Common Conversions:
1 Liter = 1000 Milliliters
1 Gram = 1000 Milligrams
1 Milligram = 1000 Micrograms
1 Kilogram = 2.2 pounds
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.
I. Basic Formula: Frequently used to calculate drug dosages.
D (Desired dose)
H (Dose on hand)
V (Vehicle-tablet or liquid)
D
x V = Amount to Give
H
D = dose ordered or desired dose
H = dose on container label or dose on hand
V = form and amount in which drug comes (tablet, capsule, liquid)
Example: Order-Dilantin 50 mg p.o. TID
Drug available-Dilantin 125 mg/5ml
D=50 mg H=125 mg V=5 ml
50 250
x5= = 2 ml
125 125
II. Ratio & Proportion: Oldest method used in calculating dosage.
Known Desired
H : V :: D : X
Means
Extremes
III. Left side are known quantities
IV. Right side is desired dose and amount to give
V. Multiply the means and the extremes
HX = DV
DV
X=
H
Example: Order-Keflex 1 gm p.o. BID
Drug available-Keflex 250 mg per capsule
VIII. D=1 gm (note: need to convert to milligrams)
1 gm = 1000 mg
IX. H=250 mg
X. V=1 capsule
25
: 1 :: 1000 : X
0
XI. 250X = 1000
1000
X=
250
XII. X = 4 capsules
XIII. Fractional Equation
H D
=
V X
XIV. Cross multiply and solve for X.
H D
=
V X
HX = DV
DV
X=
H
Example: Order - Digoxin 0.25 mg p.o. QD
Drug Available - 0.125 mg per tablet
D=0.25 mg H=0.125 mg V=1 tablet
0.125 0.25
=
1 X
XX. 0.125X = 0.25
0.25
X=
0.125
XXI. X = 2 tablets
XXII. 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)
Step 2 - = gtts/min
60 min
One Step
amount of fluid x drops/milliliter (IV set)
hours to administer x minutes/hour (60)
Example: 1000 ml over 8 hrs
IV set = 15 gtts/ml
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
XXIII. How to Calculate Continuous Infusions
A. mg/min (For example - Lidocaine, Pronestyl)
Solution cc x 60 min/hr x mg/min
= cc/hr
Drug mg
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
D. mcg/min (For example - Nitroglycerin)
Solution cc x 60 min/hr x mcg/min
= cc/hr
Drug mcg
Drug mcg x cc/hr
= mcg/hr
Solution cc x 60 min/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.
Patient’s 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 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?
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
= mcg/kg/min
Patient’s weight in kg
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!
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
Patients’s 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 patient’s weight in kg
= rate on pump
dosage concentration in mcg/cc/min
G. For example:
H. 400 mg Dopamine in 250 cc D5W = 26.6 mcg/cc/min
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
Dosage (in mcg/cc/min) x rate on pump
= mcg/kg/min
Patient’s weight in kg
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
= 3.54 mcg/kg/min
Patients’s weight in kg (75 kg)
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
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:
1. Order-1000 ml over 6
hrs IV set 15 gtts/ml
2. Order-500 ml over 4
hrs IV set 10 gtts/ml
3. Order-100 ml over 20
min. IV set 15 gtts/ml
D. Practice Problems:
1. Dopamine 400 mg in 250 cc D5W to infuse at 5 mcg/kg/min. The patient’s
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?
E. - Kilograms (kg) to grams (g) = kg x 1,000;
F.
G.
H. - Grams to milligrams (mg) = g x 1,000;
I.
J.
K. - Milligrams to micrograms (mcg) = mg x 1,000;
L.
M.
N. - Micrograms to nanograms (ng) = mcg x 1,000;
O.
P.
Q. - Litres (L) to millilitres (ml) = L x 1,000.
R.
S.
T. To convert smaller units to larger the smaller is divided:
U.
V.
W. - Grams to kilograms = g/1,000;
X.
Y.
Z. - Milligrams to grams = mg/1,000;
AA.
BB.
CC. - Micrograms to milligrams = mcg/1,000;
DD.
EE.
FF. - Nanograms to micrograms = ng/1,000;
GG.
HH.
II. - Millilitres to litres = ml/1000.
JJ.
KK.
LL.Large infusion rates
To administer fluid volumes over a specified time a gravitational flow administration set
may be used, which requires the infusion rate to be administered as ‘drops per minute’.
To calculate this the number of drops per ml for the specific set must be ascertained - this
is usually identified on its packaging. Generally, crystalloid administration sets operate at
20 drops per millilitre (d/ml) and blood (large-bore) sets operate at 15d/ml.
MM.
NN.
OO. To calculate the infusion rate in drops per minute the following formula is applied
(Fig 1):
PP.
QQ.
RR. Vol required / Duration (hr)
SS.
TT.
UU. x
VV.
WW.
XX. Set value (d/ml) / Minutes (60)
YY.
ZZ.
AAA. Fluid infusions are often administered via volumetric pumps, many of which run
in a millilitre per hour (ml/hr) rate.
BBB.
CCC.
DDD. To calculate ml/hr the following formula is applied (Fig 2):
EEE.
FFF.
GGG. Volume to be infused / Duration of infusion
HHH.
III.
JJJ.Nurses must ensure they have received specific training in the use of the particular
infusion device before operating it.
KKK.
LLL.
MMM. Required drug volume from stock strength
This is a common calculation as many prescribed doses are smaller than the available
preparation. In some drugs the stock concentration may depend on the volume of diluent.
This is often the case in reconstituting antibiotics. The following formula is applied (Fig
3):
NNN.
OOO.
PPP. Amount required / Stock strength
QQQ.
RRR.
SSS. x Stock volume
TTT.
UUU.
VVV. Or more simply
WWW.
XXX.
YYY. What you want / What you have got
ZZZ.
AAAA.
BBBB. x Volume
CCCC.
DDDD.
EEEE. Calculating weight-related doses
Occasionally, and particularly in paediatrics, drugs are prescribed based on the patient’s
body weight. The prescription may be expressed as millilitres per kilogram (ml/kg) or
milligrams per kilogram (mg/kg). The following formula is applied (Fig 4):
FFFF.
GGGG.
HHHH. Prescribed volume x Body weight
IIII.
JJJJ.
KKKK. or
LLLL.
MMMM.
NNNN. Prescribed dose x Body weight
OOOO.
PPPP.
QQQQ. Concentrations (mg/ml) from solutions
Some drugs are presented in a percentage concentration (for example, lidocaine, calcium
chloride and dextrose in solution).
RRRR.
SSSS.
TTTT. The expression refers to grams per 100ml, so a one per cent solution would be 1g
per 100ml and a 50 per cent solution would be 50g per 100ml. The volume always
remains constant (Fig 5).
UUUU.
VVVV.
WWWW. Concentrations from weight to volume ratios
Some drugs are expressed as a weight to volume ratio (such as adrenaline and
noradrenaline). These could be expressed as 1:1,000 or 1:10,000.
XXXX.
YYYY.
ZZZZ. The expression is similar to a percentage except that the weight remains constant
(1g) and the volume differs. The volume is in millilitres. Therefore:
AAAAA.
BBBBB.
CCCCC. - Adrenaline 1:10,000 = 1g in 10,000ml;
DDDDD.
EEEEE.
FFFFF. - Noradrenaline 1:1,000 = 1g in 1,000ml.
GGGGG.
HHHHH.
IIIII. Once a mg/ml concentration has been calculated, further formulae such as dose or
stock strength x volume may be necessary to calculate the volume required (Fig 6
Parkland Formula Help
4cc x Kg x BSA
1/2 over 1st 8 hours
1/2 over last 16 hours
