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MEDICATION CALCULATION GUIDELINES Think critically to avoid drug calculation errors. Do not rely only on your ability to do MATH. Basic Guidelines for Rounding Don’t round unless you have to Carry at least two decimal places (hundredths) throughout the entire problem When you have to round, only The smaller the number the more decimal places round at end of the problem and should be carried...hundredths place is a general not while working the problem guideline Round capsules and drops to Parts of capsules and drops cannot be administered Whole Numbers Round injectable medications Use a 1 cc syringe (Tuberculin syringe) which is less than 1 mL to Hundredths calibrated in hundredths (two decimal places) Round injectable medications Use a 3cc or larger syringe which is calibrated in more than 1 mL to Tenths (one tenths decimal place) Guidelines for Rounding Critical Care Meds Critical care medications are usually If pump can be set to administer meds to the administered via pump or controller hundredths' place, carry the problem to the thousandths and round to the hundredths The smaller the number the more This is especially true for pediatric patients important it becomes to not round too soon Guidelines for Expressing Dosages with a Decimal Do not use trailing zeros after a decimal If intending to give 1 mg of a medication point for doses expressed in whole and dose is expressed as 1.0 mg, the dose numbers may be misinterpreted as 10 mg Use zero before a decimal point when the If intending to give 0.5 mg of a medication dose is less that a whole number and the dose is expressed as .5 mg, the dose may be misinterpreted as 5 mg Remember: Lead Don’t Follow MEDICATION CALCULATION GUIDELINES Critical Care IV Dosages of certain IV medications must be titrated to administer a specific dosage per unit of time, for example, mg per minute, mcg per minute, or units per hour. Dimensional analysis (factoring) can be used to calculate flow rate, or when the flow rate is known, to assess the dosage being administered per unit of time. 1. 2. 3. 4. 5. Setting up the formula On the left side of the equation, place what it is you are solving for (what you are being asked to calculate). On the right side of the equation, place the available information from the problem in the form of a fraction (ratio). The numerator must be the same as the unit being calculated (what you are solving for). Enter the additional factors from the problem. Set up the numerator for each subsequent fraction so that it matches the unit in the previous denominator. Cancel out the like units on the right side of the equation. The remaining unit should match the unit on the left side of the equation (you have set up the problem correctly). Solve the equation by: a. Multiplying the numerators b. Multiplying the denominators c. Divide the numerator by the denominator in the resulting fraction Example: Order: Heparin 25,000 units in 250 mL D5W to infuse at 500 units per hour on an infusion pump. mL hr = 250 mL X 500 units 25,000 units 1 Hr = 5 mL/Hr MEDICATION CALCULATION GUIDELINES 1. To calculate the dosage being administered: Example: The patient is receiving Isuprel at 30 mL/hr. Solution is available in 2 mg Isuprel in 250 mL D5W. Calculate how many mcg/ min the patient is receiving. Mcg = min 1000 mcg X 2 mg X 1 mg 250 mL 30 mL 1 hr X 1 hr 60 min = 4 mcg/min Example: Order: Drug XYZ 100mg mixed in 250 mL of fluid with drop factor of 60 gtt/mL and infusing at 10 gtts/min. What is the mcg/min being administered? Mcg = min 1000 mcg X 100 mg X 1 mg 250 mL 1 mL 60 gtt 10 gtt 1 min = 66.67 mcg/min 2. The dosage may be titrated according to the patient's weight each day. Example: Drug A premixed – 50,000 units/600 mL Order: 70 units/kg/h Patient weighs 269 lbs How many mL/h are required to get the required units? mL hr = 600 mL X 50,000 units 70 units X Kg/hr S:/Forms/AS/Medication Calculation Guidelines Revised: October 1, 2008 1 kg X 2.2 lb 269 lb = 102.7 mL/hr