Pharmaceutical calculations

Jawzaa S. Alharbi ,BS

PHARM.D.

06/14/2023

Ph.Jawzaa ALharbi

1
Outline

• Numeral systems used in pharmacy.

• Fundamentals of Pharmaceutical Calculations .
• pharmacy calculations.
• Practice Problems.

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Numeral systems used in pharmacy.

There are two major number systems used in pharmacy :

• Arabic Numbers – these are the symbols we use every day for enumeration, such as 1, 16, and 1337.
• Roman Numerals – this is a numeral system originating in ancient Rome. Roman numerals are
expressed by letters of the alphabet, such as I, II, and x

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Roman Numerals

The following is a chart showing how

to convert back and forth between
Arabic numbers and Roman
numerals:

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Rounding Decimals

Sometimes when you are working with numbers, you will find them too large to be manageable.
In these scenarios, you should round.
• Rounding makes numbers that are easier to work with in your head.
• Rounded numbers are only approximate.
• An exact answer generally can not be obtained using rounded numbers.
• Use rounding to get an answer that is close but that does not have to be exact.

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How to round numbers

For whole numbers:

• Make the numbers that end in 1 through 4 into the next lower number that ends in 0. For example 74
rounded to the nearest ten would be 70.
• Numbers that end in a digit of 5 or more should be rounded up to the next even ten. The number 88
rounded to the nearest ten would be 90.
• For decimal numbers:
• When looking to round a significant figure that is proceeded by a 1 through 4, you may stop your
decimal there. For example 0.74 rounded to the nearest tenth would be 0.7
• When looking to round a significant figure that is proceeded by a 5 or more, it should be rounded up.
The number 0.88 rounded to the nearest tenth would be 0.9
•  

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Fundamentals of • temperature conversions
• household measurements
Pharmaceutical • metric system
Calculations. • apothecary system
• medication abbreviations

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Temperature scale conversions

The two common temperature scales used in

pharmacy are Celsius and Fahrenheit.
to convert from a Celsius temperature to a
Fahrenheit temperature:

to convert from Fahrenheit temperature to Celsius

temperature:

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Household System

The household system (sometimes referred to as the English system) is the measurement system most
commonly used in the United States today and is nearly the same as that brought by the colonists from
England. The ancient "digit," "palm," "span" and "cubic" units of length slowly lost preference to the
length units "inch," "foot," and "yard."

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Cont..

Some common conversions within this system include:

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Metric system

The metric system is based on three basic units, meter(m) for length, gram(g) for weight, and
liter(L) for volume. You can use the following prefixes to describe larger and smaller units of
meters, grams, and liters.
• Some common conversions within the metric system include:

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Converting between household units and metric units

The following are some of the more common conversions:

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Apothecary System

Although fast becoming obsolete, the apothecary system for weighing and calculating
pharmaceutical preparations is still used and must be taken into consideration. It has two divisions
of measurement: weight and volume. In this system, the basic unit of weight is the grain, and the
basic unit of volume is the minim.
• Some common conversions within the apothecary system are:

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Medication abbreviations

There are several key things to point out about the tables on the next several slides.

• categories – for ease of memorization, the abbreviations have been broken up into five categories:
route, form, time, measurement, and other.
• abbreviations – the abbreviations can often be written with or without the 'periods' and in upper or
lower case letters (e.g., p.o. and PO both mean 'by mouth').
• meaning – sometimes you will need to place an abbreviation in context to know its meaning (e.g., IV
could mean a dosage form as in an 'IV bag', it could mean a route of administration as in 'to give a
medication IV', or it could even be the roman numeral meaning 'four’). 
• Latin root – not all the words on this list are derived from Latin words, nor is it necessary to know the
Latin root words to be able to understand the abbreviations, but it is simply provided to help you
understand how some of these abbreviations were derived.

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 Abbreviation Meaning Latin Root
a.d.1 right ear auris dexter
a.s. left ear auris sinister
a.u. each ear auris utro
IM intramuscular
IV intravenous
IVP intravenous push
IVPB intravenous
piggyback
KVO keep vein open
n.g.t. naso-gastric tube

Route
n.p.o. nothing by mouth nasquam per os
nare nostril
o.d. right eye oculus dexter
o.s. left eye oculus sinister
o.u. each eye oculus utro
per neb by nebulizer
p.o. by mouth per os
p.r. rectally per rectum
p.v. vaginally
SC, SQ subcutaneously
06/14/2023 S.L. sublingually
(under the tongue)
Ph.Jawzaa ALharbi top. topically
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 Abbreviation Meaning Latin Root
amp. Ampule
aq, aqua water aqua
caps capsule capsula
cm.1 cream
elix. elixir

Form liq. liquid liquor

sol. solution
supp. suppository suppositorum
SR, XR, XL slow/extended
release
syr. syrup syrupus
tab. tablet tabella
ung., oint ointment ungentum
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Ph.Jawzaa ALharbi

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 Abbreviation Meaning Latin Root
a.c. before food, ante cibum
before meals
a.m. morning ante meridian
atc around the clock
b.i.d., bid twice a day bis in die
b.i.w., biw twice a week
h, ° hour hora
h.s. at bedtime hora somni
p.c. after meals post cibum
Time p.m. evening post meridian
p.r.n., prn as needed pro re nata
q.i.d., qid four times a day quarter in die
q each, every quaque
q.d. every day quaque die
q_h, q_° every__hour(s)
qod every other day
stat immediately statim
06/14/2023 t.i.d., tid three times a day ter in die

Ph.Jawzaa ALharbi
t.i.w., tiw three times a week

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 Abbreviation Meaning Latin Root
i, ii, ... one, two, etc.
a.a., aa1 of each ana
2
ad to, up to ad
aq. ad add water up to
BSA body surface area
cc cubic centimeter
dil dilute dilutus
f, fl. fluid
fl. oz. fluid ounce
g, G, gm gram
gr. grain
gtt drop(s) guttae

Measurement l, L
mcg, µg
liter
microgram
mEq milliequivalent
mg milligram
ml, mL milliliter
q.s. a sufficient quantum sufficiat
quantity
q.s. ad add sufficient quantum sufficiat
quantity to make ad
ss3 one-half
Tbs, T tablespoon
tsp, t teaspoon
06/14/2023 U unit
> greater than
Ph.Jawzaa ALharbi < less than

19
 Abbreviation Meaning Latin Root
c with cum
disp. dispense
f, ft1 make, let it be fac, fiat, fiant
made
n/v nausea and
vomiting
neb nebulizer
Other NR no refill
NS normal saline
s without sine
Sig write, label signatura
SOB shortness of breath
T.O. telephone order
ut dict, u.d. as directed ut dictum
06/14/2023 V.O. verbal order

Ph.Jawzaa ALharbi

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 See ISMP file these to help us not make errors in
interpreting these abbreviations.

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Calculating dosages Example
A 100 mg dose of medication is ordered, and the tablet size
when giving available is 25 mg. How many tablets will be needed per
dose?
medications in tablet
or capsule form.

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calculating dosages Example
An order for 50 mg of a drug is received. A 10 mL vial with
when giving 100 mg/mL is available. How many mL should be withdrawn
from the vial?
medications in •
liquid form, and
percentage strength
of solutions.

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Percentage Strength Solutions

There are three kinds of percentage strength that you will frequently use when doing dosage
calculations:

• weight/weight (w/w) – examples include ointments, creams, etc.

• volume/volume (v/v) – a common example is an alcohol preparation
• weight/volume (w/v) – this is the most common group and includes items such as solutions,
suspensions, etc.

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weight/weight (w/w) Example
What would be the weight, expressed in grams, of zinc oxide
A weight/weight percentage strength
expresses the number of parts in 100 (zinc oxide is the active ingredient) in 120 grams of a 10%
parts of a preparation. Typically it is zinc oxide ointment (the ointment is the total mixture)?
expressed as number of grams per 100
grams, but it could be expressed in any
unit of weight (grams, grains, ounces,
pounds, etc.) as long as the units on the
top and bottom match.

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volume/volume (v/v) Example
How mL of isopropyl alcohol are in a 480 ml bottle of 70%
Volume/volume percentage strength
problems are worked out in a similar isopropyl alcohol?
manner to w/w percentage strength
problems, except now the ingredients
are liquids. Typically it is expressed as
number of milliliters per 100 milliliters,
but it could be expressed in any unit of
volume (liters, pints, fluid ounces, etc.)
as long as the units on the top and
bottom match.

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weight/volume (w/v) Example
How many grams of sodium chloride are in a 500 mL bag of
Weight/volume (w/v) percentage
strengths are the most common 0.9% sodium chloride?
percentages worked with in pharmacy.
The units in this type of problem are
always grams of drug dissolved in
100 milliliters of solution.

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Diluting Stock Solutions

A stock solution is a concentrated solution from which less-concentrated solutions can be made. The
stock solution is diluted with a solvent (sometimes also referred to as a diluent), which may be water or
some other liquid substance.
Two questions must be answered to solve a dilution problem:
•  What volume of the stock solution must be diluted to make the ordered solution?
• What volume of solvent must be added to perform the dilution?
• These questions can be answered using ratio-proportions, the dilution formula, or the alligation
method .

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Solving dilutions using
Example
If 500 mL of a 5% solution is ordered, how much of a 25% stock solution is needed to

the ratio-proportion prepare the 5% solution?

• First, we need to figure out how much active ingredient is in our final solution:

method.
• When you solve for N you will find:

• Which means we will need to figure out how much volume of the stock solution is
required to provide 25 g of drug.

• When you solve for N you will find:

• of stock solution is required.
• 500 mL – 100 mL = 400 mL of diluent

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Solving dilutions The Dilution Formula: C1Q1 = C2Q2
• C1 = concentration of available stock solution
using the dilution • Q1 = quantity of available stock solution needed
formula. • C2 = concentration of ordered solution
• Q2 = quantity of ordered solution needed

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Solving dilutions Example
If 500 mL of a 5% solution is ordered, how much of a 25%
using the dilution stock solution is needed to prepare the 5% solution?
formula. C1Q1 = C2Q2

C1 = stock concentration is 25% To solve for Q1 we will need to get it by itself (isolate it) by
Q1 = stock quantity is ??? dividing both side by 25%.
C2 = final concentration is 5%
Q2 = final quantity is 500 mL
• of stock solution

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Solving dilutions using the alligation method.

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 Example
If 500 mL of a 5% solution is ordered, how much of a 25%
stock solution is needed to prepare the 5% solution? How
much diluent is needed?
Solving dilutions 25% 5 parts
using the alligation 5% total parts= 25
method. 0% 20 parts
•  

high concentration = 25%

desired concentration = 5%
low concentration = 0% (the diluent has no drug in it, therefore
it has a 0% concentration)
final quantity = 500 mL

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Infusion Rates

Infusion rates can be requested in many different ways: 

• Infuse at 125 mL/hr
• Infuse 1000 mL over 8 hours
• Infuse 10 mg per minute
• Infuse at a drip rate of 32 gtt/min
we can define an infusion rate as a quantity of drug per a quantity of time:

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Infusion Rates Example
A 1000 ml bag of NS is set to run for 5 hours. The infusion
set has a drop factor of 20. What is the drip rate?
•  =

• ==

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Infusion Rates Examples
If a 1 liter bag of D5W is run through an IV over eight hours,
what is the rate of infusion in mL/hr? 

An order is for Heparin IV to infuse at 1000 units/hr. What

will be the flow rate in mL/hr for a 500 mL bag of D5W with
25,000 units of heparin?

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Dosages Based on Example 
A physician orders cyclophosphamide to be given 5 mg/kg
Body Weight qid in 50 mL D5W. The patient weighs 132 pounds. If the
concentration of the drug available is 500 mg/10 mL, how
many mL should be added to each bag?
• =
• =

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Dosage Calculations Based on Body Surface Area

Various formulas:
• Dubois & Dubois; BSA (m2) = 0.007184 x weight in kg0.425 x height in cm0.725
• Mosteller; BSA (m2) =
• Haycock; BSA (m2) = 0.024265 x weight in kg0.5378 x height in cm0.3964

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Dosage Calculations • Example
A physician orders a bolus dose of doxorubicin for a 6'1”
Based on Body patient that weighs 165 lbs. The drug dose is 75 mg/m2.
What is the bolus dose in mg?
Surface Area BSA =
BSA = 1.96 m2

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Pediatric Dosing

• Clark's Rule (based on weight for children ages 2-17) 

 
• Young's Rule (based on age for all children)
 
• Fried's rule (based on age up to 24 months) 
 
• Cowling's rule 

• Pediatric nomogram, when adult dose is known (based on BSA for all children while treating the average adult BSA as 1.73 m 2)

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Pediatric Dosing
Example
A newborn (we'll count them as 1 month for calculation purposes) weighs 5.6 lbs, has a
height of 17 inches, and is ordered gentamicin to treat a meningitis infection they've
contracted.

• If based strictly on body weight, premature and full-term neonates should

receive gentamicin 2.5 mg/kg every 12 hours. Based only on body weight,
how much gentamicin should the neonate receive each day? 
• An average adult dose of gentamicin for treating meningitis is 350 mg/day
given in three equally divided doses. Based on this information, what should
this neonate's daily gentamicin be based on Cowling's rule?
• Using the above information, what would be the average daily quantity of
gentamicin be based on Fried's rule?
• Using the above information, what would be the average daily quantity of
gentamicin be based on a pediatric nomogram, when the adult dose is
known?

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Pediatric Dosing If based strictly on body weight, premature and full-term
neonates should receive gentamicin 2.5 mg/kg every 12
hours. Based only on body weight, how much gentamicin
should the neonate receive each day? 
=
=

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Pediatric Dosing An average adult dose of gentamicin for treating meningitis
is 350 mg/day given in three equally divided doses. Based on
this information, what should this neonate's daily gentamicin
be based on Cowling's rule?

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Pediatric Dosing Using the above information, what would be the average
daily quantity of gentamicin be based on Fried's rule?

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Pediatric Dosing Using the above information, what would be the average
daily quantity of gentamicin be based on a pediatric
nomogram, when the adult dose is known?

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Days' supply and Examples
A prescription is written for amoxicillin 250 mg capsules #30 i
Adjusting Refills cap t.i.d. What is the days' supply?
and Short-Fills
A prescription is written for amoxicillin 250 mg/5 mL 150 mL
i tsp tid. What is the days' supply? 1tsp=5ml tid =15ml\day,

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Days' Supply for Example
A prescription is written for Humulin N U-100 insulin 10 mL
insulins 35 units SC qd. What is the days' supply? 

•
How many viles?
==

1 vile or pen for each 28 days

because of it’s stability .

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Days' Supply for A prescription is written for ProAir HFA 8.5 g inhaler 2 puffs
q.i.d. What is the days' supply? (Hint: In order to solve this,
inhalers and sprays you will need to look at the box pictured on the right.)

How many inhaler ?

==

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Days' Supply for Example
A prescription is written for Mycolog II cream 15 g apply
ointments and sparingly bid. What is the days' supply? Dose =500mg
bid=1g\day
creams  
How many tube ?
=

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Days' Supply for Examples
A prescription is written for timolol 0.25% Opth. Sol. 5 mL i
ophthalmic and otic gtt ou q.d. What is the days' supply? 
preparations
A prescription is written for Neosporin Opth. ung 3.5 g apply
a thin strip ou q3-4h. What is the days' supply?

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Adjusting Refills Examples
A prescription is written for Dyazide #50 i cap p.o. q.d. + 3
and Short-Fills refills. The insurance plan has a 30 day supply limitation.
How many capsules can be dispensed using the insurance
plan guidelines? 
 
 
 

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Reconstituting Example
To reconstitute a 150 mL bottle of amoxicillin for oral
powders for oral suspension 250 mg/5 mL, the manufacturer recommends 88
mL of distilled water is added in two divided portions. First
suspensions loosen the powder in the bottle, then add approximately 1/3
of the total volume of water and shake the suspension. After
the powder is wet, add the remaining water. How much
water should you add each time?

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Mixing liquid Examples
How much clindamycin phosphate (the stock vial
preparations concentration is 150 mg/mL) and how much Cetaphil Lotion
are needed to make the following compound?
Rx clindamycin phosphate 1200 mg in Cetaphil Lotion
Disp: 120 mL
First, we should figure out how many mL of the clindamycin
phosphate stock solution we should use: 

Then, we should figure out how much Cetaphil Lotion we'll

need to qs this to 120 mL:

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Compounding Examples
A prescription is written for equal parts triamcinolone 0.1% cream and Lamisil
ointments, gels, and cream, dispense 30 grams. How many grams of triamcinolone 0.1% cream are
needed to fill the prescription? How many grams of Lamisil cream are needed to

creams fill the prescription? What is the final percentage strength of triamcinolone in the
compound?
• Therefore, we will need 15 g of triamcinolone 0.1% cm and 15 g of
Lamisil cm
Next, we need to evaluate the final percentage strength of triamcinolone in the
compound.
or 0.1% ÷ 2 = 0.05% triamcinolone 

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Medication Sticks Example
You receive the following prescription:
Rx Acyclovir 1200 mg
• silica gel micronized 0.12 g
• PEG 4500 MW 6.5 g
• PEG 300 MW 15 mL
• Disp: tube i
• Sig: Apply to lips tid prn cold sores
How many 200 mg acyclovir caps are needed to prepare this
compound?

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Advanced Calculations Involving Specific Gravity:
Specific gravity is commonly defined as the mass of 1
compounding milliliter of a particular substance. Therefore, if I stated that
a particular liquid had a specific gravity of 0.8, it means that
calculations. every milliliter of it weighs 0.8 grams. If a particular
compound requested 5 grams of a liquid known to have a
specific gravity of 0.8, I could determine the volume as
follows:
•

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Basic IV dosage Example
Magnesium sulfate 2 g in 100 mL of 5% dextrose in water
calculations (D5W) is ordered by the physician. How many milliliters
magnesium sulfate will be added to the bag that patient
receives if the magnesium sulfate vial provides the following
information: 50% magnesium sulfate (500 mg/mL), 4.06
mEq/mL, 10 mL single dose vial?

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Millimoles Example
A patient needs an infusion with 15 mMol of dibasic sodium phosphate
(Na2HPO4) in 150 mL of NS. How many milligrams of dibasic sodium
phosphate do you need to make this infusion?
Na2 == 46
H=1
P = 31
O == 64 
atomic mass units in a molecule of Na2HPO4.
Therefore, a mMol of Na2HPO4 would have a mass of 142 mg. With that
in mind, the problem becomes pretty straightforward to solve from
there.
= 2130 mg of Na2HPO4

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MilliEquivalents Example
1-If a patient required 4.2 g of sodium bicarbonate (NaHCO 3),
how many mEq of sodium (Na) is the patient receiving?
Na = 23
H=1
C = 12
O == 48 
• is the atomic mass of NaHCO3, therefore 1 mMol = 84 mg.
• Also, a mMol of NaHCO3 contains 1 mMol of Na, and 1 mMol
of Na = 1 mEq, so you can solve the problem as follows:
• = 50 mEq of sodium 

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MilliEquivalents 2-How many mEq of sodium and how many mEq of chloride
are in one liter of normal saline (0.9% w/v NaCl)?
Na = 23
Cl = 35.5
23+35.5=58.5 is the atomic mass of NaCl, therefore 1 mMol
= 58.5 mg.
1 mMol Na = 1 mEq
1 mMol Cl = 1 mEq
= 154 mEq
• 154 mEq sodium
• 154 mEq chloride

06/14/2023 Ph.Jawzaa ALharbi 61

 Example
What is the concentration, in mg/mL and in g %, of a solution containing 2 mEq of
potassium chloride (KCl) per milliliter?
Step 1: Find the M wt

Use of milli-equivalent Atomic wt of K = 39 and of Cl = 35.5

(meq) in preparing Molecular weight of KCl = 39 + 35.5 = 74.5 g

Step 2: Find the Eq wt

electrolyte Eq wt = Mwt / valence ,Equivalent weight of KCl = 74.5/1 = 74.5

solutions:
Step 3: Find the mEq, which is 1/1000 of the Eq wt
1 mEq of KCl = 1⁄1000 x 74.5 g = 0.0745 g = 74.5 mg
The mEq is the unit used to express the Step 4: Multiply the mEq, by the no. of mEq used
concentration of electrolytes in solution. 2 mEq of KCl = 74.5 mg x 2 = 149 mg/mL.
It is the amount in mg of a solute equal to
1/1000 of its gram Eq wt. calculate the concentration in g % (i.e. g / 100 mL) instead of
Eq wt (in gm) = Mwt / valence. mg/mL Solution
149 mg = 0.149 g
0.149 g ----> 1 mL
X g ----> 100 mL
X = 0.149 x 100 / 1 = 14.9 g%

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MilliEquivalents A person is to receive 2 mEq of sodium chloride per kilogram of body
weight. If the person weighs 132 lb., how many milliliters of a 0.9% sterile
solution of sodium chloride should be administered?
Molecular weight of NaCl = 58.5
Equivalent weight of NaCl = 58.5 /1 = 58.5
1 mEq of NaCl = 1⁄1000 x 58.5 g = 0.0585 g
2 mEq of NaCl = 0.0585 g x 2 = 0.117 g
1 kg = 2.2 lb.
Weight of person in kg = 132 lb./2.2 lb. = 60 kg
Because the person is to receive 2 mEq/kg, then 2 mEq or 0.117 g x60 = 7.02
g of NaCl needed
Normal saline is 0.9% sterile solution of NaCl
0.9 (g) of NaCl ----> 100 mL
7.02 (g) of NaCl ----> x (mL) x = 780 mL, answer

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Powder volume Example
If 95 mL of sterile water for injection (SWFI) is added to a 10
calculations g bulk powdered drug pharmacy container, the
concentration obtained is 100 mg/mL. What is the powder
volume of the drug?
We know the diluent added is 95 mL, and since we have the
weight of the drug in the vial and the final concentration
after reconstitution, we can find the total volume as follows: 
total volume
 Powder Volume = ??? ,Diluent Added = 95 mL, and Total
Volume = 100 mL

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Powder volume Example
Ordinarily IVIG is reconstituted to a concentration of 50 mg/mL. To
calculations obtain this concentration, a 5 g vial is reconstituted with 93 mL of
diluent. What is the powder volume for a 5 g vial of IVIG? How much
would you reconstitute it with if the patient was fluid restricted and the
physician requested a concentration of 100 mg/mL?
You can find the powder volume by doing the same steps as we have
already done on previous problems. The first step is to determine what
the total volume would be, and conveniently, the problem already gave
us a volume for diluent added if reconstituted to a concentration of 50
mg/mL.

•  Powder Volume = ???, Diluent Added = 93 mL, and Total Volume =

100 mL
• 100 mL – 93 mL = 7 mL powder volume

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Powder volume Now that we've answered the first question about powder
volume, we can determine the amount of diluent to add to
calculations obtain the desired concentration of 100 mg/mL. We will
once again need to determine the total volume, but this
time for our new concentration. 

Powder Volume = 7 mL, Diluent Added = ??? , and Total

Volume = 50 mL
50 mL – 7 mL = 43 mL of diluent to obtain the requested
concentration.

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 Thank you 
Jawzaa S. Alharbi

Twitter:
@jawzaa_s
06/14/2023
Email:
Ph.Jawzaa ALharbi
jawzasalem@gmail.com
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