLASS ACTIVITY
3.A client is ordered 37.5 milligrams of Nortriptyline. 25 milligram tablets are available. How many tablets will you give?
37.5 milligrams ---------------------------------- = 1.5 tablets 25 milligrams

4.A client is ordered 300 milligrams of Thioridazine. 100 milligram tablets are available. How many tablets will you give?
300 milligrams ---------------------------------- = 3 tablets 100 milligrams
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CLASS ACTIVITY
5. A client is ordered 0.5 milligrams of Digoxin. 250 microgram tablets are available. How many tablets will you give? 500 mcg (=0.5mg) ----------------------------------= 2 tablets 250 mcg 6. A client is ordered 1 milligram of Diazepam. 2 milligram tablets are available. How many tablets will you give? 1 milligram ----------------------------------= 0.5 tablets 2 milligram
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CLASS ACTIVITY
7. A client is ordered 300 milligrams of Carbamazepine. 200 milligram tablets are available. How many tablets will you give?
300 milligrams ---------------------------------- = 1.5 tablets 200 milligrams

8. A client is ordered 200 milligrams of Sodium Valproate. 100 milligram tablets are available. How many tablets will you give?
200 milligrams ---------------------------------- = 2 tablets 100 milligrams NomiWG-ACI
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9. A client is ordered 100 milligrams of Thioridazine. 25 milligram tablets are available. How many tablets will you give? 100 milligrams ---------------------------------- = 4 tablets 25 milligrams 10. A client is ordered 7.5 milligrams of Bendrofluazide. 2.5 milligram tablets are available.How many tablets will you give? 7.5 milligrams ---------------------------------- = 3 tablets 2.5 milligrams
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CLASS ACTIVITY
11. A client is ordered 100 milligrams of Pehthidine HCL. 50 milligram tablets are available. How many tablets will you give? 100 milligrams ---------------------------------- = 2 tablets 50 milligrams 12. A client is ordered 30 milligrams of Codeine phosphate. 60 milligram tablets are available. How many tablets will you give? 30 milligrams ---------------------------------- = 0.5 tablets 60 milligrams
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CLASS ACTIVITY
13. A client is ordered 2.5 grams of Neomycin sulphate. 500 milligram tablets are available. How many tablets will you give? 2.5 grams ---------------------------------- = 5 tablets 500 mg = 0.5g 14. A client is ordered 30 milligrams of Diltiazem hydrochloride. 60 milligram tablets are available. How many tablets will you give? 30 milligrams ---------------------------------- = 0.5 tablets 60 milligrams
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CLASS ACTIVITY
15. A client is ordered 62.5 micrograms of Benztropine Mesylate. 0.25 mg tablets are available. How many tablets will you give? 0.0625 milligrams ---------------------------------- = 0.25 tablets 0.25 milligrams 16. A client is ordered 60 milligrams of Phenelzine. 15 milligram tablets are available. How many tablets will you give? 60 milligrams ---------------------------------- = 4 tablets 15 milligrams
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CLASS ACTIVITY
17. A client is ordered 37.5 milligrams of Clomipramine. 25 milligram tablets are available. How many tablets will you give? 37.5 milligrams ---------------------------------- = 1.5 tablets 25 milligrams 18. A client is ordered 1.25 milligrams of Clonazepam. 0.5 milligram tablets are available. How many tablets will you give? 1.25 milligrams ---------------------------------- = 2.5 tablets 0.5 milligrams
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CLASS ACTIVITY
19. A client is ordered 2.5 milligrams of Haloperidol. 5 milligram tablets are available. How many tablets will you give? 2.5 milligrams ---------------------------------- = 0.5 tablets 5 milligrams 20. A client is ordered 40 milligrams of Imipramine. 10 milligram tablets are available. How many tablets will you give? 40 milligrams ---------------------------------- = 4 tablets 10 milligrams
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Fluid Dosage Calculations

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How to calculate fluid dosages:

Formula Used for oral, intra-muscular, intravenous or subcutaneous injection
Required Dose Stock Volume -------------------- X --------------------= Volume to be given Stock Dose 1

Note: Units for required dose and stock dose must be the same
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Example1:
A client is ordered 15mg of stemetil. You have 2ml of solution on hand which contains 25 mg Stemetil. What volume of solution would you give? Required Dose Stock Volume
-------------------- X --------------------= Volume to be given Stock Dose 1

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Example 2:
A dose of 75 mg of pethidine has been ordered. It is available in ampoules containing 100 mg in 2 ml. What volume must be administered?
Required Dose Stock Volume -------------------- X --------------------= Volume to be given Stock Dose 1

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CLASS ACTIVITY
1. A client is ordered 35 milligrams of Codeine phosphate by subcutaneous injection. 50 milligrams in 1 millilitre of liquid for SC Injection is available. How many millilitres will you administer?
35 1 35 ------------- X ------ = --------- = 0.7 ml 50 1 50
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CLASS ACTIVITY
2. A client is ordered 50 milligrams of Amoxicillin trihydrate orally. 125 milligrams in 5 millilitres of Syrup is available. How many millilitres will you administer?
50 5 250 ------------- X ------ = --------- = 2 ml 125 1 125

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CLASS ACTIVITY
3. A client is ordered 30 milligrams of Frusemide intravenously. 10 milligrams in 1 millilitre of liquid for IV Injection is available. How many millilitres will you administer?
30 1 30 ------------- X ------ = --------- = 3 ml 10 1 10
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CLASS ACTIVITY
4. A client is ordered 20 milligrams of Haloperidol decanoate by intramuscular injection. 50 milligrams in 1 millilitre of liquid for IM Injection is available. How many millilitres will you administer?
20 1 20 ------------- X ------ = --------- = 0.4 ml 50 1 50
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CLASS ACTIVITY
5. A client is ordered 50 milligrams of Aminophylline intravenously. 250 milligrams in 10 millilitres of liquid for IV Injection is available. How many millilitres will you administer?
50 10 500 ------------- X ------ = --------- = 2 ml 250 1 250
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CLASS ACTIVITY
6. A client is ordered 75 milligrams of Pethidine HCL by subcutaneous injection. 50 milligrams in 1 millilitre of liquid for SC Injection is available. How many millilitres will you administer? 75 1 75 ------------- X ------ = --------- = 1.5 ml 50 1 50
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CLASS ACTIVITY
7. A client is ordered 25 milligrams of Methyldopa intravenously. 50 milligrams in 5 millilitres of liquid for IV Injection is available. How many millilitres will you administer?
25 ------------50
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5 X ------ = 1

125 --------50

= 2.5 ml

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CLASS ACTIVITY
8. A client is ordered 5 milligrams of Flupenthixol decanoate by intramuscular injection. 40 milligrams in 2 millilitres of liquid for IM Injection is available. How many millilitres will you administer?
5 ------------40
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2 X ------ = 1

10 --------- = 0.25 ml 40
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CLASS ACTIVITY
9. A client is ordered 75 milligrams of Aminophylline intravenously. 250 milligrams in 10 millilitres of liquid for IV Injection is available. How many millilitres will you administer?
75 ------------250
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10 X ------ = 1

750 --------250

= 3 ml

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CLASS ACTIVITY
10.A client is ordered 200 milligrams of Augmentin in 600 intravenously. 600 milligrams in 6 millilitres of liquid for IV Injection is available. How many millilitres will you administer?
200 ------------600
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6 X ------ = 1

1200 --------600

= 2 ml

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CLASS ACTIVITY
11. A client is ordered 5 milligrams of Haloperidol orally. 2 milligrams in 1 millilitre of Syrup is available. How many millilitres will you administer?
5 ------------2
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1 X ------ = 1

5 --------2

= 2.5 ml

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CLASS ACTIVITY
12. A client is ordered 13 milligrams of Morphine sulphate by intramuscular injection. 5 milligrams in 1 millilitre of liquid for IM Injection is available. How many millilitres will you administer?
13 ------------5
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1 X ------ = 1

13 --------5

= 2.6 ml

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CLASS ACTIVITY
13. A client is ordered 22 milligrams of Gentamicin sulphate by intramuscular injection. 20 milligrams in 2 millilitres of liquid for IM Injection is available. How many millilitres will you administer?
22 ------------20
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2 X ------ = 1

44 --------20

= 2.2 ml

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CLASS ACTIVITY
14. A client is ordered 75 micrograms of Fenatyl citrate intravenously. 0.1 milligrams in 1 millilitre of liquid for IV Injection is available. How many millilitres will you administer?
75 ------------100
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1 X ------ = 1

75 --------- = 0.75 ml 100

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CLASS ACTIVITY
15. A client is ordered 50 milligrams of Sodium Valproate orally. 200 milligrams in 5 millilitres of Syrup is available. How many millilitres will you administer?
50 ------------200
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5 X ------ = 1

250 --------- = 1.25 ml 200

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CLASS ACTIVITY
16. A client is ordered 10 milligrams of Thioridazine orally. 50 milligrams in 5 millilitres of suspension is available. How many millilitres will you administer?
10 ------------50
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5 X ------ = 1

50 --------50

= 1 ml

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CLASS ACTIVITY
17. A client is ordered 60 milligrams of Nefopam hydrochloride by intramuscular injection. 20 milligrams in 1 millilitre of liquid for IM Injection is available. How many millilitres will you administer?
60 ------------20
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1 X ------ = 1

60 --------20

= 3 ml

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CLASS ACTIVITY
18. A client is ordered 200 milligrams of Amoxicillin trihydrate orally. 250 milligrams in 5 millilitres of Syrup is available. How many millilitres will you administer?
200 ------------250
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5 X ------ = 1

1000 --------250

= 4 ml

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CLASS ACTIVITY
19. A client is ordered 4 milligrams of Trifluoperazine orally. 5 milligrams in 5 millilitres of liquid forte is available. How many millilitres will you administer?
4 ------------5
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5 X ------ = 1

20 --------5

= 4 ml

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CLASS ACTIVITY
20. A client is ordered 2.5 milligrams of Promethazine hydrochloride orally. 5 milligrams in 5 millilitres of elixir is available. How many millilitres will you administer?
2.5 ------------5
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5 X ------ = 1

12.5 --------5

= 2.5 ml

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IV Drop Rate Calculations

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How to calculate IV flow rates:

Intravenous fluid must be given at a specific rate,Neither too fast nor too slow The specific rate may be measured as
ml/hour, L/hour drops/min

To control or adjust the flow rate only drops per minute are used.
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How to calculate IV flow rates:

The burette contains a needle or plastic dropper which gives the number of drops per ml (the drop factor). A number of different drop factors are available (determined by the length and diameter of the needle).

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COMMON DROP FACTORS

10 drops/ml (Blood Set) 15 drops / ml (Regular Set) 60 drops / ml ( Micro Drop)

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Common drop factors

To measure the rate we must know: (a) the number of drops (b) time in minutes.
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FORMULA FOR FLOW RATES

volume (ml) X drop factor (drops/ml) ---------------------------------------------- = drops / minute time (min)

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Example:
1500 ml IV Saline is ordered over 12 hours. Using a drop factor of 15 drops / ml, how many drops per minute need to be delivered? 1500 (ml) X 15 (drops/ml) ---------------------------------------------12 x 60 (gives us total minutes) Answer = 31 drops / minute
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Class Activity
1. Calculate the drip rate for 100 mls of IV Fluids to be given over a half hour via a giving set which delivers 10 drops/ml.
time = half hour = 30 minutes

100 mls X 10 drops/ml 1000 drops ---------------------------- = ------------------ = 33 drops / min 30 min 30 min
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Class Activity
2. One litre of Normal Saline is charted over 9 hours. The drop factor is 15. Calculate the number of drops per minute.
Time = 9 hours = 9 x 60 = 540 minutes 1 litre = 1000 mls 1000 mls X 15 drops/ml 15000 drops ---------------------------- = ------------------ = 28 drops / min 540 min 540 min
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Class Activity
3. One and a half litres of Normal Saline is required to be given over 4 hours. Using a giving set which delivers 10 drops/ml how many drops per minute will need to be given?
Time = 4 hours = 4 x 60 = 240 minutes 1.5 litres = 1500 mls
1500 mls X 10 drops/ml 15000 drops ---------------------------- = ------------------ = 63 drops / min 240 min 240 min
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Class Activity
4. Calculate the drip rate for 2 litres of IV Fluids to be given over 5 hours via a giving set which delivers 10 drops/ml.
Time = 5 hours = 5 x 60 = 300 minutes 2 litres = 2000 mls 2000 mls X 10 drops/ml 20000 drops ---------------------------- = ------------------ = 67 drops / min 300 min 300 min
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Class Activity
5. Ordered: 1 litre of Dextrose 5% in water over 8 hours using a giving set which delivers 10 drops/ml. Calculate the rate in drops/minute.
time = 8 hours = 8 x 60 = 480 minutes 1 litres = 1000 mls

1000 mls X 10 drops/ml 10000 drops ---------------------------- = ------------------ = 21 drops / min 480 min 480 min
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Class Activity
6. You are required to administer 100 mls of IV Fluids over 1 hour. The drop factor is 15. How many drops per minute are required to start the flow off at the correct rate?
time = 1 hour = 60 minutes 100 mls X 15 drops/ml ---------------------------60 min
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1500 drops -----------------60 min

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= 25 drops / min

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Class Activity
7. You are required to administer 500 mls of Normal Saline over 3.5 hours. The drop factor is 10. How many drops per minute are required to start the flow off at the correct rate? 3.5 hours = 210 minutes
500 mls X 10 drops/ml 5000 drops ---------------------------- = ------------------ = 24 drops / min 210 min 210 min
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Class Activity
8.Calculate the drip rate for 500 mls of Normal Saline to be given over 4.5 hours via a giving set which delivers 15 drops/ml.
4.5 hours = 270 minutes

500 mls X 15 drops/ml 7500 drops ---------------------------- = ------------------ = 28 drops / min 270 min 270 min
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Class Activity
9. You are required to administer 1 litre of Normal Saline over 7 hours. The drop factor is 10. How many drops per minute are required to start the flow off at the correct rate?
Time = 7 hours = 7 x 60 = 420 Minutes 1 litre = 1000 ml

1000 mls X 10 drops/ml 10000 drops ---------------------------- = ------------------ = 24 drops / min 420 min 420 min
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Class Activity
10. One litre of Dextrose 5% in water is charted over 8 hours. The drop factor is 10. Calculate the number of drops per minute.
time = 8 hours = 8 x 60 = 480 minutes 1 litre = 1000 ml

1000 mls X 10 drops/ml 10000 drops ---------------------------- = ------------------ = 21 drops / min 480 min 480 min
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Class Activity
11. You are required to administer 3 litres of IV Fluids over 12 hours. The drop factor is 10. How many drops per minute are required to start the flow off at the correct rate?
Time = 12 hours = 12 x 60 = 720 minutes 3 litres = 3000 ml 3000 mls X 10 drops/ml 30000 drops ---------------------------- = ------------------ = 42 drops / min 720 min 720 min
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Class Activity
12. Calculate the drip rate for 500 mls of Dextrose 5% in water to be given over 4 hours via a giving set which delivers 15 drops/ml.
time = 4 hours = 4 x 60 = 240 minutes
500 mls X 15 drops/ml 7500 drops ---------------------------- = ------------------ = 31 drops / min 240 min 240 min
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Class Activity
13. One and a half litres of IV Fluids is prescribed over 8 hours. The drop factor is 15. How many drops per minute are required to start the flow off at the correct rate?
Time = 8 hours = 8 x 60 = 480 Minutes 1.5 litres = 1500 mls
1500 mls X 15 drops/ml 22500 drops ---------------------------- = ------------------ = 47 drops / min 480 min 480 min
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Class Activity
14. Three litres of Hartmans (Lactated Ringer's) is
charted over 12 hours. The drop factor is 15. The IV has been running for 9 hours. 800 mls remain. How many drops per minute are needed so that the IV finishes in the required time?
Time remaining = 3 hours = 3 x 60 = 180 minutes volume remaining = 800 mls

800 mls X 15 drops/ml 12000 drops ---------------------------- = ------------------ = 67 drops / min 180 min 180 min
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Class Activity
15. Calculate the drip rate for 100 mls of IV Fluids to be given over 2 hours via a giving set which delivers 60 drops/ml.
Time = 2 hours = 2 x 60 = 120 minutes 100 mls X 60 drops/ml 6000 drops ---------------------------- = ------------------ = 50 drops / min 120 min 120 min
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Class Activity

16. One litre of Dextrose 5% in water is charted over 3 hours. The drop factor is10. The IV has been running for 1 hour and 15 minutes. 500 mls remain. How many drops per minute are needed so that the IV finishes in the required time? Time remaining = 1 hour 45 min = 105 minutes Volume remaining = 500 ml 500 mls X 10 drops/ml 5000 drops ---------------------------- = ------------------ = 48 drops / min 105 min 105 min
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Class Activity
17. You are required to administer 1 litre of Normal Saline over 7 hours. The drop factor is 15. How many drops per minute are required to start the flow off at the correct rate?
time = 7 hours = 7 * 60 =420 1 litre =1000 ml 1000 mls X 15 drops/ml 15000 drops ---------------------------- = ------------------ = 36 drops / min 420 min 420 min
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Class Activity
18. One litre of IV Fluids is charted over 11 hours. The drop factor is 10. The IV has been running for 9 hours and 45 minutes. 100 mls remain. How many drops per minute are needed so that the IV finishes in the required time?
time remaining = 1 hour 15 mins = 75 minutes volume remaining = 100 ml 100 mls X 10 drops/ml 1000 drops ---------------------------- = ------------------ = 13 drops / min 75 min 75 min
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Class Activity
19. Three litres of Normal Saline is charted over 12 hours. The drop factor is 15. The IV has been running for 9 hours and 45 minutes. 500 mls remain. How many drops per minute are needed so that the IV finishes in the required time?
time remaining = 2 hour 15 mins = 135 minutes volume remaining = 500 ml

500 mls X 15 drops/ml 7500 drops ---------------------------- = ------------------ = 56 drops / min 135 min 135 min
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Class Activity
20. One hundred millilitres of IV Fluids is charted over 2.5 hours. The drop factor is 15. Calculate the number of drops per minute.
time = 2.5 hours = 2.5 * 60 = 150 minutes

100 mls X 15 drops/ml 1500 drops ---------------------------- = ------------------ = 10 drops / min 150 min 150 min
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REFERENCE
Drug Calculations Quiz Page, Retriever from www.testandcalc.com/quiz/index.asp

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THANK YOU
Nomi Waqas Gul Asst. Clinical Instructor Continuing Nursing education (CNE) Pakistan Institute of Medical Sciences, Islamabad, Pakistan

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11/12/2012 NomiWG-ACI 107