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USAF, Pharmacy Apprentice/Craftsman Instructor, Sheppard AFB, TX,

in providing patient care in every pharmacy practice environment and a vital part of any

pharmacy technicians’ duty. Although most pharmaceutical calculations are not overly

difficult, they do require flawless accuracy. Correct calculations contribute as much to

patient outcomes as the newest methods and guidelines for diagnosis, treatment, and

prevention; and errors in calculations can turn the best attempts at optimal patient care

catastrophic. This session will present a review of pharmacy calculations for technicians.

Learning Objectives:

1. Identify types of pharmaceutical problems required for pharmacy operations.

2. Convert between the various denominations of each of the basic units of the metric

system.

3. Perform pharmaceutical conversions between the apothecary and the Avoirdupois

measurement systems.

4. Solve pharmaceutical problems involving reducing or enlarging pharmaceutical

formulas.

5. Solve pharmaceutical problems involving ratio and proportion pharmaceutical

formulas.

6. Solve pharmaceutical calculation problems involving percentage and ratio strengths.

7. Calculate the amount of diluent to be combined with a given amount of stock

preparation to make a product of a lesser strength.

8. Calculate the amounts of two stock preparations required to prepare a specified volume

of a stated intermediate strength preparation when given the strengths of the two stock

preparations.

9. Calculate the appropriate dose for a patient when given the recommended dosage of

that drug and the patient's weight in either pounds or kilograms.

10. Calculate the appropriate drop factors for patients receiving IV therapy.

11. Describe methods for double-checking calculations.

Types: conversion between units of measure; reducing and enlarging; ratio and

proportion; percentage and ratio strengths; concentration dilution; allegations; drug

dosages; flow rates and double check methods.

To prepare medications quickly and accurately you must be able to calculate dosages and

make conversions. This requires you to be familiar with systems of weights and

measures and their equivalents. This section will give you a starting point in refreshing

you with some common conversions used within the pharmacy.

Pharmacy Calculations: Page 2 of 39

1kg = 2.2lb

1gr = 64.8mg

compounding and concentration dilution mixtures

VOLUME

centimeters (cc)

WEIGHT

1gr = 64.8mg

METRIC TABLE

Gram

K H D Liter d c m X X mc

Meter

Kilo Hecto Deca deci centi milli micro

x 1000 x 100 x 10 1 1/10 1/100 1/1000 1/1,000,000

0.1 0.01 0.001 0.000001

Pharmacy Calculations: Page 3 of 39

2. Convert between the various denominations of each of the basic units of the

metric system.

Answers:

(1) 0.25 L (2) 15,000 m (3) 1 gm (4) 5 Dal (5) 1 cm (6) 75,000 mcg (7) 25,000 cm (8) 85

mcg (9) 0.45 L (10) 2.5 gm (11) 50,000 dl (12) 8.5 mg (13) 7.5 Hm (14) 4,500 dl (15)

25,000 mcg (16) 375 mcg (17) 3,000 mg (18) 0.012 Kg (19) 0.25 Dag (20) 25 dl (21)

2,000,000 cc (cc = ml) (22) 0.7 Hm (23) 5.40025 L (24) 8.5 gm (25) 0.375 Dam

Avoirdupois measurement systems.

When converting measures outside of the metric system, the ratio and proportion method

works well. A ratio is a given comparison between two numbers -

ratio of ounces to grains in the AV system is 1 to 437.5" this may also be

expressed as 1:437.5 or 1/437.5

Pharmacy Calculations: Page 4 of 39

When converting measures using a ratio and proportion, you must always have a

known ratio.

because we know the relationship between ounces and grains

a. Convert 3 oz to grains:

gr

1 oz 437.5 gr

3 oz X gr

e. Cross multiply the known values -

Perform the following conversions using the ratio and proportion method.

Within the AV system. (Round all decimals to 3 places to the right of the

decimal point.)

1. 1.25 lb = _____________ oz

2. 15,000 gr = ____________ lb

3. 2,188 gr = ___________ oz

4. 116 oz = ___________ lb

5. 5.6 lb = ____________ oz

Pharmacy Calculations: Page 5 of 39

6. 3.25 lb = ___________ gr

7. 3,500 gr = ___________ oz

8. 4.5 oz = _____________ gr

9. 1.65 lb = ____________ gr

Answers: (1) 20 (2) 2.143 (3) 5.001 (4) 7.25 (5) 89.6 (6) 22,750 (7) 8 (8)

1,968.75 (9) 11,550 (10) 1,225

(11) 50 (12) 0.5 (13) 15

Convert between the AV and metric systems using the ratio and proportion

method.

1. 165 lb = __________ kg

2. 5,000 gm = ___________ lb

3. 210 lb = ___________ kg

4. 45 kg = ____________ lb

5. 2.25 lb = ___________ gm

6. 3.5 oz = _____________ gm

7. 2,500 mg = ____________ gr

8. 3.25 kg = _____________ lb

9. 8 oz = _______________ gm

Pharmacy Calculations: Page 6 of 39

system and grains, and convert the grams to the appropriate unit first…)

the metric system first…)

Answers: (1) 75 (2) 11.013 (3) 95.455 (4) 99 (5) 1,021.5 (6) 99.225 (7) 38.58 (8)

7.15 (9) 226.8

(10) 88.636 (11) 5 (12) 15.432 (13) 14.109 (14) 35.273

Convert the following apothecary problems using the ratio and proportion

method.

3. 500 mg = _______________ gr

4. 100 fl oz = _____________ pt

7. 3 gr = __________________ mg

9. 3 pt = _______________ ml

Pharmacy Calculations: Page 7 of 39

Answers: (1) 4.167 (2) 16.077 (3) 7.716 (4) 6.25 (5) 3.906 (6) 139.95 (7) 194.4

(8) 5.284 (9) 1,419 (10) 4.024 (11) 320 (12) 10.417 (13) 3.125 (14) 3.171

15. 6 fl oz = _________________ ml

27. 24 fl oz = ________________ pt

Answers: (15) 177.42 (16) 2,838.75 (17) 2.083 (18) 26 (19) 22,680 (20) 1,200

(21) 7.5 (22) 2.5 (23) 44.355 (24) 7.716 (25) 3.906 (26) 12.682 (27) 1.5 (28)

8.842 (29) 33.333

Pharmacy Calculations: Page 8 of 39

Perform the following conversions (you will need to convert many of these twice -

see the example.)

Example:

1 fl oz 29.57 ml

29.57 ml x 7 fl oz = 206.99ml/fl oz

206.99ml X Tbsp

Tbsp

2. 0.74 gm = ________________ gr

4. 1.25 L = ________________ fl oz

5. 3 fl oz = _______________ tsp

6. 2.5 L = _______________ pt

10. 12 pt = ________________ L

Pharmacy Calculations: Page 9 of 39

12. 12 L = _________________ pt

14. 8 gr = _________________ gm

18. 1 gm = __________________ gr

Answers: (1) 16.077 (2) 11.42 (3) 4.353 (4) 42.273 (5) 17.742 (6) 5.285 (7) 61.49

(8) 63.083

(9) 100 (10) 5.676 (11) 31.533 (12) 25.37 (13) 11.828 (14) 0.518 (15) 1.183 (16)

33.333

(17) 20.9 (18) 15.432 (19) 1.664 (20) 5 (21) 109.91 (22) 36 (23) 2.604

formulas.

manufacturing formulas are based on quantity of 454gm or 1000mls. The pharmacist

may need to make a smaller or larger quantity and, therefore, must reduce or enlarge the

formula. The desired amount of ingredient by using the following proportion:

Total amount desired Quantity of amount desired

Pharmacy Calculations: Page 10 of 39

each ingredient is needed by using the ratio and proportion method, the factor

method or the proportional parts method.

BACLOFEN SUSPENSION 10 mg/ml

Cologel 15 ml

Simple Syrup qsad 60 ml

_______ ml

How much Loresal tablets does the "old" formula call for?

_______ tablet(s)

=

60 ml 30 ml

30 ml x 30 tablets X x 30 ml

=

60 ml 30 ml

= X

2

sure that each value is placed in the correct position in

Pharmacy Calculations: Page 11 of 39

Factor Method

(New Total)

General Formula: Total Amt Desired = factor

Total Amt in Original Formula

(Old Total)

_______ ml

60 ml

Step 4: Divide the bottom into the top which results in your

factor. 30 ml = 0.5

60 ml

find the desired amount.

20 tablets 15 ml

x 0.5 x 0.5

answer: 10 tablets answer: 7.5 ml

NOTE: When reducing formulas the value of your factor will always be less

than one (1), and when enlarging formulas the value of your factor will always

be larger

Sulfur 10 gm ______

Lime Water 50 ml ______

Bentonite Magma (QSAD) 120 ml ______

Pharmacy Calculations: Page 12 of 39

Chlorobutanol 5 gm ______

Sodium Chloride 3.6 gm ______

Purified Water (qsad 1000 ml______

3. From the following formula, calculate the quantity of each ingredient required to

prepare 1 gallon.

Talc 12 gm ______

Bentonite 3.5 gm______

Zinc Oxide 25 gm ______

Distilled Water (QSAD) 100 ml ______

4. From the following formula, calculate the quantity of each ingredient required to make

1 liter.

Lemon Oil 3 ml ______

Coriander Oil 1.2 ml ______

Anise Oil 0.3 ml ______

Alcohol USP (QSAD) 60 ml ______

Cinnamon Oil 0.16 ml______

Diphenhydramine 12 gm ______

Purified Water (QSAD) 500 ml ______

Glycerin 15 ml ______

Propylene Glycol 30 ml ______

Syrup 100 ml______

Alcohol (QSAD) 473 ml______

Orange Tincture 65 ml ______

Syrup (QSAD) 1000 ml ______

Pharmacy Calculations: Page 13 of 39

8. How many mg of zinc oxide are needed to make 4 quarts of the following?

Talc 15 gm ______

Zinc Oxide 75 gm ______

Purified Water (QSAD) 800 ml______

ANSWERS: (1) 3.32 ml, 8.3 gm, 41.5 ml, 100 ml (2) 0.9 gm, 0.15 gm, 0.108 gm,

30 ml (3) 454.2 ml, 132.48 gm, 946.25 gm, 3784 ml (4) 200.04 ml, 50.01 ml, 20

ml, 5 ml, 1000 ml (5) 2.27 ml, 0.15 ml, 11.35 gm, 473 ml (6) 480 ml, 960 ml, 3200

ml, 15140 ml (7) 14.19 gm, 30.75 ml, 473 ml (8) 70.95 gm, 354.75 mg, 3784 ml

formulas.

Sterile Liquid Medications- Read the package insert, product label or other reference

material to find the drug concentration. (Concentration = amount of drug per volume of

solution.)

Read package insert, product label or other reference, to find the amount of diluent

needed and the concentration of the product after reconstitution. (Diluent = liquid, used

to liquefy powder. Reconstitution = adding a suitable diluent.)

When the resulting concentration has been found a ratio and proportion can be used to

find the amount of medication needed for the prescribed dose.

many milliliters should be given to a patient to obtain 650 milligrams?

the proportion:

1 ml =

100 mg

1 ml = X ml

100 mg

1 ml = X ml

100mg 650 mg

Pharmacy Calculations: Page 14 of 39

Then, cross-multiply:

*Number of doses

*Total amount of drug

*Size of dose

Given any two of the above, you can solve for the third.

General Formula:

Size of dose

Number of doses

EXAMPLE: How many doses are in 120 ml of Benadryl Elixir, if one dose

contains 1 dram?

5 ml

X = 24 doses

day if the prescription indicates 300 mg tid ?

X = 900 mg total

Pharmacy Calculations: Page 15 of 39

to receive 160 mg per day?

X dose = 160 mg

4 doses

X = 40 mg

1. If you stock Aminophylline for Injection, 250mg/10ml, how many milliliters should

be used to deliver a 200mg dose?

50mg/ml. How many milliliters are required to give a 0.9gm dose?

3. If 20 milli-equivalents (mEq) of a drug is ordered daily and the drug on hand contains

40mEq/2ml, how many milliliters should be dispensed for a 30-day supply?

reconstituted with 9.6ml of sterile water for injection. How many milliliters are needed

to administer a dose of 600,000 units?

how many milliliters would you need?

Pharmacy Calculations: Page 16 of 39

vials. How many milliliters would you need to fill the order?

7. How many 5gr tablets should be dispensed to fill the following prescription?

(Note: Each tablet is 250mg)

9. How many milliliters of alcohol would be used to make 240ml of preparation if each

teaspoonful contains 2.8ml of alcohol?

10. In supply you find a vial of Kanamycin Injection labeled 1.0g per 3ml. How many

milliliters of this solution must be given to administer a dose of 750mg of drug?

11. You have a vial of Ephedrine Injection labeled 25mg/ml. How many milliliters must

be injected in order to administer a dose of 12.5mg?

12. How many milligrams of drug are contained in a 30ml vial of Naloxone, labeled

0.4mg/ml ?

13. How many tablets you would you dispense for the following prescription?

(Note each tablet is 300mg)

Pharmacy Calculations: Page 17 of 39

14. How many milligrams of drug would be in one pint if each dram has 1/8th of a

grain?

15. If 0.3mg is the dose to taken daily for 30 days, how many grams will you dispense?

16. The prescription calls for the patient to take one teaspoonful four times a day for 10

days. How many milliliters will you dispense?

17. The dose is one tablespoonful every 6 hours for 1 week. How many milliliters will

you dispense?

18. How many doses are in 180ml if each dose contains 2 tablespoonfuls?

20. The physician prescribes 8 fluid ounces of penicillin to be taken in 10ml doses. How

many doses will the patient receive?

21. The patient will take 350mg in each dose which is to be taken six times a day for 14

days. How many total grams will this patient need?

Pharmacy Calculations: Page 18 of 39

22. Twenty doses are to be obtained from 1oz of a chemical. How many milligrams are

in each dose?

23. Forty grams of a medication is to be divided into 500 doses. What is the strength of

each dose in milligrams?

24. One pound of chemical will make 60 doses. How many milligrams will each dose

contain?

25. Six fluid ounces are to be divided into 20 doses. How many milliliters are in each

dose?

doses?

27. How many tablets would you dispense if 2 tablets are to be taken every 3 hours for

15 days?

28. If a patient takes 2 and 1/2 teaspoonfuls every 8 hours for 10 days how many

milliliters of medication would you dispense?

29. If 250mg of medication are to be taken daily for 3 weeks how many grams would

you dispense?

Pharmacy Calculations: Page 19 of 39

30. How many doses can be obtained from 450ml of medication if the size of each dose

is 1.5 teaspoonfuls?

ANSWERS: (1) 8 ml (2) 18 ml (3) 30 ml (4) 6 ml (5) 0.5 ml (6) 0.8 ml (7) 84 tabs

(8) 56 tabs (9) 134.4 ml (10) 2.25 ml (11) 0.5 ml (12) 12 mg (13) 45 tabs (14)

766.26 mg (15) 0.009 gm (16) 200 ml (17) 420 ml (18) 6 doses (19) 12 doses

(20) 23.65 doses (21) 29.4 gms (22) 1,417.5 mg (23) 80 mg (24) 7,566.6 mg (25)

8.87 ml (26) ½ tablespoonsful (27) 240 tabs (28) 375 ml (29) 5.25 gm (30) 60

doses

strengths.

Percentage Preparations

Percent weight-in-weight expresses the number of grams of a drug or active ingredient in

100 grams of a mixture (g/g).

volume in volume expresses the number of milliliters of a drug or active ingredient in

100 milliliters of a mixture and is usually used for mixtures of liquids in liquids.

number of grams of a drug or active ingredient in 100 milliliters of a mixture.

Ratio strength (1:N) is one part by weight or volume in N parts by weight or volume. A

1:200 ratio strength can be 1 gm solid to 200 ml solid or 1 ml liquid to 200 ml liquid or 1

gm solid to 200 ml liquid.

hydrocortisone, what is the percentage

strength (w/w) of the ointment?

75 gm (Active ingredient)

2000 / 75 = x

x = 0.0375 *Must change decimal to %

x = 3.75 %

Pharmacy Calculations: Page 20 of 39

lotion, what is the percentage of phenol

in the lotion?

8 ml (Active Ingredient)

8 / 480 = X

the percentage of menthol in the lotion?

1.2 / 480 = x

x = 0.0025 *Must change decimal to %

x = 0.25%

PERCENTAGE PREPARATIONS

solution?

3. How many grams of phenol are required to prepare 480ml of a 1/10% solution?

Pharmacy Calculations: Page 21 of 39

solution?

percentage strength of the solution?

percentage strength of the solution?

Boric Acid 20 grains ______ %

Distilled Water (QSAD) 1 fl

8. How many milliliters of a 0.1% solution can be made from one gram of atropine

sulfate?

9. How many fluid ounces of a 0.55% solution can be prepared from 75 grains of

scopolamine hydrobromide?

10. With 43gm of hydrocortisone powder, how many grams of a 1.5% ointment could

you make?

11. How many liter of a 2% iodine tincture can be made from 123gm of iodine?

Pharmacy Calculations: Page 22 of 39

12. If 1 gallon of a solution contains 474gm of solute, what is the percentage strength of

the solution?

13. How many grains of gentian violet should be used in preparing 2 fl oz of a 1/2%

solution?

14. How many milliliters of a 6% solution can be prepared from 14gm of neomycin

sulfate?

15. What is the percentage strength of solution if 1/4 pound of chemical is dissolved in

0.25 liters?

16. How many pounds of medication are required to make 3 gallons of 7% solution?

17. How many fl oz of 16% solution can be made from 7000 grains of chemical?

18. How many quarts of 5% solution can be made from 47.3 grams of drug?

19. How many grains are needed to make 4 quarts of a 1/8% solution?

Pharmacy Calculations: Page 23 of 39

20. How many fl oz. (apothecary) of a 16% solution can be made from 9100 grains of

drug?

21. If 12 grains of powder are dissolved in enough water to make one pint of solution,

what is the percentage strength?

22. How many grains of NaCl are needed to make 8 fl oz of 0.9% solution?

23. How much Thymol would be needed if a prescription was written for 240gm of 4%?

25. If 10 grains are dissolved in 250ml of solution, what is the percentage of this

solution?

ANSWERS: (1) 12.5 gm (2) 0.6 gm (3) 0.48 gm (4) 6.83 gr (5) 85% (6) 0.35% (7)

0.43%, 4.3% (8) 1000 (9) 29.97 fl oz (10) 2866 gm (11) 6.15 L (12) 12.5% (13)

4.55 gr (14) 233.3 ml (15) 45.4% (16) 1.75 lbs (17) 96.15 fl oz (18) 1 quart (19)

72.8 gr (20) 124.65 fl oz (21) 0.164% (22) 32.76 gr (23) 9.6 gm (24) 0.00002%

(25) 0.25%

preparation to make a product of a lesser strength.

Stock solutions are bulk solutions of known concentration frequently prepared for

convenience in dispensing. They are frequently concentrated solutions from which more

dilute solutions can be quickly prepared. Although, dilute solutions are also

compounded.

Pharmacy Calculations: Page 24 of 39

percent

percent

To solve concentration and dilution problems you need to identify the two

preparations in the equation, convert ratio or percentage strengths to decimal

expressions and convert to same systems of measurement.

EXAMPLE: If 500 ml of a 15% solution are diluted to 1500 ml, what will be the

percent strength?

Amt1 x %1 = Amt2 x %2

Step 1: Identify the two preparations in the problem and assign values to

appropriate terms.

7500 = 1500X

7500/1500 = 1500X/1500

X = 5%

Step 3: Don’t forget to check the final answer for the correct units!!!

1. How many milliliters of a 25% solution can be prepared from 750ml of a 65%

solution?

2. If 30gm of a 45% powder was diluted to make a 30% powder, how many grams will

the new preparation weigh?

Pharmacy Calculations: Page 25 of 39

3. If you dilute 2 pints of a 65% solution to 30%, how many fl oz will the new

preparation measure?

4. How many grams of a 10% phosphoric acid can be made from 1kg of 85% phosphoric

acid?

strength?

6. If 55ml of an 18% solution is diluted to 330ml, what will be the percentage strength?

1:2000 solution?

strength would it be?

9. If 2 fl oz (apothecary) of a 25% solution is diluted to 5%, how many fluid ounces will

the new solution measure?

10. How many pounds of a 1% cream can be made from 10,000gm of an 8.5% cream?

Pharmacy Calculations: Page 26 of 39

11. How many milliliters of a 15% solution can be made from a quart of a 60% solution?

12. How many liters of a 1/1,000 solution can be made form 200ml of a 0.1% solution?

13. How many milliliters of a 6% solution can be made from 2L of a 36% solution?

14. How many pints of a 6% solution can be made from 4 fl oz (apothecary) of a 15%

solution?

15. How much of a 25% solution is needed to prepare 473 ml of a 10% solution?

ANSWERS: (1) 1950 ml (2) 45 gm (3) 69.33 fl oz (4) 8500 gm (5) 1:5000 (6) 3%

(7) 400 ml (8) 0.13% (9) 10 fl oz (10) 187.22 lbs (11) 3784 ml (12) 0.2 L (13)

12000 ml (14) 0.625 pts (15) 189.2 ml

volume of a stated intermediate strength preparation when given the strengths of

the two stock preparations.

Alligations

Alligation is a method used for calculating the average value of a mixture obtained by

combining known quantities of two or more substances, the values of which are known

quantities of two or more substances, the values of which are known.

Step 2: Enter the percent strength of the stronger solution in the upper left

Pharmacy Calculations: Page 27 of 39

hand box.

Step 3: Enter the percent strength of the weaker solution to be mixed in

the lower left hand box.

Step 4: Enter the desired percent strength of the solution in the center box.

Step 5: Let x and y equal the unknown volume of the solutions to be

mixed to obtain the desired mixture.

A Blank X R

Blank C Z T

B Blank Y S

Procedure:

1. Subtract C from A to solve for Y.

2. Subtract B from C to solve for X.

3. X/Y = i.e. 20/25 = 4/5, which is interpreted as 4 parts to 5 parts,

or a total of 9 parts. For every 4 parts of 95% alcohol, you must

use 5 parts of 50% alcohol to attain 70% alcohol.

volume amount of each of the components to be combined to attain a

given amount of a different strength solution.

example, however, will be expanded to include a desired amount.

How much 95% alcohol and how much 50% alcohol will be needed to

attain 450 ml of 70% alcohol?

4

95 20

70 9

50 25

5

What is the greater strength? a = _____

What is the lesser strength? b = _____

Pharmacy Calculations: Page 28 of 39

The difference between A and C. _____

(Blocks X and Y, i.e. 20/25 reduced to 4/5)

Step 6. Looking at the right half of this grid, you should recognize two ratio and

proportion problems that are set up. By solving these simple problems

you will find out exactly how much of each ingredient is necessary.

4 X 9 450 ml

9 450 ml 5 X

9 X = 4 x 450 9 X = 5 x 450

9 X = 1800 9 X = 2250

X = 200 ml X = 250 ml

of 95 % alcohol of 50 % alcohol

cream to prepare a cream containing 15% sulfathiazole?

100% Blank ? gm

Blank 15%

2. In what proportions should be 95% alcohol be mixed with 30% alcohol to make 70%

alcohol?

95 % Blank ?

Pharmacy Calculations: Page 29 of 39

Blank 70%

30% Blank ?

3. How many grams of 20% precipitated sulfur ointment and 5% precipitated sulfur

ointments should be used to make 908gm of 8% ointment?

20% Blank ? gm

Blank 8% 908gm

5% Blank ? gm

4. How many grams of coal tar solution (LCD) should be added to 2700gm of an

ointment base to prepare a 10% coal tar ointment?

5. How many grams of coal tar should be added to 925gm of zinc oxide paste to prepare

a 6% coal tar ointment?

ointment to make a 5% sulfathiazole ointment?

8. How many milliliters of 95% isopropyl alcohol must be mixed with purified water to

obtain 7568ml of 70% isopropyl alcohol?

Pharmacy Calculations: Page 30 of 39

9. How many milliliters of water should be added to a quart of 75% solution to make

25% solution?

10. How many grams of sulfur should be mixed with some 1:400 sulfur to make 2

ounces (AV) of 1:25 sulfur ointment?

11. How many grams of coal tar should be added to 908gm of zinc oxide paste to

prepare a 9% coal tar ointment?

12. How many milligrams of petrolatum should be added to 340gm of a 35% sulfur

ointment to make 10% sulfur ointment?

13. How many milliliters of water should be added to some 50% isopropyl alcohol to

make 2 gallons of 40%?

14. How many milliliters of water should be added to a liter of 1:250 solution to make a

1:4000 solution?

15. How many milliliters of 8% solution can be made if 1 liter of 30% solution is mixed

with water?

Pharmacy Calculations: Page 31 of 39

16. How many liters of water should be added to a gallon of 80% solution to make 50%

solution?

17. How many milliliters of 90% alcohol and 60% alcohol should be added together to

make 4 pints of 75% alcohol?

18. How many milliliters of alcohol should be mixed with 1.5 quarts of 30% alcohol to

make some 70% alcohol?

19. In what proportions should 90% acetone be mixed with 40% acetone to make

65% acetone?

20. How many milliliters of water should be added to a liter of 75% alcohol to make

some 45%

ANSWERS: (1) 200 gm (2) 8, 5 (3) 181.6 gm, 726.4gm (4) 300 gm (5) 59.04 gm

(6) 1 : 7 (7) 750 gm (8) 5,576.42 ml (9) 1,892 ml (10) 2.13 gm (11) 89.8 gm (12)

850,000 mg (13) 1,513.6 ml (14) 15,000 ml (15) 3,750 ml (16) 2.27 ml (17) 946

ml, 946 ml (18) 1,892 ml (19) 1 : 1 (20) 666.6 ml

9. Calculate the appropriate dose for a patient when given the reecommended

dosage of that drug and the patient’s weight in either pounds or kilograms.

Dosage Calculations - medications may be dosed by one of at least three different ways:

body weight, body surface area, and age. Body weight and surface area are the most

accurate. In any case, the appropriate patient information will need to be provided.

When medications are prescribed, there is often an acceptable dosage range the patient

may receive. Pharmacy's duty is to make sure the prescription's dosage falls within the

acceptable range. When checking a dose, first check the reference to see how the

recommended dose is expressed, then you will know how to proceed with checking the

prescription

Pharmacy Calculations: Page 32 of 39

Example 1: An adult male has a prescription that reads - penicillin 250mg, qid,

dispense 40

the dosage for adults and children over 12 years of age ranges from 125mg

bid, to 500mg qid

150ml, patient weight, 20 kg, age 6 y/o

the dose for children over 9 months of age is 25-50mg/kg/day in divided

doses every 6 or 12 hours

2. To compare, determine how much the patient is receiving per day: 150mg

x qid = 600mg/day

3. Next divide the total amount of medication by the body weight: 600mg /

20 kg = 30mg/kg, which is between 25 and 50mg

appointment for sedation, patient weight 15 kg, 3 y/o

sedative for children, 25mg/kg/day, up to 500mg per dose

Pharmacy Calculations: Page 33 of 39

3. Determine how much the patient is to receive per the prescription: ratio

and proportion is useful here:

500 mg x mg

5 ml 15 ml

a call to the provider

Given the following dosage guidelines, determine if the prescriptions below are dosed

appropriately. Answer "OK" for appropriate doses, "over" for doses over the

recommendation, and "under" for doses under the recommendation.

***These guidelines are "For Training Purposes Only" and not to be used on the job.***

Acetaminophen

Adults (> 12 yrs) - 325mg-650mg every 4-6 hours, or 1 gm 3-4 times/day - do not exceed

4 gm/day

Children (< 12 yrs) - 10-15 mg/kg per dose, not to exceed 5 doses in 24 hours

Amikacin

Adults, children and infants - 15mg/kg/day in 2-3 divided doses

Amoxicillin

Adults (> 12 yrs) - 750-1,000mg/day in 2 or 3 divided doses

Children (< 12 yrs) - 20-40mg/kg/day in 3 divided doses

Ampicillin

Children (< 12 yrs) - 50-400mg/kg/day in 4 divided doses

Adults (> 12 yrs) - 1-12 gm in 4 divided doses

Gentamycin

5-7mg/kg/day in 2-3 divided doses

Ibuprofen

Children (6 mos to 12 yrs) - 5-10mg/kg/dose, 3-4 times/day, not to exceed 40mg/kg/day

Adults - do not exceed 3.2 gm/day

Nafcillin

Children (< 12 yrs) - 100-200mg/kg/day in 4 divided doses

Pharmacy Calculations: Page 34 of 39

Penicillin V (oral)

Children (2-12 yrs) - 30-50mg/kg/day in 4 divided doses

Adults (> 12 yrs) - 250-500mg every 6-8 hours

Theophylline

Maximum daily doses for ages: (1-9 yrs 24mg/kg/day) (9-12 yrs 20mg/kg/day) (12-16 yrs

18mg/kg/day) (> 16 yrs 13mg/kg/day)

Vancomycin

Adults (> 12 yrs) - 500mg-2 gm/day in 3 or 4 divided doses

Children (< 12 yrs) - 40mg/kg/day in 3 or 4 divided doses

Abbreviations: y/o = years old, wt. = weight, < =less than, > = greater than

Rx - Nafcillin 1.2 gm IV, q6h

Rx - Amikacin 140mg IV q8h

Rx - Theophylline 200mg tabs, 2 tabs po tid

Rx - Ibuprofen 800mg tabs, 1 tab po q4h

Rx - Acetaminophen 160mg/5ml, 1 tsp po q6h

Rx - Amoxicillin 250mg caps, 2 caps po qid

Rx - Penicillin 250mg/5ml, 3ml po qid

Rx - Vancomycin, 1gm IV q6h

Rx - Gentamycin 32mg IV q8h

Rx - Ibuprofen 100mg/5ml, 3 tsp po q8h

Pharmacy Calculations: Page 35 of 39

Rx - Amikacin, 1gm IV q12h

Rx - Ampicillin, 350 mg IV q6h

Rx - Theophylline 300 mg tabs, 1 tab po tid

Rx - Ampicillin 250mg caps, 1 cap qid

Rx - Acetaminophen 500mg tabs, 2 tabs po q4h

Rx - Vancomycin 600 mg IV q8h

Rx - Penicillin 250mg/5ml, 1 tsp po qid

Rx - Ibuprofen 100mg/5ml, 2.5 tsp po q6h

Rx - Ampicillin 250mg caps, 1 cap qid

Rx - Amikacin, 70mg IV q8h

Rx - Acetaminophen 325mg, 3 tabs q6h

Rx - Amoxicillin 250mg caps, 1 cap q8h

Rx - Gentamycin, 60 mg q8h

Rx - Nafcillin, 450mg IV q8h

Rx - Theophylline 200mg tabs, 1 tab tid

Pharmacy Calculations: Page 36 of 39

Rx - Amikacin, 330mg IV q8h

Rx - Penicillin V 250mg/5ml, 9ml po qid

Rx - Ibuprofen 400mg tabs, 1-2 tabs q4-6h (determine maximum amount able to be taken

and compare to recommended dose)

Answers: (1) OK - 150mg/kg/d (2) Over - 17.5mg/kg/d (3) Over - 20.3mg/kg/d (4) Over -

4.8 gm/d (5) Under - 5.9 mg/kg/dose (6) Over - 2g/d & qid (7) Under - 17.6mg/kg/d (8)

Over - 4 gm/d (9) OK - 6 mg/kg/d (10) OK - 30.5mg/kg/d (11) Over 31.25mg/kg/d (12)

Under 36.8 mg/kg/d (13) OK 15.2 mg/gkg/d (14) OK 1gm/d (15) Over - 6 gm/d (16) OK

- 39.6 mg/kg/d (17) over - 71 mg/kg/d (18) OK - 40 mg/kg/d (19) OK - 1 gm/d (20)

Under - 4.8 mg/kg/d (21) OK - < 4gm/d (22) OK - 750 mg/d (23) Over - 9 mg/kg/d (24)

Under - 56.3 mg/kg/d (25) OK - 11.5 mg/kg/d (26) OK - 15 mg/kg/d (27) OK - 50

mg/kg/d (28) Over - 4.8 g/d

10. Calculate the appropriate drop factors for patients receiving IV therapy.

FLOW RATES

Using flow rates, you can calculate the volume of fluid and amount of drug a

patient will be receiving over a certain time period.

General Formula:

ml to be infused = ml

hours to be infused 1 hour

ml = ml

60 minutes 1 min

administered in 1000ml of 0.9% Sodium Chloride over 6 hours, with a 20gtt/ml

IV set.

1000ml = 166.6ml

6 1 hour

166.6ml/hr = 2.77ml

60 minutes 1 min

Pharmacy Calculations: Page 37 of 39

EXAMPLE: If 1000ml must be infused over an 8 hour period, what will be the

flow using a 60gtt/ml IV set?

8 hr 1 hour 60 min 1 min

(Can’t have part of a drop so you have to round up or down, in this case round

up.)

125gtt/min

gtts/ml. So in this case 125ml/hr = 125 microgtts/min.

1. What is the flow rate, in ml/hr, if 1 liter of 5% Dextrose in Water with 20mEq of KCl

is given over 12 hours?

0.9% Sodium Chloride over 6 hours, with a 20gtt/ml IV set.

hours. What will be the flow rate using a 15gtt/ml administration set?

4. Using a 10gtt/ml IV set, what will be the flow rate, if 500ml of solution is infused

every 4 hours?

5. The physician order is for 1000ml of D5W to be administered in 5 hours. If a

20gtt/ml set is used, what is the flow rate in ml/hr and gtts/min?

Pharmacy Calculations: Page 38 of 39

6. If an IV infusion of 100ml must be absorbed in 12 hours, what should be the flow rate

for:

b. 15 gtt/ml set _______

c. 10 gtt/ml set _______

d. 60 gtt/ml set _______

7. If an IV infusion of 500ml must be run over 12 hours, what should be the rate of flow

using the following administration sets?

20 gtts/ml ______

15 gtts/ml ______

10 gtts/ml ______

60 gtts/ml ______

8. Determine the flow rate of an IV infusion for an adult if the physician ordered 1000ml

to be given in 2 hours with a drop factor of 10.

9. What is the flow rate if 500ml of D5W is infused over 4 hours using micro-drip

tubing?

10. What is the flow rate in ml/min if 1 liter of solution is infused over 6 hours using a

15gtt/ml set?

11. Determine the flow rate to be used to infuse 1000ml, of dextrose 5% in water over

12 hours if the set delivers 10 drops per ml.

12. Determine the flow rate to be used to infuse 250ml, of Sodium Chloride 0.9% over 4

hours using a 20gtt/ml set.

Pharmacy Calculations: Page 39 of 39

ANSWERS: (1) 83.3 ml/hr (2) 55.4 gtt/min (3) 41.55 gtt/min (4) 20.8 gtt/min (5)

66.6 gtt/min (6) a-2.8 gtt/min b.-2.1 gtt/min c-1.4 gtt/min d-8.4 gtt/min (6) 13.8

gtt/min, 10.35 gtt/min, 6.9 gtt/min, 41.4 gtt/min (7) 83 gtt/min (8) 125 gtt/min (9)

2.77 ml/min (10) 13.8 gtt.min (11) 20.8 gtt/min

We have discussed a variety of calculations that you will use to perform your duties as a

pharmacy technician. Before we end this discussion, lets look at a few preventative measures you

can take to prevent an error in calculation, thus preventing a medication error.

• Never leave a decimal point naked. Always place a zero before a decimal expression less

than one. Example: .25mg may be read as 25 mg. The correct way is to write 0.25 mg.

• Never place a decimal point and a zero after a whole number. The decimal may not be

seen and result in a tenfold overdose. Example: 5.0 mg may be read as 50 mg. The

correct way is to write 5 mg.

• Avoid using decimals whenever whole numbers can be used as alternatives. Example: 0.5

g should be expressed as 500 mg.

• Whenever possible, use the metric system rather than grains or drams.

Developing a working knowledge of pharmaceutical calculations is crucial for success in your

career as a pharmacy technician. Your customer's health depends on your accuracy each time you

calculate a dose or make a pharmaceutical preparation. Another important aspect of your job,

especially when making those pharmaceutical preparations, is pharmaceutical chemistry. In the

next unit, we will cover basic concepts of chemistry and properties of pharmaceuticals. But first,

answer the following questions to see if you have developed that working knowledge of

pharmaceutical calculations.