Medication Math

7
Methods of Dosage
Calculations
Each problem that I solved became a rule, which served afterwards
to solve other problems.
Ren Descartes
Learning Outcomes
When you have completed Chapter 7, you will be able to:
! Describe how the information on a physicians order, medication
administration record (MAR), or prescription, along with the drug label
and package insert, is used to calculate the desired dose.
! Convert the dosage ordered to the desired dose, using fraction proportion, ratio
proportion, or dimensional analysis.
! Calculate the amount to administer of a drug, using any of the methods of
dosage calculationfraction proportion, ratio proportion, dimensional
analysis, or formula.
! Recognize common errors that occur during dose calculations.
Key Terms
Amount to administer
Dosage strength
Desired dose
Dosage unit
Dosage ordered
Dose on hand
Introduction
It is time to bring together all the information you have learned in previous
chapters to calculate the amount of medication to administer to a patient. You
will bring together basic math, information from the physicians order and drug
labels, and methods of converting quantities from one unit of measurement to
another. Do not hesitate to refer to previous rules to help you solve the problems presented here.
204
Dosages and Doses

Before you can calculate in practical terms how many dosage units of a medication to administer to a patient, you must first find the desired dosethe amount of the actual drug that the
patient is to be given at one time. To determine the desired dose, you must know the following information: the dosage ordered and the dose on hand.
The dosage ordered is the amount of drug the physician has ordered along with the
frequency with which it is given. You will find this information on the physicians order or
prescription, and the medication administration record (MAR). You may also receive this information verbally from a physician, especially in emergency situations. (Remember to check
a verbal order by repeating it as you are writing it down.) Always check the physicians original
order the first time you administer a medication to a patient and if you have any questions about the
information on the MAR.
Dosage strength measures the amount of drug per dosage unit. Many medications are
available in different dosage strengths. For example, a medication may be produced in two
versions, 75 mg per tablet and 100 mg per tablet. In both of these versions, the dosage unit is
a tablet.
Learning Link Recall from Chapter 6, dosage strength is a ratio that indicates the
amount of medication found in an amount of liquid or solid, found on page 176.
Once you have determined the dosage strength, you are able to determine two other
termsthe dose on hand and the dosage unit. The dose on hand is the specific amount of drug
that is present in a dosage unit. In this example, the dose on hand for the first tablet is 75 mg.
The dose on hand for the second tablet is 100 mg. The dosage unit is one tablet for both. For
any medication you have available, you can read the drug label to determine the dose on
hand and the dosage unit. Dosage strength, then, is the dose on hand per dosage unit.
Sometimes the dosage ordered and the dose on hand have the same unit of measurement. In
these cases, the desired dose is the same as the dosage ordered and no conversion is necessary.
Frequently, however, the dosage ordered and the dose on hand are expressed in different units
of measurement. In these cases, you must convert the dosage ordered so that it has the same
unit of measurement as the dose on hand. This conversion leads you to the desired dose.
For example, suppose the dosage ordered is written for 0.5 grams of medication. The
dose on hand is 1000 mg. To find the desired dose, you would need to convert grams (the
dosage ordered) to milligrams (the dose on hand).
See Table 7-1 for a summary of the language of dosage calculations.
Conversion Factors
Conversion factors are expressions that allow you to switch from one unit of measurement
to another.
Learning Link Recall from Chapter 3, Conversion Factors, when the numerator
and denominator of a conversion factor are equivalent the factor itself equals 1,
found on page 92.
In some cases, you convert between units in the same system of measurement; you will use
conversion factors such as 1 mg/1000 mcg and 1000 mcg/1 mg. In other cases, you convert
between systems, using conversion factors such as 1 tsp/5 mL and 5 mL/1 tsp.
Calculating the Desired Dose

Before you calculate the amount to administer, it is first necessary to determine the desired dose.
As stated in Table 7-1, the desired dose (the amount of drug given at one time) must have the
same unit of measurement as the dose on hand (found on the drug label). Unfortunately, the
Methods of Dosage Calculations
205
TABLE 7-1 The Language of Dosage Calculations

Term
Abbreviation
Definition
Examples Refer to Figure 7-1
Dosage ordered
The amount of drug to be given

to the patient and how often
it is to be given
This value will be found on the
drug order or prescription.
40 mg bid (twice a day)
Desired dose
The amount of drug to be given at

a single time
The unit of measurement must be
the same as the dose on hand.
The drug order and the drug label
must be consulted.
This amount must be calculated

when dosage ordered is a
different unit from the dose
on hand. In this problem a
calculation will not be
necessary.
Dosage unit
The units by which the drug will

be measured when it is
administered
drug label.
In Figure 7-1 this is capsules.

Other examples include:
tablets, 1 mL, 5 mL, drops,
or units.
Dose on hand
The amount of drug contained in

each dosage unit
drug label.
In Figure 7-1 this is 20 mg.
Amount to
administer
The volume of a liquid or the

number of solid dosage units
that contains the desired dose
This value is found with a
calculation.
If the desired dose is 40 mg and

the dosage strength is 20 mg
per capsule, the amount to
administer is 2 capsules.
Dosage strength
H
__
Q
Dose on hand per dosage unit

This value can be determined
from the drug label.
In Figure 7-1 this is 20 mg per

capsule.
dosage ordered will not always be written in the same units as are found on the drug label.
For example, an order may be written in grams while the drug is labeled in milligrams. When
this occurs, it is necessary to convert the dosage ordered to a desired dose having the same
units as the dose on hand.
Dosage ordered (O)
Ordered: Nexium 40 mg PO bid

Desired (D) dose
Rx only
20 mg*
*Each delayed-release
capsule contains 20 mg esomeprazole
Dosage strength H = 20 mg
Q 1 capsule
Calculate amount to administer (A)
Figure 7-1 The language of dosage calculations.
206
Chapter 7
Keep container tightly closed.

Store at 25C (77F); excursions
permitted to 1530C (5986F). [See
USP Controlled Room Temperature].
Dispense in a tight container.
USUAL ADULT DOSAGE:
See package insert.
NEXIUM and the color purple as

applied to the capsule are registered
trademarks of the AstraZeneca group.
AstraZeneca 2008
Mfd. for: AstraZeneca LP, Wilmington, DE 19850
By: AstraZeneca AB, S-151 85 Sdertlje,
Sweden
Product of France
9708304
90|No.5020
90 Delayed-Release
Capsules
Dosage
unit Q
0186-5020-54
NDC 0186-5020-54
31326-00
On hand:
Dose on hand H
This section reviews three methods that can be used to calculate the desired dose: the fraction proportion method, the ratio proportion method, and dimensional analysis. Remember,
each will give you the same result, and the method you use is a matter of personal preference.
Once you identify the method you prefer, follow the color coding of that method. Regardless
of the method that you choose, you will want to become familiar with the terms contained in
Table 7-1 before you proceed.
Rule 7-1
Calculating the Desired Dose

The unit of measurement for the desired dose must be the same as the unit
of measurement of the dose on hand before the amount to administer can be
calculated. This is calculated by converting the dosage ordered into the same unit of
measurement as the dose on hand; once converted, it becomes the desired dose.
Example
Consider that the physician has ordered the patient to receive 0.2 mg of medication.
This is the dosage ordered.
The dosage strength is 100 mcg/tablet, making the unit of measure of the dose on
hand micrograms (mcg). Recall the dosage strength is the dose on hand per dosage
unit.
Since the bottle of medication comes in micrograms and the order is for milligrams,
you must change the dosage ordered (0.2 mg) to the same unit of measurement as
the dose on hand (micrograms) to obtain the desired dose.
GO TO . . . Open the CD-ROM that accompanies your textbook, and select

Chapter 7, Rule 7-1. Review the animation and example problems, then complete the
practice problems. Continue to the next section of the book once you have mastered
the rule presented.
Fraction Proportion Method

You can use fraction proportions to convert from one unit of measure to another. Procedure
Checklist 3-1 was used. This same procedure checklist can be used to determine the desired
dose from the dosage ordered.
Learning Link Recall Chapter 3, Procedure Checklist 3-1, found on page 93.
Procedure Checklist 3-1

Converting by the Fraction Proportion Method
1. Write a conversion factor with the units that you are converting to in the numerator
and the units you are converting from in the denominator.
2. Write a fraction with the unknown? in the numerator and the number that you need to
convert in the denominator. (The unknown is the desired dose D. The number you need to
convert is the dosage ordered O.)
3. Set up the two fractions as a proportion.

4. Cancel units.
5. Cross-multiply and then solve for the unknown value.
207
Example 1
The dosage ordered is 0.2 mg once a day.

The dosage strength is 100 mcg per tablet.
Find the desired dose.
In this case, the drug is measured in milligrams on the drug order and micrograms on the drug label.
The units for the desired dose must match those found on the drug label, which means that we must
convert 0.2 mg to micrograms.
Follow the steps of Procedure Checklist 3-1.
1. Since we are converting to micrograms, micrograms must appear in the numerator of our
1000 mcg
conversion factor. Our conversion factor is ______.
1 mg
Learning Link Recall from Chapter 3, Table 3-4, 1 mg ! 1000 mcg, found on
page 84.
2. The other fraction for our proportion has the unknown D for a numerator. The value that
is being converted, 0.2 mg or the dosage ordered, must appear as the denominator. Our
D
conversion factor is _____
.
0.2 mg
3. Setting the two fractions into a proportion gives us the following equation:
1000 mcg
D ! _________
_______
0.2 mg
1 mg
4. Cancel units.
1000 mcg
D ! _________
_______
0.2 mg
1 mg
5. Cross-multiply and then solve for the unknown.
1 " D ! 1000 mcg " 0.2
D ! 200 mcg ! desired dose
Example 2
The order reads ASA gr v PO daily.

The drug label indicates 325-mg tablets.
Again, the drug order and the drug label use different units. In this case, we must convert the dosage
ordered (5 gr) to milligrams to find the desired dose.
. Note: For this
1. Since we are converting to milligrams, our conversion factor is ____
1 gr
medication 65 mg per 1 gr is used.
65 mg
Learning Link Recall from Chapter 3, Table 3-8, 1 gr ! 65 mg, found on page 92.
D
2. The other fraction for our proportion is ___
.
5 gr
3. Setting the two fractions into a proportion gives the following equation:
65 mg
D ! ______
____
5 gr
1 gr
4. Cancel units.
65 mg
D ! ______
____
5 gr
1 gr
208
Chapter 7

1 " D ! 65 mg " 5
D ! 325 mg ! desired dose
Example 3
Ordered: 500 mg q6h

Dosage strength available: 250 mg per tablet
In this case the unit for the dose ordered is the same as that for the dose on hand. No calculation is
needed. The drug is measured in milligrams on both the order and the drug label, so the desired dose
D ! 500 mg.
Ordered: Nitrostat 800 mcg sublingually PRN chest pain
On hand: See Figure 7-2.
Store at Controlled Room Temperature

20-25C (68-77F) [see USP].
NDC 0071-0418-24
Rx only
Dispense in original, unopened container.

DOSAGE AND USE
See accompanying prescribing information.
Each tablet contains 0.4 mg nitroglycerin.
Keep this and all drugs out
of the reach of children.
Warning To prevent loss of potency, keep
these tablets in the original container or in a
supplemental Nitroglycerin container
specifically labeled as being suitable for
Nitroglycerin Tablets. Close tightly
immediately after each use.
Manufactured by:
Pfizer Pharmaceuticals LLC
Vega Baja, PR 00694
Nitrostat
(Nitroglycerin
Tablets, USP)
0.4
0.4 mg (1/150 gr)
05-5873-32-2
100 Sublingual Tablets
FPO RSS
Example 4
Distributed by
8212
Parke-Davis
Division of Pfizer Inc, NY, NY 10017
Figure 7-2
In this case, the drug is measured in micrograms on the drug order and in milligrams on the drug
label. The units for the desired dose must match those found on the drug label, which means that we
will convert 800 mcg to milligrams.
1. Conversion factor 1 mg ! 1000 mcg. Since we are converting to milligrams, our first fraction is:
1 mg
_________
1000 mcg
2. The other fraction is:
D
________
800 mcg
3. Set up the fractions.
1 mg
D
________
! _________
800 mcg 1000 mcg
4. Cancel units.
1 mg
D
________
! _________
800 mcg 1000 mcg
209

D " 1000 ! 800 " 1 mg
1000 ! _____
800 " 1 mg
D " _____
1000 1000
800 ! 0.8 mg ! desired dose
D ! _____
1000
In a fraction proportion, units from the two fractions can

be canceled only when they are in the same portion of the
fraction. Units in the denominator of one fraction cannot be
canceled with units found in the numerator of the other.
If you set up a proportion with mismatched units, you will calculate the desired dose
incorrectly. In an earlier example, the dosage ordered was in grains, and the dosage
strength was measured in milligrams. Suppose that you had used the conversion
1 gr
65 mg
factor _____
instead of _____
. Your proportion would then have been:
1 gr
65 mg
1 gr
D ! _______
____
5 gr 65 mg
Here, the units are mismatched and cannot be canceled. You should immediately
realize that the conversion factor is incorrect because the units in the denominators
of the proportion do not match. If you had not included the units when setting up the
proportion, the error may have gone unnoticed. Always include the units when you
perform calculations.
Ratio Proportion Method

The following checklist (Procedure 3-2) was used in Chapter 3 to convert units by ratio
proportions. It can also be followed when you are calculating the desired dose from the
dosage ordered.

Converting by the Ratio Proportion Method
1. Write the conversion factor as a ratio A : B so that A has the units of the value that you
are converting (the dosage ordered) and B has the unit of value of the dose on hand.
2. Write a second ratio C : D so that C is the missing value (desired dose) and D is the
number that is being converted (the dosage ordered).
3. Write the proportion in the form A : B : : C : D. Note: When you are using the ratio
proportion method to calculate the desired dose, C indicates the unknown value (desired dose).
4. Cancel units.
5. Solve the proportion by multiplying the means and extremes.
210
Chapter 7
Example 1

The drug is measured in milligrams on the drug order and micrograms on the drug label. The units
for the desired dose must match those found on the drug label, which means that we must determine
how many micrograms are equivalent to 0.2 mg.
1. Since we are converting to micrograms, micrograms must appear at the beginning of our
conversion ratio. Our conversion ratio is 1000 mcg : 1 mg.
page 84.
2. The second ratio in our proportion will be C : 0.2 mg, with C being the unknown value or
desired dose and D being the dosage ordered or the number that is being converted.
3. Our proportion is:
1000 mcg : 1 mg : : C : 0.2 mg
4. Cancel units.
1000 mcg : 1 : : C : 0.2
5. Multiply the means and extremes, and then solve for the missing value.
1 " C ! 1000 mcg " 0.2
C ! 200 mcg ! desired dose
Example 2

ordered (5 gr) to milligrams to find the desired dose.
1. Since we are converting to milligrams, our conversion ratio is 65 mg : 1 gr.
Note: For this medication 65 mg per 1 gr is used.
2. Our second ratio will be C : 5 gr.
65 mg : 1 gr : : C : 5 gr
4. Cancel units.
65 mg : 1 : : C : 5
1 " C ! 65 mg " 5
C ! 325 mg ! desired dose
211
Example 3
Ordered: 500 mg q6h

In this case the unit for the dose ordered is the same as that of the dose on hand. No calculation is
D ! 500 mg.
Example 4
Ordered: Nitrostat 800 mcg sublingually PRN chest pain.

On hand: Nitrostat 0.4 mg sublingual tablets (see Figure 7-2).
In this case, the drug is measured in micrograms on the drug order and in milligrams on the drug label.
The units for the desired dose must match those found on the drug label, which means that we will
convert 800 mcg to milligrams.
1. Recall from Chapter 3 that 1 mg ! 1000 mcg. Since we are converting to milligrams, milligrams
1 mg
must appear in the numerator of our conversion factor. Our conversion factor is ______
.
1000 mcg
2. The second ratio of our proportion is C : 800 mcg. Here C is the missing value (desired dose),
and D is the number being converted, 800 mcg (dosage ordered).
1 mg : 1000 mcg : : C : 800 mcg
4. Cancel units.
1 mg : 1000 mcg : : C : 800 mcg
C " 1000 ! 1 mg " 800
C " 1000 ! 800
800 mg ! 0.8 mg ! desired dose
C ! _____
1000
In a ratio proportion, units can be canceled only when they

are found in the same part of each of the ratios.
In an earlier example, the dosage ordered was in milligrams, and the dosage strength
was measured in micrograms. Suppose that you had used the conversion ratio
1 mg : 1000 mcg instead of 1000 mcg : 1 mg. Your proportion would then have
been:
1 mg : 1000 mcg : : C : 0.2 mg
The common unit in the two ratios is not found in the same part of the ratios
milligrams are found at the beginning of the first and at end of the second ratio.
Therefore, the units cannot be canceled. You should immediately realize that the
conversion ratio is incorrect because the units cannot be canceled. If you had not
included the units when setting up the proportion, the error might have gone unnoticed. Always include the units when you are performing calculations.
212
Chapter 7
Dimensional Analysis
Recall from Chapter 3 that the dimensional analysis (DA) method is a modification of the
fraction proportion and ratio proportion methods. When we are using DA, the unknown
value ? stands alone on one side of an equation. In this case, the unknown is the desired
dose. The conversion factor is placed on the other side of the equation, and the number being converted is placed over 1

Converting Using the Dimensional Analysis Method
1. Determine the unit of measure for the answer, and place it as the unknown on one side
of the equation.
2. On the other side of the equation, write a conversion factor with the units of measure
for the answer on top and the units you are converting from on the bottom.
3. Multiply the conversion factor by the number that is being converted over 1
4. Cancel units on the right side of the equation. The remaining unit of measure on the
right side of the equation should match the unknown unit of measure on the left side
of the equation.
5. Solve the equation.
Example 1

The drug is measured in milligrams on the drug order and in micrograms on the drug label. The units
for the desired dose must match the units of the dose on hand. We must determine how many micrograms is equivalent to 0.2 mg.
1. The unit of measure for the answer is micrograms. Place this on the left side of the equation.
D mcg !
(D represents the desired dose, which is the unknown.)
2. Since we are converting to micrograms, micrograms must appear in the numerator of our
1000 mcg
conversion factor. Our conversion factor is ______. This will go on the other side of the equation.
1 mg
page 84.
3. Multiply the numerator of the conversion factor by the number that is being converted, the
dosage ordered over 1.
1000 mcg 0.2 mg
D mcg ! _________ " _______
1 mg
1
213
4. Cancel units. The remaining unit on both sides is micrograms.

1000 mcg 0.2 mg
D mcg ! _________ " _______
1 mg
1
D ! 1000 mcg " 0.2 ! 200 mcg ! desired code
Example 2

ordered (5 gr) into milligrams (mg) to find the desired dose.
1. The unit of measure for the answer is milligrams. Place this on the left side of the equation.
D mg !
(D represents the desired dose, which is the unknown.)
.
2. Since we are converting to milligrams, our conversion factor is ____
1 gr
65 mg
Note: For this medication 65 mg per 1 gr is used.
3. Multiplying the numerator of the conversion factor by the number being converted (dosage
ordered over 1) gives us the following equation.
65 mg 5 gr
D ! ______ " ____
1 gr
1
4. Cancel units.
65 mg 5 gr
D ! ______ " ____
1 gr
1
D ! 65 mg " 5 ! 325 mg ! desired dose
Example 3
Ordered: 500 mg q6h

In this case the unit for the dose ordered is the same as that for the dose on hand. No calculation is
D ! 500 mg.
214
Chapter 7
Example 4
Ordered: Nitrostat 800 mcg sublingually PRN chest pain

On hand: Nitrostat 0.4 mg sublingual tablets
In this case, the drug is measured in micrograms on the drug order and in milligrams on the drug label.
The units for the desired dose must match those found on the drug label, which means that we will
convert 1500 mcg into milligrams.
1. The unit of measure for the answer is milligrams. Place this on the left side of the equation.
D mg !
2. Since we are converting to milligrams, milligrams must appear in the numerator of our
1 mg
conversion factor. Our conversion factor is ______.
1000 mcg
3. Multiply the numerator of the conversion factor by the number that is being converted, the
dosage ordered over 1
1 mg
800 mcg
D mg ! _________ " ________
1000 mcg
1
4. Cancel units.
1 mg
800 mcg
D mg ! _________ " ________
1000 mcg
1
800 mg
D ! _______ ! 0.8 mg ! desired dose
1000
In dimensional analysis, units can be canceled only when

they are found in both the numerator and the denominator of
the fraction.
In an earlier example, the dosage ordered was in milligrams and the dosage strength
was measured in micrograms. Suppose that you had used the conversion factor
1 mg
1000 mcg
_______
instead of _______
. Your equation would then have been:
1 mg
1000 mcg
1 mg
0.2 mg
D ! __________ " _______
1
1000 mcg
You may cancel units within a fraction only when they are found in both the numerator and the denominator. Here, the common unit (milligrams) is found in the numerator only and cannot be canceled. You should immediately realize that the conversion
factor is incorrect because the units cannot be canceled. If you had not included the
units when setting up the equation, the error might have gone unnoticed. Always
include the units when you are performing calculations.
215
7-1 Calculating the Desired Dose

In Exercises 120, convert the dosage ordered to the same unit as that of the dose on hand or measuring device.
Use conversion tables from Chapter 3 as needed.
1. Ordered: Amoxicillin 0.25 g
On hand: Amoxicillin 125-mg capsules
Desired dose: _____
2. Ordered: Erythromycin 0.5 g

On hand: Erythromycin 500-mg tablets
Desired dose: _____
3. Ordered: Phenobarbital gr ss
On hand: Phenobarbital 15-mg tablets
Desired dose: _____
4. Ordered: Penicillin VK 0.25 g

On hand: Penicillin VK 500 mg
Desired dose: _____
5. Ordered: Levoxyl 0.15 mg

On hand: Levoxyl 300-mcg tablets
Desired dose: _____
6. Ordered: Duratuss HD 5 mL
Available measuring device is marked in teaspoons.
Desired dose: _____
7. Ordered: Robitussin DM 2 tsp

Available measuring device is marked in mL.
Desired dose: _____
8. Ordered: Biaxin 1 g PO daily

On hand: Refer to label A.
Desired dose: _____
9. Ordered: Meloxicam gr _14

On hand: Refer to label B.
Keep this and all drugs out of

the reach of children.
Store at 20-25C (68-77F);
excursions permitted to 15-30C
(59-86F) [see USP Controlled
Room Temperature].
Each tablet contains:

Meloxicam..................15 mg
C.S. No. 5485L04
Iss. 4/07
216
Chapter 7
Meloxicam
Tablets
15 mg
100 Tablets
Attention: Pharmacist dispense with a medication guide.
USUAL DOSAGE:
See package outsert for
complete product
information.
57664 51388
Keep in a dry place.
NDC 57664 -513-88
Rx Only
N
3
Pharmacist Information:
Dispense in tight, light-resistant
container with child resistant
closure as defined in USP.
Desired dose: _____
10. Ordered: Synthroid 0.05 mg

On hand: Refer to label C.
Desired dose: _____
11. Ordered: Synthroid 0.088 mg

On hand: Refer to label D.
Desired dose: _____
12. Ordered: Depakote 0.5 g

On hand: Refer to label E.
Desired dose: _____
E
217
13. Ordered: Synthroid 250 mcg

On hand: Refer to label F.
Desired dose: _____
14. Ordered: 1 teaspoon Zithromax 200 mg/ 5 mL PO q6h

Desired dose: _____
On hand: Refer to letter G. (Only available measuring device is marked in mL.)
15. Ordered: 7 mL clarithromycin PO q4h

Desired dose: _____
On hand: Refer to label H. (Only available measuring device is a teaspoon.)
16. Ordered: Levothroid 0.137 mg PO daily

On hand: Refer to label I.
218
Chapter 7
Desired dose: _____
17. Ordered: Levothroid 0.112 mg

On hand: Refer to label J.
Desired dose: _____
18. Ordered: Risperdal 250 mcg

On hand: Refer to label K.
Desired dose: _____
19. Ordered: Prandin 750 mcg

On hand: Refer to label L.
(repaglinide) Tablets
0.5 mg 100 tablets

Do not store above 77F (25C).
NDC 0169-0081-81
List 008181
Marketed by:
Novo Nordisk
Pharmaceuticals, Inc.
Princeton, NJ 08540
8-1767-31-201-4
Prandin
Desired dose: _____
Exp./
Control:
219
Store at controlled room

temperature 15-30C (59-86F)
NDC 57664-397-18
Metformin hydrochloride
Tablets, USP
500 mg
1000 Tablets
Rx Only
N
3
Each Tablet contains:

Metformin hydrochloride, USP.......500mg
USUAL DOSAGE:
See Package outsert
for complete product
information.
container as defined in USP
Desired dose: _____
57664 39718
20. Ordered: Metformin 1 g

On hand: Refer to label M.
C.S.No. 5274L04
Iss. 4/05
To check your answers, see page 520.
Calculating the Amount to Administer

Once you have determined the desired dose, you still have one more step that must be completed. While the desired dose tells you how many grams, milligrams, or grains of a drug
the patient is to receive, you will need to know how many tablets, capsules, teaspoons, or
milliliters of the medication must be given to deliver the desired dose. You must calculate an
amount to administer to the patient.
In this section, you will be presented with four methods for calculating the amount to
administer. As with previous calculations, you may choose to use fraction proportion, ratio
proportion, or dimensional analysis. We will also introduce the formula method. Again, the
method that you choose to use is up to youeach will give you the same result.
Rule 7-2
Calculating the Amount to Administer

To calculate the amount to administer A, the following information must be known:
! The desired dose D, or the amount of drug to be given at a single time. This is
the dosage ordered converted to the same units as those of the dose on hand, if
necessary.
! The dosage strength or the dose on hand H per dosage unit Q. Recall, the dose
on hand H is the amount of drug contained in a dosage unit. The dosage unit Q
is the unit by which you will measure the medicationtablets, capsules, milliliters, teaspoons, etc. This is obtained from the medication label.
220
Chapter 7
Example
Ordered: Erythromycin 0.5 g PO twice daily.

On hand: See label (Figure 7-3).
In this case the dose on hand is 250 mg and the dosage unit is one capsule. The
dose ordered is 0.5 g. Thus, you need to convert the dose ordered to the same unit
of measurement as that of the dose on hand, to determine the desired dose. In this
case you will be converting 0.5 g to milligrams. After calculating the desired dose,
you have all the necessary information to calculate the amount to administer.
! Desired dose ! 500 mg
! Dose on hand ! 250 mg
! Dosage unit ! 1 capsule
Dose ordered (O) [must be (converted to milligrams) to determine desired dose (D)]
Dosage ordered (O): Erythromycin 0.5 g twice daily
On hand:
250 mg
Dose on hand (H)
=
Dosage unit (Q)
1 capsule
Figure 7-3 Information necessary to calculate the amount to administer. In this case the
dose ordered must be converted to milligrams to obtain the desired dose.

Chapter 7, Rule 7-2. Review the animation and example problems, then complete the
practice problems. Continue to the next section of the book once you have mastered
the rule presented.

Calculating the Amount to Administer by Fraction Proportion Method
1. The proportion will be set up as follows:
Dosage unit
amount to administer
_____________
! ____________________
desired dose
Dose on hand
or
Q __
__
!A
H D
221
2. Cancel units.
3. Cross-multiply and then solve for the unknown value.
Example 1
Find the amount to administer.

Ordered: Famvir 500 mg PO q8h
On hand: See label in Figure 7-4.
Novartis
Rx only
Tablets
30 Tablets
5000045
250 mg per tablet
Dosage: See package insert.

permitted to 15-30C (59-86F) [see
Dispense in a tight container (USP).
Keep this and all drugs out of the
reach of children.
Mfd. by: Novartis Farmacutica S.A.
Barcelona, Spain for
Novartis Pharmaceuticals Corp.
East Hanover, NJ 07936
LOT
EXP.
Barcode
Area
NDC 0078-0367-15
Figure 7-4
The drug is ordered in milligrams, which is the same unit used on the label. Therefore, the dosage
ordered is the same as the desired dose (500 mg). By reading the label we find that the dosage unit is
1 tablet and the dose on hand is 250 mg. Therefore,
D ! 500 mg
Q ! 1 tablet
H ! 250 mg
Follow the Procedure Checklist 7-1.
1. Fill in the proportion. (Think: If 1 tablet equals 250 mg, then how many tablets equals 500 mg?)
1 tablet ! _______
A
_______
250 mg 500 mg
2. Cancel units.
1 tablet ! _______
A
_______
250 mg 500 mg
3. Cross-multiply and solve for the unknown.
250 " A ! 1 tablet " 500
500 tablets
A ! ____
250
A ! 2 tablets ! amount to administer
222
Chapter 7
Example 2

Ordered: Norvir 200 mg PO now
On hand: See label in Figure 7-5
Figure 7-5
Again, the drug order and the drug label use the same units. Our desired dose is 200 mg. Reading the
label tells us that the dosage unit is 1 mL and the dose on hand is 80 mg. Therefore,
D ! 200 mg
Q ! 1 mL
H ! 80 mg
1. Fill in the proportion. (Think: If 1 mL has 80 mg of medication, how many milliliters has 200 mg?)
A
1 mL ! _______
______
80 mg 200 mg
2. Cancel units.
1 mL ! _______
A
______
80 mg 200 mg
3. Solve for the unknown.
80 " A ! 1 mL " 200
A ! 2.5 mL ! amount to administer
223
Example 3

Ordered: 250 mg Ampicillin IM Now
On hand: Ampicillin 0.5 g/mL
In this case, the order is written in milligrams, and the drug is labeled in grams. Before we can determine the amount to administer, we must calculate a desired dose that is in grams.
1. Recall that 1 gr ! 1000 mg. Since we are converting to grams, our conversion factor is:
1g
________
.
1000 mg
D
.
2. The other fraction for our proportion is _____
250 mg
1g
D
_______
! ________
250 mg 1000 mg
4. Cancel units.
1g
D
_______
! ________
250 mg 1000 mg
1000 " D ! 250 " 1 g
D ! 0.25 g ! desired dose
We now have the three necessary pieces of information: The desired dose is 0.25 g, the dosage unit is
1 mL, and the dose on hand is 0.5 g.
D ! 0.25 g
Q ! 1 mL
H ! 0.5 mg

1. Fill in the proportion. (Think: If 1 mL has 0.5 g, then how many milliliters will have 0.25 g?)
1 mL ! ______
A
_____
0.5 g
0.25 g
2. Cancel units.
1 mL ! ______
A
_____
0.5 g
0.25 g
0.5 " A ! 1 mL " 0.25
Example 4

Ordered: Metformin 2 g PO daily
On hand: See label in Figure 7-6.
224
Chapter 7

temperature 15-30C (59-86F)
Metformin hydrochloride
Tablets, USP
USUAL DOSAGE:
See Package outsert
information.
1000 mg

Metformin hydrochloride, USP.......1000mg
N
3
1000 Tablets
Rx Only
NDC 57664-474-18
57664 47418
container as defined in USP
C.S.No. 5276L03
Iss. 4/05
Figure 7-6
In this case, the order is written in grams, and the drug is labeled in milligrams. Before we can determine the amount to administer, we must calculate a desired dose that is in milligrams.
1. Recall that 1 g ! 1000 mg. Since we are converting to milligrams, our conversion factor
1000 mg
is ______.
1g
D
.
2. The other fraction for our proportion is ___
2g
3. Set up the fraction proportion equation:

1000 mg
D ! ________
___
2g
1g
4. Cancel units.
1000 mg
D ! ________
___
2g
1g
1 " D ! 1000 mg " 2
We now have the three necessary pieces of information: The desired dose is 2000 mg, the dosage unit
is 1 tablet, and the dose on hand is 1000 mg.
D ! 2000 mg
Q ! 1 tablet
H ! 1000 mg

1. Fill in the proportion. (Think: If 1 tablet has 1000 mg, then how many tablets will have 2000 mg?)
1 tablet ! ________
A
________
1000 mg 2000 mg
2. Cancel units.
1 tablet ! ________
A
________
1000 mg 2000 mg
225

1000 " A ! 1 tablet " 2000
(divide both sides by 1000)
2000 ! 2 tablets ! amount to administer

A ! _____
1000

Chapter 7, Procedure Checklist 7-1. Review the animation and example problems,
then complete the practice problems. Continue to the next section of the book once
you have mastered the rule presented.
Use Your Critical Thinking Skills

Always use critical thinking skills to evaluate your answer before you administer a
drug. For example, in Example 4 the medication ordered is 2 g, and the medication
comes in bottles of 1000-mg tablets. If you set up the problem incorrectly, you may
get the answer _21 Here is how. First you determine that the desired dose is 2000 mg,
and then you set up the problem, reversing the dose on hand with the desired dose.
1 tablet ! _________
A
_________
2000 mg 1000 mg
1 tablet ! _________
A
_________
(Canceling the units makes the problem appear correct.)
2000 mg 1000 mg
When you cross-multiply, you come up with the following.
2000 " A ! 1 tablet " 1000
(Divide both sides by 2000.)
1000 ! __
1 tablet
A ! _____
2000 2
Question?
Using critical thinking, how would you know that your answer is incorrect?

Calculating Amount to Administer by Ratio Proportion Method
1. The proportion will be set up as follows:
Dosage unit : dose on hand : : amount to administer : desired dose
or Q : H : : A : D
2. Cancel units.
3. Multiply the means and extremes and then solve for the missing value.
Example 1

On hand: Famvir 250 mg per/tablet. See Figure 7-4 on page 222.
226
Chapter 7

The drug is ordered in milligrams, which is the same unit used on the label. Therefore, the desired
dose is 500 mg. Reading the label tells us that the dosage unit is 1 tablet and the dose on hand is 250
mg. Therefore,
D ! 500 mg
Q ! 1 tablet
H ! 250 mg
Follow Procedure Checklist 7-2.
1. Fill in the proportion. (Think: If 1 tablet is 250 mg, then how many tablets make 500 mg?)
1 tablet : 250 mg : : A : 500 mg
2. Cancel units.
1 tablet : 250 mg : : A : 500 mg
250 " A ! 1 tablet " 500
250 " A ! 1 tablet " ____
500
____
250
250
Example 2
Ordered: Norvir Liquid 40 mg PO qd

On hand: Norvir 80 mg/mL. See Figure 7-5 page 223.
Calculate the amount to administer.
Again, the drug order and the drug label use the same units. Our desired dose is 40 mg. Reading the
label, we find that the dosage unit is 1 mL and the dose on hand is 80 mg. Therefore,
D ! 40 mg
Q ! 1 mL
H ! 80 mg
1. Fill in the proportion. (Think: If 1 mL has 80 mg, then how many milliliters has 40 mg?)
1 mL : 80 mg : : A : 40 mg
2. Cancel units.
1 mL : 80 mg : : A : 40 mg
80 " A ! 1 mL " 40
40 mL
80 " A ! ______
___
80
80
227
Example 3
Ordered: 250 mg Ampicillin IM Now

In this case, the order is written in milligrams, and the drug is labeled in grams. Before we can determine the amount to administer, we must calculate a desired dose, converting the dose ordered, 250 mg,
to grams.
1. Recall that 1 g ! 1000 mg. Since we are converting to grams, our conversion ratio is:
1 g : 1000 mg
2. The other ratio for our proportion is the unknown D to the dosage ordered 250 mg.
D : 250 mg
3. Setting the two ratios into a proportion gives us the following equation:
1 g : 1000 mg : : D : 250 mg
4. Cancel units.
1 g : 1000 mg : : D : 250 mg
5. Multiply the means and extremes, and then solve for the unknown.
1000 " D ! 250 " 1 g
We now have the three necessary pieces of information: The desired dose is 0.25 g, the dosage unit is
1 mL, and the dose on hand is 0.5 g.
D ! 0.25 g
Q ! 1 mL
H ! 0.5 g

1. Fill in the proportion. (Think: If 1 mL equals 0.5 g, then how many milliliters will equal 0.25 g?)
1 mL : 0.5 g : : A : 0.25 g
2. Canceling units gives us
1 mL : 0.5 g : : A : 0.25 g
0.5 " A ! 1 mL " 0.25
0.25 mL
0.5 " A ! ____
___
0.5
0.5
Example 4
Ordered: Metformin 2 g PO daily.

On hand: Metformin hydrochloride 1000 mg. See Figure 7-6 on page 225.
In this case, the order is written in grams, and the drug is labeled in milligrams. Before we can determine the amount to administer, we must calculate a desired dose that is in milligrams.
228
Chapter 7

1. Recall that 1 g ! 1000 mg. Since we are converting to milligrams, our conversion factor is:
1000 mg : 1 g
2. The other ratio in our proportion is:
D:2g
3. Set up the ratio proportion equation:
1000 mg : 1 g : : D : 2 g
4. Cancel units.
1000 mg : 1 g : : D : 2 g
5. Multiply the means and extremes, and solve the equation.
1 " D ! 1000 mg " 2
We now have the three necessary pieces of information: The desired dose is 2000 mg, the dosage unit
is 1 tablet, and the dose on hand is 1000 mg.
D ! 2000 mg
Q ! 1 tablet
H ! 1000 mg

1. Fill in the ratio proportion. (Think: If 1 tablet equals 1000 mg, then how many tablets equal 2000 mg?)
1 tablet : 1000 mg : : A : 2000 mg
2. Cancel units.
1 tablet : 1000 mg : : A : 2000 mg
3. Multiply the means and extremes, and solve for the unknown.
1000 " A ! 2000 " 1 tablet
(Divide both sides by 1000.)


Calculating the Amount to Administer by Dimensional Analysis Method
With dimensional analysis you will not need to calculate the desired dose and amount to
administer separately. You will place your unknown (amount to administer) on one side of
the equation and then multiply a series of factors on the right side of the equation. Canceling
units will help you determine that the equation has been set up correctly.
1. Determine the unit of measure for the answer, and place it as the unknown on one side
of the equation. (In this case the answer would be the amount to administer. The unit
of measure will be the same unit of measure as that of the dosage unit.)
229
2. On the right side of the equation, write a conversion factor with the unit of measure
for the desired dose on top and the unit of measure for the dosage ordered on the
bottom. (This is necessary if the dose ordered is in a different unit of measurement than the
dose on hand.)
3. Multiply the conversion factor by a second factorthe dosage unit over the dose on
hand.
4. Multiply by a third factordose ordered over the number 1
5. Cancel units on the right side of the equation. The remaining unit of measure on the
right side of the equation should match the unknown unit of measure on the left side
of the equation.
Example 1

On hand: Famvir 250 mg per tablet. See Figure 7-4 on page 222.
1. The unit of measure for the amount to administer will be tablets. This is the dosage unit.
A tablets !
2. Since the unit of measurement for the dosage ordered is the same as the dose on hand, no
conversion factor is necessary.
3. The dosage unit is 1 tablet. The dosage strength is 250 mg. This is our first factor.
1 tablet
_______
250 mg
4. The dose ordered is 500 mg. Place this quantity over the number 1 for the next factor.
500 mg
1 tablet " _______
A tablets ! _______
250 mg
1
5. Cancel the units.
500 mg
1 tab " _______
A tablets ! _______
250 mg
1
500 mg
1 tablet " _______
A tablets ! _______
250 mg
1
Example 2
Ordered: Norvir liquid 40 mg PO daily

On hand: Norvir 80 mg/1 mL. See Figure 7-5 page 223.
1. The amount to administer will be in milliliters. This is the dosage unit or how the medication is
supplied.
A mL !
2. Since the unit of measure for the dosage ordered is the same as that for the dose on hand, no
conversion factor is necessary.
230
Chapter 7
3. The dosage unit is 1 mL. The dose on hand is 80 mg. This is our first factor.
1 mL
______
80 mg
4. The dose ordered is 40 mg. Place this over 1
40 mg
1 mL " ______
A mL ! ______
80 mg
1
5. Cancel units on the right side of the equation.
40 mg
1 mL " ______
A mL ! ______
80 mg
1
40 mL ! 0.5 mL ! amount to administer
A ! ______
80
Example 3
Ordered: 250 mg Ampicillin IM now

1. The unit of measure for the amount to administer will be milliliters.
A mL !
2. The unit of measure for the dosage ordered is milligrams. The unit of measure for the dose on
hand is grams. Recall the conversion factor 1 g ! 1000 mg. We will be converting the dosage
ordered to grams, to obtain the desired dose. Put this unit on top.
1g
________
1000 mg
3. The dosage unit is 1 mL, and the dose on hand is 0.5 g. This is our second factor.
1g
1 mL
________
" _____
0.5 g
1000 mg
4. The dose ordered is 250 mg. Place this over 1
1g
250 mg
1 mL " _______
A mL ! ________ " _____
0.5 g
1000 mg
1
5. Cancel units to check your equation.
1g
250 mg
1 mL " _______
A mL ! ________ " _____
0.5 g
1000 mg
1
250 mL
A mL ! _______
500
(Reduce the fraction to its lowest terms.)
Example 4

On hand: Metformin hydrochloride 1000 mg. See Figure 7-6 on page 225.
231

1. The unit of measure for the amount to administer will be tablets.
A tablets !
2 . The unit of measure for the dosage ordered is grams. The unit of measure for the desired dose is
milligrams. Recall the conversion factor 1 g ! 1000 mg. We will be converting to milligrams.
1000 mg
________
1g
3. The dosage unit is 1 tablet, and the dose on hand is 1000 mg. This is our second factor.
1000 mg ________
________
" 1 tablet
1g
1000 mg
4. The dose ordered is 2 g. Place this over 1
1000 mg
2g
1 tablet " ___
A tablets ! ________ " ________
1g
1000 mg
1
5. Cancel units.
1000 mg
2g
1 tablet " ___
A tablets ! ________ " ________
1g
1000 mg
1
2000
A tablets ! _____
1000
(Reduce the fraction to its lowest terms.)


Calculating the Amount to Administer by the Formula Method
1. Determine the desired dose. Calculate it using the fraction proportion, ratio
proportion, or dimensional analysis method. Determine the dose on hand H and
dosage unit Q.
2. Fill in the formula:
D"Q!A
__
H
where D ! desired dose (This is the dose ordered changed to the same unit of measure
as the dose on hand.)
H ! dose on handthe amount of drug contained in each unit.
Q ! dosage unithow the drug will be administered, such as tablets or milliliters.
A ! unknown or amount to administer.
3. Cancel the units.
232
Chapter 7
Example 1

On hand: Famvir 250 mg per tablet (Figure 7-4)
1. The drug is ordered in milligrams, which is the same unit used on the label. Therefore, the
desired dose is 500 mg. Reading the label tells us that the dosage unit is 1 tablet and the dose on
hand is 250 mg. Therefore,
D ! 500 mg
Q ! 1 tablet
H ! 250 mg
2. Fill in the formula.
500 mg " 1 tablet
________________
!A
250 mg
3. Cancel units.
500 mg " 1 tablet
________________
!A
250 mg
Example 2
Ordered: Norvir liquid 40 mg PO qd

On hand: Norvir 8 mg/1 mL. See Figure 7-5 on page 223
1. Again, the drug order and the drug label use the same units. Our desired dose is 40 mg.
Reading the label, we find that the dosage unit is 1 mL and the dose on hand is 80 mg.
Therefore,
D ! 40 mg
Q ! 1 mL
H ! 80 mg
2. Insert the numbers and units into the formula.
40 mg " 1 mL
_____________
!A
80 mg
3. Cancel units.
40 mg
______
" 1 mL ! A
80 mg
0.5 mL ! A ! amount to administer
233
Example 3
Ordered: Ampicillin 250 mg IM now

In this case, the order is written in milligrams, and the drug is labeled in grams. Before we can
determine the amount to administer, we must calculate a desired dose that is in grams. (In this
example we will use fraction proportion method Procedure Checklist 3-1.)
1. Recall that 1 g ! 1000 mg. Since we are converting to grams, our conversion factor is:
1g
________
.
1000 mg
D
2. The other fraction for our proportion is _____
.
250 mg
1g
D
_______
! ________
250 mg 1000 mg
4. Cancel units.
1g
D
_______
! ________
250 mg 1000 mg
1000 " D ! 250 " 1 g
1. The three necessary pieces of information to complete the formula are that the desired dose is
0.25 g, the dosage unit is 1 mL, and the dose on hand is 0.5 g.
D ! 0.25 g
Q ! 1 mL
H ! 0.5 g

0.25 g
______
" 1 mL ! A
0.5 g
3. Cancel units.
0.25 g
______
" 1 mL ! A
0.5 g
0.5 mL ! A ! amount to administer
Example 4

On hand: Metformin hydrochloride 1000 mg. See Figure 7-6 on page 225
In this case, the order is written in grams, and the drug is labeled in milligrams. Before we can
determine the amount to administer, we must calculate a desired dose that is in milligrams. (In this
example we will use the ratio proportion method Procedure Checklist 3-2.)
234
Chapter 7
1. Recall that 1 g ! 1000 mg. Since we are converting to milligrams, our conversion factor is:
1000 mg : 1 g
2. The other ratio in our proportion is:
D:2g
3. Set up the ratio proportion equation.
1000 mg : 1 g : : D : 2 g
4. Cancel units.
1000 mg : 1 g : : D : 2 g
5. Multiply the means and extremes and solve the equation.
1 " D ! 1000 mg " 2
1. The three necessary pieces to complete the formula are the desired dose of 2000 mg, the dosage
unit of 1 tablet, and the dose on hand of 1000 g.
D ! 2000 mg
Q ! 1 tablet
H ! 1000 mg

2000 g
______
" 1 tablet ! A
1000 g
3. Cancel units.
2000 g
______
" 1 tablet ! A
1000 g
2 tablets ! A ! amount to administer

235
When in Doubt, Check

Jorge was working in the emergency room when a patient arrived with life-threatening
internal bleeding. The physician in charge told Jorge, Aminocaproic acid 5 grams
STAT! Youd better give him liquid, I dont think hes able to swallow pills. Jorge
repeated the order, Aminocaproic acid liquid 5 grams STAT.
On hand, Jorge had Amicar Syrup (aminocaproic acid) 25%, 1.25 g/5 mL (see
Figure 7-7). Jorge determined the amount to administer by using the ratio proportion
method.
5 mL : 1.25 g : : A : 5 g
5 mL : 1.25 g : : A : 5 g
1.25 " A ! 5 mL " 5
25 mL
A ! ______
1.25
A ! 20 mL ! 4 tsp
Question?
What should Jorge do?
AL
TION
A
C
U
R ED
.
E. FO ES ONLY
L
P
M
S
SA
O
P
PUR
Figure 7-7
236
Chapter 7
7-2 Calculating the Amount to Administer

In Exercises 1-20, calculate the amount to administer.
1. Ordered: Thorazine 20 mg PO tid
On hand: Thorazine 10 mg tablets
2. Ordered: Ranitidine hydrochloride 150 mg PO bid

On hand: Zantac syrup 15 mg ranitidine hydrochloride per mL
3. Ordered: Ceclor 0.375 g PO bid
On hand: Ceclor Oral Suspension 187 mg per 5 mL
1
4. Ordered: Nitroglycerin gr ___
SL stat
On hand: Nitroglycerin 0.3-mg tablets
100
5. Ordered: Amoxicillin 250 mg PO tid

AMOXICILLIN
for Oral Suspension, USP
equivalent to
250 mg per 5 mL
amoxicillin when reconstituted according to directions.
Usual Dosage: Adults 250 mg - 500 mg every eight

hours, depending on type and severity of infection.
Children 20 mg - 40 mg/kg/day in divided doses every

eight hours, depending on type and severity of infection.
See accompanying literature.
WARNING: NOT FOR INJECTION
only
150 mL (when mixed)
Amoxicillin trihydrate equivalent to 7.5 g amoxicillin.

Store dry powder at controlled room temperature,
between 20 and 25C (68 and 77F) (see USP).
TO THE PHARMACIST: Prepare suspension at time of dispensing. Add
to the bottle a total of 90 mL of water. For ease in preparation, tap
bottle to loosen powder, add the water in two portions, shaking well
after each addition. The resulting suspension will contain amoxicillin
trihydrate equivalent to 250 mg amoxicillin in each 5 mL (teaspoonful).
Oversized bottle permits shaking space.
IMPORTANT
When stored at room temperature or in refrigerator discard unused
portion of reconstituted suspension after 14 days.
Date of reconstitution: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Shake well before using. Keep tightly closed.
KEEP THIS AND ALL MEDICATIONS OUT OF THE REACH OF CHILDREN.
Manufactured In Canada By:
Novopharm Limited
Toronto, Canada M1B 2K9
Manufactured For:
TEVA PHARMACEUTICALS USA
Sellersville, PA 18960
66965LA-6247 Rev. 02
Rev. D 10/2004
Printed in Canada
NDC 0093-4155-80
6. Ordered: Tricor 108 mg PO daily

237
10 mg
Pfizer Labs
8. Ordered: Targretin 150 mg PO q.d. a.c.

9. Ordered: Synthroid 0.3 mg PO q.d.

1473
MADE IN USA
05-4052-32-8
10
Distributed by
Rx only
Chapter 7
0069-2600-66
Procardia
(nifedipine)
Manufactured by Pfizer Inc.

Encapsulated by R.P. Scherer
Clearwater, FL 33518
238
NDC 0069-2600-66
N
3
100 Capsules
FPO UPC: 80% x 5.5 mm
Store between 59F-77F

(15C-25C).
DO NOT PERMIT TO FREEZE.
containers (USP).
Protect capsules from light at all times.
DOSAGE AND USE: See accompanying
prescribing information.
PROTECT FROM MOISTURE
AND HUMIDITY.
Replace cap tightly after each opening.
Each capsule contains 10 mg nifedipine.
6505-01-126-3842
7. Ordered: Procardia 20 mg PO tid

100 mg
Rx only
Each capsule equivalent

to 100 mg atomoxetine
Do not use if Lilly inner seal
is missing or broken.
www.strattera.com
5
0002-3251-30
NDC 0002-3251-30
No. 3251

permitted to 15 to 30C (59 to 86F)
[see USP Controlled Room Temperature].
Expiration Date /Control No.
Eli Lilly and Company

Indianapolis, IN 46285, USA
WX 0601 AMX
30 Capsules
Medication Guide is to be dispensed to patients.

Keep tightly closed.
Keep out of the reach of children.
See accompanying literature for dosage
information.
10. Ordered: Strattera 0.1 g PO bid

11. Ordered: Keflex 500 mg PO q12h

On hand: Keflex 250 mg per 5 mL
12. Ordered: Decadron 6 mg IM q.i.d.
On hand: Decadron 4 mg per mL
13. Ordered: Ketoconazole 100 mg PO qd
On hand: Ketoconazole 200-mg scored tablets
14. Ordered: Dilaudid 2 mg IM prn for pain q6h
On hand: Dilaudid for injection, 4 mg per mL
15. Ordered: Erythromycin Oral Suspension 150 mg PO bid
On hand: Refer to label G.
16. Ordered: Tranxene 30 mg PO qhs

On hand: Refer to label H.
67386 30301
3
03-2431-5/R2 (4391)
Lot
Exp.
NDC 67386-303-01
100 Tablets
TRANXENE
(Clorazepate
Dipotassium)
T-TAB Tablets, USP
15 mg
only
Each tablet contains

15 mg clorazepate dipotassium.
See package insert for full
Store below 77 F (25 C).
Protect from moisture.
Keep bottle tightly closed.
Dispense in a USP tight,
light-resistant container.
Do not accept if seal over bottle
opening is broken or missing.
Manufactured by
Abbott Pharmaceuticals PR Ltd.
Barceloneta, PR 00617
for Ovation Pharmaceuticals, Inc.
Deerfield, IL 60015, U.S.A.
H
239
EXP.
Bar Code Area
Chapter 7
10 mL
100 units per mL
20. Ordered: Targretin 75 mg PO q am ac

100 tablets
0002-8215-01
NDC 0002-8215-01
U-100
HI-210
NDC 0078-0439-05
Ritalin HCI
methylphenidate HCl USP
5 mg
Dispense with Medication Guide

attached or provided separately.
Rx only
Eli Lilly and Company, Indianapolis, IN 46285, USA
LOT & EXP
19384446
NDC 0085-1133-01
Neutral
Copyright 1996, 1998, Schering

Corp., Kenilworth, NJ 07033 USA.
All rights reserved. US Lic. No. 994.
IM/SC/IL
Rx only
25 million IU multidose vial
5 million IU / 0.5 mL
Solution for Injection
Intron A
Important: See enclosed insert.

Keep in a cold place. Avoid freezing.
Refrigerate between 2 and 8C (36 and 46F).

Usual Dose: See package insert.
Product of Ireland.
U.S. Patent No. 5,935,566.
Rev. 4/07
(Interferon alfa-2b,
recombinant)
Dosage: See package insert.

permitted to 15-30C (59-86F)
[see USP Controlled Room
Temperature].
Protect from light.
container (USP).
Mfd. by: Novartis Pharmaceuticals Corp.
Suffern, NY 10901
Dist. by: Novartis Pharmaceuticals Corp.
East Hanover, New Jersey 07936
5001171
Novartis
Exp. Date/Control No.
L
WG 3431 AMX
240
LOT
17. Ordered: Interferon Alfa-2b, recombinant 5 million units IM

18. Ordered: Humulin R 28 U sc stat

19. Ordered: Ritalin 15 mg PO bid ac

Answer the following questions.

1. Define the term dosage ordered.
2. Define the term desired dose.
3. Define the term dosage unit.
4. Define the term dose on hand.
5. Define the term amount to administer.
6. Define the term dosage strength.
7. One milligram (mg) is equal to how many micrograms (mcg)?
8. One grain (gr) is equal to how many milligrams (mg)?
9. One ounce (oz) is equal to how many milliliters (mL)?
10. One kilogram (kg) is equal to how many pounds (lb)?
241
Select the appropriate label for the following drug orders and indicate the number of tablets/capsules/milliliters
that will be required to administer the dosage ordered.
Assume that all tablets are scored. Notice that both generic and brand names are used for the orders.
11. Ordered: 2 grams amoxicillin liquid.
Label ____________________
Amount to administer: ____________________
12. Ordered: Zemplar 1 mcg.
Label ____________________
13. Ordered: Meperidine 150 mg.
Label ____________________
14. Ordered: Plendil 5 mg.
Label ____________________
15. Ordered: Cefprozil 500 mg liquid.
Label ____________________
16. Ordered: Valproic acid 250 mg.
Label ____________________
17. Ordered: Sertraline HCL 75 mg.
Label ____________________
18. Ordered: Digoxin 0.5 mg.
Label ____________________
19. Ordered: Omnicef 300 mg liquid.
Label ____________________
20. Ordered: Esomeprazole 40 mg.
Label ____________________
Amoxicillin trihydrate equivalent to 7.5 g amoxicillin.

Store dry powder at controlled room temperature,
between 20 and 25C (68 and 77F) (see USP).
TO THE PHARMACIST: Prepare suspension at time of dispensing. Add
to the bottle a total of 90 mL of water. For ease in preparation, tap
bottle to loosen powder, add the water in two portions, shaking well
after each addition. The resulting suspension will contain amoxicillin
trihydrate equivalent to 250 mg amoxicillin in each 5 mL (teaspoonful).
Oversized bottle permits shaking space.
IMPORTANT
When stored at room temperature or in refrigerator discard unused
portion of reconstituted suspension after 14 days.
Date of reconstitution: . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Shake well before using. Keep tightly closed.
Manufactured In Canada By:
Novopharm Limited
Toronto, Canada M1B 2K9
Manufactured For:
Rev. D 10/2004
66965LA-6247 Rev. 02
Printed in Canada
LABEL A
242
NDC 0093-4155-80
AMOXICILLIN
for Oral Suspension, USP
equivalent to
250 mg per 5 mL
amoxicillin when reconstituted according to directions.

Usual Dosage: Adults 250 mg - 500 mg every eight
hours, depending on type and severity of infection.
Children 20 mg - 40 mg/kg/day in divided doses every
eight hours, depending on type and severity of infection.
only
See accompanying literature.

WARNING: NOT FOR INJECTION
150 mL (when mixed)
LABEL B
Chapter 7

temperature 15-30C (59-86F).
[See USP]
100 mg

Meperidine
hydrochloride,USP . . . . 100 mg
NDC 0186 - 0450 - 58
N
3
100 Tablets
Rx Only
se
urpo
al P
tion
a Tablets
100 Extended-Release
duc
E
2.5 mg
Rx only
C.S.No. 5255L01
Iss. 11/00
Protect from light.

Store below 30C (86F).
Tablets should be swallowed whole,
not crushed or chewed.
USUAL ADULT DOSAGE:
See package insert.
All trademarks are the property of
the AstraZeneca group
AstraZeneca 2000
Manufactured for: AstraZeneca LP
Wilmington, DE 19850
By: MERCK & CO., Inc.
Whitehouse Station, NJ 08889, USA
nly
sO
C
II
USUAL DOSAGE:
See Package outsert for
complete product
information.
0186-0450-58
NDC 57664 -471- 08
Meperidine
hydrochloride
Tablets, USP

containers as defined in USP.
57664 47108
LABEL D
LABEL C
NDC 0093-1075-78
NDC 0049-4900-66
Rx only
100 Tablets
Zoloft
(sertraline HCI)
CEFPROZIL
for Oral Suspension USP
125 mg/5 mL *
50
5 mL, when constituted according to

*Each
directions, contains 125 mg anhydrous cefprozil.
50 mg*
Roerig
LABEL E
only
LABEL F
75 mL (when mixed)
Rx only
20 mg*
*Each delayed-release
capsule contains 20 mg esomeprazole

permitted to 1530C (5986F). [See
Dispense in a tight container.
USUAL ADULT DOSAGE:
See package insert.
NEXIUM and the color purple as

applied to the capsule are registered
trademarks of the AstraZeneca group.
AstraZeneca 2008
Mfd. for: AstraZeneca LP, Wilmington, DE 19850
By: AstraZeneca AB, S-151 85 Sdertlje,
Sweden
Product of France
9708304
90|No.5020
90 Delayed-Release
Capsules
0186-5020-54
NDC 0186-5020-54
31326-00
LABEL H
LABEL G

temperature 15-30C
(59-86F) (see USP.)
Store in a dry place.
Protect from light.
Digoxin
Tablets, USP
0.125 mg
100 Tablets
Rx Only
Usual Dosage: See package

outsert for complete product
information.
57664 43788
Keep out of reach of children.
NDC 57664-437-88
N
3
Dispense in tight,
light-resistant container
as defined in the USP.
LABEL J
Each Tablet Contains:

Digoxin, USP . . . . 0.125 mg
C.S. No. 5280L01
Iss. 7/02
LABEL I
243
Chapter 7 Review
Check Up
In Exercises 123, calculate the desired dose. Then calculate the amount to administer.
1. Ordered: Valium 5 mg PO tid
On hand: Valium 2-mg scored tablets
Desired dose: __________
Amount to administer: __________
2. Ordered: Atacand 16 mg PO bid

On hand: Atacand 8-mg tablets
3. Ordered: Cimetidine 400 mg PO qid hs

On hand: Tagamet 200 mg tablets
_
4. Ordered: Noroxin 800 mg PO qd ac c H2O
On hand: Noroxin 400-mg tablets
5. Ordered: Tenex 2 mg PO qd hs
On hand: Tenex 1-mg tablets
6. Ordered: Tranxene 7.5 mg PO qd hs

On hand: Tranxene 3.75-mg tablets
7. Ordered: Pergolide mesylate 100 mcg PO tid

On hand: Pergolide mesylate 0.05-mg tablets
8. Ordered: Zyloprim 0.25 g PO bid

On hand: Zyloprim 100-mg scored tablets
9. Ordered: Zaroxolyn 7.5 mg PO daily

On hand: Zaroxolyn 2.5-mg tablets
244
Chapter 7
10. Ordered: Ciprofloxacin hydrochloride 500 mg PO q12h

11. Ordered: Lexapro 20 mg PO daily

12. Ordered: Toprol-XL 100 mg PO bid

32195-00
NDC 0186-1088-05
100 tablets
-XL
TOPROL
(metoprolol succinate)
extended-release tablets
25 mg *
nly
sO
se
urpo
P CAUTION
Rx only
nal LP Verify
Mfd. for:
Product
DE 19850
atioAstraZeneca
cWilmington,
Dispensed
u
By: AstraZeneca AB
d
E S-151 85 Sdertlje, Sweden
Made in Sweden
LOT
EXP
N3 0186-1088-05
* Each tablet contains 23.75 mg

metoprolol succinate equivalent to
25 mg metoprolol tartrate, USP.
DOSAGE: See package insert.
WARNING: As with all medications, keep out of the reach of
children. Store at 25C (77F).
Excursions permitted to 15-30C
(59-86F) [see USP].
TOPROL-XL is a trademark of the
AstraZeneca group of companies.
unvarnished area
245
13. Ordered: Depakene 250 mg PO bid

14. Ordered: Dilantin 60 mg PO daily

15. Ordered: Lisinopril 40 mg PO daily

246
Chapter 7
16. Ordered: Biaxin 125 mg PO tid

On hand: Refer to label G.
17. Ordered: Amoxicillin 1 gram PO bid

On hand: Refer to label H.
(cetirizine HCI)
TABLETS
5 mg
Marketed by
Marketed/Distributed by
UCB, Inc.
Smyrna, GA 30080
Pfizer Labs
5741
0069-0732-66
Zyrtec
05-4573-32-7
NDC 0069-0732-66
Rx only
100 Tablets
N3
Store at 20 25C
(68 77F); excursions
permitted to 15 30C
(59 86F) [see USP Controlled Room Temperature].
Dispense in tight
containers (USP).
DOSAGE AND USE
See accompanying
Each tablet contains 5 mg
cetirizine hydrochloride.
FPO UPC 30% x 5.5 mm
18. Ordered: Zyrtec 5 mg PO daily

LOT
&
EXP
AREA
247
5 mL, when constituted according to

*Each
directions, contains 125 mg anhydrous cefprozil.
only
75 mL (when mixed)
20. Ordered: Acyclovir 0.5 g IV

ACYCLOVIR
FOR INJECTION USP
FOR IV INFUSION ONLY

Equivalent to
500 mg
acyclovir
NDC 55390-612-10
Usual Dosage - See package insert.
Preparation of Solution: Inject 10 mL Sterile Water
for Injection into vial. Shake vial until a clear solution
is achieved and use within 12 hours. DO NOT USE
BACTERIOSTATIC WATER FOR INJECTION
CONTAINING BENZYL ALCOHOL OR PARABENS.
Dilute to 7 mg/mL or lower prior to infusion.
See package insert for additional reconstitution and
dilution instructions.
Store between 15 to 25C (59 to 77F).
Manufactured by:
Manufactured for:
Ben Venue Labs, Inc. Bedford Laboratories
Bedford, OH 44146 Bedford, OH 44146
Rx ONLY
ACYV03
21. Ordered: Kytril Oral Solution 4 mg PO tid

0004-0237-09
L
248
Chapter 7
NDC 0004-0237-09
KYTRIL
(granisetron HCl )
ORAL SOLUTION
2 mg/1O mL
3O mL
only.
0093-1075-78
CEFPROZIL
for Oral Suspension USP
125 mg/5 mL *

permitted to 15 to 30C (59 to
86F). Protect From Light.
Keep bottle closed tightly and
stored in an upright position.
Each 10 mL contains 2.24 mg
granisetron hydrochloride equivalent
to 2 mg granisetron.
Usual Dosage: See accompanying
Distr. by: Roche Laboratories Inc.
Nutley, New Jersey 07110
Made in UK
40230US1
27897835-0401
Lot
Exp.
N
3
Store constituted suspension in refrigerator. Discard after 14 days.

Phenylketonurics: This product contains 10.1 mg of phenylalanine per
5 mL (approx. one teaspoonful) of suspension.
SHAKE WELL BEFORE USING.
L52974
Rev. A 7/2005

NDC 0093-1075-78
To the Pharmacist: Prepare suspension at time of dispensing. Add to the

bottle a total of 59 mL water. For ease in preparation, add the water in two
portions. Shake well after each addition. This provides 75 mL of
suspension. Each 5 mL contains cefprozil equivalent to 125 mg anhydrous
cefprozil.
Usual Dosage: See package insert for full prescribing information.
Store powder at 20 to 25C (68 to 77F) [See USP Controlled Room
Temperature] prior to constitution.
19. Ordered Cefprozil 200 mg PO q8h

Rx only
Single Dose Vial
63323-280-04
For IM or IV Use
4 mL
40 mg/4 mL
(10 mg/mL)
401736C
INJECTION, USP
LOT/EXP
28004
FUROSEMIDE
Sterile, Nonpyrogenic
Preservative Free
Discard unused portion.
Each mL contains: Furosemide 10 mg;
Water for Injection q.s. Sodium chloride to adjust isotonicity. pH adjusted
with sodium hydroxide and if
necessary hydrochloric acid.
Usual Dosage: See insert.
PROTECT FROM LIGHT. Do not use if
discolored. Use only if solution is clear
and seal intact.
Store at 20 to 25C (68 to 77F) [see
NDC 63323-280-04
22. Ordered: Furosemide 100 mg IM now

On hand: Refer to label M.

temperature 20-25C (68-77F);
excursions permitted to 15-30C
(59-86F) [See USP].
Store in a dry place. Protect from
moisture.
10 mg
500 Tablets
Rx Only
C
IV
USUAL DOSAGE:
See package outsert
information.
57664 51613

container as described in the USP.
Dispense with: Information For
Patients.
NDC 57664-516-13
Zolpidem Tartrate
Tablets
N
3
Container closure is not childresistant and is not intended for
dispensing.
23. Ordered: Zolpidem 20 mg PO now

On hand: Refer to label N.
Each Tablet Contains:

Zolpidem Tartrate...............10 mg
C.S. No. 5433L01
Iss. 4/05
Critical Thinking Applications

Use the following label to answer these questions.
249
1. A physicians order reads Cipro 250 mg q12 hr PO " 3 days. Calculate the amount to administer.
2. In some cases, the patient may receive 500 mg q12 hours " 10 days. Calculate the amount to administer
for this dose.
3. For cutaneous anthrax a physician may order 250 mg PO bid " 60 days. Calculate the amount to
administer for 1 dose.
4. In each of the cases above, determine the total number of tablets the patient will need.
Case Study
You are working in a pharmacy when the following prescription comes in: Valium 7 mg PO tid for 7 days. The
drug labels below represent what you have on hand for filling this prescription.
1. What is the amount to administer?
2. How many total tablets will the patient need?
3. What changes would you make in filling the order if the prescription read Valium 15 mg PO tid for
7 days? How many tablets will the patient need for this new order?
2 mg
1OO Tablets
5 mg
only.
27897477-0900

containers as defined in USP/NF.
STORE AT 59 TO 86 F
(15 TO 30 C).
6505-01-230-3131
LOT
EXP.
NDC 0140-0006-01
VALIUM
(diazepam)
1O mg
1OO Tablets
Chapter 7
0140-0005-01
(diazepam)
0140-0006-01
VALIUM
Each tablet contains 5 mg diazepam.

USUAL DOSAGE: See package insert.
CONTENTS MADE IN CANADA
Distributed by: ROCHE LABORATORIES INC.
Nutley, New Jersey 07110 for Roche Products Inc.
27897476-0900

STORE AT 59 TO 86 F
(15 TO 30 C).
6505-01-230-3130
LOT
EXP.
NDC 0140-0005-01
1OO Tablets
250
0140-0004-01
(diazepam)

VALIUM

27897475-0900

STORE AT 59 TO 86 F
(15 TO 30 C).
6505-01-230-3129
LOT
EXP.
NDC 0140-0004-01
Many times medications come in different dosage strengths. (Recall the dosage
strength is the dose on hand per dosage unit.) If you do not look at the label carefully,
you can easily select the wrong medication and/or calculate the amount to administer incorrectly. Search the Internet for at least three medications, other than ones
found in this chapter, that come in different dosage strengths. List each medication
and its various dosage strengths. You may want to focus on the top 200 medications
at www.rxlist.com.
GO TO . . . Open the CD-ROM that accompanies your textbook, and complete a

final review of the rules, practice problems, and activities presented for this chapter.
For a final evaluation, take the chapter test and email or print your results for your
instructor. A score of 95 percent or above indicates mastery of the chapter concepts.
251

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7

Dosages and Doses

Calculating the Desired Dose

TABLE 7-1 The Language of Dosage Calculations

Examples Refer to Figure 7-1

The amount of drug to be given

40 mg bid (twice a day)

The amount of drug to be given at

This amount must be calculated

The units by which the drug will

In Figure 7-1 this is capsules.

The amount of drug contained in

In Figure 7-1 this is 20 mg.

The volume of a liquid or the

If the desired dose is 40 mg and

Dose on hand per dosage unit

In Figure 7-1 this is 20 mg per

Ordered: Nexium 40 mg PO bid

Figure 7-1 The language of dosage calculations.

Keep container tightly closed.

NEXIUM and the color purple as

Calculating the Desired Dose

GO TO . . . Open the CD-ROM that accompanies your textbook, and select

Fraction Proportion Method

Procedure Checklist 3-1

and the units you are converting from in the denominator.

3. Set up the two fractions as a proportion.

The dosage ordered is 0.2 mg once a day.

The order reads ASA gr v PO daily.

5. Cross-multiply and then solve for the unknown.

Ordered: 500 mg q6h

Store at Controlled Room Temperature

Dispense in original, unopened container.

0.4 mg (1/150 gr)

100 Sublingual Tablets

Division of Pfizer Inc, NY, NY 10017

Methods of Dosage Calculations

5. Cross-multiply and then solve for the unknown.

In a fraction proportion, units from the two fractions can

Ratio Proportion Method

Procedure Checklist 3-2

The dosage ordered is 0.2 mg once a day.

The order reads ASA gr v PO daily.

Methods of Dosage Calculations

Ordered: 500 mg q6h

Ordered: Nitrostat 800 mcg sublingually PRN chest pain.

In a ratio proportion, units can be canceled only when they

Procedure Checklist 3-3

The dosage ordered is 0.2 mg once a day.

Methods of Dosage Calculations

4. Cancel units. The remaining unit on both sides is micrograms.

The order reads ASA gr v PO daily.

Ordered: 500 mg q6h

Ordered: Nitrostat 800 mcg sublingually PRN chest pain

In dimensional analysis, units can be canceled only when

Methods of Dosage Calculations

7-1 Calculating the Desired Dose

Desired dose: _____

2. Ordered: Erythromycin 0.5 g

Desired dose: _____