8

SECTION I

PHARMACEUTICAL PRACTICE

INTRAVENOUS INFUSIONS, PARENTERAL

ADMIXTURES, AND FLOW RATES
Intravenous infusions are large volumes of sterile,
aqueous preparations administered intravenously
(through a vein) over an extended period of time.

Example:
An order is written for 25,000 units of heparin in 250 mL of
D5W to infuse at 2000 units/hr. What is the correct rate of
the infusion (in mL/hr)?

Solution:
Concentration of IV
IV rate
Concentration of IV

Total amount of drug

Total volume
Dose desired
Concentration of IV
25;000 units of heparin
250 mL of D5W

Concentration of IV 100 units=mL of heparin

2000 units=hr
IV rate
100 units=mL
IV rate 20 mL=hr

References
Ansel H, Stoklosa M: Pharmaceutical Calculations, ed 12,
Baltimore, MD, 2005, Lippincott Williams & Wilkins.
Bhatt SHL: Aminoglycoside Pharmacokinetics and
Therapeutics, MCPHS Boston Campus, MA, 2006, White
Hall.
Institute of the Certification of Pharmacy Technicians
(ICPT): ExCPT Exam for the Certification of Pharmacy
Technicians. Available at http://www.nationaltechexam.
org/pdf/math_questions-answers070618.pdf, Accessed
December 24, 2008.
London, Eastern and South East Specialist Pharmacy
Services. Available at http://www.londonpharmacy.nhs.
uk/educationandtraining/prereg/supportMaterial/
calculations/download/Calculations%20WorkBook%
202005.pdf, Accessed December 24, 2008.
Pearson J, Powers M: Systematically Initiating Insulin. The
Staged Diabetes Management Approach, Diabetes Educ
32(Suppl 1):23s, 2006.
Shargel L: Applied Biopharmaceutics & Pharmacokinetics,
New York, 2005, McGraw-Hill Medical Publishing
Division, pp 4346.
Zatz J: Pharmaceutical Calculations, ed 4, Hoboken, NJ,
2005, John Wiley & Sons, Inc, pp 3033.
Mosteller RD: Simplified Calculation of Body Surface Area,
N Engl J Med 317:1098, (letter) 1987.

Parenteral admixtures are a sterile preparation that involves

the combination of one or more drugs to large-volume.

REVIEW QUESTIONS

Example:

(Answers and Rationales on page 313.)

A patient weighs 170 pounds. A pharmacist receives a

prescription order for 0.25 mg amphotericin B per
kilogram body weight. How many milliliters of a 25 mg/
10 mL solution are needed to supply the dose, which will
then be diluted in 500 mL of 5% dextrose?

Solution:
170 lb
77 kg patient
2:2 lb
0:25 mg  77 kg 19:25 mg dose needed
25 mg
10 mL

19:25 mg
X mL
X 7:7 mL, answer
Calculating IV flow or drip rates are necessary to ensure
that the patient is receiving the desired amount of drug
that was ordered.

Example:
If 20 mg of drug is added to a 750 mL parenteral fluid, what
flow rate, in millilters per hour, will deliver 2 mg of drug
per hour?

Solution:
20 mg 750 mL

2 mg
X mL
X 75 mL per hour, answer

1. A patient is prescribed 10 mEq of potassium daily.

The source of potassium chloride in the pharmacy
is 5 mEq/mL in 1 mL vials. How many vials per day is
needed for the patient?
a. 0.5 vial
b. 1 vial
c. 2 vials
d. 1.5 vials
2. How much elemental iron is present in every
150 mg of ferrous sulfate (FeSO4  7H2O)?
(Atomic weights are iron 55.9; sulfur 32.1;
oxygen 16.0; and hydrogen 1.0. Iron has
valences of 2 and 3)
a. 25 mg
b. 30 mg
c. 48 mg
d. 54 mg
e. 60 mg
3. A 130-lb patient has a creatinine clearance rate
of 40 mL/min. Assuming Drug X is eliminated
exclusively by renal mechanisms, what maintenance
dose should be administered if the normal
maintenance dose is 3 mg/lb of body weight?
a. 50 mg
b. 100 mg
c. 150 mg
d. 200 mg
e. 250 mg