Chapter three
Course outline
i. Calibration of Droppers
ii. Calculations of doses (dose size, number of doses,
amount dispensed, quantity of ingredient)
iii. Drug Dosage based on Age (pediatrics and geriatrics)
iv. Drug Dosage based on Body Weight
v. Drug Dosage based on Body Surface Area
vi. Enlarging and reducing formulas
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Calibration of droppers
• Occasionally, the drop (abbreviated gtt) is used as a
measure for small volumes of liquid medications.
• A drop does not represent a definite quantity,
because drops of different liquids vary greatly.
• In an attempt to standardize the drop as a unit of
volume, the United States Pharmacopeia defines
the official medicine dropper as being constricted
at the delivery end to a round opening with an
external diameter of about 3 mm.
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Cont…
• The dropper, when held vertically, delivers
water in drops, each of which weighs between
45 and 55 mg. Accordingly, the official dropper
is calibrated to deliver approximately 20 drops
of water per milliliter (i.e., 1 mL of water 1
gram or 1000 mg 50 mg [ave.]/drop 20 drops).
• It should be kept in mind, that few medicinal
liquids have the same surface and flow
characteristics as water, and therefore the size of
drops varies materially from one liquid to
another.
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Cont…
• The drop should not be used as a measure
for a specific liquid medication until the
volume that the drop represents has been
determined for that liquid.
• This determination is made by calibrating
the dispensing dropper.
• The calibrated dropper is the only one
that should be used for the measurement
of medicine.
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Cont…
• A dropper may be calibrated by counting the
drops of a liquid as they fall into a graduate until a
measurable volume is obtained. The number of
drops per unit volume is then established (e.g., 20
drops/mL).
• If a pharmacist counted 40 drops of a medication
in filling a graduate cylinder to the 2.5-mL mark,
how many drops per milliliter did the dropper
deliver?
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Cont…
Case in Point 3.1
• A physician asks a pharmacist to calculate the dose of a
cough so that it may be safely administered dropwise to a
child. The cough syrup contains the active ingredient
dextromethorphan HBr, 30 mg/15 mL, in a 120-mL bottle.
Based on the child’s weight and literature references, the
pharmacist determines the dose of dextromethorphan HBr to
be 1.5 mg for the child. The medicine dropper to be dispensed
with the medication is calibrated by the pharmacist and
shown to deliver 20 drops of the cough syrup per 1 mL.
• Calculate the dose, in drops, for the child.
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Examples of calibrated droppers used in the
administration of pediatric medications
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General Dose Calculations
• The dose of a drug is the quantitative amount
administered or taken by a patient for the intended
medicinal effect.
• The dose may be expressed as a single dose, the
amount taken at one time; a daily dose; or a total
dose, the amount taken during the course of therapy.
• A daily dose may be subdivided and taken in divided
doses, two or more times per day depending on the
characteristics of the drug and the illness.
• The schedule of dosing (e.g., four times per day for
10 days) is referred to as the dosage regimen.
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Cont…
• A pharmacist often needs to calculate the
size of a dose, the number of doses, or the
total quantity of medication to dispense.
• For these calculations the following
equation is useful with the terms
rearranged depending on the answer
required.
• In using the equation, the units of weight or
volume must be the same for the total
quantity and size of the dose.
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Cont…
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Calculation of size of a dose
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Example Calculations of the Total Quantity
of Product
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Drug Dosage Based on Age
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• An over-the-counter cough remedy contains
120 mg of dextromethorphan in a 60-mL bottle
of product. The label states the dose as 1.5
teaspoonfuls for a child 6 years of age. How
many milligrams of dextromethorphan are
contained in the child’s dose?
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Drug Dosage Based on Body Weight
• usually dose is expressed as a specific quantity
of drug per unit of patient weight, such as
milligrams of drug per kilogram of body
weight (abbreviated mg/kg).
• Dosing in this manner makes the quantity of
drug administered specific to the weight of the
patient being treated
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• The usual initial dose of chlorambucil is 150
mcg/kg of body weight. How many milligrams
should be administered to a person weighing
154 lb.?
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• A hospital pharmacist is called to a pediatric
nursing station to calculate the quantity of an
injection to administer to a pediatric patient.
• The daily dose of the injection for the child’s
weight is stated as 15 mg/kg/day, divided into three
equal portions. The child weighs 10 kg. The
injection contains 5 mg/mL of the prescribed drug.
• How many milliliters of injection should be
administered?
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Drug Dosage Based on Body Surface Area
If the adult dose of a drug is 100 mg, calculate the approximate
dose for a child with a BSA of 0.83 m2,
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REDUCTION AND ENLARGEMENT OF
FORMULAS
• Most of the preparations made in a pharmacy
are from proven formulas that have been
tested and are listed in the United State
Pharmacopeia/National Formulary (USP/NF)
as official formulas.
• These formulas list the amount of each
ingredient needed to make a certain amount of
the preparation.
• At times, it is necessary to reduce or enlarge a
formula to satisfy the needs of your pharmacy.
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RATIO AND PROPORTION METHOD
*NOTE: Most of the time, the unknown factor will
be the “Amount of each ingredient
needed.”
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Cont…
b. Sample Problem: Using the official formula
below, calculate the amount of each ingredient
needed to make 240 ml of Peppermint Spirit.
Peppermint Spirit
• Peppermint Oil............ 100 ml
• Peppermint Powder.........10 g
• Alcohol.....qsad.......... 1000 ml
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Cont…
c. Knowing that qsad means to “add a
sufficient quantity up to,” take 2.4 g of
peppermint powder, add 24 ml of
peppermint oil, and add as much alcohol
as is necessary to make 240 milliliters.
The final product will be Peppermint
Spirit.
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CONVERSION FACTOR METHOD
• The conversion factor method is the easiest
and therefore the most widely used method for
reducing or enlarging formulas.
a. Find the conversion factor:
NOTE: The “Total Quantity Desired” and the “Total
Quantity of Official Formula” must have the same
units so the units will cancel and yield a conversion
factor
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:
(1) The first step is to find the conversion
factor
120ml = conversion factor
1000ml
NOTE: The units, by being the same,
cancel.
0.12 = conversion factor
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Chapter 4
Dilution and concentration
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Relationship Between Strength and Total
Quantity
• If a mixture of a given percentage or ratio strength
is diluted to twice its original quantity, its active
ingredient will be contained in twice as many parts
of the whole, and its strength therefore will be
reduced by one half.
• By contrast, if a mixture is concentrated by
evaporation to one-half its original quantity, the
active ingredient (assuming that none was lost by
evaporation) will be contained in one half as many
parts of the whole, and the strength will be doubled.
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Cont…
• So, if 50 mL of a solution containing 10 g of
active ingredient with a strength of 20% or 1:5
w/v are diluted to 100 mL, the original volume
is doubled, but the original strength is now
reduced by one half to 10% or 1:10 w/v.
• If, by evaporation of the solvent, the volume
of the solution is reduced to 25 mL or one half
the original quantity, the 10 g of the active
ingredient will indicate a strength of 40% or
1:2.5 w/v.
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Cont…
• If, then, the amount of active ingredient
remains constant, any change in the quantity
of a solution or mixture of solids is inversely
proportional to the percentage or ratio
strength; that is, the percentage or ratio
strength decreases as the quantity increases,
and conversely.
• This relationship is generally true for all
mixtures except solutions containing
components that contract when mixed
together.
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Problems in this section generally may be solved by any of the following methods:
1. Inverse proportion.
2. The equation: (1st quantity)x(1st
concentration)=(2nd quantity)x(2nd
concentration), or Q1 x C1 = Q2 x C2.
3. By determining the quantity of active
ingredient (solute) present or required and
relating that quantity to the known or desired
quantity of the preparation.
• Note: This will become clear as the chapter
proceeds.
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Dilution and Concentration of Liquids
• Example Calculations of the Dilution and
Concentration of Liquids
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Cont…
Note: you may find it simpler in solving certain problems to
convert a given ratio strength to its equivalent percentage
strength.
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Strengthening of a Pharmaceutical Product
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Dilution and Fortification of Solids and
Semisolids
• The dilution of solids in pharmacy occurs
when there is need to achieve a lower
concentration of an active component in a
more concentrated preparation (e.g., a
powdered vegetable drug).
• There also is a type of diluted pharmaceutical
preparation, termed a trituration that
represents a useful means of preparing and
administering very potent therapeutic
substances.
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Example Calculations of Solid and Semisolid
Dilutions
• If 30 g of a 1% hydrocortisone ointment were
diluted with 12 g of Vaseline, what would be the
concentration of hydrocortisone in the mixture?
30 g x 1% = 0.3 g hydrocortisone
30 g+ 12 g = 42 g, weight of mixture
0.3 g x100 = 0.71% (w/w), answer. or
42 g
30 (g) x 1 (%) = 42 (g) x X (%)
X = 0.71% (w/w), answer.
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Cont…
• How many grams of zinc oxide should be
added to 3200 g of 5% zinc oxide ointment to
prepare an ointment containing 20% of zinc
oxide?
3200 g x 0.05 = 160 g of zinc oxide in 3200 g
of 5% ointment
3200 g - 160 g = 3040 g of base (diluent) in
3200 g of 5% ointment
In the 20% ointment, the diluent will represent
80% of the total weight
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Cont…
80 (%) = 3040(g)
20 (%) x(g)
x = 760 g of zinc oxide in the 20% ointment
Because the 5% ointment already contains 160 g of zinc
oxide,
760 g - 160 g = 600 g, answer
• A simpler method of solving this problem can be used
if we mentally translate it to read:
• How many grams of zinc oxide should be added to
3200 g of zinc oxide ointment containing 95% diluent
to prepare an ointment containing 80% diluent?
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Cont…
80% = 3200 (g)
95% x(g)
x = 3800 g of ointment containing 80% diluent
and 20% zinc oxide
3800 g - 3200 g = 600 g, answer.
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Trituration
• Trituration are dilutions of potent medicinal
substances. They were at one time official and
were prepared by diluting one part by weight
of the drug with nine parts of finely powdered
lactose.
• They are, therefore, 10% or 1:10 w/w
mixtures.
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Example Calculations of Triturations
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Cont…
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Cont…
• How many milligrams of a 1:10 dilution of
colchicine should be used by a manufacturing
pharmacist in preparing 100 capsules for a
clinical drug study if each capsule is to contain
0.5 mg of colchicine?
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Alligation
• Alligation is an arithmetical method of solving
problems that involves the mixing of solutions
or mixtures of solids possessing different
percentage strengths.
• Alligation Medial. Alligation medial is a
method by which the ‘‘weighted average’’
percentage strength of a mixture of two or
more substances of known quantity and
concentration may be easily calculated.
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Cont…
• By this method, the percentage strength of each
component, expressed as a decimal fraction, is
multiplied by its corresponding quantity;
• then the sum of the products is divided by the
total quantity of the mixture; and the resultant
decimal fraction is multiplied by 100 to give the
percentage strength of the mixture.
• Of course, the quantities must be expressed in a
common denomination, whether of weight or
volume.
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Example Calculations Using Alligation
Medial
• What is the percentage strength (v/v) of alcohol in a
mixture of 3000 mL of 40% v/v alcohol, 1000 mL of
60% v/v alcohol, and 1000 mL of 70% v/v alcohol?
Assume no contraction of volume after mixing.
0.40 x 3000 mL = 1200 mL
0.60 x 1000 mL = 600 mL
0.70 x 1000 mL= 700 mL
Totals: 5000 mL 2500 mL
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Cont…
• What is the percentage of zinc oxide in an
ointment prepared by mixing 200 g of 10%
ointment, 50 g of 20% ointment, and 100 g of
5% ointment?
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Cont…
• What is the percentage strength of alcohol in a
mixture of 500 mL of a solution containing 40% v/v
alcohol, 400 mL of a second solution containing 21%
v/v alcohol, and a sufficient quantity of a
nonalcoholic third solution to make a total of 1000
mL?
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Alligation Alternate
• Alligation alternate is a method by which
we may calculate the number of parts of
two or more components of a given
strength when they are to be mixed to
prepare a mixture of desired strength.
• A final proportion permits us to translate
relative parts to any specific
denomination.
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Cont…
• The strength of a mixture must lie somewhere
between the strengths of its components; that is, the
mixture must be somewhat stronger than its
weakest component and somewhat weaker than its
strongest.
• As indicated previously, the strength of the mixture
is always a ‘‘weighted’’ average; that is, it lies
nearer to that of its weaker or stronger components
depending on the relative amounts involved.
• This ‘‘weighted’’ average can be found by means of
an extremely simple scheme, as illustrated in the
subsequent diagram.
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Example Calculations Using Alligation
Alternate
• In what proportion should alcohols of 95% and
50% strengths be mixed to make 70% alcohol?
• Note that the difference between the strength of
the stronger component (95%) and the desired
strength (70%) indicates the number of parts of the
weaker to be used (25 parts), and the difference
between the desired strength (70%) and the
strength of the weaker component (50%) indicates
the number of parts of the stronger to be used (20
parts).
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Cont…
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• In what proportion should 20% benzocaine
ointment be mixed with an ointment base to
produce a 2.5% benzocaine ointment?
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• How many milliliters each of a 2% w/v
solution and a 7% w/v solution should be used
in preparing 1 gallon of a 3.5% w/v solution?
• 1 gallon 3785 mL
Answer:
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Cont…
• A hospital pharmacist wants to use three lots
of zinc oxide ointment containing,
respectively, 50%, 20%, and 5% of zinc oxide.
In what proportion should they be mixed to
prepare a 10% zinc oxide ointment?
• The two lots containing more (50% and 20%)
than the desired percentage may be separately
linked to the lot containing less (5%) than the
desired percentage:
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Specific Gravity of Mixtures
• The methods of alligation medial and
alligation alternate may be used in
solving problems involving the specific
gravities of different quantities of liquids
of known specific gravities, provided no
change in volume occurs when the liquids
are mixed and that they are measured in a
common denomination of volume.
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Example Calculations of Specific Gravity
Using Alligation
• What is the specific gravity of a mixture of
1000 mL of syrup with a specific gravity of
1.300, 400 mL of glycerin with a specific
gravity of 1.250, and 1000 mL of an elixir with
a specific gravity of 0.950?
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Cont…
• In what proportion must glycerin with a
specific gravity of 1.25 and water be mixed to
prepare a liquid having a specific gravity of
1.10?
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Be a good pharmacists
Thank you!!!
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Quiz(10%)
show all clear steps
1. How many milliliters of each of two liquids with specific
gravities of 0.75 and 0.85 should be used to prepare 1200 mL of
a liquid having a specific gravity of 0.95?(2%)
2. How many grams of 2.5% hydrocortisone cream should be
mixed with 360 g of 0.25% cream to make a 1% hydrocortisone
cream?(2%)
3. The solvent for the extraction of a vegetable drug is 70%
alcohol. In what proportion may 95%, 60%, and 50% alcohol
be mixed to prepare a solvent of the desired concentration?(1%)
4. A prescription calls for furosemide (Lasix) 40 mg tid for 10
day. What will be the total dose (amount) to be dispensed if
only 20 mg is available at the pharmacy?(1% )
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5. How many drops would be prescribed in each dose of a liquid
medicine if 10 mL contained 50doses. The dispensing dropper
calibrates 20 drops/mL?(1%)
6. If a preparation contains 5 g of a drug in 500 mL, how many
grams are contained in each tablespoonful dose?(1%)
7. How many grams of zinc oxide should be added to 3400 g of a
10% zinc oxide ointment to prepare a product containing 15% of
zinc oxide?(2%)
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