DISPENSING PRICE

CALCULATIONS

Formulas
DP = cost of ingredient + (cost of
ing x % mark-up) + minimum fee
DP = cost of ingredient + (cost of
ing x % mark-up)
DP = cost of ingredient +
professional/dispensing/compound
ing fee

 The pharmacy department

compounded 30 pieces of cough
syrups. Total cost of the ingredient
per syrup is P 60.00. The pharmacist
used bottles which cost P 15.00
each. Each bottle has its own label
P 10.00/label. If a 20% mark-up was
added, compute for the dispensing
price of the products with % mark-up
and minimum fee.

 The pharmacy department

compounded 30 pieces of cough
syrups. Total cost of the ingredient
per syrup is P 60.00. The pharmacist
used bottles which cost P 15.00
each. Each bottle has its own label
P 10.00/label. If a 20% mark-up was
added, compute for the dispensing
price of the products with % mark-up
and minimum fee.

 A prescription order calls for 35

pieces paper tablets. All the items
will be placed in one paper envelope.
Compute for the dispensing price
given the following data:
Antihypertensive drug/pptab = P 25.00
Paper envelope = P12.75/envelope
Glassine paper = P3.50/paper
+ 50% mark-up

 The prescription calls for 500 mg of

Drug B per capsule, 1 capsule four
times a day for 3 days. The standard
dispensing fee for pharmacy is P5.50
per capsule. What is the dispensing
price of the Drug B capsules if one
capsule of Drug B 1000mg costs
P10.75?

 Rx order: 15 pcs of 500mg Drug A capsule

Acquisition cost of ingredient: Drug A the
quantity purchased from Company B is
P1,500 per 50g.
Empty capsule shells P3.00/capsule shell
60mL wide-mouthed amber bottle
P15.00/bottle
** 15 capsules should be placed in one
bottle. Add 10% mark-up

IV ADMIXTURES AND IV
INFUSIONS

 40% of all drugs administered in

hospitals are in the form of injections
and their use is increasing
due to the wider use of intravenous
fluids
fluid replacement, electrolyte-balance
restoration and supplementary nutrition
as vehicles for other substances and in
total parenteral nutrition

area of specialization
prepare solutions, recognizing their
compatibility and stability problems
and the potential for contamination
participate of an order for TPN
requires knowledgeable personnel
capable of working accurate
calculations, compounding and
having perfect aseptic technique

Intravenous Admixture
Programs
Preparation of sterile products and
assuring that all such products used in the
institution are:
(1) therapeutically and pharmaceutically
appropriate for the patient;
(2) free from microbial and pyrogenic
contaminants;
(3) free from unacceptable levels of particulate
and other toxic contaminants;
(4) correctly prepared, &
(5) properly labeled, stored and distributed

Intravenous Fluids
large volume parenterals to be administered
by intavenous infusion
also includes irrigation solutions and solutions for
dialysis
prepared with Water for Injection,
USP
Single-dose
pyrogen free

Feverproducing
substances

injections
100 mL or more
containing no
added
substances

Indications
1.
2.
3.
4.

correction of electrolyte imbalance

fluid replacement
means of providing basic nutrition
basis for the practice of providing
parenteral nutrition
5. vehicles for other drug substances

Examples of IV fluids

Dextrose 5%, 10% Injection

NaCl
NaCl Injection (0.9%, 0.45%)
Dextrose and NaCl Injection
CaCl
Ringers Injection
Lactated Ringers Injection
Lactated Ringers and Dextrose
Injection

KCl
Na
lacta
te

Intravenous Admixture
Sterile product produced when one or
more drugs are added to the IV
solution/fluid
Dru
gA

additives

IV
fluid
Dru
gB

IV Admixture

Types of IV Administration
IV injection/IV push

IV Infusion

small volume of
drugs/solution
1-50 mL
directly from a
syringe
short period of time
1-5 min
can be made through a
resealable Y-injection site
of an already hanging IV
fluid

larger volumes of
solution
permitted to flow into
the vein
over a long period of
time

IV Infusion
Indications:
dehydration
depleted blood volume
supply drugs and nutrients

May be administered in one of the

two ways:

Administering IV Infusion
1. Continuous infusion
Used to administer a large volume of solution
over several hours at a slow constant rate
40 mEq of KCl in 1000mL of 5% dextrose injection
over 8 hours

2. Intermittent infusion
Used to administer a relatively small volume
over a short time at specific intervals
1 g of ampicillin in 50 mL of 0.9% NaCl injection over
15-20 minutes every 6 hours

To calculate infusion time:

To calculate flow rate in drops/minute:

Three methods of intermittent

administration
1. Direct IV injection (IV bolus or push)
2. Addition of the drug to a
predetermined volume of fluid in a
volume-control device
3. Use of a second container (minibag,
minibottle) with an already hanging
IV fluid (piggybacking)

Direct IV Injection
Small volumes of drugs are injected
into the vein over a short period of
time
Injection also can be made through a
resealable Y injection site of an
already hanging IV fluid
Suitable for a limited number of
drugs but too hazardous for most
drugs

Volume-Control Chamber /
Soluset
infusion of drug
solutions in precise
quantities at
controlled rates of
flow
with calibrated,
plastic, fluid
chamber
(microcontainer)
placed in a direct
line
drug to be
administered is first
reconstituted
recommended only

Piggyback Method
two solutions with
common tubing and a
common venipuncture site
Primary solution
Secondary/piggyback
solution

eliminates the need for

another venipuncture

Intravenous Admixture
Incompatibilities
1. Physical occurs when two drugs are
combined in a solution to produce a
change in the appearance of that solution
2. Chemical occurs when two drugs react to
cause the chemical degradation of one or
both drugs
3. Therapeutic occurs when two or more
drugs are administered together to
produce a response which differs in nature
or intensity from that which was intended

Factors affecting
incompatibility:
1.
2.
3.
4.
5.
6.

pH of the admixture
complexation
light
degree of dilution
temperature
buffer capacity of the additive
solution
7. order of mixing

Adverse Reactions to
Intravenous Therapy
1. Infiltration
the accumulation of medication in the tissue which
causes pain, swelling, and occasionally abscess formation
2. 2. Pyrogens
by product of bacterial growth which cause fever and
chills in the patient
3. Phlebitis
the inflammation of the vein
symptoms include pain, heat, redness, and swelling of the
immediate area
if the inflammation is specifically associated with a blood clot, the
condition is called thrombophlebitis
if the thrombus is dislodged, it eventually become trapped in the
lungs, causing an obstruction in the circulation there

FACILITIES
Centralized admixture area
adjacent to the dispensing and orderprocessing areas to facilitate communication
designed for an efficient flow of orders
most frequently used drugs should be
conveniently accessible

EQUIPMENTS
Laminar Flow Hoods
reduce the risk of airborne contamination by
providing an ultraclean environment
IV admixtures, ophthalmic solutions, TPN, and
filling syringes
HEPA (high-efficiency particulate air) filter
filters air in a parallel flow at a velocity of 90 fpm
remove 99.97% of all particles larger than 0.3 m
movement of air may be in either horizontal or
vertical pattern

HORIZONTAL LFH
HEPA filter is
located at the
back of the hood
and the air flows
to the front

VERTICAL LFH
Air passes
through the HEPA
filter located on
top of the cabinet

EQUIPMENTS
Laminar Flow Hoods
not a means of sterilization
an area of proper aseptic techniques
DOP (dioctylphthalate) test
Test used to detect efficiency of the HEPA
filter
Should be done every 6 months

SUPPLIES

Administration Set
An administration set is attached to an
intravenous bottle or bag to deliver the
fluid into the patients vein
The sets may be standard (macrodrip)
or pediatric (microdrip)
Depending on the particular set used,
the drip rate can vary from 10 to 15
drops/mL for standard sets to 60
drops/mL for microdrip sets

Administration Set
Components:

Plastic spike
Drip chamber
PVC tubing
Needle or
catheter adapter
Adjustable clamp

Syringes
Tuberculin syringe
small syringe not
exceeding 1 mL in
capacity
0.1- or 0.01-mL
divisions

Hypodermic syringe
2- to 50-mL capacity

Parts:
Barrel tube that is
open at one end and
tapers into a hollow tip
at the other end
Plunger piston-type
rod with a slightly coneshaped tip that passes
inside the barrel

 Needles or Cannulas
Hollow devices composed of stainless
steel or plastic
Parts:
Shaft long, slender stem of the needle that
is beveled at one point
Lumen hollow bore of the needle shaft

Hub to which a syringe can be attached

Needle Size
Length in inches
(1/4 in to 6 in)
Gauge outside
diameter of the
cannula (G11 G27)

SOLUTION CONTAINERS
Maintain sterility, clarity
and nonpyrogenicity
Types:

Glass vacuum systems,

sealed by a rubber closure
held in place by an aluminum
band
Plastic have eyelet
openings or plastic straps for
attachment

Single-dose
Scales can be read vice
versa
Closures facilitate
insertion of administration

FILTERS
devices through
which a solution
is passed to
remove
suspended
particles
Depth filters
Membrane filter

Heparin Lock
Short infusion set

IV catheter or needle
3-3.5 inches of plastic
tubing
resealable rubber
diaphragm

avoid multiple
venipunctures
no need for continuous
drip primary solution to
keep the vein open
(KVO)

Problem 1
A prescription requires 7,500 units
(U) of heparin. Heparin vials
containing 1,000 U per milliliter are
available in the pharmacy. What
volume of heparin injection should be
added to the IV solution to provide
7,500 U?

Problem 2
A 200-mg dose of cimetidine is
prescribed. It is available in the
pharmacy in 300 mg/2 mL vials.
What volume should be withdrawn
from the vial to provide a 200-mg
dose?

Problem 3
A prescription for 1 L of an admixture
to be infused over a period of eight
hours is received. If the
administration set delivers 10 drops
per milliliter, what infusion rate, in
drops per minute, should appear on
the label of the admixture?

Problem 4
A prescription is received for drug
additives in 500 mL of 8% dextrose
injection. No solution of 8% dextrose
injection is available, but 500-mL
bags of 5%, 10%, 20%, and 50%
dextrose injection are available. How
can 8% dextrose injection can be
prepared?

Problem 5
A prescription is received for 1 L of a
parenteral nutrition solution with a
final concentration of 15% dextrose.
The physician specifies that 500 mL
is to be an amino acid solution. The
pharmacy has 50% dextrose injection
in 500-mL bags. How would this
prescription be prepared?

Problem 6
Tobramycin may be administered to
neonates at a dose of up to 4
mg/Kg/day in two equal doses every
12 hours. One kilogram =
approximately 2.2 lb. Tobramycin is
available in a pediatric vial with a
concentration of 20 mg/2mL. If the
neonate weighs 4.0 lb, what volume
of tobramycin should be withdrawn
for the dose described above?

ON PARENTERAL
NUTRITION

Computations
1.

Determine Total Fluid Requirement (TFR)

Maintenance

10 Kg
100 mL/Kg
11-20 Kg 1st 10 Kg
1000mL
succeeding Kg
50 mL/Kg
>20 Kg
1st 20 Kg
1500 mL
succeeding Kg
20 mL/Kg

Plus 30%
60%
90%

2.

fever
moderate dehydration
severe dehydration

Compute for the required VOLUME of each of

the ingredients

Case #1
Prepare a TPN solution for a 3 Kg
infant
Aminosyn 5%
2g/Kg
Ca gluconate 10% 2mL/Kg
D50W
Dextrosity 10%
D5W

Case #2
Wt = 10 kg with fever
Vamin 7%
1g/Kg/day
Ca gluconate 10% 2mL/Kg
D50W
Dextrosity 10%
D5W

Case #3
5 Kg infant
D50W

dextrosity 10%

Aminosyn 5% 0.75 g/Kg/day

NaCl
2.5 mEq/Kg/day
KCl
1 mEq/Kg/day
MVP
0.5mL
D5W