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The document outlines the calculation of drug doses, including definitions of various dose types such as single, daily, total, and maintenance doses. It also covers dosage forms, measurement units, and provides examples of dose calculations and special dosing regimens. Additionally, it discusses fixed-dose combination products and the importance of proper dosing for patient compliance.

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3 views

7

The document outlines the calculation of drug doses, including definitions of various dose types such as single, daily, total, and maintenance doses. It also covers dosage forms, measurement units, and provides examples of dose calculations and special dosing regimens. Additionally, it discusses fixed-dose combination products and the importance of proper dosing for patient compliance.

Uploaded by

ar2596034
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Calculation of Doses

Lecture 7

Berivan Ajeel Ibrahim


B.Sc. Pharmacy, M.Sc. Pharmaceutics
E mail: [email protected]
Date: 21/1/2025
Objectives:

Differentiate between the various types of doses.

Perform calculations related to the quantity of a dose, the


dosage regimen, and the supply of medication required for the
prescribed period.
Dose
The dose of a drug is the quantitative amount administered or taken by a
patient for the intended medicinal effect. The dose may be expressed as:

Single dose: the amount taken at one time.

Daily dose: the amount that may be subdivided and taken in divided
doses, two or more times per day.

Total dose: the amount taken during the course of therapy.

Dosage regimen: it is the schedule of dosing (frequency: number of times


per day)(duration: number of days), e.g., four times per day for 10 days).
Usual dose: is the amount that ordinarily produces the medicinal effect.

Priming or loading dose: is the amount that is larger-than-usual initial


dose which is required to achieve the desired blood drug level rapidly.

Maintenance dose: it is similar in amount to usual doses, is then


administered according to the dosage regimen to sustain the desired
drug blood levels or drug effects.
Prophylactic doses: are certain biologic or immunologic products,
such as vaccines, that are administered to protect the patient from
contracting a specific disease.

Therapeutic dose: it is the dose that is used to counter a disease after


exposure or contraction.

The therapy could be of low-dose or of high-dose or it could be of


mono-therapy, or adjunctive-therapy.
Dosage Forms
Prefabricated Dosage Forms

Are those which prepared on a large scale


within the pharmaceutical manufacturing
industry for distribution to institutional and
community pharmacies.

Compounding Dosage Forms

Are those which prepared on smaller scale by


carefully weighing, measuring, and mixing
the individual ingredients.
Dose Measurement
A variety of measuring devices may be
used for oral liquids, including
calibrated cups, calibrated spoon,
calibrated oral dropper and oral
dispenser. Measuring devices for
parenteral medications include
syringes and intravenous sets.
Dose Measurement
Measuring Units:
1 teaspoonful (tsp.) = 5 mL
1 tablespoonful (tbsp.) = 15 mL

1 mL = 20 drops (gtt) (for water and medicated fluids that have same flow
and surface properties of water).
International unit (IU)
Example:

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?

Solution:

𝟒𝟎 (𝒅𝒓𝒐𝒑𝒔) 𝟐.𝟓 (𝒎𝑳)


=
𝑿 (𝒅𝒓𝒐𝒑𝒔) 𝟏 (𝒎𝑳)

X = 16 drops / mL
General Dose Calculations

𝑻𝒐𝒕𝒂𝒍 𝑸𝒖𝒏𝒂𝒕𝒊𝒕𝒚
Number of Doses =
𝑺𝒊𝒛𝒆 𝒐𝒇 𝑫𝒐𝒔𝒆

In using the equation, the total quantity and the size of dose must be in
the same unit of measure.

Giving two factors in the above equation, by rearrangement, the third may
be calculated.
Abbreviations
Abbreviation Meaning
ad Up to; to make
Disp. dispense
q.s. Quantity sufficient
b.i.d Twice a day
p.r.n or s.o.s As needed
q.i.d Four times a day
s.i.d Once a day
Stat. Immediately
t.i.d Three times a day
Sig. Write (directions on label)
a.c. and p.c. Before meals and after meals
h.s. At bed time
Example:

If 1 tablespoon is prescribed as the dose, approximately how many doses


will be contained in 1 pint of the medicine?

Solution:

1 tablespoon = 15 mL

1 pint = 473 mL

Number of doses = total dose / size of dose

Number of doses = 473 mL / 15 mL = 31.5 or 32 doses


Example:

How many drops would be prescribed in each dose of a liquid medicine if 15


mL contained 60 doses? The dispensing dropper calibrates 32 drops / mL.

Solution:

Number of doses = total dose / size of dose

Size of dose = 15 mL / 60 dose = 0.25 mL / dose

Size of dose in drop = 0.25 * 32 = 8 drops / dose


Example:

How many milliliters of a mixture would provide a patient with a teaspoonful


dose to be taken three times a day for 16 days?

Solution:

Number of doses = 16 (duration) * 3 (frequency) = 48 doses

Size of dose = 1 tsp = 5 mL

Total quantity = 48 * 5 mL = 240 mL per 48 doses.


How many milligrams each of hydrocodone bitartrate and guaifenesin will be
contained in each dose of the following prescription?
Rx Hydrocodone Bitartrate 0.12 g
Guaifenesin 2.4 g
Cherry Syrup ad 120 mL
Sig. Teaspoonful for cough.

Solution:
1 dose = 1 tsp = 5 mL
For hydrocodone bitartrate : 120 ml / 5 mL = 0.12 g / x
x = 0.005 g = 5 mg of hydrocodone bitartrate
For guaifenesin: 120 ml / 5 mL = 2.4 g / x
x = 0.1 g = 100 mg of Guaifenesin
Dosing Options
Fixed-Dose Combination Products

A variety of products are available containing two or more therapeutic


agents in fixed-dose combinations.

For example, caplets containing amlodipine and valsartan (Potenza), two


drugs used in the treatment of hypertension, are available in strengths of
5 mg / 80 mg, 5 mg / 160 mg, and 10 mg / 160 mg. The prescriber can
select the desired combination.
Dosing Options
Fixed-Dose Combination Products
Example: Valsartan and hydrochlorothiazide tablets are available
separately and in combination in strengths of 80 mg / 12.5 mg,
160 mg / 12.5 mg, and 160 mg / 25 mg. If a patient was receiving
the lowest-dose combination product and the physician wished
to double the dose of hydrochlorothiazide, what is the option?

Answer: ?
Splitting Tablets
A number of tablets are scored, or grooved, to allow breaking into
approximately equal pieces (usually halves).

This allows dosage flexibility, it also enables a patient to take a product at


a strength that is not otherwise available, for economic reasons, and for
patients who are unable to swallow intact solid dosage forms.

However, it can not be used for all tablets.

Which types of tablets should not be cut? And why? (subgroup


homework)
Subgroup Homework
Acetaminophen Drops
Disp. 15 mL
Sig. 0.5 mL t.i.d.
(a) If acetaminophen drops contain 1.5 g of acetaminophen per 15 mL
container, how many micrograms are there in each prescribed dose?
(b) If the dropper is calibrated to deliver 22 drops/mL, how many
drops should be administered according to the direction to patient?
Special Dosing Regimens
Some drugs need to be taken in different doses in different period of time
during the dose regimen.

The tablets of these drugs are usually color coded and packaged in
special dispensers to facilitate compliance.

Examples of special dosing regimens are Hormonal tablets as


contraceptives and chemotherapeutics.
Example

The ORTHO TRI-CYCLEN LO 28-day regimen consists of norgestimate (N),


ethinyl estradiol (EE), and nonmedicated tablets as follows:

7 white tablets containing 0.18 mg (N), 0.025 mg (EE)

7 light blue tablets containing 0.215 mg (N), 0.025 mg (EE);

7 dark blue tablets containing 0.25 mg (N), 0.025 mg (EE);

7 green tablets containing 0 mg (N), 0 mg (EE).

How many milligrams each of norgestimate and ethinyl estradiol are taken
during each 28-day cycle?
Answer
Norgestimate (N): 0.18 mg * 7 = 1.26 mg

0.215 mg * 7 = 1.505 mg

0.25 mg * 7 = 1.75 mg

0 mg * 7 = 0 mg

So (N) = 1.26 + 1.505 + 1.75 = 4.515 mg taken in 28 days cycle

Ethinyl estradiol (EE): 0.025 mg * 21 = 0.525 mg

0 mg * 7 = 0 mg

So (EE) = 0.525 mg taken in 28 days cycle


Practice Problems

All practice problems in page 115, 116, and 117, except practice

problems no. 5 and 7.

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