Naplex-Required Formulas (calculations sheet)

1 tsp = ? mL

5 mL

1 tablespoon= ? mL

15 mL

1 cup= ? oz

8 oz

1 pint= ? OZ

16 oz

1 quart

**946 mL (actual)

2 pints

960 mL (approx)

1 gallon

4 quarts

1 kg = ? lbs

2.2 lbs

1 oz= ? grams

28.4 grams

1 lb = ? Grams

454 grams

1 grain = ? mg

65mg (approximately)

64.8 mg (actual)

me1:mmol

1:1 for monovalent ions

1:0.5 for divalent ion

1 inch = ? cm

2.54cm

1 Meter= ______ Centimeters?

100 centimeters

Percentage Strength

%w/v: X(g)/100ml

%w/w: X(g)/100g

%v/v: X (ml)/100ml

ratio strength

percentage strength= 100/ratio strength

Ratio Strength= 100/percentage strength

PPM(Parts Per Million)--> Percentage Strength

Move decimal left 4 places

Percentage Strength--> PPM (Parts Per Million)

Move the decimal RIGHT 4 places

Specific Gravity

SG= weight of substance (g)/weight of equal volume of water (g) OR g/ml

Dilution & Concentration (changing strength or volume)

Q1 x C1= Q2 x C2

Q1= Old Quantity

C1= Old Concentration

Q2= New Quantity

C2= New Concentration

Alligation

High % X Parts of High %

Desired %

Low % X parts of Low %

Osmalarity

mOsmol/L

wt of substance(g/L)/MW(g/mole)x (# of particles)x 1000

Compound

1**

Dextrose

Mannitol

2**

Potassium Chloride (KCL)

Sodium chloride (NaCl)

Sodium Acetate (NaC2H3O2)

Mag Sulfate (MgSO4)

3**

Calcium Chloride (CaCl2)

4**

Sodium citrate (NaC6H5O7)

Isotonicity (Evalue)

E= 58.5(i)/MW of Drug (1.8) # of dissociated ions/ I value 1- 1 2-1.8 3-2.6 4-3.4 5-4.2

Moles or Millimoles

mols= g/MW mmols=mg/MW

Milliequivalent

mEq = (mg x valence)/MW or mEq= mmols x Valence

Compound

1**

Ammonium chloride (NH4CL)

Potassium chloride (KCL)

Potassium gluconate (KC6H11O7)

Sodium acetate (NaC2H3O2)

Sodium Bicarb (NaHCO3)

Sodium Chloride (NaCl)

2**

Calcium carbonate (CaCO3)

Calcium Chloride (CaCl2)

Ferrous Sulfate (FeSO4)

Magnesium Sulfate (MgSO4)

Corrected Calcium for Albumin < 3.5 (not needed with ionized Ca)

CAcorrected (mg/dl)= Calcium (reported serum) + ((4.0-albumin)x(0.8))

Parenteral Nutrition Calories

Dextrose Monohydrate= 3.4kcal/gram

Amino Acid Solutions= 4kcal/gram

ILE 10%= 1.1 kcal/ml

ILE 20%= 2 kcal/ml

ILE 30%= 3 kcal/ml

Enteral Nutrition

Carbs, Protein= 4 kcal/gram

Fat= 9kcal/gram

Determining Fluid Needs

When weight > 20 kg: 1500+(20ml)(weight in kg-20)

Total Energy Expenditure

TEE=BEE x activity factor x stress factor

Grams of Nitrogen From Protein

Nitrogen (g) = Protein intake(g)/ 6.25

Cockcroft-Gault equation

140-age x IBW/(72 x Scr)

Body Mass Index (BMI)

weight (kg)/ height (m) OR weight (lb)/ height (inches) x 703

Ideal Body Weight

IBW(males)= 50 kg+ (2.3 kg x in >5 ft)

IBW(females)= 45.5kg + (2.3 kg x in > 5ft)

Adjusted Body Weight

IBW + 0.4(TBW-IBW)

Selecting Patients Weights

All Drugs (if underweight)= TBW

Most Drugs (if normal weight or obese) = TBW

Exceptions

Acyclovir, Aminophylline, Levothyroxine, Theophylline (normal weight, obese) = IBW

Aminoglycosides= AdjBW

Flow Rates Drop Factor (drops/min)

(# drops/ml) x (ml/hr) x (hr/60 min)= # drops/ min

Dehydration

BUN: SCr >20:1

Arterial Blood Gas

ABG: pH/pCO2/pO2/HCO3/)02sat

1. pH<7.35 --> Acidosis

pH> 7.45 --> Alkalosis

2.

Respiratory:

pCO2> 35 --> Acidosis

pCO2 < 35 --> Alkalosis

Metabolic

HCO3 <22 --> Acidosis

HCO3 >26 --> Alkalosis

Anion Gap (AG)

NA-Cl-HCo3

ph Calculations

Weak Acid

pH = pKa + log (salt/acid)

Weak Base

pH = pKa + log (base/salt)

pH>pKa more of the acid is ionized

pH=pKA the ionized and un-ionized forms are equal

pH

Percent Ionization

Weak Acid % ionization= 100/ (1+10Pka-pH) Weak Base % ionization= 100/(1+10pH-pKa)

Temperature Conversions

C= (F-32)/1.8

F=(Cx1.8)+ 32

Biostatistics

Mean= Average Value

Median= value in the middle of an ordered list

Mode= value that occurs most frequently

Risk (R), Risk Ratio(RR), Relative Risk Reduction (RRR), Absolute Risk Reduction (ARR)

R=(# of subjects with unfavorable event)/ (total # of subjects in group)

RR= (risk in treatment group)/ (risk in control group)

RRR= (% risk in control group- % risk in treatment group)/(% risk in the control group)

ARR= (% risk in control group)-(% risk in treatment group)

NNT/NNH

1/ ARR(decimal)

ODDS ratio

ad/bc

Hazard Ratio

(hazard rate in tx group)/(hazard rate in the control group)

Sensitivity and Specificity

Sensitivity (A/(A+C)x100

Specificity= (D/(B+D)x100

Time To Burn

TTB (with sunscreen in min)= SPF x TTB (without screen)

Initiating Basal- Bolus Insulin Type 1 Diabetes

1. Calc TDD 0.6 units/kg/day using TBW

2. Divide into 1/2 basal & 1/2 rapid acting. If using NPH/R use 2/3 & 1/3

3. Split rapid-acting among meals

Insulin-to-carbohydrate ratio: Rule of 500 for Rapid acting insulin

500/TDD= grams of carb covered by 1 unit of rapid-acting insulin

Insulin-to-Carbohydrate Ratio: Rule of 450

450/TDD= grams of carbohydrate covered by 1 unit of REGULAR INSULIN

Correction Factor: 1,800 Rule

1,800/TDD= correction factor for 1 unit of

RAPID ACTING insulin

Non-Sterile Compounding- MWQ

MWQ= Sensitivity Requirement/0.05

Oncology II- BSA calculation

Sq Root Ht(cm) x Wt (kg)/ 3,600

Volume of Distribution

Vd = (amount of drug in the body) / (plasma drug concentration)

Clearance

Cl= (Fx Dose)/AUC OR Cl= Ke x VD

Elimination Rate Constant

KE= Cl/Vd

Predicting Drug Concentrations

C2= C1x (e-kt)

Ke=ln(C1/C2)/t

Half-Life (t1/2)

t(1/2)=0.693/ke

LD

Desired Concentration X VD/ F

Phenytoin Correction for Albumin <2.5

phenytoincorrected (mcg/ml)= total phenytoin measured/ (0.2x albumin)+ 0.1

Dose Conversions- KCL solution (oral) to tablets

KCL 10%= 20 mEq/15ml

KCL 20%= 40 mEq/15ml

Calcium Salta

Calcium Carbonate= 40% elemental calcium

Calcium Citrate= 21% elemental calcium

Aminophylline <-->Theophylline

Aminophylline x 0.8 = Theophylline

(Aminophylline to Theophylline: Multiply by 0.8 i.e ATM)

Theophylline to Aminophylline: Divide by 0.8

Loop Diuretics

Ethacrynic acid = 50

Furosemide = 40

Torsemide = 20

Bumetanide = 1

Furosemide IV: PO 2:1

Other Loops VI:PO 1:1

Metoprolol Conversions

IV: PO 1:2.5

Iron, Elemental Conversions

Ferrous Sulfate= 20% elemental iron (e.g 325 mg x 0.2)

Insulin conversions

Usually 1:1 conversion

Exceptions:

NPH dosed BID --> glargine dosed daily, use 80% of NPH dose

Toujeo--> Lantus or Basaglar, use 80% of Toujeo dose

Steroids

Cortisone = 25 mg

Hydrocortisone = 20 mg

Prednisone = 5 mg

Prednisolone =5 mg

Methylprednisolone =4 mg

Triamcinolone = 4 mg

Dexamethasone = 0.75mg

Betamethasone = 0.6 mg

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Statins

Pitavastatin = 2mg

Rosuvastatin = 5 mg

Atorvastatin = 10 mg

Simvastatin = 20 mg

Lovastatin = 40 mg

Pravastatin = 40 mg

Fluvastatin = 80 mg

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Insulin-to-carbohydrate ratio: Rule of 500 for

500/ TDD= grams of carbs covered by 1 unit of *RAPID ACTING*

Insulin-to-carbohydrate ratio: Rule of 450

450/TDD= grams of carbohydrate covered by 1 unit of *REGULAR INSULIN*

Correction Factor: 1,800 Rule for

1,800/Tdd= correction factor for 1 unity of rapid acting insulin *RAPID ACTING*

Correction Factor: 1,500 Rule for

1,500/TDD=Correction factor for 1 unit of *REGULAR INSULIN*

Correction Dose

(blood glucose now)-(target blood glucose) / correction factor= correction dose

Dyslipidemia Friedewald Equation

LDL= TC-HDL-(TG/5) *do not use if TG> 400

Bioavaliability

F(%)= 100 x (AUCextravascular/ACUiv) x (Dose intravenous/dosextavascular)

Elimination Rate Constatn

Ke= Cl/VD

Absolute Neutrophil Count (ANC)

WBC x ((%segs+ %bands)/100)