PRESCRIPTION PRICING Mark-up Margin of profit (gross profit) Difference between the cost of merchandise and its selling

ing price Example Pharmacist buys an article P10.50 Sells it for P13.50 Mark-up (gross profit) P3.50 Percentage mark-up (% gross profit) Mark-up (gross profit) divided by the selling price Methods of Prescription Pricing % mark-up method % mark-up = cost of ingredients + (cost of ingredients x % mark-up) Mark-up + minimum fee Cost of ingredients + (cost of ingredients x % mark-up) + minimum fee Professional fee method Cost of ingredients + professional fee Given: Dispensing fee P13.50 Cost of ingredients P10.50 Find: % mark-up 13.50 = 10.50 + (10.50x) 13.50 10.50 = 10.50x X = 29% % Mark-up Cost Profit Customer (Volume Sales) 5 DOWN DOWN UP 10 20 UP UP DOWN Medicines with low cost increase mark-up (Cortal, Medicol) % Mark-up If the cost of quantity of drug product to be dispensed is P4.00 and the pharmacist applies an 80% mark-up on cost, what would be the prescription price? 4.00 + (4.00 x 80%) 4.00 + 3.20 P7.20 % Mark-up and Minimum Fee If the cost of quantity of a drug product to be dispensed is P4.00 and the pharmacist applies 40% mark-up on cost plus a professional fee of P2.25, what is the prescription price? 4.00 + (4.00 x 40%) + 2.25 4.00 + 1.60 + 2.25 P7.85

Professional Fee Averaging the amount previously charged, above the cost of ingredients, for prescription dispensed over a specified period of time Using a more exacting cost analysis method in which all costs attributed to the Rx dept. are divided by the Rx volume in determining the actual cost of filling a Rx, with the profit & desired fee then determined. Pharmacies utilizing the professional fee - Commonly make adjustments for Rxs requiring compounding to compensate for the extra time, materials & equipment (includes the packaging/Rx bottle) utilized If the cost of quantity of a drug product to be dispensed is P4.00 and the pharmacist utilizes a professional fee of P4.25, what is the prescription price? 4.00 + 4.25 = P8.25 There should only one (1) professional fee in all prescriptions. Includes all dispensing costs and professional remuneration True professional fee o Independent of the cost of ingredient o Does not vary from one prescription to another Variable or sliding professional fee Fee is varied based on the cost of ingredients. Increase cost of the ingredients means an increase in the professional fee Cost of inventory maintenance must be recovered Cheaper ingredients low professional fee

Example: NH4Cl (7g) P400.00 per kg NaHCO3 (6g) P390.00 per kg Lemon syrup (50mL) P350.00 per liter Purified water, q.s. ad P20.00 per liter Sig. One (1) tablespoonful every four (4) hours Prescription bottle P60.00 per dozen Minimum fee P35.50 % mark-up 20% Professional fee P50.00 Calculate for the: a. Dispensing price based professional fees b. Dose of NH4Cl c. Daily dose of NH4Cl d. No. of doses in preparation

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7.0g:x = 1000g:P400 x = P2.80 NH4Cl 6.0g:x = 1000g:P390 x = P2.34 Na benzoate 50.0mL:x = 1000mL:P350 x = P17.50 lemon syrup 120-50:x = 1000mL:P20 x = P1.40 purified H2O Total: P24.40 (cost of ingredients) Bottle P60/12 = P 5.00 A. %Mark-up plus Minimum Professional Fee D.P. = cost of ing. + (cost of ing. X %mark-up) + minimum fee = P24.04 + (P24.04 x 20%) + P35.00 = P63.85 Professional Fee D.P. = cost of ing. + professional fee = P24.04 + P50 = P74.04 B. Dose of NH4Cl: 1 dose = 1 tbspful 7:0g:120mL = x:15mL x = 0.875 g NH4Cl C. Daily dose of NH4Cl: 0.875x6 = 5.25g NH4Cl/day (one tbsp. every 4 hours) D. No. of doses in preparation: 120/15 = 8 doses *If the dose is ex 7.8 = 7 doses

Price Code Composed of any word letter consisting of letters VOLUMETRIC 12345678910 BLACKSMITH 12345678910

PERCENTAGE USP states: % concentrations of soultions are expressed as: %w/w for solids %w/v for solutions of liquids in solids %v/v for gases in liquids; liquids in liquids Percentage Concentration Weight-in-volume Examples of Applicable Dosage Forms Solutions (e.g. opthalmic, otic, topical) Lotions Sprays Aromatic waters Lotions Ointments Creams Suppositories

Weight-in-weight Percentages 480gr in an apothecary ounce (480gr/ fluid ounce) Density is considered in some problems Since solutions are made to be given by weight, a given volume is not always obtainable 2 ounce does not equal to 2 fluid ounce and 100 g of solution does not equal 100mL Equation used to calculate the grains of solute required: 480gr/ounce x % (decimal) x no. of ounce = gr solute required No. of gr (solute) = (480gr solute/1 ounce) x % (decimal) x no. of ounce (soln.) Example: How many grams of a chemical are needed to prepare 30g of a 15% w/w solution? 15g / 100g = x/ 300g x = 45 grams solute needed * NOTE: Compounding problems involving solid preparations (such as mixtures of powders) and semi-solid preparations (ointments, creams, suppositories) are also percent w/w. Volume-in-volume Percentages Basis: 480 minims = 1 fluid ounce may be used: No. of minims of drug = (480minims/fluid ounce) x %(decimal) x no. of fluid ounce Example: How much of a liquid is needed to make 6 fluiod ounces of a hand lotion containing 0.5 %v/v of the liquid? 480minims/fluid ounce x % (decimal) x no. of fluid ounce = minims of drug 480minims/fluid ounce x 0.005 x 6 fluid ounces = 14.4 minims of liquid needed * Add sufficient lotion to 14. 4minims of the liquid to make 6 fluid ounces of the product.

SAMPLE PROBLEMS: 1. How many grams of a drug are needed to prepare 120mL of a 0.25% w/v solution? 120mL x (0.25g/100mL) = 0.30 grams 2. How many mL of a 3% v/v Rx can be compounded from 2mL of active ingredient? 2mL x (100mL/3mL) = 66.67 mL 3. How many grams fo a drug will be needed to prepare 5.0 kg of a 10%w/w solution? 5000g x (10g/100g) = 500 grams 4. How many ounce of a compound can be prepared from 0.47gram of a 15% w/v solution? 0.47g x (100mL/15g) = 3.13mL 3.13mL x (16.23 oz/1mL) = 50.8 ounce 5. A cough syrup contains 2.5grams of an expectorant per 100mL. How many grains of the expectorant are present in a tbspful? 15mL x (2.5g/100mL) = 0.375g 0.375g x (15.42 gr/1g) = 5.79 grains 6. How may grains of the drug are required to make 5 fluid ounce of a 40%w/v solution?

Volume-in-volume Weight-in-weight

%w/w = g solute / 100g solution %w/v = g solute / 100mL solution %v/v = mL solutie / 100mL solution Weight-in-volume Percentages Bases: 1 apoth ounce of solvent weighs 455gr or 1mL of solvent weighs 1g Density of the solvent or solution is NOT reuqired and assumed to be one No. of gr (solute) = (455gr solute/1 fluid ounce solution) x %w/v (decimal) x no. of fluid ounce (solution) Example: Prepare 1 fluid ounce of a 20% solution of a solid in liquid w/v solution. 455gr / fluid ounce taken as the base

(455gr/1fluid ounce) x (40/100) x 5 fluid ounce) = 910 grains 7. How many fluid ounce of a 26.5% v/v solution can be prepared from 850 oz. of a liquid?

455gr /fluidounce x %w/v (decimal) x no. of fluid ounce = grain solute 455gr/fluidounce x 0.20 x 1 fluido ounce = 91.0gr solute * 91.0 gr is dissolved in sufficient purified water to make 1 fluid ounce of solution

850 oz / [(480oz/1 fluid ounce) x (26.5%/100)] = 6.68 fluid ounce 8. 1550 grains fo a chemical are needed to prepare 15 ounce of an ointment. Calculate the % of the ointment.

{1550 gr / [(480gr x 15 fluidounce)/1 fluidounce] } x 100 = 21.53%

STOCK SOLUTIONS Concentrated solutions containing the higer concentration of active ingredient Portions are diluted to give required solutions of lesser strenth Properly labled and fractional parts needed to make various strengths Advantage: easier compounding SAMPLE PROBLEMS: 1. How many grams of a salt are required to make 120mL of a stock solution, 5mL of which makes 1:2000 solution when diluted to 500mL? Determine how many grams are in 500mL of a 1:2000 solution 1g:2000mL = x:500mL x = 0.25 grams salt in 500mL of a 1:2000 solution The 0.25grams in the dilute solution came from the 5mL of the original stock solution (Rx order). The following proportion can be used: 0.25g:5mL = x:120mL x = 6 grams salt needed to make the original 120mL of the stock solution 2. How much of a drug is needed to copmpound 400mL of a stock solution such that when 1tspful of solutions is diluted to 1 quart, 1:600 solution results? 1 tspful (5mL) 1 quart (946mL) = 1:600 solution 1g:600mL = x:946mL x = 1.58 grams 1.58g:5mL = x:40mL x = 126.4 grams 3. How many of a drug are needed to make 200mL of solution of such strength that when 1 dessert spoonful is diluted to 5 pints, a 1:2500 solution results? 1 pt = 473mL 5 pt = 2365mL 1 dessertspoonful = 8mL 1g:2500mL = x:2365mL x = 0.946 grams 0.946g:8mL = x:200mL x = 23.65 grams

MIXING DIFFERENT STRENGTHS Rules: Th sum of the products obtained by multiplying a series of quantities by their respective concentrations = product obtanined by multiplying a concentration by the sum of the quantities When mixing products of various strengths, the units and type of percent must be kept constants SAMPLE PROBLEMS: 1. What is the percent alcohol in a mixture made by mixing 5 liters of a 15%, 1 liter of 40% and 1 liter of 95% alocohol? Determine the total amount of alcohol in the solutions and the total amount of solution Assume additivity of volumes on mixing: 0.15 x 5000mL = 750mL 0.40 x 1000mL = 400mL 0.95 x 1000mL = 950mL ------------- -----------Total: 7000mL 2100mL Determine the % of alcohol in the mixture. There is a total of 2100mL of alcohol in 7000mL of the total solution. 2100mL:7000mL = x:100mL x = 30mL * Because 30mL of alcohol are in 100mL, a 30% of solution is formed. or (2100mL/7000mL) x 100 = 30%

POSOLOGY Dose for children o Regulated according to the age or weight, a fraction of the adult dose being given Rules for Infants and Childrens Doses a. Youngs Rule (for children 2 years and older) Childs Dose = (Age (yr) / Age (yr) + 12) x adult dose b. Clarks Rule Childs Dose = (Weight (lb) / 150) x adult dose c. Frieds Rule (for infants up to 2 years old Infants Dose = (Age (months) / 150) x adult dose

2.

What % of a drug contained in a mixture of powder consisting of 300 grams containing 0.042%w/w of a drug and 2000 grams containing 0.057%w/w? 0.00042 x 300 grams = 0.126 grams 0.-00057 x 2000 grams = 1.14 grams 300 grams + 2000 grams = 2300 grams 0.126 grams + 1.14 grams = 1.266 grams %w/w = (1.266g/2300g) x 100 = 0.055%

RULES FOR CALCULATING DOSAGE ON Rx ORDERS Amount of an ingredient/dose in a compound Rx = total amount of ingredients prescribed / no. of doses Total amt of ingredients used to compound a Rx order = amount or dose prescribed x total no. of doses On Rx orders, when the instructions to the pharmacist include the expression D.T.D. No. (i.e send..such doses) = dose or amt of drug x no. indicated in the DTD No The Square Meter Surface Area Method relates the surface area of individuals to dose, It is thought that this may be a more realistic way of relating dosages Childs dose = (BSA of child/BSA of adult) x adult dose * BSA = Body Surface Area The average body surface area for an adult has been given as 1.73m2; hence, Childs dose = (BSA of child (m 3)/1.73m2) x adult dose Many drugs have doses stated as so much drug/m 2 body surface area and may be calculated as follows: Individuals dose = amt of drug/m2 x BSA (m2) Drug dose are often stated in mg/kg body weight and may be calculated as follows: Individuals dose = amt of dose in mg/kg x BW (kg) * BW = body weight Drug doses may also be stated in unites (Internation Units IU) e.g. Vitamin A and D, antibiotics, and hormones Means that a certain quantity of biologic acitivity of that drug si called one (1) unit Term unit is used in connection with a drug Calculations involved are the same as those for more familiar weight or volume notations USP often standardizes the unit for such drugs so that the sexrpession USP units is used Calculated based on a USP assay procedure and a reference standard

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SAMPLE PROBLEMS: 1. 24 capsules of AtSO4 each to contain 1/250 grain are to be made. How many tablets of AtSO4 0.5mg are needed to compound the Rx? 1/250 grains = 0.004 grains 0.004 grains x 65mg/1g = 0.26mg 0.26mg x 24 capsules = 6.24mg 6.24mg x tab/0.5mg = 12.48 or 13 tablets 2. An antibiotic is available as an ingredient containing 40mg/mL. How many mL are needed for a child weighing 35kg, the dose being 2.4mg/kg BW? 2.4mg:1kg = x:35kg x = 84mg 40mg:1mL = 84mg:x x = 2.1mL