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Pharmacy Calculations

Curriculum: Pharmacy
Target Audience: Pharmacists and Pharmacy Technicians
Philip Trapskin, PharmD
Rebecca Reagan, RPh
Kimberley Hite, MS, PharmD
Authors: John Armitstead, MS, RPh, FASHP

Service Area: Pharmacy Services


Phone: (859) 257-8414
Email: khite2@email.uky.edu
Date Developed
Or Revised: April, 2005
All materials on this template are Copyright 2004 University of Kentucky Chandler Medical Center Learning Center unless
otherwise noted. All rights reserved. Certain graphic images, text elements and logos are derived from The University of Kentucky
and NetLearning and are used by permission.

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Supplies needed for this CBL


Please have a calculator, pencil and paper
available to complete this CBL.

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Menu
Objectives
Basic Mathematics
Units of Measure
Ratios and Proportions
Intravenous flow (drip) rate calculations
Common Abbreviations

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Objectives
Review basic mathematics
Review units of measure
Review ratios and proportions
Review concentration and dilution
Review intravenous flow (drip) rate calculations
Provide sample problems and solutions

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Basic Mathematics
Numerals
A numeral is a word or a sign, or a group of words
or signs that expresses a number.
Arabic (0, 1, 2, 3, 4...)
Roman (I, X, L, D, C, M )
Numbers
A number is a total quantity or amount that is made
of one or more numerals.

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Basic Mathematics cont.

(Kinds of Numbers)

Whole Numbers (10, 220, 5, 19)


Fractions
Parts of whole numbers (1/4, 2/7, 11/13)

Numerator
Decimal Numbers
Denominator
Another means of writing fractions
(1/2 =0.5, 1&3/4 = 1.75)

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Basic Mathematics cont.

(Kinds of Numbers)

WARNING: Writing decimals incorrectly can lead to


medication errors.
Trailing zeros
Write 5 not 5.0
Naked decimal points
Write 0.5 not .5
Periods are sometimes difficult to see leading to a 10
fold error.

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Basic Mathematics cont.

(Problem Set #1)

Convert the following fractions to decimal numbers:


a. 1/2

b. 3/4

c. 1

e. 1/3

f. 5/8g. 50/100 h. 12/48

i. 11/2

j. 2 2/3

k. 5 1/4

d. 2/5

l. 3 4/5

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Basic Mathematics cont.

(Problem Set #1)

Answers for problem set #1:


a. 0.5

b. 0.75

c. 1

d. 0.4

e. 0.33

f. 0.625

g. 0.5

h. 0.25

i. 5.5

j. 2.67

k. 5.25

l. 3.8

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Basic Mathematics cont.

(Percentages)

Percentage means by the hundred or in a hundred.


Percents (%) are just fractions, but fractions with a set
denominator of 100.
Example: 50% means 50 in a hundred or 50/100 or
1/2.
Converting percentages to fractions
Write the number preceding the percent sign over 100
and simplify the resulting fraction
Example: 25%=25/100=1/4

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Basic Mathematics cont.

(Percentages)

Converting fractions to percentages


1. Write the fraction in decimal form. (3/4=0.75)
2.Write the decimal over one. (0.75/1)
3.Multiply the numerator and denominator by 100.
(0.75/1 = 75/100)
4.Because you already know the divided by a
hundred is the same as percent you can write
75/100 as 75%.

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Basic Mathematics cont.

(Percentages)

Concentration expressed as percentage


Percent weight-in-weight (w/w) is the grams of
drug in 100 grams of the product.
Percent weight-in-volume (w/v) is the grams of
drug in 100ml of the product.
Percent volume-in-volume (v/v) is the milliliters of
drug in 100ml of the product.
These will be discussed further later in the CBL.

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Units of Measure

(Metric System)

The metric system is based on the decimal system, in which everything is


measured in multiples or fractions of 10.
Standard measures
Meter; Length
Gram; Weight
Liter; Volume
Prefixes
kilo-; 1000
milli-; 1/1000 = 0.001
micro-; 1/1000000 = 0.000001

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Units of Measure cont.

(Metric System)

Volume is the amount of space occupied by a


three-dimensional object as measured in cubic
units (as milliliters or liters)
L = Liter
ml = milliliter
1 Liter = 1000 milliliters
3.5L = 3500ml

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Units of Measure cont.

(Metric System)

Mass is a property of physical objects which measures the


amount of matter in an object.
kg = kilograms
g = gram
mg = milligram
mcg = microgram
ng = nanogram
1 kilogram = 1000 grams
1 gram = 1000 milligrams
1 milligram = 1000 micrograms
1 microgram = 1000 nanograms

Example
0.004kg = 4g = 4000mg = 4,000,000mcg

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Units of Measure cont.

(Other Systems)

Avoirdupois used in measuring bulk medications


(pounds, ounces, grains)
Apothecary developed after the Avoirdupois system to
enable fine weighing of medications (pounds, ounces,
drams, scruples, grains, gallons, pints, fluid ounces, fluid
drams, minims)
Household commonly used to measure liquids with
home utensils (teaspoons, tablespoons, cups, pints,
quarts)

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Units of Measure cont.

(Equivalencies)

Equivalencies among systems


1 inch = 2.54 cm
1 kg = 2.2 pounds (lb)
1 fluid ounce (fl oz) = 29.57(30) milliliters (ml)
1 pint (pt) = 473.167 (480) milliliters (ml)
1 teaspoonful (tsp) = 5 milliliters (ml)
1 tablespoonful (TBS) = 15 milliliters (ml)
1 ounce (oz) = 28.35 grams (g)
1 pound (lb) = 453.59 (454) grams (g)

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Units of Measure cont.

(Problem set #2)

Fill in the blanks:


a.1 liter (L) = ________ml
b.1000 g = __________kg
c.1 g = _____________mg
d.1000 mcg =_________mg
e.1 TBS = ____________tsp
f. 1 TBS =_____________ml
g. 2 fl oz =_____________ml
h.70 kg = ______________pounds (lb)

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Units of Measure cont.

(Problem set #2)

Fill in the blanks:


a.1 liter (L) = 1000 ml
b.1000 g = 1 kg
c.1 g = 1000 mg
d.1000 mcg = 1 mg
e.1 TBS = 3 tsp
f. 1 TBS = 15 ml
g. 2 fl oz = 60 ml
h.70 kg = 154 pounds (lb)

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Ratios and Proportions


A ratio states a relationship between two quantities.
Example: 5 g of dextrose in 100 ml of water (Dextrose 5% in
Water often abbreviated as D5W)

A proportion is two equal rations.


Example: 5 g of dextrose in 100 ml of water equals 50 g of
dextrose in 1000 ml of water
5g
100ml

50 g
1000ml

If you know three of the four terms you can calculate the fourth.

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Ratios and Proportions cont.


A vial of drug contains 40mg/2ml. How many milliliters
(ml) are required to obtain 300mg of drug?
1. 40mg = 300mg
2ml
X

2. (40mg)(X)= (2ml)(300mg)

3. X = (2ml)(300mg)
(40mg)

4. X=15ml

5. TIP Make sure your units cancel

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Concentration and Dilution


Terminology
5% dextrose in water is the same as D5W.
0.9% sodium chloride (NaCl) is the same as
normal saline (NS).
Half-normal saline is half the strength of
normal saline (0.9% NaCl), or 0.45% NaCl.
This may also be referred to as 1/2NS

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Concentration and Dilution cont.


Reminder
Percent weight-in-weight (w/w) is the grams
of drug in 100 grams of the product.
Percent weight-in-volume (w/v) is the grams
of drug in 100ml of the product.
Percent volume-in-volume (v/v) is the
milliliters of drug in 100ml of the product.

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Concentration and Dilution cont.


Example 1:
0.9% sodium chloride (w/v) = 0.9 g of sodium chloride in
100 ml of solution.
Example 2:
5% dextrose in water (w/v) = 5 g of dextrose in 100 ml of
solution.
Example 3:
23.4% sodium chloride (w/v) = 23.4 g of sodium chloride
in 100 ml of solution.

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Concentration and Dilution cont.


Example 4:
How many grams of dextrose are in 1 L of D5W?
Know ratio: D5W means
5g
100ml
Unknown ratio:
X
1000ml
Write the proportion and solve for X:
X
5g X = 50 g
1000ml 100ml

=
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Concentration and Dilution cont.


Solving concentration and dilution problems
1. Calculate the number of grams in 100 ml of solution. That
is your known ratio.
2. Then calculate the number of grams in the volume
requested in the problem by setting up a proportion.
3. Check to make sure your units are in the same order.
4. Make sure that the units that are across from each other
are the same.
5. Convert your answer to the requested units.

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Concentration and Dilution cont.

(Problem Set #3)

1. In 100 ml of D5W/0.45% NaCl solution:


a.How many grams of NaCl are there?
b.How many grams of dextrose are there?
2. How many grams of dextrose are in 1 L of a 10% dextrose
solution?
3. How many grams of NaCl are in 1 L of 1/2NS?
4. How many mg of neomycin are in 50 ml of a 1% neomycin
solution?
5. How many grams of amino acids are in 250 ml of a 10% amino acid
solution?

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Concentration and Dilution cont.

(Problem Set #3)

Solutions
1. a. 0.45g
b. 5g
2. 100g
3. 4.5 g
4. 500 mg
5. 25 g

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Concentration and Dilution cont.

(Problem Set #4)

1. An order calls for 5 million units of aqueous penicillin. How


many milliliters are needed if the concentration is 500,000
units/ml?
2. How many milliliters are needed fro 15 million units of
penicillin if the concentration is 1 million units per milliliter?
3. Pediatric chloramphenicol comes in a 100mg/ml
concentration. How many mg are present in 5 ml of solution?
4. How many milliliters of a 250mg/ml chloramphenicol solution
are needed for a 4 g dose?

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Concentration and Dilution cont.

(Problem Set #4)

5. Oxacillin come in a 500mg/1.5ml solution. How many milliliters will be


required for a 1.5 g dose?
6. How many grams of ampicillin are in 6 ml of a 500mg/1.5ml solution?
7. How many milliliters contain 3 g of cephalothin if the concentration of
the solution is 1g/4.5 ml?
8. How many grams of magnesium sulfate are in 2 ml of a 50%
magnesium sulfate solution?
9. How many milliliters of a 50% dextrose solution are needed for a 10 g
dextrose dose?
10. How many grams of dextrose are in 50 ml NS solution?

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Concentration and Dilution cont.


Solutions:
1. 10 ml
2. 15 ml
3. 500 mg
4. 16 ml
5. 4.5 ml

(Problem Set #4)

6. 2 g
7. 13.5 ml
8. 1 g
9. 20 ml
10. zero

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Intravenous (IV) flow (drip) rate calculations


Using flow rates you can calculate the volume of fluid or
amount of drug a patient will be receiving over a certain
period of time.
Calculation of IV flow (drip) rates is necessary to ensure
that patients are receiving the amount of medication the
physician ordered.
At UKCMC pharmacy technicians perform drip rounds to
verify drip rate doses for patient safety, enhance patient
care, and minimize drug waste.

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Intravenous (IV) flow (drip) rate calculations cont.

Example:
An order is written for 25,000 units of heparin in 250 ml of
D5W to infuse at 1000units/hr, what is the correct rate of the
infusion (in ml/hr)?

1. Concentration of IV =
2. Concentration of IV =

4. IV rate =

Total amount of drug


Total
5. IV
rate volume
=

Dose desired
Concentration of IV

25,000 units of heparin


(1000 units/hr)
250ml
of D5W6. IV rate = 10 ml/hr (100 units/ml)
3. Concentration of IV = 100units/ml
of heparin

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Intravenous (IV) flow (drip) rate calculations cont.


Practice problem set #5
1. An order is written for 2 g of lidocaine in 250 ml
of D5W to infuse at 120mg/hr. What is the correct
infusion in (ml/hr)?
2. An order is written for 25,000 units of heparin in
250 ml of D5W to infuse at 17ml/hr. How many
units of heparin will the patient receive in 12
hours?

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Intravenous (IV) flow (drip) rate calculations cont.


Practice problem set #5 solutions
1. An order is written for 2 g of lidocaine in 250 ml
of D5W to infuse at 120mg/hr. What is the correct
infusion in (ml/hr)? 15ml/hr
2. An order is written for 25,000 units of heparin in
250 ml of D5W to infuse at 17ml/hr. How many
units of heparin will the patient receive in 12
hours? 20,400 units

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Common Abbreviations
D5W 5% dextrose in water
D10W 10% dextrose in water
NSS or NS 0.9% sodium chloride (normal saline)
1/2NS 0.45% sodium chloride (half normal saline)
1/4NS or 0.2NS 0.225% sodium chloride (quarter normal saline)
LR Lactated Ringers
D5LR 5% dextrose in Lactated Ringers

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Common Abbreviations cont.


D5NS 5% dextrose in 0.9% sodium chloride
CL or Cl Chloride
Na Sodium
Mg Magnesium
K Potassium
SO4 or SO4 Sulfate
mEq milliequivalent
mmol - millimole

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Summary
For more information on this topic or to request additional training please
contact:
Kimberley Hite, MS, PharmD
khite2@email.uky.edu
Please proceed to the test and complete all the questions.
The passing score for this module is 25 correct answers.
Successful completion of this exam is required to demonstrate pharmacy
calculations competency.

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Exit
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Feel free to review the screens of this course until you are confident about your knowledge of the material presented.

Click the Take Test button on the left side of the screen when you are ready to complete the requirements for this course.

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