Calculation of doses and formulas

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Learning Objectives
 Upon successful completion of this chapter, the student will be
able to:
 Differentiate between the various kinds of doses.
 Perform calculations of doses involving household
measures.
 Perform calculations pertaining to the quantity of a dose,
the dosage regimen, and the supply of medication required
for the prescribed period.

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Definition of dose
 The dose of a drug is : -
 the quantitative amount of drug administered or taken by a
patient for the intended medicinal effect.
 Expressed as;
 a single dose: the amount taken at one time
 a daily dose: the amount taken per day, or
 a total dose: the amount taken during the course of
therapy.

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 A daily dose ：
 may be subdivided and taken in divided doses,
 two or more times per day depending on the characteristics
of the drug and the illness.
 The schedule of dosing {e.g., four times per day for 10 days) is
referred to as the dosage regimen.

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Cont…
 Drug doses vary greatly between drug substances; some drugs
have small doses, other drugs have relatively large doses.
 The dose of a drug is based on;
Drug factors Patient factors
 biochemical and  age,
pharmacologic activity,  body weight,
 physical and chemical  surface area,
properties,  liver and kidney function (for
 dosage form used, drug metabolism and
 route of administration elimination), and
 the severity of illness.

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Dose measurement
Doses are measured and administered by professional and
paraprofessional personnel.
A variety of measuring devices may be used. Such as;
s
s

poon
on

s
po

ge

ps
ri n
as

s
Table

calibrated cu
Sy
Te

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The drop as a unit of volume measure
 The drop (abbreviated gtt):
 is used as a measure for small volumes of liquid
medications.
 A drop does not represent a definite quantity, because drops of
different liquids vary greatly.

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Cont…
 Accordingly, the official dropper is calibrated as when held
vertically, it delivers water in drops, each of which weighs
between 45 and 55 mg.
It deliver approximately 20 drops of water per milliliter
i.e., 1 mL of water = 1 gram or
1000 mg ÷ 50 mg [ave.]/drop ≅ 20 drops).
The dropper may be calibrated by counting the drops of a liquid
as they fall into a graduate until a measurable volume is
obtained.
The number of drops per unit volume is then established(e.g., 20
drops/mL).

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Cont…
E.g. if a pharmacist counted 40 drops of a medication in filling a
graduate cylinder to the 2.5-mL mark, how many drops per
milliliter did the dropper deliver?
Sol/n;
40drops = 2.5mL
X drops = 1mL
40 drops x 1mL = xdrops x2.5mL
X= 16 drops/mL

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Calculation of doses
A pharmacist often needs to calculate
 the size of a dose,
 the number of doses, or
 the total quantity of medication to dispense.
Number of doses = Total quantity/Size of dose
 In this equation, the units of weight or volume must be the
same for the total quantity and size of the dose.

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Cont’d…
Examples
1. If the dose of a drug is 200 mg, how many doses are contained
in 10 g?
Sol/n;
total quantity = 10g = 10,000mg
dose size = 200mg;
Dose no = 10,000mg/200mg = 50 doses

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Cont’d…
2. How many teaspoonful would be prescribed in each dose of
an elixir if 180 mL contained 18 doses?
Sol/n;
total quantity = 180 mL
no of dose = 18
Size of dose = total quantity =
dose no
= 180 mL
18
= 10 mL = 2 teaspoonful

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Cont’d…
3.If 0.050 g of a substance is used in preparing 125 tablets, how
many micrograms are represented in each tablet?
Sol/n;
0.050 g = 50 mg = 50,000 mcg
50,000mcg/125tablets = y mcg/1tablet,
y = 400mcg

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 Patient related factors determining dose
 The pharmacist is much concerned with the maximum limit of the
doses which, if exceeded, may cause untoward effects in the
patient.
 The actual dose of a drug is to be decided by the prescriber
depending on patient's
age, body surface area
sex, severity of illness
Body weight, route of administration etc.

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Cont’d…
A. Drug Dosage based on Age (pediatrics and geriatrics)
The adjustment of dosing and dosage regimen in children and
elder needs special consideration due to different changes like;
change in pharmacokinetics parameters, age, body weight,
surface area and etc.
The age of the patient is a consideration in the determination of
drug dosage; b/c of the physiologic differences between
different age groups.

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Cont’d…
I. Pediatric patient
 From birth through adolescence(17yrs).
 Dose adjustment for pediatrics needed; b/c of
underdeveloped;
biologic functions such as respiration and circulation,
and
body systems for drug metabolism (e.g. liver enzymes)
and drug elimination (e.g., renal system).

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Cont’d…
 Various rules of dosage in which the pediatric dose was a
fraction of the adult dose, based on relative age
 Young’s rule
Dose for child = Age(yrs.)/[Age(yrs.) + 12] x Adult dose
 Cowling’s rule:
Dose for child = [Age at next birthday (in yrs.)/24] x Adult dose
 Today, these rules are not in general use; b/c, age alone is no
longer considered a singularly valid criterion in the
determination of accurate dosage for a child.

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Cont’d…
Example
 Calculate the dose of valium of a 13months old child by the
Young’s rule, if the adult dose is 10mg. Valium is available as
5mg/5mL.
Soln
Dose for child = Age(yrs.)/ [Age(yrs.) + 12] x Adult dose
= [13/12] / [13/12+12] x 10mg
= 0.83mg
5mg/5mL = 0.83mg/0.83mL

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Cont’d…
II. Geriatric patient
 Geriatric medicine or geriatrics is the field that concerned with
the promotion of health and the treatment and prevention of
disability and disease in old age(>65years).
 The functional capacities of most organ systems decline
throughout adulthood(17-45 years), and important changes in
drug response occur with advancing age.

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Cont’d…
Example:
 The adult dose of a drug is 500 mg every eight hours. For an
elderly patient with impaired renal function, the dose is reduced
to 250 mg every 6 hours. Calculate the reduction in the daily
dose, in milligrams.
Soln; daily dose for
 a, adult = 500mg x 3(every 8hrs.) = 1500mg
 b, elder = 250mg x 4(every 6hrs.) = 1000mg
reduction in daily dose = [1500 – 1000]mg = 500mg

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Cont’d…

B. Drug Dosage calculation based on Body Weight

 Common in children and obese patients.
 The volume of distribution of drug is the function of the
total body water and extracellular fluid(ECF) which in turn
are related to body weight.
 The doses of the majority of drugs based on body weight
are conveniently expressed in terms of mg/kg.

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Cont’d…

A useful equation for the calculation of dose based on body

weight is:

Patient’s dose (mg)

= Patient’s weight (kg) x Drug dose (mg)/1(kg)

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Cont’d…
 When the percent of fat is greater, the ECF is less. Therefore,
 There is less distribution of polar drugs. As a result, the
plasma concentration of polar drugs will be higher and
there may be a need to a dose of such drugs.
 Nonpolar/ lipid soluble drugs distribution in cellular
tissues will be more and there may be a need to increase a
dose of such drugs.

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Cont’d…
Example
 The usual initial dose of chlorambucil is 150 mcg/kg of body
weight. How many milligrams should be administered to a
person weighing 93 kg?
Sol/n:
150 mcg = 0.15 mg
Patient’s dose (mg)
= patient’s weight (kg) x drug dose (mg)/1 (kg)
= 93kg x 0.15mg/kg = 13.95mg

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Cont’d…
C. Drug Dosage based on Body Surface Area
 Widely used for two types of patient groups:
 cancer patients receiving chemotherapy and
 pediatric patients, with the general exception of neonates,
who are usually dosed on a weight basis with consideration
of age and a variety physiological factors.

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Cont’d…
• BSA (m²) = ([Height(cm) x Weight(kg)] 3600 )½
• Patient’s dose = [Patient’s BSA (m2)/1.73 (m2)] x Drug dose
(mg)
Example
If the adult dose of a drug is 100 mg, calculate the
approximate dose for a child with a BSA of 0.83 m2.
Soln,
Child’s dose = [0.83 m2/1.73 m2] x 100 mg
= 47.97 or 48 mg,

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