Introduction to medication calculation

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In medicine, different systems are used to measure and express doses.

medication presentations:
Drug concentration: for example: morphine 10 mg/1 ml

Medication dosage: Dopamine: dose 10 mcg/kg/min

Electrolyte or drug vials at 2%, 10%, etc.

It is important to understand the units in which drugs are measured.

indicated, and how to convert from one unit to another

Never confuse ml with units when working with drug doses.

such as insulin or heparin.
Be very careful when preparing and administering medications that
they are indicated in units.
The correct syringes must be used to measure units or ml and
determine that the dosage corresponds to the medical indication.
In medicine or pharmacology, cm is not used.3, but it should be used ml

Reflect on the calculation made.

Is the result reasonable?

Is it within the passing ranges?

If you have doubts, check the dosage and your calculations with another person.

Increase in volume upon reconstitution

Medications that come in lyophilized (or dry powder) form

they need to be reconstituted with a diluent or solvent before being
administered. Generally, the final volume of the reconstituted medication is
greater than the volume of liquid that was added to dissolve the lyophilisate.

Suspended antibiotics are an example that illustrates this shift.

the increase in final volume when dissolving.

For preparing a 100 ml suspension of Amoxicillin, you only need to

Add 68 ml of water. The Amoxicillin powder occupies a volume of 32 ml.
So out of the 100 ml of Amoxicillin, 68 are water and 32 are Amoxicillin.

Is this increase in final volume ?

For most patients, this is not important because they are

administers the total volume that is prepared in a syringe. However
this may be important when you need to administer a dose that
is less than the total content of the syringe, which occurs frequently
in pediatrics and neonatology.

The final volume in the syringe that results after the

dilution of the medication for dosage effects of mg/ml. The volume can
is significantly increasing, and if it is not taken into account for the calculation,
There may be errors in the administered doses (lower or higher than what...
indicated), especially when the doses indicated are very small.
newborns.

The amounts of increase of diluted medications depend on the

drug, manufacturer and its concentration. The information must be reviewed
included with the medications by the manufacturer to observe the estimates
of volume increase when diluting.

1. INTERNATIONAL SYSTEM OF UNITS (METRIC SYSTEM OF

MEASUREMENT)

The main units are those used to measure weight, volume, and
amount of a substance.
expressed in Kilograms, kg, mg, mcg

expressed in liters, ml.

Amount of a Substance: expressed in Moles (mol, millimoles)

Small volumes of liquids are expressed in milliliters (ml) and are used
to describe small doses.
The concentration of a drug is usually expressed in milligrams (mg).

Metric Equivalences:

1g = 1000 mg

1 mg = 1000 mcg or 1000 μg = 1000 grams

1 liter = 1000 ml

1 mol = 1000 millimoles

Molar solution or Molarity of a Solution

Molarity is a term used in chemistry to describe concentrations:

When a substance is dissolved in ONE LITER of solution, it is

known as a solution to One Molar (1 M). If 2 Moles of a substance
they are dissolved in 1 liter of liquid, so it is said to be a 2 M solution
(Molar).

2. PRESENTATION OF MEDICATIONS AND INTRAVENOUS SOLUTIONS

a) Concentration in Percentage %
When expressed as a Percentage (%), it is meant to express a quantity of substance.
solid dissolved in a certain liquid volume. For practical purposes
corresponds to the number of grams dissolved in 100 ml.

% weight/volume = number of grams in 100 ml

For example: 5% means there are 5 g in 100 ml

There will always be the same amount of drug present in 100 ml.
regardless of the total volume. In the example, at 5%, there are always 5 g
dissolved in every 100 ml of liquid, and there will be the same concentration if it is a
500 ml or 1 liter bag of the solution.
To find the total amount of the drug present, the total volume must
being taken into account, so 500 ml at 5% means that the solution has
a total of 25 g. (5 g/100 ml, 5 x 5 = 25 g)

b) Concentration expressed in mg / ml

Express the number of milligrams of the drug per milliliter of liquid (mg/ml).

Parenteral presentations are usually expressed in the number

milligrams (mg) dissolved in the volume of liquid in the vial (1ml,
2ml, 5 ml, 10 ml, 20 ml) Ex.: Adrenaline 1mg/1ml

c) Conversion of concentration in Percentage % to concentration of

mg/ml

Multiply the percentage % by 10

Lidocaine 2% vial 10 ml

2 x 10 = 20 mg / ml = 200 mg/10 ml = 2 g / 100 ml (2000 mg/100

ml)
Sometimes it is more useful to convert the concentration expressed in percentage to
concentrations in mg/ml, e.g.:

Sodium Chloride 0.9% 0.9 g / 100 ml 900 mg / 100 ml 9 mg/ml

Glucose 5% 5 g/100 ml 5000 mg/100 ml 50 mg/ml

If the solution is expressed in %, it is easy to convert the concentration in

mg/ml multiplying the % by 10: e.g.:

2% x 10 = 20 mg/ml

d) Concentrations:

Defined as 1 gram in many milliliters

1 in 1,000 means 1 gram in 1000 ml

1 in 10,000 means 1 gram in 10,000 ml

It can be said that a concentration of 1 gram in 10,000 is weaker.

that one of 1g in 1,000 (the higher the number, the weaker the
concentration

Adrenaline 1 in 1,000 is equivalent to 1 mg of adrenaline in 1 ml

Adrenaline 1 in 10,000 equals 1 mg in 10 ml

To easily remember the concentration, the 3 zeros must be removed.

they are after the period:

Adrenaline 1 in 1,000 = eliminate 1.Ø Ø Ø = 1 in 1 which corresponds to 1mg

in 1ml

1 in 10,000 = eliminate 10.Ø Ø Ø = 1 in 10 = 1mg in 10 ml

Example of this dilution: Morphine 10% = 10 mg/1 ml + 9 cc saline = 10 mg/10

cc = 1mg / 1cc

Adrenaline 1 mg/1 ml = 1 ml + 9 cc saline = 1 mg/10 ml = 0.1 mg/1 cc

e) Medications expressed in Units

Due to the purity of medications such as Insulin and Heparin of origin

biosynthetic or animal, they should be expressed in terms of units instead of
the standard measures of weight or volume.

One must be vigilant to avoid confusing units with ml and to prevent errors in the
dosage.

There are no calculations that need to be done in insulin administration, but

just to measure the units of insulin to be administered in a syringe for
insulin, graduated in units and not ml. The insulin syringe is
calibrated at 100 units in 1 ml.

3. DRUG DOSAGE CALCULATIONS

There are many ways to perform medication dosage calculations.

The easiest way is the rule of 3. What you place on one side of the equation,
do the same on the other side.

It must be expressed in the same units for correct results. Use

whole numbers instead of decimals to avoid errors.

A quick estimate of the response should always be made.

approximation, to know the ranges in which the answer should be. This
calculate with those figures that are easy to calculate.
For example: A dose of 125 mcg is required. The drug comes in a presentation of 50.
mcg/ml.

It has: 50 mcg / 1 ml

So there are: 100 mcg / 2ml

150 mcg / 3ml

It follows from this that our response should be in the range of 2–3 ml.
of the drug.

To calculate this example we should:

Step 1:

Write what we have: presentation 50 mcg 1 ml

Step 2:

Write the proportion of the unit that has (drug presentation) this is
50 mcg in 1 ml

1 = 0.02

50

Step 3

Multiply your result by the dose you need to administer 0.02 x 125 =
2.5 ml

2.5 ml of the medication should be administered.

This result is within the range of the initial dose approximation.

From the described calculation formula, it can be derived that for the calculation
from the UD dose, it must be calculated:

Dose needed x volume in which the dose is

Dose that is included in the presented format

Ejm:

Dose required: 125 mcg

Dose available in the presentation: 50 mcg

Volume in which the dose is presented: 1 ml

Substituting the numbers in the formula: 125 x 1 = 2.5 ml

50
You can apply this type of formula to any type of calculation.

4. DRIP CALCULATION

drops/minute

In all drip calculations, you must remember that you simply have to
convert a volume of liquid into drops, or vice versa, and hours to minutes.

The drip sets or (flebos or perfusion) deliver:

Drip standard delivers 20 drops/ml of solution.

15 drops/ml of blood

Microdrop Set delivers 60 microdrops/ml

Example: administer 1000 cc of Physiological Solution in 8 hours

Step 1:

Convert the total volume into the number of drops.

1 liter of solution = 1000 ml then it will be 1,000 x 20 = 20,000 drops in

1000 ml

Step 2:

Convert hours into minutes by multiplying the number of hours by

The solution should be passed for 60 minutes.

8 hours x 60 minutes = 480 minutes

With these calculations, the indication has been converted in terms of drops and
minutes, which is what is desired to be known.

If it is not necessary to convert into minutes, this operation is not required.

Step 3

Combine both calculations made: 20,000 drops to be passed in 480 minutes.

Step 4

Calculate the number of drops per minute by dividing the total drops by the
number of minutes.

20,000 = 41.76 drops / minute = 42 drops/min

480

Since it is impossible to divide the drop, approximate to the next whole number.
obtained figure.
Answer: to administer one liter of saline solution in 8 hours using a
Standard phlebotomy equipment, the drip should be at 42 drops per minute.

You can also use the following formula:

Drops/min = (Drops/ml that the IV delivers) x total volume to

infuse (ml)

Number of hours the infusion should take x 60

In this case it would be:

Drops / ml delivered by the Infusion Set = 20 drops / ml

1000 ml

Number of hours to infuse the solution = 8 hours

Number of minutes in an hour (factor to convert hours into

minutes) =60
By substituting the numbers in the formula it would be:

20 x 1000 = 41.67 = 42 drops/min

480

b) Dose Conversion to ml/hr (to program Infusion Pump)

Continue):

Doses can be expressed in various ways: mg/min, mcg/min,

gamas/min, mg/kg/min or mcg/kg/min and it must be necessary to convert to ml/hr
for use in BIC.

The following example shows the various steps in this type of calculation and that it
adopt for any dose to be calculated for drip infusion.

Example: You must administer a dopamine infusion of 800 mg

in 250 ml. The required dose is 2 mcg/kg/min for a patient of 68
kg. What is the drip ml/hr to program?

Step 1

Calculate the required dose for the patient:

Required Dose = Patient weight (kg) x indicated dose

Required dose = 68 kg x 2 mcg/min = 136 mcg/min

If the dosage is indicated as a total and the patient's weight is not taken into account,
So do not carry out this step.

Step 2
The dose is 136 mcg/min. Since the final answer is needed in terms of
hours, multiply by 60 to convert minutes into hours.

136 x 60 = 8160 mcg/hour

Convert mcg to mg by dividing by 1000

8160 = 8.16 mg/hr

1000

Step 3

Calculate the volume required for that dose.

Calculate the volume for 1 mg of drug.

You have 800 mg in 250 ml = 250 = 0.3 ml 1 mg is in 0.3 ml

800

Step 4

Multiply the necessary dose for the patient by the ml that contain 1 mg.
of the drug.

So for the dose of 8.16 mg/hr the volume corresponds to:

8.16 mg/hr x 0.3 ml = 2.5 ml/hr = 3 ml/hr

Response:

To administer a dose of 2 mcg/kg/min of dopamine for the patient, you

It requires programming the pump for a drip of 3 ml/hour, from a dilution of 800.
mg of dopamine in 250 cc of saline solution.

Source: San Sebastian University - School of Nursing