IV Therapy Course: Drug & Fluid

Calculation

By: SSN.Asila Al-Breiki

(CNF,NIP Coordinator)
Objectives:

At the end of this presentation, the intern will be able to:

List the 10 rights of medication administration
Know basic quantities & common conversions
Know & practice medication calculations in:
 Oral forms (Tab/Capsules) & liquid
 Drops/minuts
 ml/Hr via infusion & syringe pumps
 mcg/kg/mt
 mcg/minuts & mg/minuts
 mg/kg/Hr
 mg/Hr
 iu/Hr
 The percentage & ratio strengths of medication
 Key Concepts

 Medication/Drug: any chemical substance

used in the treatment, cure, prevention, or
diagnosis of disease or used to enhance
physical or mental well-being.
 Medication(drug) use/administration: it is a
complex process that include describing,
dispensing, administering & monitoring,
involving different healthcare professionals.
 Rights of Drug administration

1. Right patient
2. Right medication
3. Right dose
4. Right route
5. Right time
Basic Quantities & Common Conversions

Weight:

 kg gm mg mcg
 1kg x 1000 = 1000g
 1g x 1000 = 1000mg
 1mg x 1000 = 1000mcg
 1teaspoon = 5ml
 1tablespoon = 15ml
 Common convertions

 Unit of volum: 1Liter = 1000Milliliters

 Percentage: 1% = Grams per 100ml of fluid
(1g in 100ml)

 Remember to Convert units of

measurements to one system
 Calculation of oral medication in Liquids
form

 Formula
Dose of drug required x Volume of drug available
Strength of drug available

 Example: Dr. order liquid Theophylline 150mg orally, available

concentration of drug is 60mg/5ml, how many ml you will
give?

150mg x 5ml
60mg

= 12.5 ml
 Calculation of oral medication in
Tablets/Capsule form

 Formula
Dose of drug required x Unit available(1tablet/capsule)
Strength dose (Available dosage)

 Example: Dr. order Tab. Lasix 80mg for a patient, each one
Tab. Lasix contains 40mg, how many tablets you will given?

80mg x 1tab.
40mg

= 2 tabs
 IV Infusions using drop factors

Drop Factors used to figure drip rate when

infusion pump is not used (Drops/ml).

Two types:
 Macro drip: 10drops/ml, 12 drops/ml &
15drops/ml & 20drops/ml
 Micro drip: 60drops/ml
IV Infusions using drop factors

 Formula:
Total Volume (ml) x Drop Factor/ml
Time x 60mts

 Example: IVF D5% 500ml to be started for

12Hrs, how many drops/mt if the drop factor
is 15drops/ml?
Calculate infusion time from drops/minute

 Formula: Total Volume of infusion(ml) x Drop Factor/ml

Rate of infusion (drops/minute)

 Example: How long will it take to infuse 500ml IVF D5%

using a giving set with drop factor of 15drops/ml & at rate
of 40drops/min?
500ml x 15 drops/ml
40 drops/min

=187.5min= 3.125 (3hrs 7.5min)

 Calculate infusion volume from
drops/minute

 Formula:
Rate of infusion (drops/min) x Total infusion time (in min)
Drop factor/ml of giving set

 Example: IV fluid is infused at a rate of 40drops/min & the

giving set has a drop factor of 10drops/ml. How much fluid
will infuse in 4 hours?

40 drops/min. x 240mt
10 drops/ml

= 960ml
 Calculate infusion rate in ml/hr from
drops/minuts

 Formula:
Rate of infusion (drops/min) x Total infusion time (in min)
Drop factor/ml of giving set

 Example: An IV fluid RL is infused at a rate of

25drops/minute & the drop factor is 15drops/ml. How many
ml/Hr is infusing?

25drops/min. x 60min/hr
15 drops/ml

= 100ml/hr
Calculation of ml/Hr via infusion pump

 Formula
Total Volume to be infused (in ml)
Total infusion Time(in Hrs)

 Example: IVF Normal Saline 0.9% 500ml to be given over

6Hrs via infusion pump, how many ml/Hr?

500ml
6hr

= 83.3ml/hr
 Calculation of ml/Hr via syring pump

 Formula :
Volume to be infused (in ml) x 60min/hr
Infusion Time(in min)

 Example: IV fluid to be infused 20ml over

30min, how many ml/hr?
20mlx 60min/hr
30min

=40ml/hr
 Calculation of ml/Hr via syring pump

 Example:
Glyceryl Trinitrate (GTN) to be infused at rate of
2mg/hr. in the syring pump is GTN 50mg (10ml) &
N.Saline 40ml to make a total of 50ml (1mg GTN/ml),
how many ml/hr?

Order(2mg) x Volume (50ml)

Strength (50mg)

= 2ml/hr
 Calculation in Microgram/Kg of body
WT/Minute

 Formula
Required dose x wt x 60min/hr x volume (ml)
Total micrograms in available solution

 This formula also can be used for calculating mg/kg/min.

 Example: Inj Dobutamin to be infused for a patient 10mcg/kg/mt, if

patient’s body WT:80kg, stock 250mg in 50ml, how many ml/Hr to be
infused?

10x 80 x 60min/hrx 50ml

(250mg x 1000) 250000 mic

= 9.6ml/hr
Calculation in Microgram/Minute

 Formula
Required dose (microgram/min) x 60min/hr x volume (ml)
Total strength of medication (micrograms)

 Example:
Inj Epinephrine to be infused 3mcg/min, the strength of
solution is 5mg in 50ml. What is the rate in ml/hr?

3mcg/minx 60min/hr x 50ml

(5mg x 1000) 5000mcg

= 1.8ml/hr
Calculation in Microgram/Minute

 Inj Epinephrine 5mg in total volume of 50ml

infused 1.8ml/hr, how many mcg/min is
infused?
 Calculation in Mg/Minute

 Formula:
Required dose (mg/mt) x 60 x Volume (ml)
Total strength (mg)

Example: Dr. order Inj Lidocain 2mg/mt for cardiac patient, if the
Lidocaine concentration prepared is 1g (100ml) in 400ml D5%
to form a totle of 500ml, what is the rate in ml/Hr?

2 x 60 x 500ml
(1g x 1000) 1000 mg

= 60ml/Hr
 Calculation of Doses in mg/kg/Hour

 Formula:
Required dose (mg/kg/hr) x wight (Kg) x Volume (ml)
Total strength (mg)

 This formula can also be used to calculate

mcg/kg/hr
 Calculation of Doses in mg/kg/Hour

 Dr. order Inj. Aminophylline 1mg/kg/hr to be

infused for a child weighing 15kg, the
Aminophylline strength is 250mg in 40ml D5% to
make total of 50ml, at what rate in ml/hr you will
set the syring pump?

1 x 15kg x 50ml
250mg

= 3ml/Hr
 Calculation of Doses in mg/kg/Hour

 Inj. Aminophylline infused for a child weighing

15kg, at rate of 3ml/hr, the Aminophylline
strength is 250mg in 40ml D5% to make total
of 50ml, at what is the order in mg/kg/hr you
will set the syring pump?
 Calculation of Doses in mg/Hour

 Formula
Required dose (mg/hr) x Volume (ml)
Total strength (mg)
 This formula can be used to calculate mcg/Hr, g/Hr or IU/Hr

 Example:
Inj Midazolam to be infused 3mg/hr, 30mg of Midazolam diluted to
make total of 30ml. What is the rate in ml/Hr?

3mg/hr x 30ml
30mg

= 3ml/Hr
 Calculation of Doses in mg/Hour

 Inj Aminophyllin to be infused for adult

patient with COPD 20mg/Hr, if the dug
concentration prepared 500mg in 500ml D5%,
how many ml/Hr?

20 mg/hr x 500ml
500mg

= 20ml/Hr
 Calculation of Doses in mg/Hour

 Inj Morphine to be infused 5ml/Hr for sickler

patient, if Morphine concentration is 50mg in
45ml NS to make total volume of 50ml, how
many mg/Hr to be infused?
 Calculation of Doses in iu/Hour

Required dose (iu/hr) x Volume (ml)

Total strength (iu)

 Example: Inj Heparin infusion for DVT patient to be

infused 1000iu/Hr, if Heparin concentration prepared
25000 (5ml) in 45ml NS to form total volume of 50ml,
how many ml/Hr?

1000iu/hr x 50ml
25000iu

= 2ml/Hr
 Calculation of Doses in iu/Hour

 Example: Inj Insulin to be infused 2iu/Hr, the

Insulin concentration prepared is 50iu (0.5ml)
in 49.5ml NS, to form total volume of 50ml,
How many ml/Hr started on syring pump?

2iu/hr x 50ml
50iu
 Calculation of mg/kg/day doses

Dose of drug mg/kg/day x body Wt

Number of doses per day (24hrs)

 A neonate weighing 2.6kg is ordered IV Cefuroxime

40mg/kg/day, to be given in 3 divided doses (q8Hrly).
How many mg will be given?

40mg/kg/day x 2.6kg
3doses/day

= 34.66mg/dose (34.7mg)
 Calculation of mg/kg/day doses

 A doctor prescribed Inj Amikacin

15mg/kg/day. It is to be given 2 divided doses
(q12Hrly), patient wt: 46kg, how many mg of
Amikacin required for each dose?

15mg/kg/day x 46kg
2doses/day

= 345mg/dose
 Calculation of Parenteral Medication
Dosages

 Formula
Dose of drug required x Volume available
Strength of drug available

 A doctor orders Inj Gentamycin 28mg q8hrly for a child. The

strength of Gentamycin available is 80mg/2ml. How many ml
will you draw up to obtain 28mg?

28mg x 2ml
80mg

= 0.7ml
 Calculation of % in I.V. Fluids

Percent (%) = Grams per 100ml of fluid

 5% Dextrose = 500ml contains 25 grams

 10% Dextrose = 500ml contains 50 grams
 0.18% Sodium Chloride = 500ml contains 0.9g
 DNS (0.9% NS & D5%) = 4.5g NS & 25g D5%
 Strength of medications

1. Ratio Strength:
 Inj Adrenaline 1: 1000 = 1g of Adrenaline in
1000ml = 0.001g = 1mg
Percentage strength of Adrenaline 1:1000
calculated as 1gx 100 = 0.1%
1000
2. Percentage strength:
 Inj Calcium Gluconate 10%
 References:
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http://www.nursingcenter.com/ncblog/may-2011/8-rights-of-medication-administratio
n
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Cavell G. Nicholls J. Rehman B. Dougherly L. Sarpal N. Tomlin S. Root T. 2014. Good
practice for drug calculation [Online]. Availanle at:
http://www.baxterhealthcare.co.uk/downloads/healthcare_professionals/therapies/p
harmacy_services/ps_calc_guide.pdf
[Accessed: 7 August 2016].
Haigh S. 2015. How to calculate drug dosages accurately. Nursing Times Journal
[Online]. Available at:
http://www.nursingtimes.net/clinical-archive/medicine-management/how-to-calculat
e-drug-dosage-accurately-advice-for-nurses/199884.fullarticle
[Accessed: 7 August 2016].
Miller W.2016. The nurse’s quick guide to IV drug calculation. Nursing Made Incredible
Easy Journal [Online] 11. Available at:
http://journals.lww.com/nursingmadeincrediblyeasy/Fulltext/2013/03000/The_nurse_
s_quick_guide_to_I_V__drug_calculations.1.aspx
[Accessed: 7 August 2016].