Free study guide · Updated 2026
NREMT medication math.
The exact formulas, shortcuts, and worked problems you need for dose, volume, drip rate, and weight-based dosing on the NREMT. No memorization without context.
The formulas you must know
Medication math on the NREMT almost always comes down to four equations. The exam usually gives you enough information to set up one of these; the trick is knowing which one to use.
Dose to give
Dose (mg) = weight (kg) × ordered dose (mg/kg)
If the order is in mcg/kg, convert the final dose to mg before drawing if needed: 1 mg = 1,000 mcg.
Volume to draw
Volume (mL) = dose (mg) ÷ concentration (mg/mL)
Concentration is the amount of drug in each mL of solution. Higher concentration = smaller volume.
IV drip rate
gtt/min = (volume (mL) × drop factor (gtt/mL)) ÷ time (min)
Drop factor is printed on the tubing package. Macrodrip is 10–20 gtt/mL; microdrip is 60 gtt/mL.
Infusion rate (mL/hr)
mL/hr = total volume (mL) ÷ total hours
Pump-driven infusions use mL/hr; gravity drips use gtt/min.
Weight-based dosing
Weight-based orders are written as dose per kg. Convert pounds to kilograms first, then multiply by the ordered dose. If the final answer is in mcg but the syringe is labeled in mg, convert: 1 mg = 1,000 mcg.
Worked example
Order: fentanyl 2 mcg/kg for a 110 lb patient. 110 lb ÷ 2.2 = 50 kg. Dose = 50 × 2 = 100 mcg. If the concentration is 50 mcg/mL, draw 100 ÷ 50 = 2 mL.
Concentration ratios
A ratio such as 1:1,000 means 1 g of drug in 1,000 mL of solution. Since most EMS doses are in mg or mcg, convert the ratio to mg/mL before you use the volume formula. Use the table below for the most common field concentrations.
| Drug | mg/mL | Common use |
|---|---|---|
| Epinephrine 1:1,000 | 1 | Anaphylaxis IM (0.3 mg adult), bronchodilator neb |
| Epinephrine 1:10,000 | 0.1 | Cardiac arrest IV/IO (1 mg = 10 mL) |
| Epinephrine 1:100,000 | 0.01 | Drip concentrations |
| Lidocaine 1% | 10 | Local anesthesia, IO anesthesia |
| Lidocaine 2% | 20 | Local blocks, cardiac (less common in field) |
| Dextrose 50% | 500 | Hypoglycemia (25 g = 50 mL) |
IV drip rates
Drip-rate problems are rare on the EMT exam but common on AEMT and Paramedic tests. The drop factor is printed on the tubing package. Pump infusions use mL/hr; gravity drips use gtt/min.
Worked example
Order: 500 mL NS over 2 hours with 15 gtt/mL macrodrip tubing. Time = 2 × 60 = 120 min. Rate = (500 × 15) ÷ 120 = 62.5 → 63 gtt/min.
Pediatric dosing & caps
Pediatric orders are weight-based, but the exam often tests the adult maximum cap. Rule: calculate the weight-based dose, then apply the cap if it is lower. Do not round up in pediatrics; always confirm the protocol.
| Drug | Weight-based dose | Adult / max cap |
|---|---|---|
| Epinephrine IM | 0.01 mg/kg | 0.3 mg adult max |
| Epinephrine IV/IO arrest | 0.01 mg/kg | 1 mg adult max |
| Amiodarone | 5 mg/kg | Follow local protocol; cumulative max applies |
| Adenosine 1st dose | 0.1 mg/kg | 6 mg |
| Adenosine 2nd dose | 0.2 mg/kg | 12 mg |
| Naloxone | 2 mg (intranasal) or 0.1 mg/kg IV/IO | Per protocol / titrate |
Free calculators
Use these tools to check your work and build speed. They are not substitutes for understanding the formula, but they are great for repetition.
Drug dosage calculator
Weight-based mg to mL.
IV drip rate calculator
gtt/min for any tubing.
MAP calculator
Mean arterial pressure.
Concentration cheat sheet
Ratio → mg/mL above.
Practice problems
Try the full walkthrough problem set with hidden answers and step-by-step breakdowns.
Medication math practice problems
10 NREMT-style dose, drip, and concentration problems with worked solutions.
Start practice problemsFAQ
What percentage of the NREMT is medication math?
Pure math questions are only a small fraction of the exam, but pharmacology and dosing logic appear in many scenario questions. Being able to convert lbs to kg, calculate mg from mg/kg orders, and pick the right volume to draw is essential for AEMT and Paramedic candidates.
Do I need to memorize drug doses for the NREMT?
Yes. EMT candidates need common doses (epinephrine, naloxone, aspirin, nitroglycerin). AEMT and Paramedic candidates need a much broader dosing library including weight-based pediatric calculations.
How do I convert pounds to kilograms?
Divide pounds by 2.2. For quick field math: 110 lb ≈ 50 kg, 154 lb ≈ 70 kg, 220 lb ≈ 100 kg. Always use the exact value on a written test.
What is the difference between a ratio and a percentage concentration?
A ratio (1:1,000) means 1 g of drug in 1,000 mL of solution. A percentage (1%) means 1 g per 100 mL. So 1% lidocaine = 10 mg/mL, and 1:1,000 epinephrine = 1 mg/mL.
Should I round up or down on pediatric doses?
Pediatric doses are not rounded to make them easier. Calculate the exact weight-based dose, then apply the adult maximum cap if the protocol requires it. Many pediatric medications are titrated to effect rather than rounded.
Ready to test?
Put the math into context.
Free NREMT-style practice tests let you see medication math inside real scenarios, with full rationales for every answer.