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💊 Pharm Flashcards BETA

NCLEX-focused pharmacology flashcards organized by body system References

Drug information verified against Davis's Drug Guide and Pharmacology and the Nursing Process (10th ed.) by Lilley, Rainforth Collins, & Snyder.

Always consult current drug references for clinical practice.

Last reviewed: January 2025

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Cardiovascular

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Metoprolol

Beta-1 Blocker

Treats hypertension, angina, heart failure, and rate control in AFib

25-200 mg PO daily

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Medication Calculations

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💊 Basic Dosage Infinite practice

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Mrs. Garcia, Maria

68 y/o Female • Sepsis, Pneumonia

ICU

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D/H Method Dimensional Analysis IV Drip Rates Weight-Based Conversions Insulin Rounding

💊 The D/H × Q Method (Desired Over Have)

The most commonly used formula for basic medication calculations. Master this and you'll solve 80% of dosage problems!

D (Desired) H (Have)

× Q = Amount to Give

What Each Letter Means:

D (Desired) — The dose the doctor ordered
H (Have/On Hand) — The strength of medication you have available
Q (Quantity) — The form it comes in (1 tablet, 5 mL, etc.)

📝 Worked Example #1

Order: Metoprolol 50 mg PO
Available: Metoprolol 25 mg tablets
How many tablets will you give?

1

Identify your values
D = 50 mg | H = 25 mg | Q = 1 tablet
2

Plug into the formula
50 mg ÷ 25 mg × 1 tablet
3

Solve: Divide first, then multiply
50 ÷ 25 = 2 → 2 × 1 = 2

✓ Give 2 tablets

📝 Worked Example #2 (Liquid)

Order: Amoxicillin 400 mg PO
Available: Amoxicillin 250 mg/5 mL
How many mL will you give?

1

Identify your values
D = 400 mg | H = 250 mg | Q = 5 mL
2

Plug into formula
400 mg ÷ 250 mg × 5 mL
3

Solve
400 ÷ 250 = 1.6 → 1.6 × 5 = 8

✓ Give 8 mL

💡 Pro Tip

Always check that D and H have the same units (both mg, both mcg, etc.). If they don't match, convert first before using the formula!

🔗 Dimensional Analysis (Factor-Label Method)

A systematic approach that uses unit cancellation. Great for complex, multi-step problems!

How It Works:

Set up fractions so units cancel out diagonally. What you want ends up on top, what you want to eliminate goes on bottom.

📝 Worked Example

Order: Digoxin 0.25 mg PO daily
Available: Digoxin 125 mcg tablets
How many tablets?

1

Notice units don't match! Convert mg to mcg
1 mg = 1,000 mcg
2

Set up the chain
0.25 mg × (1000 mcg/1 mg) × (1 tab/125 mcg)
3

Cancel units and solve
0.25 × 1000 ÷ 125 = 2 tablets

✓ Give 2 tablets

💧 IV Flow Rate Calculations

Calculate mL/hr for pump settings and gtt/min for manual IV regulation.

mL/hr =

Total Volume (mL) Time (hours)

gtt/min =

Volume (mL) × Drop Factor Time (minutes)

Common Drop Factors:

Tubing Type	Drop Factor
Macrodrip	10, 15, or 20 gtt/mL
Microdrip (Pediatric)	60 gtt/mL

📝 Worked Example (mL/hr)

Order: NS 1000 mL IV over 8 hours
What rate do you set the pump?

1

Use the mL/hr formula
1000 mL ÷ 8 hours = 125 mL/hr

✓ Set pump to 125 mL/hr

📝 Worked Example (gtt/min)

Order: D5W 500 mL over 4 hours
Tubing: 15 gtt/mL
What is the drip rate?

1

Convert hours to minutes
4 hours × 60 = 240 minutes
2

Apply the gtt/min formula
500 mL × 15 gtt/mL ÷ 240 min
3

Solve
7500 ÷ 240 = 31.25 ≈ 31 gtt/min

✓ Set drip rate to 31 gtt/min

💡 Quick Mental Math Trick

With 60 gtt/mL microdrip tubing: gtt/min = mL/hr (they're the same number!)

⚖️ Weight-Based Dosing

Many medications, especially in pediatrics and critical care, are dosed based on patient weight.

Dose =

mg kg

× Weight (kg)

Converting Pounds to Kilograms:

kg =

Weight (lbs) 2.2

📝 Worked Example

Order: Vancomycin 15 mg/kg IV
Patient weighs 176 lbs
How many mg should the patient receive?

1

Convert lbs to kg
176 ÷ 2.2 = 80 kg
2

Calculate the dose
15 mg/kg × 80 kg = 1,200 mg

✓ Give 1,200 mg Vancomycin

🔄 Essential Unit Conversions

Memorize these conversions — they're tested on NCLEX and used daily in nursing!

Metric Weight	Equivalent
1 kg	1,000 g
1 g	1,000 mg
1 mg	1,000 mcg
1 kg	2.2 lbs

Volume	Equivalent
1 L	1,000 mL
1 tsp	5 mL
1 tbsp	15 mL
1 oz	30 mL
1 cup	240 mL (8 oz)

💡 Memory Trick for Metric

King Henry Died By Drinking Chocolate Milk
Kilo → Hecto → Deka → Base → Deci → Centi → Milli

🩺 Insulin Calculations

Insulin is measured in units. Always use an insulin syringe and double-check your math!

Key Insulin Facts:

Standard concentration: U-100 (100 units/mL)
Always draw up in insulin syringes
With U-100: units = mL × 100
HIGH ALERT medication — always double-check!

📝 Worked Example (Sliding Scale)

Blood glucose: 285 mg/dL
Sliding scale: Give 2 units for BG 150-200, add 2 units for each 50 mg/dL above 200
How many units of insulin?

1

Base dose for 150-200 range
2 units
2

Calculate excess above 200
285 - 200 = 85 mg/dL above
3

How many 50s in 85? (round down)
85 ÷ 50 = 1.7 → 1 additional increment
4

Total insulin
2 + (1 × 2) = 4 units

✓ Give 4 units of insulin

⚠️ Safety Alert

Never abbreviate "units" as "U" — it can be mistaken for a zero! Always write out "units" completely.

🔢 Rounding Rules for Nursing

Knowing when and how to round is critical for patient safety. Different situations require different rounding rules.

⚠️ The Golden Rule

When in doubt, do NOT round — give the exact calculated amount when possible. Rounding should only be done when necessary for practical administration.

📋 Rounding Rules by Medication Type

Medication Type	Rounding Rule
Tablets	Round to nearest ½ tablet (if scored) or whole tablet
Oral Liquids	Round to nearest tenth (0.1 mL)
IV Fluids (pump)	Round to nearest whole number (mL/hr)
IV Drip (manual)	Round to nearest whole drop (gtt/min)
Insulin	Round to nearest whole unit (NEVER give partial units)
Heparin	Round to nearest whole unit
Pediatric doses	Round to nearest hundredth (0.01 mL) — BE PRECISE!
High-alert meds	Do NOT round — use exact calculation

📐 How to Round: The 5 Rule

Standard Rounding (≥5 round UP, <5 round DOWN)

If the digit is 5 or greater → Round UP
If the digit is less than 5 → Round DOWN

📝 Rounding to Whole Numbers

31.4

4 < 5, round DOWN

= 31

31.5

5 ≥ 5, round UP

= 32

31.7

7 ≥ 5, round UP

= 32

📝 Rounding to Tenths (1 decimal place)

2.43

3 < 5, round DOWN

= 2.4 mL

2.47

7 ≥ 5, round UP

= 2.5 mL

2.45

5 ≥ 5, round UP

= 2.5 mL

📝 Rounding to Hundredths (2 decimal places) — Pediatrics

0.333

3 < 5, round DOWN

= 0.33 mL

0.667

7 ≥ 5, round UP

= 0.67 mL

0.125

5 ≥ 5, round UP

= 0.13 mL

🏥 Real-World Examples

📝 IV Pump Rate

Calculated rate: 83.33 mL/hr
What do you set the pump to?

1

IV pumps accept whole numbers only
83.33 → look at .3
2

3 < 5, so round DOWN
83.33 → 83 mL/hr

✓ Set pump to 83 mL/hr

📝 Oral Liquid Medication

Calculated dose: 7.83 mL
How much do you give?

1

Oral liquids round to tenths
7.83 → look at .03
2

3 < 5, so round DOWN
7.83 → 7.8 mL

✓ Give 7.8 mL

📝 Insulin Dose

Calculated dose: 6.7 units
How many units do you give?

1

Insulin is ALWAYS whole units
6.7 → look at .7
2

7 ≥ 5, so round UP
6.7 → 7 units

✓ Give 7 units

📝 Manual IV Drip

Calculated rate: 24.6 gtt/min
What drip rate do you count?

1

Can't count partial drops!
24.6 → look at .6
2

6 ≥ 5, so round UP
24.6 → 25 gtt/min

✓ Count 25 drops per minute

💡 NCLEX Tip

On the NCLEX, if a question asks for a specific decimal place (like "round to the nearest tenth"), follow those instructions exactly. If no rounding instruction is given, use the rules above based on medication type.

⚠️ When NOT to Round

High-alert medications (chemotherapy, anticoagulants)
Pediatric/neonatal doses — be as precise as possible
When the answer is already a whole number or clean decimal
Critical care drips where small differences matter

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⚖️ Weight-Based Dosing

🔄 Essential Unit Conversions

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📋 Rounding Rules by Medication Type

📐 How to Round: The 5 Rule

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🔄 Essential Unit Conversions

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🔢 Rounding Rules for Nursing

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📐 How to Round: The 5 Rule

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