Systems of Measurement

Metric Equivalencies for Weight 1 kilogram = 1000 g 1 gram = 1000 mg 1 miligram = 1000 mcg

When converting within the metric system, you can simply move the decimal point three places to the left or right, depending whether you are changing to a larger or smaller unit of measure. The method I have found useful is to consider the alphabet: The letter L represents larger unit, the letter S represent smaller unit. To convert from large to small, the decimal moves three places in the direction you move from L to S, or to the right. Example 1 illustrates that move. To convert from a smaller unit to a larger one, the decimal moves three places in the direction you move from S to L, or to the left. Example 2 illustrates that move. Example 1: change 200mg to mcg 200 mg goes to 200,000mcg Example 2: change 200mg to g 200. 0 mg goes to 0.2 g Metric Abbreviations for Volume liter L milliliter mL Metric Equivalencies for Volume 1000 mL =1L The Apothecary System uses grains, drams and ounces as units of weight. Lowercase Roman numerals are used when amounts are greater than one; fractions are used when amounts are less than one. The abbreviation precedes the amount, for example, grains x or grains 1/150. One-half may be expressed as ss, thus: iiiss = 3 1/2. Apothecary Abbreviations grain dram ounce gr dr oz

Equivalencies that should be memorized when converting from apothecary to metric are: Apothecary & Metric Equivalencies 1 ounce 30 mL 1 dram 4 mL 1 grain 60 mg

Household measures are commonly used to measure medications at home. Abbreviations and equivalencies follow. Equivalencies

Household Measure Abbreviation Metric Measure Apothecary Measure 1 cup C 1 C = 240 mL = 8 oz 1 tablespoon T (tbs) 1 T = 15 mL 1 teaspoon t (tsp) 1 t = 5 mL drop gtt depends on size of drop pound lb 2.2 lb = 1 kg 1 lb = 16 oz

The Five Rights Remember the five rights: The minimum standard of practice for medication administration is checking the five rights to provide patient safety. 1. Do I have the right drug? 2. Do I have the right patient? 3. Do I have the right dose? 4. Do I have the right time? 5. Do I have the right route? Now add to this the sixth right...the right to refuse! The 3 Checks The three checks prior to Administration of Medications are: 1. taking medication off shelf 2. taking out medication 3. putting medication back on shelf US Liquid Measurements and Metric Fluid Measures U.S. Liquid 1 drop (gtt) 15 drops (gtts) 1 teaspoon (tsp) 1 tablespoon (Tbsp) 1 ounce (oz) 1 cup (c) 1 pint 1 quart 4 cups (c) Length 2.5 centimeters = 1 inch Centigrade/Fahrenheit Conversions C = (F - 32) X 5/9 F = (C X 9/5) + 32 Metric = .06 milliliter (ml) = 1 milliliter (ml) = 5 milliliters (ml) = 15 milliliters (ml) = 30 milliliters (ml) = 240 milliliters (ml) = 480 milliliters (ml) = 960 milliliters (ml) = 960 milliliters (ml)

Conversion Table

WEIGHTS AND MEASURES CONVERSION TABLE

METRIC WEIGHT MEASURE 1 Kilogram (Kg) = 100 grams (Gm) 1 Gram (Gm) 1 Gram (Gm) = .001kilogram (Kg) 1 Gram = 1000 milligrams (mg) 1 Milligram (mg) = .001 gram (Gm) 1 Milligram = 1000 Microgams (mcg) 1 Microgram (Mcg) = .001 Milligram (mg) METRIC FLUID MEASURE 1 Liter (L) = 1000 milliters (ml) 1 Milliliter (ml) = .001 liter (L) 1 Milliliter (ml) = 1 cubic centimeter APOTHECARY WEIGHT TO METRIC SYSTEM 1 grain (gr) = .065 gram = 60 milligrams (sometimes considered to be 64 to 65 milligrams) WEIGHT CONVERSION 1 kg = 2.2 lbs Basic Formula, flow rates, & infusion time Review Basic Formula Desired Dose x VOLUMEDose on Hand = VOLUMEDesired
Dose

Infusion Time Infusion Time = Total Volume to be Infused mL/hr being infused Infusion Time = Total Volume to Infuse gtt / min x 60 mi Set calibration

Dose on Hand or D xV=A H Flow Rates (gtt/min) Flow Rate (gtt/mL) Time (min) Flow Rate = mL/hr Division Factor Division Factor = 60 calibration = Total Volume (mL) x Set Calibration

Pediatric Dosage Calculations Most drugs in children are dosed according to body weight (mg/kg) or body surface area (BSA) (mg/m2). Care must be taken to properly convert body weight from pounds to kilograms (1 kg= 2.2 lb) before calculating doses based on body weight. Doses are often expressed as mg/kg/day or mg/kg/dose, therefore orders written "mg/kg/d" which is confusing, require further clarification from the prescriber. Chemotherapeutic drugs are commonly dosed according to body surface area which requires an extra verification step (BSA calculation) prior to dosing. Medications are available in multiple concentrations, therefore orders written in "mL" rather than "mg" are not acceptable and require further clarification. Dosing also varies by indication, therefore diagnostic information is helpful when calculating doses. The following examples are typically encountered when dosing medication in children.
Example 1. Calculate the dose of amoxicillin suspension in mLs for otitis media for a 1-yr-old child weighing 22 lb. The dose required is 40 mg/kg/day divided BID and the suspension comes in a concentration of 400 mg/5 mL. Step 1. Convert pounds to kg: Step 2. Calculate the dose in mg: Step 3. Divide the dose by the frequency: Step 4. Convert the mg dose to mL: 22 lb 1 kg/2.2 lb = 10 kg 10 kg 40 mg/kg/day = 400 mg/day 400 mg/day 2 (BID) = 200 mg/dose BID 200 mg/dose 400 mg/5 mL = 2.5 mL BID

Example 3. Calculate the dose of vincristine in mLs for a 4-yrold with leukemia weighing 37 lb and is 97 cm tall. The dose required in 2 mg/m2 and the drug comes in 1 mg/mL concentration. Step 1. Convert pounds to kg: Step 2. Calculate BSA (see Body Surface Area Nomograms): Step 3. Calculate the dose in mg: Step 4. Calculate the dose in mL: 37 lb 1 kg/2.2 lb = 16.8 kg 16.8 kg 97 cm/3600 = 0.67 m2 2 mg/m2 0.67 m2 = 1.34 mg 1.34 mg 1 mg/mL = 1.34 mg

Example 2. Calculate the dose of ceftriaxone in mLs for meningitis for a 5-yr-old weighing 18 kg. The dose required is 100 mg/kg/day given IV once daily and the drug comes pre-diluted in a concentration of 40 mg/mL. Step 1. Calculate the dose in mg: Step 2. Divide the dose by the frequency: 18 kg 100 mg/kg/day = 1800 mg/day 1800 mg/day 1 (daily) = 1800 mg/dose

Step 3. Convert the mg 1800 mg/dose 40 dose to mL: mg/mL = 45 mL once daily