Medical Math
Conversions and Formulas
Conversions Units
Conversion Units: Weight
Conversions Examples
POUNDS to KILOGRAMS: DIVIDE by 2.2
1 Kg = 1L =1000 gm = 1000 ml
1 gm = 1000 mg
1 mg = 1000 mcg (micrograms) How many Kilograms does a 25 lb dog weigh?
1 pound = 16 oz 25 lb ÷ 2.2 = 11.36 Kg
1 Kg = 2.2 lbs
1 oz = 0.0625 lbs KILOGRAMS to POUNDS: MULTIPLY by 2.2
1 oz = 0.028 kg
1 grain = 64.8 mg How many pounds does a 0.378 kg Kitten weigh?
Conversion Units: Volume 0.378 kg x 2.2 lbs/kg = 0.8316 lbs
1 L = 1000 ml
OUNCES to POUNDS :DIVIDE by 16 oz/lb
1 cup = 8 oz =240 ml
How many pounds does a 4.4 oz Kitten weigh?
1 ml = 1000 ul (microliters)
1 cc = 1ml
1 Tbs = 15 ml 4.4 oz ÷ 16 oz/lb = 0.275 lbs
1 tsp = 5 ml
1 ml = 20 drops OUNCES to KILOGRAMS:
1) convert to lbs
Conversion Units: Misc
2) 0.275 lbs ÷ 2.2 lbs/kg = 0.125 Kg
celscius= (degree F -32) x 5/9
Farenheight = (degree C x 9/5) + 32
1% = 10 mg/ml
10% = 100 mg/ml
Formulas to Know
Injections and Oral dosing
Common Conversions
Amount = Dose
___________
on Hand
Pounds to Kilograms: DIVIDE by 2.2
Flow Rate Infusion Pump
Kilograms to Pounds: MULTIPLY by 2.2
Flow Rate = Volume
_____________
Kilograms to Grams: MULTIPLY by 1000
Time
Ounces to Pounds: DIVIDE by 16 Drug Rate
OR
MULTIPLY by 0.0625 kg x mg/kg/hr ÷ mg/ml = ml/hr
Ounces to Kilograms: Convert to lbs,
then DIVIDE by 2.2 Spike a bag with a solution
Concentration you want
% solution to mg/ml: PUT a ZERO by the % _________________________ x volume you want
Concentration you have
mg ÷ mg/ml = ml(s) mg ÷ mg/tab =tab(s) = Volume to add
mg ÷ mg/cap= cap(s) kg x mg/kg = mg
C1V1=C2V2
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Oral dosing
Order : A 20 kg dog needs 10 mg/kg of oral doxycycline twice a day for 30 days.
Doxycycline is available in 100 mg tablets. How many tablets do you dispense?
Calculate the twice daily dose. 20 kg x 10mg/kg = 200 mg per dose
Amount = 200mg
___________ = 2 tablets per dose
100mg /tab
3. Two tablets , twice a day for 30 days
= 4 tablets per day x 30 days
= 120 tablets
ORAL DOSING WITHIN TABLET SIZES:
Order: Rimadyl dosed at 2.2 mg/kg twice a day for a week for a 50.6 lb dog. The Clinic has
100 mg and 25 mg tablets on hand.
1. Convert the dog's weight to kg: 50.6 ÷ 2.2 = 23 kg
2. Solve for mg amount of medication given twice a day: 23kg x 2.2 mg/kg = 50.6mg
3. Figure out how much of each tablet size you can use: 50.6 mg rounded down is 50mg
So, you can use 1/2 of a 100 mg tablet per dose
100 mg Tablet
1/2
In other words 1/2 tablet twice daily of the 100 mg tabs = 1 tab per day x 7 days=
Seven 100 mg tabs
OR
25 mg Tablet
2 of the 25 mg tablets per dose
2 tablets per dose of the 25mg tabs = 4 tabs per day x 7 days
= Twenty Eight 25 mg tabs
You choose the 100 mg tabs because you can dispense less tablets and that is more cost-effective 14
If you're making the UNITS LARGER If you're making the UNITS SMALLER
move the decimal to the LEFT 3 X move the decimal to the RIGHT 3 X
10.0 mg .010 gm 10.0 Kg 10,000 gm
SMALLER unit to LARGER UNIT, makes LARGER unit to SMALLER UNIT, makes
the number SMALLER . the number BIGGER .
If you break the pie into BIGGER pieces, If you break the pie into SMALLER pieces,
you need less pieces to make up the pie you need more pieces to make up the pie
ug ------> mg kg------> gm
Divide by 1000 Multiply by 1000
mg ------> gm gm ------> mg
gm ------> kg ug ------> mg
Remember to move the DECIMAL to the LEFT 3 PLACES Move the DECIMAL to the RIGHT 3 PLACES
when converting a SMALLER unit to LARGER unit when converting a LARGER unit to a SMALLER unit
mcg to mg, mg to grams, grams to Kg Kg to grams, grams to mg, mg to mcg
Injectable dosing
INJECTION ORDER: Give a patient 150 mcg of dexmedetomidine IM
How many ml do you need to draw up of a 0.5mg/ml solution of dexmedetomidine?
1. Convert Dexmedetomidine solution to mcg/ml so everything is in the same units
0.5mg/ml dexmedetomidine x 1000 mcg/mg = 500 mcg/ml solution of dexmedetomidine
MOVE THE DECIMAL 3 PLACES TO THE RIGHT
Dose
AMOUNT= _________
2. Calculate how many mls you need for 150 mcg
on Hand
D = Desired Dose
H = Medication on Hand AMOUNT = 150 mcg
A = Amount of medication you need (SOLVE for this) __________
500 mcg/ml
= 0.3 ml dexmedetomidine
INJECTION ORDER: A 6 kg cat needs 30 mcg/kg of transmucosal buprenorphine.
Buprenorphine comes as a 0.3 mg/ml solution. What volume of buprenorphine needs to be
administered to this cat?
1. First convert to the same units. 0.3mg/ml x 1000 mcg/mg = 300 mcg/ml solution
2. Calculate the dose needed for the cat: 6 kg x 30mcg/kg = 180 mcg
Amount = 180 mcg (DOSE) = 0.6 ml is needed
3. ___________
300 mcg/ml (HAVE)
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Oral Liquid dosing
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Liquid Dose Order: A 3.2 kg dog needs a 2mg/kg dose of oral furosemide. Furosemide comes as a 5%
solution. How much volume is the dose?
1. Convert the furosemide solution you have into mg/ml: 5%= 50 mg/ml of furosemide
2. Calculate the dose needed in mg: 3.2kg x 2mg/kg = 6.4 mg is needed per dose
3. Amount = 6.4mg = 0.128 ml is needed (draw up 0.13ml)
__________
50mg/ml
Spiking a fluid Bag
Order: Dextrose supplementation
You need to spike a bag to 5% dextrose. The fluid bag contains 450 ml of fluid. You have a 50%
dextrose solution. How many ml of dextrose do you add to the bag?
Volume to add = 5% (concentration you want)
___________________________________ X 450 ml (volume you want)
50% (concentration on hand)
0. 1 x 450
= 45 ml of 50% dextrose to add to 450 ml of fluid
Thought of another way, if you had 100% dextrose, you'd need 5% of 450ml (0.05 x450 = 22.5 ml).
But, you have a half-strength solution (50% dextrose) so you need double the volume: 45 ml.
Order: Insulin Infusion
You need to spike a 250 ml bag of 0.9% NaCl with 1.1 units/Kg Regular Insulin. You are treating a 10
kg dog. Humulin R is 100 units/ml. How many ml of insulin do you add to the bag?
1. How many units do you need to add to the bag: 1.1 units/Kg x 10 kg = 11 units
2. Calculate the dose needed in ml:
Amount = 11 units = 0.11 ml is added to the bag
_______________
100 units/ml 16
CRI out of a fluid bag
Order: 2 mg/kg/day Metoclopramide CRI
A 5 kg dog needs 2 mg/kg/day added to a liter of fluids to be delivered at 22ml/hr.
How many ml of a 5 mg/ml metoclopramide do you add to a Liter of fluids?
1. Figure out how many mg given per hour:
5 kg x 2 mg/kg/day = 10 mg/day of metoclopramide or 10 mg every 24 hours
10 mg ÷ 24 hours = 0.42 mg metoclopramide per hour
2. Figure out how many hours 1 bag lasts run at 22 ml/hr
1000 ml/bg ÷ 22 ml/hr = The bag lasts 45.45 hours
3. Mg added to the bag: 45.45 hours x 0.42mg per hour = 19.09 mg (round down to 19 mg)
added to the bag
4. Convert the mg into ml: 19mg ÷ 5mg/ml metoclopramide = 3.8ml of metoclopramide to 1 liter
OR
0.42 mg metoclopramide/hr. Convert to ml/hr = 0.42 mg/hr x 1ml/5mg = 0.084 ml/hr
22 ml/hr rate = 0.084 ml metoclopramide per 22ml = 0.084/22 = 0.0038 ml metoclopramide per ml
0.0038 ml x 1000ml = 3.8 ml of metoclopramide in 1 liter
***BONUS***
If you have a partially used bag of fluids, you can figure out the volume to add to 1 Liter,
then divide by 1000ml to know the volume added per ml. Then multiply that by the ml in the
partially used bag.
Example: 1 liter bag has only 650ml left in it. You need 3.8 ml per Liter. OR 3.8 ml ÷ 1000 =
0.0038 ml metoclopramide per ml of fluid in the bag. 650ml fluid x 0.0038= 2.47ml
metoclopramide added to the 650ml remaining in the bag.
Syringe Pump Infusion
Order: A dog in status epilepticus needs a Diazepam CRI run at 0.5mg/kg/hr. You're treating
a 17 kg dog. Diazepam is available as a 5mg/ml solution. You want enough to last 4 hours.
17kg dog x 0.5mg/kg/hr = 8.5mg diazepam per hour
8.5 mg/hr ÷ 5 mg/ml = 1.7 ml/hr of diazepam delivered via syringe pump OR
8.5 mg/hr x 1ml/5mg = 1.7 ml/hr
If you're planning to deliver the CRI for 4 hours, you need 1.7 ml/hr x 4 hr = 6.8 ml diazepam
Order: Fentanyl 4mcg/kg/hr to a 48 kg dog Post-op. Fentanyl comes as a 0.05mg/ml solution
1) Convert to the same units. 0.05mg/ml = 50mcg/ml solution
2) 4 mcg/kg/hr x 48kg = 192 mcg/hr
3) 192mcg/hr ÷ 50 mcg/ml = 3.84 ml/hr of fentanyl
4) If you're planning to have enough for 6 hours of fentanyl: 3.84 ml/hr x 6 hours = 23.04 ml of
fentanyl is needed [Link]
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CRI Examples
Order: Nitroprusside 2 mcg/kg/minute run at 12 ml/hr
Nitroprusside is a 25mg/ml solution
A 3.8 kg dog needs 2mcg/kg/minute of Nitroprusside added to 500 ml bag of fluids to be
delivered at 12 ml/hr.
How many ml of a 25mg/ml nitroprusside do you add to a 500ml bag of fluids?
1. Figure out how many mcg given per minute:
3.8 kg x 2 mcg/kg/minute = 7.6 mcg/minute
2. Figure out how many mcg per hour:
7.6 mcg/minute x 60 minutes/hour = 456 mcg/ hour
3. Figure out how many mcg per ml:
We know that 12 ml of fluid are delivered every hour. So, that means there are 456 mcg per 12 ml.
This can be reduced to : 456 mcg/ 12 ml = 38 mcg/ml
4. Figure out mg nitroprusside per fluid bag:
We have a 500ml bag. So 38mcg/ml x 500ml/bag = 19000 mcg/500ml bag or 19 mg/500 ml bag
5. Figure out ml of nitroprusside per bag:
19 mg of nitroprusside x 1ml/25mg nitroprusside = 19/25 = 0.76 ml Nitroprusside added to
500ml. Remember to take out 0.76ml from your bag first. So, you add 0.76ml of Nitroprusside
to 499.24 ml of fluid in your bag.
Another way :
3.8 kg x 2 mcg/kg/min x 60 min/1 hour x 1mg/1000mcg x 1ml/25 mg/ x 1 hr/12ml x
500ml/bag = 0.76ml /bag. All the units get crossed out to end up with ml/bag at the end.
Now Titrate...
You're now asked to INCREASE the rate from 2 mcg/kg/minute to 4 mcg/kg/minute
What is the new fluid rate in ml/hour?
The fluid rate of 2 mcg/kg/minute is 12 ml/hour . If we double it to 4 mcg/kg/minute, we double the
rate per hour to 24 ml/hour
Another way:
Our fluid bag has 0.76ml nitroprusside/500ml
0.76 ml x 25mg/ml = 19 mg nitroprusside/500ml = 0.038mg/ml = 38 mcg/ml nitroprusside
We want 4 mcg/kg/minute. 4 mcg/kg/minute x 3.8kg = 15.2 mcg/minute x 60 min/hour = need 912
mcg/hr. 912 mcg/hr x 1 ml/ 38mcg = 912/ 38 = 24 ml/hr 18
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Make an Easy to Titrate CRI
Order:
Start Norepi at 0.1mcg/kg/minute- (norepinephrine =1mg/ml)
Weight of patient is 6.24Kg
0.1mcg/kg/minute x 624 kg = 0.624 mcg/min x 60 min/hr = 37.4 mcg/hour or .0374 mg/hr
Because NorEpi is 1mg/ml : divide 37.4 mcg by 1000 to turn the number into mg
0.0374 mg/hour which is the same as 0.0374 ml/hour of nor Epi
( 0.0374 mg/hr x 1ml/mg = 0.0374 ml/hr)
If you want to draw up 10 hours of medication at that rate, multiply the number by 10
0.0374 ml/hr of Nor Epi x 10 hours = 0.374 ml of 1mg/ml NorEpi to last 10 hours if run at
0.1mcg/kg/minute **
If you want your CRI to run at 1ml/hr to equal 0.1mcg/kg/minute, you want your solution to have
0.0374 mcg of Nor epi in every 1 ml delivered to the patient***
Dilute it into 10ml by adding 0.374ml (0.374mg ) of Norepi to 9.63ml of d5W.
You will have 10 hours of Norepi if run at 1ml/hr = 0.0374 mg/hr
NOW if your solution is run at 1ml/hr it equals 0.1mcg/kg/minute (0.0374 mg/hr)
If you run it at 2ml/hr you deliver 0.2mcg/kg/minute, AND
3ml/hr you deliver 0.3 mcg/kg/minute
4ml/hr you deliver 0.4mcg/kg/minute
5ml/hr you deliver 0.5mcg/kg/minute **
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Your Own Notes
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