Pharmacy Calculations Workbook

Introduction ....................................................................................... 3
Purpose of the Workbook ..................................................................................................................... 3
How to Use This Workbook ................................................................................................................. 3
Basic Math Review ........................................................................... 5
Arithmetic Review: Addition, Subtraction, Multiplication, and Division ............................................ 5
Fractions, Decimals, and Percentages: Conversion and Basic Operations ........................................... 6
Units of Measurement: Metric, Imperial, and Household Systems ...................................................... 7
Rounding Numbers and Significant Figures: Accuracy in Calculations .............................................. 8
Measurement Conversions .............................................................. 10
Metric System Conversions ................................................................................................................ 10
Apothecary and Household Systems................................................................................................... 10
Temperature Conversions ................................................................................................................... 11
Dosage Calculations ........................................................................ 13
Basic Dosage Calculations: Determining Dosages Based on Patient Weight and Body Surface Area
............................................................................................................................................................. 13
Pediatric Dosing: Calculations Using Age-Based and Body Weight-Based Formulas ...................... 14
Dilutions and Concentrations: Preparing Solutions of a Specified Concentration from a Stock Solution
............................................................................................................................................................. 16
Compounding and IV Flow Rates ................................................... 18
Compounding Calculations: Creating Specific Quantities of a Compound ....................................... 18
IV Flow Rates: Calculating Drip Rates, Total Infusion Times, and Adjusting Flow Rates ............... 19
Drug Orders and Prescriptions ........................................................ 21
Interpreting Prescriptions: Understanding Prescription Notations ..................................................... 21
Days' Supply Calculations: Determining the Number of Days a Given Prescription Will Last ......... 21
Billing and Reimbursement Calculations: Basics of Calculating Costs, Insurance Copays, and Patient
Charges ............................................................................................................................................... 22
Advanced Pharmacy Math .............................................................. 24
Pharmacokinetics Calculations: Drug Absorption, Distribution, Metabolism, and Excretion ........... 24
Bioavailability and Half-Life: Calculating a Drug's Bioavailability and Half-Life ........................... 24
Concentration Gradient Calculations: Calculating Dosages Based on Concentration Gradients ....... 25
Practice Problems ............................................................................ 26
Comprehensive Practice Problems ..................................................................................................... 26
Answer Key ........................................................................................................................................ 26
Appendices ...................................................................................... 29
Appendix A: Formula Sheet ............................................................................................................... 29

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Appendix B: Abbreviations List ......................................................................................................... 29
Appendix C: Glossary......................................................................................................................... 30

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Introduction
Purpose of the Workbook
Welcome to the Pharmacy Calculations Workbook, a comprehensive resource designed specifically to
bolster your readiness for the Pharmacy Technician Certification Board (PTCB) exam. Mastery of
pharmacy calculations is not just a requirement for the exam but a fundamental skill essential for the
accurate and safe dispensing of medications in your future role as a pharmacy technician. This workbook
aims to provide you with a thorough understanding and practice in a wide range of calculations you will
encounter in both the examination and the pharmacy setting.

Pharmacy calculations can initially seem daunting. However, with the right practice, you can develop a
strong proficiency that will not only help you succeed on the PTCB exam but also instill confidence in your
day-to-day tasks in a pharmacy. This workbook covers everything from basic math skills to more complex
pharmaceutical calculations, ensuring a well-rounded preparation.

How to Use This Workbook

Start with the Basics: Before diving into pharmacy-specific calculations, we recommend reviewing the
Basic Math Review section. This will ensure your fundamental math skills are solid, which is crucial for
accurately performing more complex calculations later on.

Progress Gradually: Each section of this workbook is designed to build upon the previous one. Start at
the beginning and work your way through each section methodically. Skipping ahead might cause you to
miss essential concepts that are foundational for understanding subsequent sections.

Practice Regularly: Consistent practice is key to mastery. Set aside regular study times and focus on
solving the practice problems. Repetition will help reinforce your understanding and improve your speed
and accuracy.

Check Your Answers: Each practice problem comes with an answer and, in most cases, a step-by-step
solution at the end of the workbook. After attempting a problem, check your answer against the solution
provided. If you make a mistake, review the solution carefully to understand where you went wrong.

Take Notes: If you encounter a concept or problem-solving strategy that seems particularly helpful, take
notes. These notes can serve as a quick reference as you continue your studies or as a review before taking
the exam.

Use the Appendices: The appendices contain valuable resources such as a formula sheet, common
abbreviations used in pharmacy calculations, and a glossary of terms. Familiarize yourself with these
resources early on, as they will be useful throughout your study and practice.

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Seek Understanding, Not Memorization: While memorization can be helpful for certain aspects of
pharmacy calculations, true understanding allows you to adapt and apply concepts to a variety of problems.
Strive to understand the "why" behind each calculation method.

By following these guidelines and dedicating yourself to consistent practice, you will enhance your
calculation skills and increase your confidence in handling the mathematical aspects of the PTCB exam
and your future career as a pharmacy technician. Let's embark on this journey together towards achieving
your certification and beyond.

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Basic Math Review
Arithmetic Review: Addition, Subtraction, Multiplication, and Division
Before we dive into the complexities of pharmacy calculations, let's brush up on the four basic arithmetic
operations: addition, subtraction, multiplication, and division. These operations are the foundation upon
which all pharmacy calculations are built.
• Addition (+): The process of combining two or more quantities.

• Subtraction (−): The process of taking one quantity away from another.

• Multiplication (×): The process of increasing a quantity by adding it to itself a certain number of
times.

• Division (÷): The process of splitting a quantity into several parts.

Practice Problems:
1. A pharmacy technician needs to combine two liquid medications. The first medication is 120 mL,
and the second is 150 mL. How much total liquid will there be?

Solution:
120 mL + 150 mL = 270 mL
There will be 270 mL of total liquid after combining the two medications.

2. A prescription requires 500 mg of medication. The pharmacy has tablets of 650 mg. How much
more medication is in the tablet than the prescription requires?

Solution:
650 mg (tablet strength) - 500 mg (required dose) = 150 mg
There is 150 mg more medication in the tablet than the prescription requires.

3. A medication requires a dosage of 250 mg, to be taken 3 times a day for a week. How many
milligrams of medication are needed in total for the week?

Solution:
250 mg/dose × 3 doses/day × 7 days/week = 5,250 mg
A total of 5,250 mg of medication is needed for the week.

4. A bottle contains 600 mL of cough syrup. Each dose is 15 mL. How many doses are in the bottle?

Solution:
600 mL (total volume) ÷ 15 mL (dose volume) = 40 doses
There are 40 doses in the bottle.

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 5. A patient needs to take 2 tablets in the morning and 3 tablets at night for a 5-day course. Each tablet
contains 150 mg of the medication. How much medication, in milligrams, will the patient have
taken by the end of the course?

Solution:
(2 tablets + 3 tablets) × 150 mg/tablet × 5 days = 3,750 mg
The patient will have taken a total of 3,750 mg of medication by the end of the course.

Fractions, Decimals, and Percentages: Conversion and Basic Operations

Pharmacy calculations often involve fractions, decimals, and percentages. Understanding how to convert
between these forms and how to perform operations with them is crucial.
• Fractions to Decimals: Divide the numerator by the denominator.

• Decimals to Fractions: Write the decimal as the numerator with a denominator of 1, and then
multiply both numerator and denominator by 10 for each digit after the decimal until you have an
integer.

• Percentages: Remember that a percent is simply a fraction with a denominator of 100. To convert
a percentage to a decimal, divide by 100.

Practice Problems:
1. A medication is prescribed at 3/4 mg. Convert this dose to a decimal for accurate measurement.

Answer: 3/4 as a decimal is 0.75 mg

2. A liquid medication is available in 0.25 L bottles. Convert this volume to a fraction to understand
how it relates to a full liter.

Answer: 0.25 L as a fraction is 1/4 of a liter

3. A medication has a bioavailability of 0.85. Convert this to a percentage to explain its effectiveness
to a patient.

Answer: 0.85 as a percentage is 85%

4. A patient is advised to use a cream with a concentration of 2.5%. Convert this percentage to a
decimal for dosage calculations.

Answer: 2.5% as a decimal is 0.025

5. A pharmacy receives a stock bottle containing 2.5 L of cough syrup. If each dose is 5%, how much
of the active ingredient is in a 10 mL dose?

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 Answer: For a 10 mL dose at 5% concentration, the amount of active ingredient is 10 mL × 0.05 =
0.5 mL or 0.5 grams, assuming the density of the active ingredient is approximately 1 g/mL

6. A medication's effectiveness increases by 0.15% for each milligram added to the dose. If a patient
starts with a dose of 0.05% effectiveness at 1 mg, what is the effectiveness at 5 mg?

Answer: Starting at 0.05% effectiveness, adding 0.15% for each additional milligram over 1 mg (for
4 mg total added) results in an increase of 0.15% × 4 = 0.6%

Adding this to the initial effectiveness of 0.05% gives an overall effectiveness of

0.05%+0.6%=0.65%

Units of Measurement: Metric, Imperial, and Household Systems

In pharmacy, medications can be measured in metric (grams, liters), imperial (pounds, ounces), or
household (cups, tablespoons) units. Proficiency in converting between these systems is essential.
• Metric System: The most common system used in pharmacy, based on units of ten.

• Imperial System: Less common in pharmacy, but important for interpreting prescriptions from
certain countries or older patients.

• Household System: Occasionally used in patient instructions.

Practice Problems:
1. How many milliliters are in 3 liters of saline solution?

Solution: 1 liter = 1,000 milliliters, so 3 liters × 1,000 mL/liter = 3,000 mL

2. If a patient weighs 70 kilograms, what is their weight in pounds?

Solution: 1 kilogram ≈ 2.20462 pounds, so 70 kg × 2.20462 lbs/kg ≈ 154.3234 lbs

3. A prescription requires 240 mL of cough syrup. How many fluid ounces is this?

Solution: 1 milliliter ≈ 0.033814 fluid ounces, so 240 mL × 0.033814 fl oz/mL ≈ 8.11536 fl oz

4. A medical device requires a length of 10 inches. Convert this measurement to centimeters for
international shipping.

Solution: 1 inch = 2.54 centimeters, so 10 inches × 2.54 cm/inch = 25.4 cm

5. A recipe for a compounding pharmacy requires 1.5 cups of a base solution. Convert this volume to
liters.

Solution: 1 cup ≈ 0.236588 liters, so 1.5 cups × 0.236588 liters/cup ≈ 0.354882 liters

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 6. A child's medication dosage is 10 mg per kg of body weight. The child weighs 44 pounds. How
many milligrams of medication should the child receive?

Solution: First convert pounds to kilograms: 44 lbs ÷ 2.20462 lbs/kg ≈ 20 kg. Then, 10 mg/kg × 20
kg = 200 mg

7. A pharmacist needs to prepare 500 mL of a 10% dextrose solution but only has a 5% solution
available. How many milliliters of the 5% solution and how many grams of dextrose powder are
needed to prepare the required solution?

Solution:
This problem requires a dilution calculation rather than a direct conversion, but here's a
simplified approach assuming you want to end up with a 10% solution from a 5% solution
without considering volume changes from adding solid dextrose:

To make 500 mL of a 10% solution directly from a 5% solution isn't feasible without adding
pure dextrose.

To calculate the amount of dextrose needed: first, calculate the total grams of dextrose
required for a 10% solution (500 mL × 10% = 50 grams).

If you were starting with 500 mL of a 5% solution, you'd initially have 25 grams of dextrose
(500 mL × 5% = 25 grams).

You would need to add an additional 25 grams of dextrose to reach the desired
concentration, assuming the volume change is negligible for this calculation.

Rounding Numbers and Significant Figures: Accuracy in Calculations

Rounding is the process of adjusting numbers to make them simpler to work with, while significant figures
are used to indicate the precision of a measurement. Both concepts are vital in pharmacy to ensure accuracy
and safety.
• Rounding Rules: Typically, if the digit to the right of your rounding digit is 5 or more, you round
up. If it's less than 5, you round down.

• Significant Figures: The number of meaningful digits in a number. When calculating, it's important
to not overestimate the precision of your results.

Practice Problems:
1. Round 7.5 to the nearest whole number.

Answer: 8 (According to standard rounding rules, when the digit to the right of the rounding digit
is 5, you round up.)

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 2. Round 3.46 to the nearest tenth.

Answer: 3.5 (The digit in the hundredths place is 6, so you round up the tenth's place to 5.)

3. The concentration of a medication in a solution is 0.12345%. Round this concentration to the nearest
hundredth for labeling purposes.

Answer: 0.12% (The third digit after the decimal is 3, so you round down, keeping the second digit
as is.)

4. How many significant figures are in the measurement 0.05060 kg?

Answer: 4 significant figures (In this context, zeros between non-zero digits and trailing zeros after
the decimal point are significant.)

5. A medication requires 2.34567 grams. Round this to three significant figures, and identify what the
rounded number is.

Answer: 2.35 grams (The fourth significant figure is 5, so you round up the third significant figure
to 5.)

6. A solution contains 0.98765% w/v of an active ingredient. Round this concentration to four
significant figures and convert it to a percentage rounded to the nearest hundredth.

Answer: 0.9877% when rounded to four significant figures. To the nearest hundredth as a
percentage, it is 0.99%. (The fifth significant figure is 5, so you round up the fourth significant
figure to 7. When rounding to the nearest hundredth, the third significant figure is 7, and because
the next digit is also 7, you round up.)

This chapter lays the groundwork for the more specialized calculations you'll encounter as you continue
your studies. Mastery of these basic math concepts is crucial for success both on the PTCB exam and in
your future career as a pharmacy technician.

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Measurement Conversions
Metric System Conversions
The metric system is the standard system of measurement in pharmacy and healthcare. Its units are based
on multiples of ten, making conversions straightforward. Key units include grams (g) for weight, liters (L)
for volume, and meters (m) for length.

Key Conversions:
• 1 kilogram (kg) = 1,000 grams (g)
• 1 gram (g) = 1,000 milligrams (mg)
• 1 milligram (mg) = 1,000 micrograms (mcg)
• 1 liter (L) = 1,000 milliliters (mL)

Practice Problems:
1. Convert 5 grams to milligrams.

Answer: 5,000 milligrams (1 gram = 1,000 milligrams, so 5 grams × 1,000 mg/g = 5,000 mg)

2. If a medication is prescribed at 500 micrograms, how many milligrams is this?

Answer: 0.5 milligrams (1 milligram = 1,000 micrograms, so 500 micrograms ÷ 1,000 µg/mg = 0.5
mg)

3. A liquid medication is available in a 2-liter bottle. How many milliliters are in the bottle?

Answer: 2,000 milliliters (1 liter = 1,000 milliliters, so 2 liters × 1,000 mL/L = 2,000 mL)

Apothecary and Household Systems

While the metric system is predominant, understanding the apothecary and household systems is crucial
for interpreting some prescriptions and patient instructions.

Apothecary System:
• Often uses Roman numerals and older units such as grains (gr) for weight and fluid ounces (fl oz)
for volume.

Household System:
• Uses common kitchen measurements like teaspoons (tsp), tablespoons (tbsp), and cups.

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Key Conversions:
• 1 tbsp = 3 tsp
• 1 cup = 8 fluid ounces (fl oz)
• 1 ounce (oz) = 28.35 grams (g)

Practice Problems:
1. Convert 1 tablespoon to teaspoons.

Answer: 3 teaspoons (1 tablespoon equals 3 teaspoons.)

2. A recipe requires 4 cups of water Convert this volume to fluid ounces.

Answer: 32 fluid ounces (1 cup equals 8 fluid ounces, so 4 cups × 8 fl oz/cup = 32 fl oz.)

3. You have a medication that weighs 1 ounce. Convert this weight to grams.

Answer: Approximately 28.35 grams (1 ounce is approximately 28.3495 grams, commonly rounded
to 28.35 grams for practical purposes.)

Temperature Conversions
Temperature is another critical measurement in pharmacy, particularly when dealing with medications
requiring refrigeration or body temperature calculations.

Key Formulas:
𝟗
• Celsius to Fahrenheit: F = (C × 𝟓) + 32
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• Fahrenheit to Celsius: C = (F − 32) × 9

Practice Problems:
1. Convert 37°C (normal body temperature) to Fahrenheit.
𝟗
Solution: (37× 𝟓 ) + 32 = 98.6°F

2. A refrigerator is set to 40°F. What is this temperature in Celsius?

𝟓
Solution: (40−32) × 𝟗 = 4.44°C

3. A patient has a fever of 101°F. Convert this temperature to Celsius.

𝟓
Solution: (101−32) × 𝟗 = 38.33°C

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This chapter equips you with the knowledge to accurately convert various measurements critical in
pharmacy practice. Mastery of these conversions will aid in medication dispensing, preparation, and patient
counseling, ensuring safety and efficacy in patient care.

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Dosage Calculations
Dosage calculations are a critical aspect of pharmacy practice, ensuring patients receive the correct amount
of medication based on various factors. This chapter focuses on the essential methods used to determine
dosages, particularly for unique patient needs such as those of pediatric patients, and on calculations related
to dilutions and concentrations.

Basic Dosage Calculations: Determining Dosages Based on Patient Weight and Body Surface
Area
Medication dosages are often prescribed based on a patient's weight or body surface area (BSA) to ensure
efficacy and minimize toxicity. This section covers how to calculate dosages using these factors.

• Weight-Based Dosage: The formula for weight-based dosage is Dosage = mg per kg × Patient
Weight (kg).

• BSA-Based Dosage: BSA is commonly used for more precise dosing of certain medications, such
as chemotherapy agents. The Mosteller formula for calculating BSA is:
𝐻𝑒𝑖𝑔ℎ𝑡(𝑐𝑚)×𝑊𝑒𝑖𝑔ℎ𝑡(𝑘𝑔)
BSA (m2) = √ 3600

Practice Problems:
1. A physician prescribes Amoxicillin for a child who has a bacterial infection. The recommended
dosage is 50 mg of Amoxicillin per kilogram of the child's body weight per day. The dosage needs
to be divided into three equal doses throughout the day. If the child weighs 20 kg, how much
Amoxicillin should be given in each dose?

Solution:
Total Daily Dosage: 50 mg/kg × 20 kg = 1,000 mg per day.
Dosage Per Dose: 1,000 mg ÷ 3 doses = 333.33 mg per dose.
Approximately 333 mg per dose, given three times a day.

2. A patient requires a dose of Ciprofloxacin, which is prescribed at 15 mg per kg of body weight for
treating a severe infection. The medication is to be taken twice a day. If the patient weighs 70 kg,
calculate the amount of Ciprofloxacin the patient should receive for each dose.

Solution:
Total Daily Dosage: 15 mg/kg × 70 kg = 1,050 mg per day.
Dosage Per Dose: 1,050 mg ÷ 2 doses = 525 mg per dose.
525 mg per dose, taken twice a day.

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 3. A chemotherapy medication is prescribed at a dose of 250 mg/m² of body surface area (BSA). Use
the Mosteller formula to calculate the BSA for a patient who is 165 cm tall and weighs 60 kg. Then,
determine the total dose of medication the patient should receive.
Solution:
165×60 9900
For a patient 165 cm tall and weighing 60 kg: BSA (m2) = √ = √3600 = √2.75 =
3600

1.66𝑚2
Total Dose of Medication: 250 mg/m² × 1.66 m² = 415 mg.
The patient should receive a total dose of approximately 415 mg.

4. An immunotherapy drug is administered at a dosage of 200 mg/m² BSA for treating a certain
condition. A patient, who is 175 cm tall and weighs 80 kg, is to receive this treatment. Calculate the
patient's BSA with the Mosteller formula and determine the exact dosage of the drug that should be
administered.

Solution:
175×80 14000
For a patient 175 cm tall and weighing 80 kg: BSA (m2) = √ = √ 3600 = √3.89 =
3600
2
1.97𝑚
Total Dose of Medication: 200 mg/m² × 1.97 m² = 394 mg.
The patient should receive a total dose of approximately 394 mg.

Pediatric Dosing: Calculations Using Age-Based and Body Weight-Based Formulas

Pediatric dosing takes into account the unique physiological characteristics of children and infants,
requiring careful calculation to ensure safety and effectiveness.
• Clark's Rule for Age-Based Dosing: This is one of the methods to estimate a child's dose from an
𝐴𝑔𝑒 𝑜𝑓 𝐶ℎ𝑖𝑙𝑑(𝑦𝑒𝑎𝑟𝑠)
adult dose based on age: Child’s Dose = 𝐴𝑔𝑒 𝑜𝑓 𝐶ℎ𝑖𝑙𝑑 + 12 × 𝐴𝑑𝑢𝑙𝑡 𝐷𝑜𝑠𝑒
• Fried's Rule for Infants: This rule is specifically for infants and calculates dose based on age in
𝐴𝑔𝑒 𝑜𝑓 𝐼𝑛𝑓𝑎𝑛𝑡 (𝑚𝑜𝑛𝑡ℎ𝑠)
months: Infant’s Dose = × 𝐴𝑑𝑢𝑙𝑡 𝐷𝑜𝑠𝑒
150

Practice Problems:
1. A medication for cough relief is to be administered to a child. The adult dose of the medication is
100 mg. Using Clark's Rule, calculate the dose for a child who is 6 years old.

Solution:
6 6 1
Child’s Dose = 6 + 12 × 100𝑚𝑔 = 18 × 100𝑚𝑔 = 3 × 100𝑚𝑔 = 33.33𝑚𝑔
The child's dose should be approximately 33.33 mg.

2. An antibiotic is prescribed for an infant with an ear infection. The adult dosage of the antibiotic is
500 mg. According to Fried's Rule, the infant's dose is calculated based on the infant's age in months.

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 Solution:
6 1
Child’s Dose = 150 × 500𝑚𝑔 = 25 × 500𝑚𝑔 = 20 𝑚𝑔
(6 / 150) × 500 mg = (1 / 25) × 500 mg = 20 mg.
If the infant is 6 months old, the dose would be approximately 20 mg. The exact dosage
would depend on the actual age of the infant in months, as per the formula.

Dilutions and Concentrations: Preparing Solutions of a Specified Concentration from a Stock

Solution
In pharmacy practice, medications often need to be diluted to achieve a specific concentration for patient
use. Understanding how to perform these dilutions accurately is essential.

• Calculating Dilutions: The formula for dilutions is 𝐶1 𝑉1 = 𝐶2 𝑉2, where 𝐶1 and 𝐶2 are the initial
and final concentrations, and 𝑉1 and 𝑉2 are the initial and final volumes.
• Concentration Calculations: Concentrations are often expressed as percentages, such as a 1%
solution (1g/100mL).

Practice Problems:
1. A pharmacist needs to prepare 200 mL of a 2% w/v sodium chloride solution for a patient's nasal
rinse. However, the pharmacy only has a stock solution of 10% w/v sodium chloride. How much of
the 10% stock solution and how much water should the pharmacist use to prepare the 200 mL of
the 2% solution?

Solution:

This problem can be solved using the alligation method or a simple dilution calculation. However,
given the direct request, we'll use a dilution approach.

Goal: Prepare 200 mL of a 2% solution using a 10% stock solution.

𝐶1 𝑉1 = 𝐶2 𝑉2, Here, 𝐶1 =10%, 𝐶2 = 2%, and 𝑉2 = 200𝑚𝐿. We need to find 𝑉1, the volume of the
10 % solution needed.
𝐶2 ×𝑉2
Rearranging the formula to solve for 𝑉1: 𝑉1 = 𝐶1
2%×200𝑚𝐿 0.2×200
𝑉1 = = = 40mL of the 10% stock solution
10% 0.1

2. A medication is available in a concentration of 0.5% w/v. A doctor prescribes a dosage of 10 mg of

this medication. How many milliliters of the medication should be administered to the patient?

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 Solution:

A 0.5% w/v solution means there are 0.5 grams of medication in 100 mL of solution.

10 mg (which is equal to 0.01 grams, since 1000 mg = 1 gram)

To find out how many milliliters contain 10 mg of the medication, use the concentration to set up
a proportion, knowing that 0.5 grams are in 100 mL.
0.5𝑔 0.01𝑔 0.01𝑔×100𝑚𝐿
= solve for x: 𝑥 = = 2 𝑚𝐿
100𝑚𝐿 𝑥 𝑚𝐿 0.5𝑔

To administer 10 mg of the medication, 2 mL of the 0.5% w/v solution should be given to the
patient.

This chapter will feature step-by-step examples, practice problems, and real-world scenarios that reflect the
challenges faced in pharmacy calculations. By mastering these dosage calculation techniques, you'll be
well-prepared to ensure patient safety and medication efficacy in any pharmacy setting.

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Compounding and IV Flow Rates
This chapter delves into the crucial aspects of pharmaceutical compounding and the administration of
intravenous (IV) medications, focusing on the calculations needed to ensure accuracy and patient safety.
Understanding how to perform these calculations is essential for any pharmacy technician, especially those
involved in preparing compounded medications or overseeing IV medication administration.

Compounding Calculations: Creating Specific Quantities of a Compound

Compounding involves preparing personalized medications by mixing, combining, or altering ingredients
to create a medication tailored to the needs of an individual patient. Calculations in compounding can range
from simple arithmetic to complex formulas, depending on the nature of the medication being prepared.

Compounding Example:
You need to prepare a 100 mL solution of a topical medication with a concentration of 2% w/v of Active
Ingredient A for a patient's treatment regimen. The density of Active Ingredient A is 1.2 g/mL. Calculate
how much of Active Ingredient A and how much of the solvent you will need to prepare this solution.

Solution:
1. Calculate the total weight of Active Ingredient A needed:
• A 2% w/v solution means 2 grams of Active Ingredient A per 100 mL of solution. Therefore,
for a 100 mL solution, we need 2% × 100 mL = 2 grams of Active Ingredient A.
2. Determine the volume of Active Ingredient A using its density:
𝑀𝑎𝑠𝑠
• The density formula is 𝐷𝑒𝑛𝑠𝑖𝑡𝑦 = , which can be rearranged to find the volume:
𝑉𝑜𝑙𝑢𝑚𝑒
𝑀𝑎𝑠𝑠
𝑉𝑜𝑙𝑢𝑚𝑒 = .
𝐷𝑒𝑛𝑠𝑖𝑡𝑦
• Given that the mass of Active Ingredient A required is 2 grams and its density is 1.2 g/mL,
2 𝑔𝑟𝑎𝑚𝑠
the volume of Active Ingredient A is 1.2 𝑔/𝑚𝐿 = 1.67 𝑚𝐿.
3. Calculate the amount of solvent needed:
• Since the volume of Active Ingredient A is 1.67 mL, and the total desired volume of the
solution is 100 mL, the volume of the solvent (usually water or another suitable liquid for
topical medications) needed to achieve the final volume is 100 𝑚𝐿 − 1.67 𝑚𝐿 = 98.33 𝑚𝐿
4. To prepare a 100 mL solution with a 2% w/v concentration of Active Ingredient A:
• Active Ingredient A needed: 2 grams
• Volume of Active Ingredient A: 1.67 mL
• Solvent needed: Approximately 98.33 mL to achieve the final desired volume of 100 mL

This calculation ensures you account for the volume contributed by the Active Ingredient A,
maintaining accuracy in the final solution's concentration and volume.

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IV Flow Rates: Calculating Drip Rates, Total Infusion Times, and Adjusting Flow Rates
IV flow rate calculations are essential to ensure that patients receive IV medications and fluids at the correct
rate. These calculations are critical for patient safety and require an understanding of different variables,
including the volume of fluid to be infused, the time over which it should be infused, and the drop factor
of the IV tubing.

IV Flow Rate Example:

A patient is ordered to receive 1,000 mL of normal saline IV fluid over a 6-hour period. Calculate the flow
rate in milliliters per hour (mL/hr) to set on the IV pump to ensure the patient receives the correct volume
within the specified time.

Additionally, halfway through the administration, the physician decides to shorten the infusion time to a
total of 4 hours from the start, instead of the originally planned 6 hours. Recalculate the adjusted flow rate
based on this new order.

Solution Steps:
Initial Calculation:
To calculate the initial flow rate (before the physician's new order):
Total volume (mL)
𝐹𝑙𝑜𝑤 𝑟𝑎𝑡𝑒 =
Time (hr)
1000 mL
𝐹𝑙𝑜𝑤 𝑟𝑎𝑡𝑒 =
6 hrs
𝐹𝑙𝑜𝑤 𝑟𝑎𝑡𝑒 = 166.67 𝑚𝐿/ℎ𝑟
So, the initial flow rate to administer 1,000 mL of normal saline over 6 hours is approximately
166.67 mL/hr.

Adjustment for New Physician Order:

Halfway through the administration (3 hours in), the physician changes the order to complete the
infusion in a total of 4 hours instead of 6. This means that with 3 hours already passed, there is 1
hour left to administer the remaining volume.

Volume administered in the first 3 hours: At 166.67 mL/hr for 3 hours,

𝑉𝑜𝑙𝑢𝑚𝑒 𝑎𝑑𝑚𝑖𝑛𝑖𝑠𝑡𝑒𝑟𝑒𝑑 = 166.67𝑚𝐿/ℎ𝑟 × 3ℎ𝑟 = 500 𝑚𝐿

Remaining Volume: 1,000 mL - 500 mL = 500 mL

Given the physician's new order to complete the infusion in 4 hours total, with 3 hours already
passed, we now have 1 hour left to administer the remaining 500 mL.

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 Adjusted Flow Rate: To administer the remaining 500 mL in the remaining 1 hour,
500 𝑚𝐿
𝐴𝑑𝑗𝑢𝑠𝑡𝑒𝑑 𝐹𝑙𝑜𝑤 𝑅𝑎𝑡𝑒 = = 500 𝑚𝐿/ℎ𝑟
1 ℎ𝑟

The initial flow rate should be set at approximately 166.67 mL/hr to administer 1,000 mL of IV
fluid over 6 hours. After the physician's new order, adjust the flow rate to 500 mL/hr to administer
the remaining 500 mL over the last hour, completing the infusion in a total of 4 hours from the
start.

This chapter will equip you with the mathematical skills necessary to accurately compound medications
and calculate IV flow rates, ensuring that patients receive their medications safely and effectively. Through
a series of step-by-step examples and practice problems, you'll gain confidence in these essential pharmacy
technician skills.

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Drug Orders and Prescriptions
This chapter focuses on the fundamental aspects of interpreting drug orders and prescriptions, calculating
the days' supply of medications, and understanding the basics of billing and reimbursement in a pharmacy
setting. These skills are essential for pharmacy technicians to accurately dispense medications and manage
pharmacy operations.

Interpreting Prescriptions: Understanding Prescription Notations

Pharmacy technicians must be able to interpret the information on prescriptions accurately. This includes
understanding the medication name, dosage form, strength, directions for use, quantity to be dispensed, and
any special instructions.

Practice Problem
A prescription reads: "Amoxicillin 250mg, disp: #60, sig: 1 cap po q8h x 10 days." Calculate the total
quantity to be dispensed and verify if the quantity aligns with the dosing schedule.

Solution:
• Dosing Frequency: The prescription indicates that the medication should be taken every 8 hours.
Since there are 24 hours in a day, this equates to 3 doses per day.
• Total Dose for the Course: To calculate the total amount of medication needed for the entire
course:
3 doses/day × 10 days = 30 doses
• Verification with the Dispense Quantity: The prescription specifies to dispense #60 capsules,
which would actually cover a 20-day supply at the prescribed dosing frequency, not the 10 days
as indicated by the directions.

Based on the directions to take 1 capsule every 8 hours for 10 days, the patient should need a total of
30 capsules for the course, not 60. Therefore, there seems to be a discrepancy between the quantity to
be dispensed (#60) and the calculated quantity needed (30 capsules) for a 10-day course as per the
dosing instructions. It's important to clarify such discrepancies with the prescriber to ensure patient
safety and adherence to the treatment plan.

Days' Supply Calculations: Determining the Number of Days a Given Prescription Will Last
Calculating the days' supply of a medication is crucial for compliance, insurance billing, and ensuring the
patient has enough medication until the next refill.

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Practice Problem
Given the prescription "Lisinopril 20 mg, take 1 tablet daily, #30 tablets," calculate the days' supply.
Then, for a prescription that reads "ibuprofen 400 mg, take 1-2 tablets every 4-6 hours as needed for
pain, #120 tablets," calculate the minimum and maximum days' supply.

Solution:
Lisinopril Prescription Days' Supply Calculation
1. Prescription: "Lisinopril 20 mg, take 1 tablet daily, #30 tablets."
2. Calculation: If the patient takes 1 tablet daily and there are 30 tablets, then:
• Days' Supply = Number of tablets / Tablets per day
• Days' Supply = 30 tablets / 1 tablet per day = 30 days
The days' supply for the Lisinopril prescription is 30 days.

Ibuprofen Prescription Days' Supply Calculation

Prescription: "Ibuprofen 400 mg, take 1-2 tablets every 4-6 hours as needed for pain, #120 tablets."

For calculating the minimum and maximum days' supply, we consider the minimum and maximum
number of tablets that could be taken per day based on the instructions:
1. Minimum Days' Supply (taking 1 tablet every 6 hours):
• A day has 24 hours. If a patient takes 1 tablet every 6 hours, they would take 4 tablets in
a day.
• Minimum Days' Supply = 120 tablets / 4 tablets per day = 30 days
2. Maximum Days' Supply (taking 2 tablets every 4 hours):
• If a patient takes 2 tablets every 4 hours, they would take 12 tablets in a day (since 24
hours / 4 hours = 6 doses, and 6 doses × 2 tablets = 12 tablets).
• Maximum Days' Supply = 120 tablets / 12 tablets per day = 10 days

For the Ibuprofen prescription, the minimum days' supply is 30 days, and the maximum days' supply
is 10 days, depending on the frequency and amount of dosage taken as needed for pain relief.

Billing and Reimbursement Calculations: Basics of Calculating Costs, Insurance Copays, and
Patient Charges
Pharmacy technicians often need to calculate the cost of prescriptions, including determining insurance
copays and what charges the patient will be responsible for paying.

Practice Problems
1. A patient's prescription costs $100 total. Their insurance covers 70% of medication costs. Calculate
the insurance's contribution and the patient's out-of-pocket expense.

22
 Solution:
The insurance will pay $70 (70% of $100), leaving the patient with a $30 out-of-pocket expense.

2. If a medication is priced at $0.50 per tablet and a patient is prescribed 90 tablets with a $10
insurance copay, calculate the total charge to the insurance and the cost to the patient.

Solution:
The total cost of the medication is $45 (90 tablets at $0.50 each). With a $10 copay from the patient,
the insurance will pay the remaining $35.

This chapter aims to provide pharmacy technicians with the knowledge and skills needed to navigate the
complexities of drug orders, prescription interpretation, and the financial aspects of dispensing medications,
ensuring accuracy and efficiency in the pharmacy.

23
Advanced Pharmacy Math
This chapter addresses more complex calculations in pharmacy practice, focusing on pharmacokinetics,
bioavailability, half-life, and concentration gradients. Understanding these concepts is crucial for pharmacy
technicians to assist in optimizing medication therapy and ensuring patient safety.

Pharmacokinetics Calculations: Drug Absorption, Distribution, Metabolism, and Excretion

Pharmacokinetics involves the study of how a drug moves through the body. Calculations in this area help
predict drug levels at various points after administration, which is critical for dosing considerations.

Practice Problem
If a medication has a bioavailability of 80% and the oral dose is 100 mg, calculate the amount of drug
that becomes available in the systemic circulation.

Solution:
Bioavailability = 80%, Oral dose = 100 mg.
The amount of drug that becomes available in the systemic circulation is calculated as a percentage
of the oral dose.
100 𝑚𝑔 × 0.80 = 80 𝑚𝑔
80 mg of the drug becomes available in the systemic circulation.

Bioavailability and Half-Life: Calculating a Drug's Bioavailability and Half-Life

Bioavailability refers to the fraction of an administered dose of unchanged drug that reaches the systemic
circulation. The half-life of a drug is the time it takes for the plasma concentration of a drug to reduce to
half its original value.

Practice Problem
A drug with a half-life of 4 hours is administered at a dose of 200 mg. How much of the drug remains
in the body after 8 hours?

Solution:
Half-life = 4 hours, Initial dose = 200 mg.
The amount of drug remaining in the body after one half-life (4 hours) is reduced by half. After
another half-life (total of 8 hours), it is reduced by half again.
200 𝑚𝑔
Calculation after 4 hours: = 100 𝑚𝑔
2
100 𝑚𝑔
Calculation after 8 hours (another half-life): = 50 𝑚𝑔
2

24
 50 mg of the drug remains in the body after 8 hours.

Concentration Gradient Calculations: Calculating Dosages Based on Concentration

Gradients
Concentration gradients are vital in understanding the movement of drugs across cell membranes.
Calculations in this area can help determine the effective dosage needed to achieve a therapeutic effect.

Practice Problem
If the minimum effective concentration (MEC) of a drug is 10 mg/L and the maximum safe
concentration (MSC) is 50 mg/L, calculate the therapeutic window. If a dose of 500 mg achieves a peak
plasma concentration of 60 mg/L, is the dose within the therapeutic window?

Solution:
MEC = 10 mg/L, MSC = 50 mg/L, Peak plasma concentration after 500 mg dose = 60 mg/L.
The therapeutic window is the range between the minimum effective concentration and the
maximum safe concentration.
𝑀𝑆𝐶 − 𝑀𝐸𝐶 = 50𝑚𝑔/𝐿 − 10𝑚𝑔/𝐿 = 40𝑚𝑔/𝐿
To determine if the dose is within the therapeutic window, compare the peak plasma concentration
to the MEC and MSC.
The therapeutic window is 40 mg/L (from 10 mg/L to 50 mg/L). Since the peak plasma
concentration of 60 mg/L exceeds the MSC of 50 mg/L, the dose is not within the therapeutic
window and may be considered unsafe due to the risk of toxicity.

This chapter guides pharmacy technicians through advanced mathematical concepts related to drug therapy
management. Mastery of these calculations is essential for supporting pharmacists in making informed
decisions about medication dosing and adjustments to maximize therapeutic efficacy and minimize adverse
effects.

25
Practice Problems
This chapter compiles comprehensive practice problems that span all the topics covered in the workbook,
designed to simulate the experience of taking the Pharmacy Technician Certification Board (PTCB) exam.
These problems are intended to test your knowledge, reinforce your understanding, and improve your
calculation skills in a variety of pharmacy-related scenarios. An answer key with detailed explanations
follows the practice problems, providing insight into each solution and aiding in self-assessment and
learning.

Comprehensive Practice Problems

1. A pharmacy technician needs to split a stock bottle containing 1200 mL of cough syrup into
individual bottles of 90 mL. How many individual bottles can be filled?

2. Convert 3/8 of a dose to a decimal.

3. The doctor orders 0.5 kg of an ointment. How many grams does the pharmacy technician need to
dispense?

4. A medication's instructions recommend 15 mg per kg body weight. Calculate the dose for a patient
weighing 50 kg.

5. Using Clark's Rule, calculate the dose for a child aged 4 years if the adult dose is 200 mg.

6. You need to prepare 250 mL of a 5% (w/v) saline solution. How much salt (in grams) and water (in
mL) are required?

7. An IV bag of 1000 mL saline is to be administered over 12 hours. Halfway through, the doctor
orders the rate to be increased to complete the infusion 2 hours earlier. What is the new flow rate?

8. A drug has a half-life of 8 hours. If a patient takes a 200 mg dose, how much of the drug remains in
their system after 24 hours?

9. A physician orders an IV drip of Drug X at a concentration of 20 mg per L. If the patient needs a

dose of 0.04 mg/min, what should be the flow rate in mL/hr?

10. A patient is prescribed a medication that costs $0.75 per pill and takes 2 pills, 3 times a day for 30
days. The insurance covers 50% of medication costs after a $20 deductible is met. Calculate the
patient's total out-of-pocket expense for this medication.

Answer Key
1. To determine how many 90 mL bottles can be filled from 1200 mL, divide the total volume by the
1200 𝑚𝐿
volume of each bottle. 𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑏𝑜𝑡𝑡𝑙𝑒𝑠 = 90 𝑚𝐿/𝑏𝑜𝑡𝑡𝑙𝑒 = 13.33 𝑚𝑔. Since you can't have a

fraction of a bottle, you round down to the nearest whole number; thus, 13 bottles can be filled.

26
 3
2. To convert a fraction to a decimal, divide the numerator by the denominator. 𝐷𝑒𝑐𝑖𝑚𝑎𝑙 = 8 = 0.375

3. Since there are 1000 grams in a kilogram, multiply the kg amount by 1000 to convert to grams.
1000𝑔
𝐺𝑟𝑎𝑚𝑠 = 0.5 𝑘𝑔 × = 500𝑔
𝑘𝑔
𝑚𝑔
4. Multiply the patient's weight by the dosage per kg. 𝐷𝑜𝑠𝑎𝑔𝑒 = 15 𝑘𝑔 × 50𝑘𝑔 = 750 𝑚𝑔
𝐶ℎ𝑖𝑙𝑑′ 𝑠 𝑎𝑔𝑒 4
5. Apply Clark's Rule formula: Child’s Dose = (𝐶ℎ𝑖𝑙𝑑′ 𝑠 𝑎𝑔𝑒 + 12) × Adult dose = × 200 𝑚𝑔 =
4+12
4
× 200 𝑚𝑔 = 0.25 × 200 𝑚𝑔 = 50 𝑚𝑔
16

6. To find the amount of salt needed for a 5% solution, calculate 5% of 250 mL. 𝑆𝑎𝑙𝑡 𝑅𝑒𝑞𝑢𝑖𝑟𝑒𝑑 =
250 𝑚𝐿 × 0.05 = 12.5 𝑔. The rest of the solution is water, so: 𝑊𝑎𝑡𝑒𝑟 𝑅𝑒𝑞𝑢𝑖𝑟𝑒𝑑 = 250 𝑚𝐿 −
𝑣𝑜𝑙𝑢𝑚𝑒 𝑜𝑓 𝑠𝑎𝑙𝑡. Since the salt's volume is not typically subtracted in these calculations for
simplicity, we assume the volume change is negligible. The answer is 12.5 grams of salt, 237.5 mL
of water (assuming no volume change from salt addition).
1000 𝑚𝐿
7. Initially, the flow rate is = 166.67 𝑚𝐿/ℎ𝑟. Since 500 mL has been administered in 3 hours,
6 ℎ𝑜𝑢𝑟𝑠

500 mL remains. The new flow rate to administer the remaining 500 mL over the remaining 1 hour
500 𝑚𝐿
is = 500 𝑚𝐿/ℎ𝑟.
1 ℎ𝑜𝑢𝑟

8. First Half-Life (8 hours): The amount reduces to half in 8 hours, so after the first 8 hours, 100 mg
remains. Second Half-Life (16 hours): The amount reduces to half again, so after 16 hours, 50 mg
remains. Third Half-Life (24 hours): The amount reduces to half once more, so after 24 hours, 25
mg remains. So, the answer is that 25 mg of the drug remains in the body after 24 hours.
9. Convert the dosage to an hourly basis: 0.04 𝑚𝑔/𝑚𝑖𝑛 × 60 𝑚𝑖𝑛/ℎ𝑟 = 2.4 𝑚𝑔/𝑚𝑖𝑛. Calculate the
volume of solution needed to deliver 2.4 mg in an hour, given the concentration is 20 mg per 1000
2.4
mL (or 20 mg/L). Since 20 mg is contained in 1000 mL, 2.4 mg will be contained in × 1000 =
20

120𝑚𝐿. The flow rate should be set to 120 mL/hr to deliver the required dose.
10. Calculate the total number of pills first: 2 𝑝𝑖𝑙𝑙𝑠/𝑡𝑖𝑚𝑒 × 3𝑡𝑖𝑚𝑒𝑠/𝑑𝑎𝑦 × 30 𝑑𝑎𝑦𝑠 = 180 𝑝𝑖𝑙𝑙𝑠.
Then, calculate the total medication cost before insurance: 180 𝑝𝑖𝑙𝑙𝑠 × $0.75/𝑝𝑖𝑙𝑙 = $135. Apply
insurance deductible and coverage: First, subtract the deductible from the total cost to determine the
amount subject to insurance coverage. Then, calculate how much of the remaining cost is covered
by insurance (50%). The patient pays the deductible plus any costs not covered by insurance. Cost
after deductible $135 − $20 = $115. Insurance coverage: 50% 𝑜𝑓 $115 = $57.50. Patient’s out-

27
 of-pocket expense: 𝐷𝑒𝑑𝑢𝑐𝑡𝑖𝑏𝑙𝑒 ($20) + 𝐴𝑚𝑜𝑢𝑛𝑡 𝑎𝑓𝑡𝑒𝑟 𝑖𝑛𝑠𝑢𝑟𝑎𝑛𝑐𝑒 𝑐𝑜𝑣𝑒𝑟𝑠($115 − $57.50). So
the total Out-of-Pocket expense is: $20 + $57.50 = $77.50.

These practice problems are designed to ensure comprehensive coverage of the workbook's topics, with
increasing complexity to challenge your understanding and application of pharmacy math concepts in
preparation for the PTCB exam.

28
Appendices
The appendices serve as a valuable resource for quick reference and review, consolidating various tools to
aid in the understanding and application of pharmacy calculations. This section is designed to support
pharmacy technicians in their preparation for the PTCB exam and daily practice.

Appendix A: Formula Sheet

This quick reference sheet includes all the essential formulas covered throughout the workbook, organized
by chapter for easy access. Formulas range from basic math operations to more complex pharmaceutical
calculations, including:
• Basic Dosage Calculation: Dosage required = 𝐷𝑜𝑠𝑒 𝑝𝑒𝑟 𝑢𝑛𝑖𝑡 𝑤𝑒𝑖𝑔ℎ𝑡 × 𝑃𝑎𝑡𝑖𝑒𝑛𝑡 ′ 𝑠 𝑤𝑒𝑖𝑔ℎ𝑡
Where:
o Dosage required is the total amount of medication needed, usually expressed in mg
(milligrams) or g (grams).
o Dose per unit weight is the amount of medication recommended per unit of weight, typically
given in mg/kg (milligrams per kilogram) or mg/lb (milligrams per pound).
o Patient's weight should be in the same unit as used in the dose per unit weight (kg or lb).
𝐻𝑒𝑖𝑔ℎ𝑡 (𝑐𝑚)×𝑊𝑒𝑖𝑔ℎ𝑡 (𝑘𝑔)
• BSA Calculation: BSA (m²) = √ 3600

𝑇𝑜𝑡𝑎𝑙 𝑣𝑜𝑙𝑢𝑚𝑒 (𝑚𝐿)

• IV Flow Rate: Flow rate (mL/hr) = 𝐼𝑛𝑓𝑢𝑠𝑖𝑜𝑛 𝑡𝑖𝑚𝑒 (ℎ𝑟)
𝑇𝑖𝑚𝑒
1 )
• Half-Life: Remaining amount = Initial amount(2)𝐻𝑎𝑙𝑓−𝑙𝑖𝑓𝑒

Appendix B: Abbreviations List

This list compiles common abbreviations used in pharmacy calculations and prescriptions, helping users
quickly decipher and apply them. Examples include:
• q.d. (quaque die) - every day
• b.i.d. (bis in die) - twice a day
• t.i.d. (ter in die) - three times a day
• q.h. (quaque hora) - every hour
• mg - milligrams
• mL - milliliters
• kg - kilograms

29
Appendix C: Glossary
The glossary defines key terms and concepts encountered in pharmacy calculations and the broader field
of pharmacy practice. Definitions are provided in clear, concise language to ensure understanding of terms
that are crucial for accurate medication dispensing and patient care. Examples include:
• Bioavailability: The degree and rate at which a drug is absorbed by the bloodstream and becomes
available at the site of action.
• Compounding: The process of combining, mixing, or altering ingredients to create a medication
tailored to the needs of an individual patient.
• Pharmacokinetics: The study of how the body absorbs, distributes, metabolizes, and excretes
drugs.
• Concentration Gradient: The process of particles, which are sometimes called solutes, moving
through a solution or gas from an area with a higher number of particles to an area with a lower
number of particles.
• Half-Life: The time required for the concentration of a drug in the body to be reduced by one-half.

These appendices are designed to be a go-to resource for pharmacy technicians, providing quick access to
the information needed for efficient study, review, and application of pharmacy math and practices.

30