Pharma

Method 1: Basic Formula

The following formula is often used to calculate drug dosages. The basic formula (BF) is the most
commonly used method, and it is easy to remember.

D or desired dose: drug dose ordered by physician or health care providers (HCPs).

H or on-hand dose: drug dose on label of container (bottle, vial, ampule)

V or vehicle: form and amount in which the drug comes (tablet, capsule, liquid)

Method 2: Ratio and Proportion

Ratio and proportion (RP) is the oldest method used for calculating dosage problems:

H and V: On the left side of the equation are the known quantities, which are dose on hand and vehicle.

D and X: On the right side of the equation are the desired dose and the unknown amount to give.

Multiply the means and the extremes. Solve for X.

Method 3: Fractional Equation

The fractional equation (FE) method is similar to RP, except it is written as a fraction.

H: the dosage on hand or in the container

V: the vehicle or the form in which the drug comes (tablet, capsule, liquid)

D: the desired dosage

X: the unknown amount to give Cross multiply and solve for X.

Method 4: Dimensional Analysis

Dimensional analysis (DA) is a calculation method known as units and conversions. The advantage

of DA is that it decreases the number of steps required to calculate a drug dosage. It is set up as one

equation.

1. Identify the unit/form (tablet, capsule, mL) of the drug to be calculated. If the drug comes in tablet,
then tablet = (equal sign)

2. The known dose and unit/form from the drug label follow the equal sign.
Example order: Amoxicillin 500 mg. On the drug label: 250 mg per 1 capsule.

3. The milligram value (250 mg) is the denominator and it must match the NEXT numerator, which

is 500 mg (desired dose or order). The NEXT denominator would be 1 (one) or blank.

4. Cancel out the mg, 250 and 500. What remains is the capsule and 2. Answer: 2 capsules.

When conversion is needed between milligrams (drug label) and grams (order), then a conversion factor
is needed, which appears between the drug dose on hand (drug label) and the desired dose (order). You
should REMEMBER the following:

Metric Equivalent

1 g 5 1000 mg

1 mg 5 1000 mcg

Also use Table 6-1 for metric and household conversions.

As with other methods for calculation, the three components are D, H, and V. With DA, the conversion
factor is built into the equation and is included when the units of measurements of the drug order and
the drug container differ. If the two are of the same units of measurement, the conversion factor is
eliminated from the equation.

Solve the following calculation problems using Method 1, 2, 3, or 4. To convert units within the metric
system (grams to milligrams), refer to Chapter 1. To convert apothecary to metric units and vice versa,
refer to Chapter 2, Table 2-1. For reading drug labels, refer to Chapter 3. Several of the calculation
problems have drug labels. Drug dosage and drug form are printed on the drug label.

Extra practice problems are available in the chapters on oral drugs, injectable drugs, and pediatricdrug
administration.

Knowing how to convert drug doses among the systems of measurement is essential in the clinical
setting.

In discharge teaching for individuals receiving liquid medication, converting metric to household
measurement may be important.

Table 2-1 gives the metric and apothecary equivalents by weight and the metric, apothecary, and
household equivalents by volume.

Remember, conversion from one system to another is an approximation. Though the apothecary

system is not or infrequently used, the table is included as a reference for approximate metric,
apothecary,and household equivalents.
Additional Dimensional Analysis (Factor Labeling)

Order: cimetidine (Tagamet) 0.8 g, po, bedtime.

Drug available:

Drug label: 400 mg = 1 tablet

0.8 g (drug order)

Conversion factor: 1 g = 1000 mg (units of measurements are not the same; conversion factor is

needed) How many tablet(s) would you give?

Calculate the dose of vincristine in mLs for a 4-yr-old with leukemia weighing 37 lb and is 97 cm tall. The
dose required in 2 mg/m2 and the drug comes in 1 mg/mL concentration.

Step 1. Convert pounds to kg: 37 lb × 1 kg/2.2 lb = 16.8 kg

Step 2. Calculate BSA: √16.8 kg × 97 cm/3600 = 0.67 m2

Step 3. Calculate the dose in mg: 2 mg/m2 × 0.67 m2 = 1.34 mg

Step 4. Calculate the dose in mL: 1.34 mg ÷ 1 mg/mL = 1.34 mL