Calculations Problem Set

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A 25-year-old female major trauma patient survives surgery and is recovering in the surgical intensive care unit. The medical team wants to start PN therapy. She is 122 pounds, 5'7'' with some mild renal impairment. Calculate her BEE using the Harris-Benedict equation and her TEE (stress factor = 1.7 and activity factor = 1.2). Round each to the nearest whole number.

BEE = 1,385 kcal/day TEE = 2,825 kcal/day

A drug has the following pharamcokinetic parameters: Vd = 50 liters and Cl = 5,000 mL/hour. Calculate the elimination rate constant of the drug.

0.1 hr^-1

The ratio strength of a 10 mL vial of epinephrine injection USP is 1:10,000. Express its concentration in mg/mL.

0.1 mg/mL

TPN formula · Dextrose = 200 grams · HepatAmine = 60 grams · Sodium Chloride = 50 mEq · Potassium Chloride = 40 mEq · Sodium Acetate = 20 mEq · Magnesium Sulfate = 10 mEq · Sodium Phosphate = 9 mMol · Potassium Acetate = 15 mEq · Calcium Chloride = 2 mEq · Multivitamins = 12 5 ml · Trace Elements = 5 1 mL · Vitamin K = 1 0.5 mg · Pepcid = 10 mg · Regular Insulin = 20 units · Sterile Water qs ad 960 ml · Flow Rate = 80 ml per hour Question The pharmacist will be using Pepcid Injection, 40 mg per 4 ml vial, to prepare the product. What quantity of Pepcid Injection will be used?

1 mL needed

You have Sodium Phenobarbital Injection, 13%. How many ml will be needed to obtain 2 grains?

1 mL needed

Neupogen Injection is supplied at a concentration of 0.48 mg/1.6 ml. Your patient (weighs 132 pounds) and is to receive a dose of 5 mcg/kg/day. What volume of Neupogen Injection is required for this dose?

1 mL per day

Two fluid ounces of acetazolamide oral suspension (25 mg/mL) is to be compounded. How many grams of acetazolamide are needed to compound the suspension?

1.479 g

How many grams of potassium chloride are needed to make 200 mL of a solution containing 250 mOsmol/L? Round to the nearest hundreth. (M.W. K = 39, M.W. Cl = 35.5)

1.86 g

You need to prepare 30 grams of 0.25% triamcinolone in Cold Cream. Triamcinolone is available in a suspension of 40 mg per ml that has a specific gravity of 1.0. How many ml of the triamcinolone solution will be needed?

1.875 mL

How many milliliters of hydrocortisone liquied (40 mg/mL) will be needed to prepare 30 grams of a 0.25% cream (w/w)? Round to the nearest hundredth.

1.88 mL

You need a 1:5000 solution of benzalkonium chloride as a preservative. You have 20 ml of a 1:200 solution in stock. How much of the 1:5000 solution can you prepare by using all 20 ml of the 1:200 solution?

500 mL would be produced

Calcium gluconate injection USP is available in 10% strength vials. A patient needs 25 mEq calcium. How many milliliters of the 10% vial will provide the required dose? (Molecular weight of calcium gluconate = 430.4 g/mol.)

54 mL

How many milliliters of sterile water for injection must be mixed with two 4 mL vials of sterile hypertonic NaCl solution 7% USP so as to make the mixture isotonic?

54.2 mL

A patient is receiving 180 mL of 30% lipids. HOw many calories is the patient receiving from the lipids?

540 kcal

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL Using potassium phosphate (3 mmol od phosphate and 4.4 mEq of potassium/mL) vials in stock. Calculate the amount of potassium phosphate and should be added to teh PN oto meet the phosphate requirement.

6 mL of potassium phosphate

Prescription Hyoscine HBr 0.3 mg Oxycodone 7.5 mg Acetaminophen 300.0 mg DTD: caps no. XX Sig: i or ii caps q 4-6 hrs prn pain Question What will be the total amount of Hyoscine HBr used to fill the prescription?

6 mg needed

A pharmacy technician is asked to compound three 500 mL doses of 5% albumin. How many 50 mL vials of 25% albumin will be required?

6 vials of 25% albumin required

A patient was ordered 1 liter of D5NS with 20 mEq KCl for dehydration. How many milliosmoles are in 1 liter of this fluid (MW dextrose = 198, Na = 23, K = 39, Cl = 35.5)? Round to the nearest whole number.

600 mOsmol/L

You receive the following parenteral nutrition order: Clinimix (4.25/10) with electrolytes: Amino acids 4.25%/Dextrose 10% Infuse: Daily Rate: Continuous infusion @ 75 mL/hr How many calories will the PN provide from carbohydrates each day? Round to the nearest whole number.

612 kcal from carbs

A pharmacist is asked to prepare 80 grams of a 12.5% ichthammol ointment with 16% and 12% ichthammol ointments that she has in stock. How many grams of the 16% and 12% ointment are required?

10 g of the 16% ichthammol ointment 70 g of the 12% ichthammol ointment

The pharmacist is going to add 80 mEq of sodium to the PN; half will be given as sodium acetate (2 mEq/mL) and half as sodium chloride (4 mEq/mL). How many milliliters of sodium chloride will be needed?

10 mL

10 mL of 16.4% sodium acetate

The volume of distribution of Piperacillin/tazobactam, as found in the product insert, was 0.15 L/kg. Calculate the volume of distribution of this medication in a patient weighing 152 lb.

10.37 L

A diphenhydramine elixir contains 12.5 mg drug in one teaspoon of elixir. What volume of oral vehicle should be added to 100 mL of this elixir to reduce its strength to one half of its original strength?

100 mL

Calculate 3.5 squared (3.5^2)

12.25

A sample of an intravenous solution is found to contain 0.4 PPM of DEHP. How much of the solution, in milliliters, will contain 50 micrograms of DEHP?

125 mL

If a gallon of a 20% (w/v) solution is evaporated to a solution with a 50% (w/v) strength, what will be the new volume (in milliliters)? Round to the nearest 100 mL.

1500 mL

Fentanyl is to be administered as a slow IV as an adjunct to general anesthesia during surgery. The dose required is 2 μg/kg. Questions Calculate the following for a 169 lb patient: a. The dose required. b. The volume required to supply the dose if fentanyl citrate injection USP 250 μg/5 mL is to be used.

153.6 µg; 3.1 mL

A patient is 5'2'' tall. What is her height in centimeters? Round to the nearest whole number.

157 cm

Calculate 2^4, two to the fourth.

Diclofenac sodium gel 1% (Voltaren gel) comes with a dosing card marked with a 2-gram line and a 4-gram line. The daily dosing of diclofenac sodium should not exceed 320 mg over all affected areas. If a patient uses 2 grams of gel at a time, how many applications can be made daily to provide 320 mg of the drug?

WT is needing a protein shake with the following nutrition facts, how many calories will WT receive from the fat component of 1 (8 fl oz.) shake? Round to the nearest whole number.) Calories: 356 kcal Total fat: 17.8 g Protein: 19.6 g

160 kcal

A 55-year-old female bedridden patient who weighs 141 lb and is 5 ft 6 in tall needs enteral nutrition. Her recommended total Calories per day is 25 kcal/kg/day. Calculate the total caloric intake, protein requirement, and fluid needs for this patient.

1602.5 kcal/day; 51.3 g/day; 1923 mL/day

Lidocaine Injection for cardiac use is a 4% solution. If the dose is 2 mg per minute, how long will a 500 ml bag run?

166.7 hours

A patient took acarbose 25 mg once daily for four weeks, followed by taking it twice daily for four weeks, and finally by taking it three times daily for four weeks. How many tablets did the patient receive in total? How many milligrams of acarbose did the patient receive?

168 tablets; 4200 mg

A buffer solution is prepared using 0.3 mole of a weakly basic drug and an unknown quantity of its salt (pKa of the drug = 10.1). The final solution has a pH of 8.99. HOw much of the salt was used? Round to the nearest hundredth.

3.86 mole of the salt

Prescription: Resperine Liquid (1mg/mL) Disp: 60 mL Sig: 0.01 mg per kg per dose. One dose twice a day You have tablets that contain 0.25 mg of reserpine per tablet. You can mix ground up reserpine tablets in cherry syrup to make a liquid that will be stable for at least 3 months. The patient is a child that weighs 22 pounds. How long will this prescription last at the dose ordered?

30 days

Zolpidem spray mist (Zolpimist) to be sprayed directly into the mouth over the tongue delivers 5 mg zolpidem in 100 μL with each metered actuation (one spray). The manufacturer states that there are 60 metered actuations present in each child-resistant container after the initial recommended priming of the device. How many 10 mg doses are present in one Zolpimist container?

30 doses

What will be the dose, in ml per hour of dopamine, will the patient be receiving?

30 mL per hour

An order is written for phenytoin IV. A loading dose of 15 mg/kg is to be infused at 0.5 mg/kg/min for a 33-pound child. The pharmacy has phenytoin injection solution 50 mg/mL in a 5 mL vial in stock. The pharmacist will put the dose into 50 mL NS. Over how many minutes should the dose be administered? Round to the nearest whole number.

30 minutes

50 mL of a topical emulsion was prepared using the following formula: Formula · Safflower oil = 30 mL · Glycerin = 20 mL · Rose oil = 2 mL · Polysorbate 80 = 2 mL · Benzyl alcohol = 1 mL · Purified water qs 100 mL Question What is the percent v/v of safflower oil in the emulsion?

30%

Charles Fox has an IV hanging that has 40 mEq of potassium chloride in 1000 mL of Dextrose 5% in Half Normal Saline. The IV has been running at a rate of 80 mL per hour for the past 6.5 hours. A recent lab report indicates that Mr. Fox's serum potassium level is only 3.5 mEq/L and his physician wants to increase the potassium dose. The physician ask you to slow the IV flow rate to 40 mL per hour and also add enough potassium chloride injection, 14.9%, so that Mr. Fox will receive a total of 80 mEq of potassium over the next 12 hours. K = 39, Cl = 35.5

30.4 mL

You receive the following parenteral nutrition order: Clinimix (4.25/10) with electrolytes: Amino acids 4.25%/Dextrose 10% Infuse: Daily Rate: Continuous infusion @ 75 mL/hr How many calories will the PN provide from protein each day? Round to the nearest whole number.

306 kcal/day from protein

What is the osmolarity, in mOsmol/L, of normal saline (0.9% NaCl)? M.W. = 58.5. Round to the nearest whole number.

308 mOsmol/L

A female patient is to receive 5 mg/kg/day of theophylline. The patient is 5'7'' and weighs 243 pounds. Calculate the daily theophylline dose the patient should receive.

308 mg

A physician orders an IV infusion of D5W 1 liter to be delivered over 8 hours. The IV infusion set delivers 15 drops/mL. How many drops/min will the patient receive? Round to the nearest whole number.

31 drops/min

The dosing recommendation for Abacavir tablets twice daily in children and adolescents weighing ≥ 14 kg is given as follows: Weight (kg) --> AM dose --> PM dose 14 to < 20 --> 150 mg --> 150 mg 20 to < 25 --> 150 mg --> 300 mg ≥ 25 --> 300 mg --> 300 mg Question Calculate the quantity of Abacavir that a 14-year-old patient weighing 49.3 lb will receive over a period of 1 week on the twice-daily regimen.

3150 mg

A pediatric patient is receiving 5.25 mL of drug every 4 hours. How many milliliters will be required for the entire day? Round to the nearest whole number.

32 mL

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question How many mLs of Sodium Chloride Injection, 4 mEq per mL, will be needed to prepare one liter of the formula? Na = 23; Cl = 35.5

32 mL needed

A metered dose inhaler provides 90 micrograms of albuterol sulfate with each inhalation. The canister provides 200 inhalations. If the patient uses the entire canister, how many total milligrams will the patient have received?

18 mg

A patient is the ICU has recently developed an acidosis. Using the laboratory parameters below, calculate the patient's anion gap. Na: 139 Cl: 101 K: 4.6 HCO3: 19 SCr: 1.6 BUN: 38

Calcium Chloride Dihydrate Injection is supplied as a 10% solution in water. How many milliosmoles are present in a single 10 ml vial? Ca = 40, Cl = 35.5, H = 1, O = 16

20.4 milliosmoles

A 34-year-old (height 6'7'', weight 287 pounds) is hospitalized after a motor vehicle accident. He develops a Pseudomonas aeruginosa infection. The physician orders tobramycin 2 mg/kg IV Q8H. Calculate the tobramycin dose. Round to the nearest 10 milligrams.

220 mg IV Q8H

What is the osmolarity, in mOsmol/L, of D5W? M.W. = 198. Round to the nearest tenth.

252.5 mOsmol/L

Prescription Indomethacin 0.05% Boric Acid qs Water qs ad 15 mL Question Boric Acid can be used as a preservative in ophthalmic solutions. It can also be used to replace NaCl when making a product isotonic. What quantity of boric acid will be needed to make the eye drop shown isotonic? E values are boric acid = 0.52, indomethacin = 0.16

257.3 mg of boric acid needed

A hydrocodone bitartrate and acetaminophen oral solution contains 500 µg hydrocodone bitartrate per milliliter of the solution. How many milligrams of hydrocodone bitartrate are necessary to prepare 16 fl oz of the solution?

236.6 mg

Calculate the CrCl for a 58-year-old female patient, 5 ft 3 in tall and weighing 240 lb, if her SCr is 2.2 mg/dL.

33 mL/min

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question How many mL of water will be required to prepare one liter of the formula?

330.3 mL water to add

A patient is receiving 30 mmol of phosphate and 8 mEq of calcium. The volume of the PN is 2,000 mL. There are 2 mEq PO4/mmol. Confirm that the sum of the calcium and phophorus does not exceed 45 mEq/L.

34 mEq/L, which is less than 45 mEq/L

A PN order is written for 500 mL of 50% dextrose. The pharmacy only has D70W in stock. How many milliliters of D70W should be added to the PN bag? Round to the nearest whole number.

357 mL of D70W

A patient being treated with vancomycin had supratherapeutic trough of 28 mcg/mL. If his ke = 0.15 hr^-1, predict how long it will take for the trough to decrease to his goal therapeutic trough (15 mcg/mL). Round to the nearest hour.

4 hours

What is the pH of a solution prepared to be 0.5 M sodium citrate and 0.05 M citric acid (pKa for citric acid = 3.13)? Round to the nearest hundredth.

4.13

You are out of Robitussin-AC, a cough syrup that contains 10 mg of codeine per 5 ml. You can make Robitussin-AC by adding codeine injection to Robitussin. If the codeine injection has 60 mg per ml, how many milliliters of the injection will you ADD TO a four fluid ounce bottle of Robitussin to produce the same amount of codeine as in Robitussin-AC?

4.14 mL of codeine injection

A 40-year-old female patient weighing 152 lb was treated for acetaminophen poisoning with an acetyl cysteine infusion. The 21-hour IV (Acetadote) regimen consists of 3 doses as follows: · Loading dose: 150 mg/kg (maximum = 15 g) infused over 1 h · Second dose: 50 mg/kg (maximum = 5 g) infused over 4 h · Third dose: 100 mg/kg (maximum = 10 g) infused over 16 h 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W Question The infusion rates used for the loading dose, the second dose, and the third dose, in mL/min.

4.2 mL/min; 2.2 mL/min; 1.1 mL/min

RS is a 45-year-old male, 5'5'', 168 pounds, hospitalized with a diabetic foot infection. The pharmacist prepared a 500 mL bag of D5W containing 1 gram of vancomycin to be infused over 4 hours using a 20 gtts/mL IV tubing set. How many mg of vancomycin will the patient receive each minute? Round to the nearest tenth.

4.2 mg/min

What is the pH of a buffer solution containing 0.5 M acetic acid and 1 M sodium acetate in 1 liter of solution (pka for acetic acid = 4.76)? Round to the nearest hundredth.

5.06

Dimethyl Sulfoxide Liquid is supplied as a 50% weight / weight solution with a specific gravity of 1.40. What is the percent weight / volume of liquid dimethyl sulfoxide?

70% w/v

Amino acids 15% IV solution has a specific gravity of 1.05. Calculate the weight of the solution that contains 100 g amino acids.

700 g

If a 50% dextrose injection provides 170 kcal in each 100 mL., how many milliliters of a 70% dextrose injection would provide the same caloric value? Round to the nearest tenth.

71.4 mL

A patient is to receive acyclovir 5 mg/kg every 8 hours for an acute outbreak of herpes zoster. What daily dose, in milligrams, should a 110 pound female receive?

750 mg/day

A mouthwash formula is as follows: Formula · Benadryl elixir (12.5 mg/5mL) = 90 mL · Maalox = 90 mL · Lidocaine viscous 2% = 0 mL · Distilled water USP = 180 mL · Total 450 mL Question Calculate the volume of each ingredient necessary to prepare 2 pints of the mouthwash.

Benadryl, Maalox, and lidocaine = 189.2 mL, water = 378.4 mL

A multielectrolyte concentrate for IV injection after dilution contains the following in each 20 mL of solution: Formula · Potassium acetate = 1.96 g · Sodium chloride = 1.49 g · Sodium acetate (trihydrate) = 1.292 g · Magnesium chloride (hexahydrate) = 0.51 g · Calcium chloride (dihydrate) = 0.331 g Question How many milliequivalents of each of the following ions are present in 20 mL of the injection: acetate, potassium, chloride, sodium, magnesium, and calcium? Molecular weights · potassium acetate = 98.2 g/mol; · sodium chloride = 58.5 g/mol; · sodium acetate = 136.1 g/mol; · magnesium chloride hexahydrate = 203.3 g/mol; · calcium chloride dihydrate = 147 g/mol.)

acetate = 29.4 mEq; potassium = 20 mEq; chloride = 35 mEq; sodium = 35 mEq; magnesium = 5 mEq; calcium = 4.5 mEq

Tetracycline has a clearance of 7.014 L/hr and a volume of distribution of 105 L. Calculate the half-life of tetracycline (round to the nearest tenth) and the time required for elimination of greater than 95% of the drug from the body.

half-life = 10.4 hours Time required = 52 hours

A 52-year-old female patient comes to a compounding pharmacy to get a 90-day supply of diclofenac sodium 50 mg, which she takes three times daily. She also needs a 90-day supply of the levothyroxine sodium/liothyronine sodium 75/5 μg SR capsules that she takes once a day and an ounce of DHEA 1.3% cream. The formula for Levothyroxine sodium/liothyronine sodium 75/5 μg SR capsules is as follows: · Levothyroxine sodium 2% stock powder blend - TBD as needed · Liothyronine sodium 0.5% stock powder blend - TBD as needed · Hydroxypropyl methyl cellulose (4000 CPS) USP - 200 mg · Microcrystalline cellulose NF - 50 mg ~ 255 mg fill volume in size #1 capsule shells. Formula for DHEA 1.3% cream DHEA 1.3% Commercial cream base qs Question Calculate the amount of each ingredient needed to compound the levothyroxine sodium/liothyronine sodium SR capsules.

levothyroxine dilution = 337.5 mg; liothyronine dilution = 90 mg; hydroxypropyl methyl cellulose = 18 g; microcrystalline cellulose = 4.5 g

Lidocaine-Epinephrine-Tetracaine (LET) gel is to be compounded using a commercial carbomer gel base according to the following formula: Formula · Lidocaine Hydrochloride USP = 4 g · Epinephrine bitartrate USP = 0.05 g · Tetracaine USP = 0.5 g · Gel base qs ad 100 g Question Calculate the amounts of each ingredient necessary to prepare ½ oz (avoir) of the gel.

lidocaine = 0.56 g; epinephrine = 0.007 g; tetracaine = 0.07 g

Mr Shirrah is very ill and needs antibiotic therapy for an infection. The microbiology lab reports that the infecting agent will require a higher than normal blood level to be effective. The attending physician asks you to determine exactly how often each dose of the antibiotic should be administered to keep the blood level at, or above, the determined minimum inhibitory concentration (MIC) You receive the following pharmacokinetic data on Mr. Shirrah for a drug eliminated 100% by the kidney. Mr Shirrah has normal renal function. Pharmacokinetic Data IV bolus dose:0.5 gram; Peak level: 12 mcg/mL; Trough level at 12 hrs: 0.75 mcg/ml Therapeutic MIC level: 3 mcg/ml Question Based on first order pharmacokinetics, what is the half life of this drug?

t 1/2 = 3 hrs

The formula used to make a spray to relieve radiation-induced hyposalivation is as follows: Formula · Pilocarpine hydrochloride 1.2 g · Oralube qs to make 180 mL Question Pilocarpine hydrochloride 4% ophthalmic solution is available to compound the preparation. Calculate the volumes of the ophthalmic solution and of Oralube to be used to prepare 90 mL of the spray.

Volumes: pilocarpine HCl solution = 15 mL; Oralube = 75 mL

A drug product costs $62.20 an avoirdupois ounce. What will be the cost of the 60 mg of drug you need for a prescription?

$0.13

Prescription: Resperine Liquid (1mg/mL) Disp: 60 mL Sig: 0.01 mg per kg per dose. One dose twice a day You have tablets that contain 0.25 mg of reserpine per tablet. You can mix ground up reserpine tablets in cherry syrup to make a liquid that will be stable for at least 3 months. The patient is a child that weighs 22 pounds. If reserpine tablets cost $20.00 per 100 tablets, what will be the cost of the tablets used?

$4.80

A 61-year-old female patient needs enteral nutrition. The patient is 6 ft tall and weighs 176 lb (IBW 73.1 kg). The nutritional requirements for this patient were determined as follows: · Protein: 77 g/day · Carbohydrates: 259 g/day · Fat: 60 g/day · Total feed calories: 1800 kcal/day · Total fluids: 2700 to 2800 mL/day The enteral nutrition formula selected provides the nutrients as listed below: · Calories = 1.5 kcal/mL · Free water = 75% Macronutrients per 1000 mL: · Protein = 63.8 g (255 kcal) · Carbohydrates = 215.7 g (733 kcal) · Fat = 49.8 g (448 kcal) Question Calculate the following: a. The volume of EN formula required by the patient. b. The amount of each macronutrient and the total Calories of each macronutrient (carbohydrate (4 kcal/g), protein (4 kcal/g), and fat (9kcal/g)) provided to the patient by the formula. c. Will the EN formula be sufficient to provide the required fluids per day? d. What flow rate should be used if the formula is to be given over a 24-hour period?

(a) 1200 mL/day; (b) carbohydrate: 258.8 g/day, 1035.2 kcal/day; protein: 76.6 g/day, 306.4 kcal/day; fat: 59.8 g/day, 538.2 kcal/day; (c) no; (d) 50 mL/h

A 64-year-old female patient, 5 ft 4 in tall and weighing 135 lb, is receiving meropenem 1 g every 8 hours. When the infusion was started, her SCr was 0.84. The manufacturer recommends CrCl-based dosing modifications as follows: · CrCl > 50 mL/min: No dosage adjustment necessary. · CrCl 26-50 mL/min: Administer the recommended dose as indicated every 12 hours. · CrCl 10-25 mL/min: Administer one-half the recommended dose as indicated every 12 hours. · CrCl < 10 mL/min: Administer one-half the recommended dose as indicated every 24 hours. Later, her SCr increased to 1.54. The manufacturer's recommendation for reconstitution is as follows: Vial size --> Diluent added (mL) 500 mg --> 10 mL 1 g --> 20 mL The infusion vials were reconstituted with an appropriate volume of NS (as per the table above) from a 500 mL IV bag and added back to the bag. Question Calculate the patient's creatinine clearance (a) when her SCr was 0.84, (b) when her SCr was 1.54.

(a) 58.4 mL/min (b) 31.9 mL/min

The EPA recommends that when lead levels in drinking water are equal to or greater than 15 PPB, measures be taken to reduce lead concentration. Express this concentration in percent strength.

0.0000015%

Express a 5 PPM of iron in water as a percentage.

0.0005%

Express 30 PPM of copper in solution as a percentage.

0.003%

How many moles are equivalent to 875 milligrams of aluminum accetate (MW = 204)? Round to 3 decimal places.

0.004 mols

Latanoprost ophthalmic solution (Xalatan) contains 125 micrograms per 2.5 mL of the solution. What is its percent strength?

0.005%

A physician has requested a 20 mL vial of Lidocaine 1% with Epinephrine 1:200,000 from your pharmacy. The shelf spot for that product is empty but you do have Lidocaine 1% Injection and Epinephrine Amps, 1%. How much of the Epinephrine Injection must you add to the vial of Lidocaine Injection to prepare the needed product?

0.01 mL

A vial containing 4.4 mCi of thallous chloride Tl201 for IV administration decayed to 4 mCi in 10 hours. Calculate the drug's decay constant and half-life.

0.01/h, 69.3 h

Cod liver oil is to be flavored using spearmint oil and peppermint oil at a concentration of 0.5% v/v each. What is the volume of peppermint oil, in mL, present in a 5 mL dose of the flavored cod liver oil?

0.025 mL

Budesonide inhalation suspension (Pulmicort Respules) contains 0.5 mg budesonide in 2 mL of suspension. What is the percent strength of this preparation?

0.025%

Express 1:4,000 as a percentage strength

0.025%

How many grams are equal to 50,000,000 nanograms?

0.05 g

A levocetirizine dihydrochloride oral solution is labeled to contain 2.5 mg/5 mL solution. How many grams of the drug will be present in a bottle containing 5 fl oz of the oral solution?

0.074 g

Physostigmine salicylate (MW = 413) is a 2-ion electrolyte, dissociating 80% in a given concentration (i.e., use a dissociation factor of 1.8). Calculate its sodium chloride equivalent. Round to two decimal places.

0.14

A formula calls for using 0.01% of hydrochloric acid in a formula for 1000 ml of a topical liquid. HCl has a specific gravity of 1.2 and is supplied as a 40% weight/weight solution. How many ml of hydrochloric acid are needed to prepare the 1000 ml?

0.21 mL HCl needed

Human Growth Hormone (somatropin, Nutropin-AQ) is dosed at a rate of 0.3 mg per Kg per week given in equally divided daily doses. Nutropin-AQ Injection is supplied at a strength of 10 mg per 2 mL. What will be the daily dose for a patient who weighs 55 pounds?

0.22 mL/dose/day

An IV solution containing potassium chloride is being administered at a rate of 30 drops per minute using IV tubing that delivers 15 drops per mL. At the end of 8 hours, the patient has received 30 mEq of potassium chloride. What was the initial concentration of potassium chloride in the IV fluid? K = 39, Cl = 36

0.234 grams per 100 mL or 0.234%

Cod liver oil is to be flavored using spearmint oil and peppermint oil at a concentration of 0.5% v/v each. What is the volume of spearmint oil, in mL, needed to flavor 50 mL of cod liver oil?

0.25 mL

A patient 61 years old and weighing 158 lb is being prepared for surgery. Anesthesia is to be induced using ketamine (Ketalar) IV injection at a dose of 2 mg/kg administered at a rate of 0.5 mg/kg/min. Ketamine injection of strength 10 mg/mL was used for induction (no further dilution is necessary when using this strength). The induction was augmented using a diazepam 2 mg IV in a separate syringe given over 60 seconds. A maintenance dose of ketamine at an infusion rate of 0.25 mg/min will be given during the surgery. A 500 mL maintenance infusion is to be made at a strength of 1 mg/mL by taking adequate volume from a ketamine injection of strength 100 mg/mL and diluting it with D5W. (Ketamine 100 mg/mL is NOT supposed to be given without dilution.) The maintenance infusion is to be given using a microdrip infusion set calibrated to 60 drops/mL. The infusion rate recommended is 15 mg/kg/min. Question Calculate the maintenance infusion rate in mL/min.

0.25 mL/min

A sample of fresh tuna was found to contain 9 PPB mercury. How many micrograms of mercury will be present in 1 oz of the fish?

0.27 µg

A fentanyl transdermal system is labeled to deliver fentanyl at 12 µg/hour. How many milligrams of fentanyl will a patient receive from the transdermal system over a 24-hour period?

0.29 mg

Calculate log (1/0.5). Round to the nearest tenth.

0.3

Aqueous boric acid 1.9% is used to buffer ophthalmic solutions in the mid-acid range (∼5). Question Calculate the molar concentration of this solution if the molecular weight of boric acid is 61.84 g/mol.

0.3 M

Gentamicin ophthalmic solution USP contains 3 mg gentamicin base per mL of the solution. What is its percent strength?

0.3%

What is the percent strength of a solution prepared by dissolving 30 mg of ofloxacin in 10 mL water for injection?

0.3%

How many moles are equivalent to 45 grams of potassium carbonate (MW = 138)? Round to the nearest thousandth.

0.326 mols

Calculate the E value for potassium iodide, which dissociates into 2 particles (MW = 166). Round to two decimal places.

0.35

A patient is receiving D5(1/2)NS with potassium chloride at 20 drops/min. After 10 hours, the patient has received a total of 40 mEq of potassium chloride using tubing that delivers 15 drops/mL. What is the percentage concentration chloride in the patient's IV fluid? Round to 2 decimal places (MW of K = 39, MW of Cl = 36).

0.38%

Ms. Roberta Snagg has a recurring mycotic infection of the bladder. Her physician wants to use a bladder irrigation of amphotericin B to be continuously run through the bladder for at least 24 hours. You are to prepare a 2 liter bag of amphotericin B irrigation solution, 1:5000 concentration, that will be administered at a rate of 80 mL per hour. You have vials of amphotericin B, 50 mg, that, when properly reconstituted, contain 50 mg of amphotericin B in a total volume of 10 mL. Question How much amphotericin B must be mixed in the 2 liter bag to provide the desired concentration of irrigation solution?

0.4 grams (or 400 mg)

0.4 mL

How many milliliters of a thimerosal 25% stock solution must be used to prepare 100 mL of thimerosal topical solution of 1:1000 ratio strength?

0.4 mL

Pediatric Lanoxin Injection is supplied in ampules of 100 mcg per ml. What quantity must a nurse administer to provide a dose of 0.04 mg?

0.4 mL

A 165-pound patient is to receive 250 mL of a dopamine drip at a rate of 17 mcg/kg/min. The pharmacy has dopamine premixed in a concentration of 3.2 mg/mL in D5W. Calculate the infusion rate in mL/minute. Round to the nearest tenth.

0.4 mL/min

A 22 G needle had an inner bore diameter of 0.016 in and a length of 2 in. Express the dimensions in millimeters.

0.41 mm diameter; 50.8 mm length

An oral vehicle was prepared according to the following formula: Formula · Methyl cellulose 1% solution = 50 mL · Glycerin = 3 mL · Sodium benzoate = 200 mg · Preserved flavored syrup qs ad 100 mL Question Calculate the effective concentration of methyl cellulose, in percent w/v, in the vehicle.

0.5%

Atorvastatin, an acidic drug, has a pKa of 4.3. Calculate the percent of the drug ionized in in the stomach (pH 2) and in the small intestine (pH 8).

0.5% and 100%

One milliliter of amiodarone hydrochloride 50 mg/mL concentrate for injection/infusion contains 50 mg amiodarone hydrochloride, which is equivalent to 46.9 mg amiodarone. One ampule with 3 mL of the amiodarone hydrochloride concentrate was diluted as recommended in 250 mL of D5W. Calculate the final concentration of amiodarone, in mg/mL, in the diluted infusion. (Round your answer to one decimal place.)

0.56 mg/mL

Naproxen, an acidic drug, has a pKa of 4.15. Calculate the percent of the drug ionized in the stomach (pH 2) and in the small intestine (pH 8).

0.7% and 100%

Sodium nitroprusside infusion was made by adding the contents of a 2 mL vial of sodium nitroprusside injection (25 mg/mL) to sufficient quantity of D5W to make a 250 mL infusion. A 176 lb patient was started on this infusion at a rate of 0.3 µg/kg/min. After 5 minutes, the infusion rate was changed to 1.5 µg/kg/min. How many milligrams of sodium nitroprusside did the patient receive over 10 minutes from the start of the infusion?

0.72 mg

Ropivacaine hydrochloride injection USP is available as 150 mg in a 20 mL single-dose vial. Calculate the percent strength of the injection.

0.75%

What is the specific gravity of 30 mL of a liquid weighing 23,400 milligrams? Round to the nearest hundredth.

0.78

Digoxin Injection is supplied in ampules of 500 mcg per 2 ml. What quantity, in mL, must a nurse administer to provide a dose of 0.2 mg?

0.8 mL needed

An estriol cream contains 8 mg estriol per gram of the cream. Calculate its strength in percent w/w.

0.8%

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question Amikacin sulfate injection USP 1 g/4 mL is to be used. Calculate the volume required to provide the dose.

0.9 mL

Levetiracetam (Keppra) is available as 500 mg strength in 5 mL vials. If two vials are added to a 100 mL NS bag, what is the final percent strength of levetiracetam in the admixture?

0.9%

A pharmacist received a prescription for Bactrime that stated "TMP/SMX 40-200 mg/5 mL. Sig: 1 tspPO BID x 10 days, until all taken." The pharmacist dispense 3 oz. to Ms. Brooks. How many days of therapy will Ms. Brooks be short? Use 30 mL for 1 fluid ounce.

1 day of therapy

A patient was advised to take two puffs of beclomethasone inhalation (40 µg per puff) daily for 60 days. The pharmacy wants to dispense beclomethasone dipropionate inhalation (QVAR) 40 µg/actuation. If each inhaler contains 120 inhalations, how many inhalers must be dispensed?

1 inhaler

1 mL/dose

A patient is to receive Keppra at a rate of 5 mg/min. The pharmacy has a 5 mL Keppra vial (100 mg/mL) which will be diluted in 100 mL of NS. WHat is the Keppra infusion rate, in mL/min? Do not include the volume of the 5 mL additive.

1 mL/min

The ratio strength of a single-dose ampule of epinephrine injection USP is 1:1000. Express its concentration in mg/mL.

1 mg/mL

To make a 500 mL amiodarone infusion, 18 mL of amiodarone hydrochloride for injection (50 mg/mL strength) was added to sufficient volume of D5W. The infusion is to be administered in two phases. The first 360 mg is to be infused over 6 hours. Following this, the remaining amount is to be administered over 18 hours. Calculate the infusion rates, in mg/min, to be used.

1 mg/min; 0.5 mg/min

You need a 1:750 solution of Zephiran Chloride to disinfect the pharmacy counters. Zephiran is available as a 17% concentrated solution. How much Zephiran concentrate will you mix with enough water to make one gallon of the 1:750 solution you need?

1 ounce would be added to one gallon of water to make the 1:750 solution

You receive the following parenteral nutrition order: Clinimix (5/15) with electrolytes: Amino acids 5%/Dextrose 15% Infuse: Daily Continuous infusion @ 60 mL/hr How many calories will the patient receive each day from the following PN order? Round to the nearest whole number.

1,022 kcals/day

After you finished mixing the 3% sodium chloride, how many milliosmoles of sodium chloride, per liter, are in the final product? Molecular weights sodium = 23, chlorine = 35.5

1,025.64 milliosmoles

AH is receiving 640 mL of D50W in her PN. How many calories does this provide?

1,088 kcal

The pharmacy stocks FreAmine 10%. A patient requires 122 grams of protein per day. How many milliliters of FreAmine will the patient need?

1,220 mL

Using the following pharmacokinetic parameters, what oral loading dose of digoxin is appropriate to rapidly achieve a peak concentration of 1.5 mcg/L? F = 0.6, Vd = 500 L and Cl = 120 L/day

1,250 mcg or 1.25 mg

DF, a 44-year-old male, is receiving 1,235 mL of D30W, 1,010 mL of FreAmine 8.5%, 200 mL of Intralipid 20% and 50 mL of electrolytes/minerals in his PN. HOw many calories from dextrose is DF receiving from the PN? Round to the nearest whole number.

1,260 kcal/day

If the pharmacy stocks Aminosyn 8.5%, how many milliliters will be needed to provide 108 grams of protein? Round to the nearest whole number.

1,271 mL

A nephrologist is treating a patient with hyponatremia. She estimates the patient's sodium deficit to be 210 mEq. How many milliliters of normal saline (MW Na = 23, MW Cl = 35.5) will be required to replace the deficit?

1,365 mL of NS are required

JR is a 55-year-old male (weight 189 pounds) who is confined to bed (activity factor 1.2) due to his current infection (stress factor 1.5). JR requires 1.4 g/kg/day of protein and the pharmacy stocks Aminosyn 8.5%. Calculate the amount of Aminosyn, in milliliters, JR should receive. Round to the nearest whole number.

1,415 mL

How many grams of tolnaftate are contained in a 108 g (3.8 oz) container of 1% tolnaftate foot powder?

1.08 g

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question The dose is to be diluted with 200 mL NS. Calculate the final strength (ignore the minor volume change caused by mixing), in mg/mL, of the admixture that is to be administered to the patient. (The manufacturer recommends a final concentration between 0.25 mg/mL and 5 mg/mL.)

1.1 mg/mL

You have a stock drug solution that contains 10% active drug. What volume of this stock solution will you use to prepare 120 ml of a 1:1000 solution?

1.2 mL needed

If 200 mg of drug are added to a 500 mL bag, what rate of flow, in milliliters per hour, will deliver 500 mcg of drug per hour? Round to the nearest hundredth.

1.25 mL/hour

What is the percentage strength of imiquimod in the following prescription? Round the nearest hundredth. Imiquimod 5% cream: 15 g Xyxlocaine: 20 g Hydrophilic ointment: 25 g

1.25%

Prescription Tetracycline HCL 2% NaCl to isotonicity qs 30 mL Sig: 2 drops into OS QID Question In order to obtain the sodium chloride amount you calculated in No. 32, you will need to use Sodium Chloride Injection, 2.5 mEq per ml as your source for NaCl. How many ml will you use? MW Na = 23, Cl = 35.5

1.35 mL needed

Lactated Ringer's Injection contains 20 mg of calcium chloride dihydrate per 100 ml of IV fluid. How many milliMoles of calcium are present in one liter of Lactated Ringer's Injection? Molecular weights: Ca = 40, Cl = 35.5, H = 1, O = 16

1.36 millimoles per liter

Rituximab and Hyaluronidase human injection contains 120 mg rituximab and 2000 units human hyaluronidase per milliliter. If a patient received 11.7 mL of the injection, calculate the amount of rituximab, in grams, the patient received from the dose.

1.4 g

Ninety capsules of liothyronine (T3) 15 µg are to be prepared. The formula calls for a 1:10,000 dilution of pure liothyronine with a proprietary capsule diluent mixture. Calculate the amount of liothyronine and capsule diluent that are needed to compound the capsules. (Round your answer to one decimal place.)

1.4 mg liothyronine and 13.5 g diluent

The pharmacy has insulin vials containing 100 units of insulin/mL. A physician orders 15 units of regular insulin to be added to a liter of D5W to be given over 10 hours. How many units of insulin will the patient receive each hour if the IV set delivers 15 drops/mL? Do not round the answer.

1.5 units/hour

On a mercy mission to a Third World country you have been asked to calculate the correct amounts of ferric gluconate injection (Ferrlecit) to administer to severely anemic patients. You are given the following formula for such calculations. (NOTE: this is an old formula that is no longer used.) The first patient weighs 110 pounds and has a hemoglobin of 8 gms/dl. Ferrlecit contains 12.5 mg elemental iron per mL; what volume of drug will be given each dose? Normal Hgb (15 gm/dl) minus Patient's Hgb (gm/dl) = Hgb deficiency Hgb deficiency (x) Patient's weight (in kg) = milligrams of elemental iron required Give 5% of the total dose calculated every other day

1.54 mL per dose

If phenobarbital elixir contains 18.2 mg of phenobarbital per 5 mL, how many grams of phenobarbital would be used in preparing a pint of the elixir? Round to the nearest tenth.

1.7 g

A patint received a dose of gentamicin. Just after the infusion, it is known that the drug level was 10 mg/L, and the patient's ke = 0.22 hr^-1. Calculate the predicted concentration after 8 hours.

1.72 mg/L

A patient is taking 3 calcium citrate tablets daily (one tablet, TID). Each weighs 1,500 mg total (non-elemental) weight. She wishes to trade her calcium tablets for the carbonate form. IF she is going to use 1,250 mg carbonate tablets (by weight), how many tablets will she need to take to provide the same total daily dose?

1.89 tablets

The bulk density of lactose monohydrate NF is 0.53 g/cc. How much volume is occupied by 1 gram of the powder?

1.9 mL

Prescription Atropine Sulfate 0.4 mg Morphine Sulfate 5 mg Acetaminophen 325 mg DTD: 20 caps SIG: 1-2 caps q 4 hrs prn Question Approximately how much atropine sulfate, IN GRAINS, will you need to use to compound the prescription?

1/8th grain

The pharmacist has calculated that a patient requires 30 mmol of phosphate and 80 mEq of potassium. The pharmacy has stock solutions of potassium phosphate (3 mmol of phosphate with 4.4 mEq of potassium/mL) and potassium chloride (2 mEq K/mL). How much potassium phosphate and how much potassium chloride will be required to meet the patient's needs?

10 mL of potassium phophate 18 mL of potassium chloride

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 1,000 units/hour. The pharmacy has the following premixed heparin bags in stock: 25,000 units in 500 mL 1/2 NS, 10,000 units in 250 mL D5W, and 25,000 units in 250 mL D5W. What should the infusion rate be set at in mL/hour?

10 mL/hr

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question If the Zyvox infusion is given over one hour, calculate the infusion rate in mg/min.

10 mg/min

Prescription Morphine Sulfate 7.5 mg Acetaminophen 325 mg DTD: XX caps Sig: one cap q 4 hrs prn pain Question Morphine Sulfate is available in 15 mg tablets. How many tablets would provide the amount of morphine needed for this prescription?

10 tabs needed

Sterile NS was mixed with 300 mL of a stock solution of potash of alum to prepare 3 L of 1% alum irrigation. Calculate the percent strength of the stock solution.

10%

Labs Total WBC Count = 14,000/mm3 Bands = 5 Segs = 65 Basophils = 1 Eosinophils = 2 Lymphocytes = 24 Monocytes = 3 Question What will be the absolute granulocyte count for a patient with the WBC result shown above?

10,200

What is the pH of a solution prepared to be 0.4 M ammonnia and 0.04 M ammonium chloride (pKb for ammonia = 4.76)? Round to the nearest hundredth.

10.24

Dobutamine is to be administered to a pediatric patient (body weight 32 lb). The drug is available as 250 mg/20 mL vials. A volume of the injection sufficient to contain 90 mg of the drug is diluted to 100 mL with D5W and infused over 10 hours. Calculate the infusion rate in µg/kg/min.

10.3 µg/kg/min

What is the pH of a solution containing 0.2 mole of a weakly basic drug and 0.02 mole of its salt per liter of solution (pKa of the drug = 9.36)? Round to the nearest hundredth.

10.36

A 40-year-old female patient weighing 152 lb was treated for acetaminophen poisoning with an acetyl cysteine infusion. The 21-hour IV (Acetadote) regimen consists of 3 doses as follows: · Loading dose: 150 mg/kg (maximum = 15 g) infused over 1 h · Second dose: 50 mg/kg (maximum = 5 g) infused over 4 h · Third dose: 100 mg/kg (maximum = 10 g) infused over 16 h 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W Question The loading dose in grams and the volume of Acetadote required to provide it.

10.4 g; 52 mL

How many milliliters of 70% ethanol and 20% ethanol must be mixed to prepare 500 mL of 30% ethanol?

100 mL of 70% ethanol and 400 mL of 20% ethanol

When preparing an ounce of 1% hydrocortisone cream, the technician made an error and added 200 mg of hydrocortisone to the preparation. Calculate the additional amount of hydrocortisone powder that should be added to the 1-ounce cream to make its strength 1%.

100 mg

Efavirenz, a basic drug, has a pKa of 12.5. Calculate the percent of the drug ionized in the stomach (pH 2) and in the small intestine (pH 8).

100% and 100%

Fluoxetine, a weak base, has a pKa of 9.8. Calculate the percent of the drug ionized in the stomach (pH 2) and in the small intestine (pH 8).

100% and 98%

One milliliter of ragweed allergen extract concentrate was diluted to 10 mL by adding sufficient quantity of phenol-saline solution containing 0.03% human serum albumin. The strength of the dilution was 10,000 allergen units/mL (AU/mL). Calculate the strength of the allergen extract concentrate in AU/mL.

100,000 AU/mL

101.8 °F

A physician orders one liter of 3% sodium chloride injection for a sodium depleted patient. You have 0.9% sodium chloride injection in one liter bags and sodium chloride injection, 23.4%, in 50 ml vials. How many milliliters of the 23.4% NaCl solution will you ADD TO the one liter bag of 0.9% NaCl to prepare the 3% sodium chloride injection? Molecular weights sodium = 23, chlorine = 35.5

102.9 mL

A patient is receiving PN containing 480 mL of dextrose 50% and 50 grams of amino acids plus electrolytes. Calculate the non-protein calories to nitrogen ratio for this patient.

102:1

A patient is receiving 660 mL of 10% Intralipid on Saturdays along with his normal daily PN therapy of 1,420 mL of D20W, 450 mL Aminosyn 15%, and 30 mL of electrolytes. What is the daily amount of calories provided by the lipids? Round to the nearest whole number.

104 kcal/day

A mannitol injection label states that each 100 mL of the injection contains mannitol USP 20 g and water for injection USP qs. Calculate the concentration of mannitol (molecular weight = 182.2 g/mol) in mOsm/L.

1098 mOsm/L

11 mL of 23.4% NaCl

Instead of adding the required 45 mL of corn syrup when compounding a suspension, 50 mL of syrup was used by mistake. Calculate the percent error associated with the mistake.

11.1 %

The proper concentration of benzalkonium to prevent bacterial contamination in an eye drop is 1:750. You have a stock solution of 17% benzalkonium chloride and a dropper that delivers 50 drops per ml. How many drops will you need for a 30 ml bottle of eye drops?

11.76 (or 12) drops needed

A patient has been receiving 200 mL of an enteral mixture that contains 432 mOsm/L. The pharmacist will reuce the contents to 278 mOsm/L. How many milliliters of bacteriostatic water should be added to the bag? Round to the nearest mL.

111 mL of bacteriostatic water

112.5 mg/min

Calculate the CrCl for a 31-year-old male patient, 5 ft 8 in tall and weighing 166 lb, if his SCr was determined to be 0.91 mg/dL.

113.8 mL/min

A 49-year-old male patient, 6 ft tall and weighing 152 lb, requires a cisplatin infusion at a dose of 60 mg/m2. Cisplatin comes in vials containing 50 mg lyophilized powder. The 50 mg powder has to be reconstituted with 50 mL of sterile water for injection. After reconstitution, the solution will contain 1 mg/mL of the drug. Questions a. Calculate the dose required using the patient's BSA obtained from the BSA equation. b. How many vials are necessary to compound the chemotherapy infusion? c. What volume of the solution is necessary to provide the dose?

114 mg; 3 vials; 114 mL

A 10 lb infant takes six 1 oz bottles of a commercial infant formula (with 0.36 mg iron per 1 oz) daily. How much iron, in PPM, is present in one 1 oz bottle?

12 PPM

How many grams of dextrose are in 250 mL of D5W? Round to the nearest tenth.

12.5 g

A boric acid stock solution was prepared by dissolving 19 g boric acid in a small amount of purified water USP and then adding enough purified water USP to increase the volume to 1000 mL. Calculate the volume of this solution needed to prepare 25 mL of 0.95% boric acid solution in purified water.

12.5 mL

TPN formula · Dextrose = 200 grams · HepatAmine = 60 grams · Sodium Chloride = 50 mEq · Potassium Chloride = 40 mEq · Sodium Acetate = 20 mEq · Magnesium Sulfate = 10 mEq · Sodium Phosphate = 9 mMol · Potassium Acetate = 15 mEq · Calcium Chloride = 2 mEq · Multivitamins = 12 5 ml · Trace Elements = 5 1 mL · Vitamin K = 1 0.5 mg · Pepcid = 10 mg · Regular Insulin = 20 units · Sterile Water qs ad 960 ml · Flow Rate = 80 ml per hour Question How many ml of 23.4% Sodium Chloride Injection will be needed to prepare the TPN? Na = 23, Cl = 35.5

12.5 mL needed

A levofloxacin 750 mg per 30 mL vial is to be added to D5W to make an admixture of final drug concentration 5 mg/mL. How many milliliters of D5W should be mixed with the 30 mL vial to obtain this final strength?

120 mL

The parents of a child cannot read or speak English and a pediatrician knows the mother is going to give the child one teaspoonful of medication per dose no matter what dose is ordered. The pediatrician wants you to add enough water to make Biaxin Oral Suspension to a concentration of 150 mg per 5 mL. You have a container of Biaxin powder for oral suspension that says that addition of 55 mL of water will result in a final volume of 100 mL at a concentration of 250 mg per 5 mL. How much water must you use to change the final concentration of this container to 150 mg per 5 mL?

121.67 mL of water to add

PP is a 46-year-old male who weighs 207 pounds. He is admitted for bowel resection surgery. Post surgery, he is to be started on PN therapy. The physician wants the patient to receive 1.3 g/kg/day of protein. Calculate his protein requirement. Round to the nearest whole number.

122 g protein/day

1 US gallon = _________ fluid ounces

128 fluid ounces

A physician has ordered 2 grams of cefotetan to be added to 100 mL NS for a 56-year-old female with an anaerobic infection. Using a reconstituted injection containing 154 mg/mL, how many milliliters should be added to prepare the order? Round to the nearest whole number.

13 mL

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question How many mLs of Potassium Chloride Injection, 2 mEq/ml, will be needed to prepare one liter of the formula? K = 39; Cl = 35.5

13.4 mL needed

You receive the following parenteral nutrition order: Clinimix (5/20): Amino acids 5%/Dextrose 15% Infuse: Daily Volume: 1.5 (liters/day) How many calories will this PN provide per day? Round to the nearest whole number.

1320 kcal/day

TPN formula · Dextrose = 200 grams · HepatAmine = 60 grams · Sodium Chloride = 50 mEq · Potassium Chloride = 40 mEq · Sodium Acetate = 20 mEq · Magnesium Sulfate = 10 mEq · Sodium Phosphate = 9 mMol · Potassium Acetate = 15 mEq · Calcium Chloride = 2 mEq · Multivitamins = 12 5 ml · Trace Elements = 5 1 mL · Vitamin K = 1 0.5 mg · Pepcid = 10 mg · Regular Insulin = 20 units · Sterile Water qs ad 960 ml · Flow Rate = 80 ml per hour Question How many calories (or kilocalories; kcals) will the dextrose provide per 24 hours?

1350 calories in 24 hours

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question The first patient to receive this IV fluid had GI tract surgery and needs to be NPO for 5 days. The patient weighs 85 kilograms. How many calories from the dextrose and the amino acids will the patient receive in 24 hours?

1355.8 cals in 24 hours

A patient is to receive a potassium acetate infusion prepared by adding 9 mL of 39.2% potassium acetate (KC2H3O2) to 0.45% NS to make 1 liter. The patient is to receive the potassium acetate at 5 mEq/hr. What rate (mL/hr) will provide this dose? Round to the nearest whole number. (MW of K = 39, MW of C2H3O2 = 59)

139 mL/hr

One 50 mg vial of alteplase lyophilized powder was reconstituted by adding sufficient quantity of the accompanying sterile preservative-free water for injection to produce 50 mL of 1 mg/mL infusion. This solution was infused over 6 hours to treat multiple thromboemboli in a patient in the pediatric intensive care unit. Calculate the infusion rate used in µg/min. If a microdrip set that delivers 100 drops/mL was used, what was the drip rate in drops/min?

139 µg/min; 14 drops/min

A patient will receive 400 mg of a drug that has been put in a 250 mL IV bag. The rate of drug administration is 375 mcg per minute. Calculate the flow rate in milliliters per hour. Round to the nearest whole number.

14 mL/hr

14.4 mL

How many milligrams of sodium chloride (MW = 58.5) represent 0.25 mmol? Do not round the answer.

14.625 mg

143.6 mg

Patient case: Helene Gudot Age: 84 Sex: F Race African American Height: 5'5'' Weight 135 pounds Sodium on 12/11: 145 mEq/L The pharmacist is asked to convert several of Mrs. Gudot's labs to different units so her case can be compared to a published case report. Convert her serum sodium level (MW of Na = 23) on December 13th to mmol/L. Round to the nearest whole number.

145 mmol/L for sodium

A 15-year-old patient is using fluticasone propionate nasal suspension, two sprays (50 μg/actuation) per nostril every day. Each 9.9 mL (0.34 fl oz) container is labeled to contain 60 metered sprays. How many days will the product last on the basis of the patient's use? How many micrograms of fluticasone does the patient receive per nostril? How many micrograms of fluticasone are contained in 60 actuations?

15 days; 100 µg; 3000 µg

15 drops/min

A dose of 120 mg of gentamicin is administered IV. After 10 minutes, a blood sample is assayed for gentamicin content. The result is 8 mcg per ml. What is the volume of distribution for gentamicin?

15 liters

You are to mix this IV using the materials shown. You must ADD the volumes of the dextrose and NaCl to the 1000 ml of Sterile Water. Prescription: Sterile Water for Injection 1000 ml Dextrose 10 % Sodium chloride 60 mEq Administer over 24 hours Using the following supplies Sterile Water for Injection, 1000 ml Sod Chloride Inj, 23.4% (MW = 58.5) Dextrose 70% in Water Injection Question How many ml of the Sodium Chloride Injection, 23.4%, will you add to the sterile water?

15 mL required

Mr Smith is unable to take his Epivir and will have a NG tube inserted to make oral drug administration more practical. If the physician prescribes Epivir Oral Solution, 10 mg per ml, what will be the actual volume administered to Mr Smith?

15 mL/dose

A 7-year-old male child (48 pounds) presents to the urgent care clinic with a fever of 102 degrees F, and nausea/vomiting that started teh previous day. He will receive an acetaminophen 5 grain suppositroy for the fever. A pharmacist receives a prescription for the suppository with the instructions: Use 1 PR Q4-6H PRN temperature > 102 degrees F. HOw many milligrams per kilogram (mg/kg) will the child receive per dose? Round to the nearest whole number.

15 mg/kg

Prescription Hyoscine HBr 0.3 mg Oxycodone 7.5 mg Acetaminophen 300.0 mg DTD: caps no. XX Sig: i or ii caps q 4-6 hrs prn pain Question You have Hyoscine HBr tablet triturates (similar to nitroglycerine tablets) that contain 1/150th grain per tablet. How many will you need for the RX?

15 tabs

A pharmacist has mixed 200 mL of D20% with 100 mL of D5%. What is the final concentration in the bag?

15%

A pediatric iron supplement drop contains 15 mg iron per 1 mL supplement. Express the concentration in PPM.

15,000 PPM

The usual recommended dosing regimen for bimatoprost ophthalmic solution is to instill one drop into the affected eye(s) every evening. If 20 drops are equal to one mL of the ophthalmic solution, how many doses are present in a 7.5 mL container?

150 doses

The dosing literature for Epivir has the following information concerning use in renal failure. What is the appropriate dose for Mr. McClure? Creatine Clearance ---Initial Dose ---Maintenance Dose < 5 ml/min --- 50 mg --- 25 mg once daily 5 - 14 ml/min --- 150 mg --- 50 mg once daily 15 - 29 ml/min --- 150 mg --- 100 mg once daily 30 - 49 ml/min --- 150 mg --- 150 mg once daily

150 mg once, then 150 mg once daily for CrCl between 30 and 49 mL/min

Ms. Roberta Snagg has a recurring mycotic infection of the bladder. Her physician wants to use a bladder irrigation of amphotericin B to be continuously run through the bladder for at least 24 hours. You are to prepare a 2 liter bag of amphotericin B irrigation solution, 1:5000 concentration, that will be administered at a rate of 80 mL per hour. You have vials of amphotericin B, 50 mg, that, when properly reconstituted, contain 50 mg of amphotericin B in a total volume of 10 mL. Question Your irrigation set delivers 12 drops per mL. What will be the flow rate, in drops per minute, to administer the amphotericin B at the desired dose?

16 drops/minute

Patient case: Helene Gudot Age: 84 Sex: F Race African American Height: 5'5'' Weight 135 pounds Glucose readings on 12/12 140 @ 0700 280 @ 1100 300 @ 1700 220 @ 2100 Mrs Gudot uses the following regular insulin sliding scale: "take 1 unit of insulin SC for every 20 mg/dL of blood sugar > 160 mg/dL." How many units of sliding scale insulin should have been administered on December 12th?

16 units

This formulation is for 24 hours of a total parenteral nutrition (TPN) formulation. Dextrose provides 3.4 calories (or kilocalories or kcals) per gram and Amino Acids provide 4 calories per gram. The electrolytes and vitamins do not provide any calories. (Fat provides 9 calories per gram.) Total Parenteral Nutrition Formula · Dextrose Injection, 50% = 1000 ml · Amino Acids, 10% = 400 ml · Electrolytes / Vitamins = 200 ml · Sterile Water = 800 ml Question The IV set will deliver 10 drops per ml. What will be the flow rate, in drops per minute, to administer the formula above over 24 hours?

16.7 (or 17) drops per min

A 1 g vial of ertapenem (Invanz) was reconstituted by adding 10 mL NS. The reconstituted injection was transferred to a 50 mL NS IV bag. Calculate the final concentration of ertapenem, in mg/mL, in the IV bag. (Ignore any volume change during reconstitution, and round your answer to one decimal place.)

16.7 mg/mL

Patient case: Helene Gudot Age: 84 Sex: F Race African American Height: 5'5'' Weight 135 pounds Potassium on 12/13: 4.3 mEq/L The pharmacist is asked to convert several of Mrs. Gudot's labs to different units so her case can be compared to a published case report. Convert her serum potassium (MW of potassium = 39) on December 13th to mg/dL. Round to the nearest tenth.

16.8 mg/dL

A male patient 52 years old, weighing 139.8 lb, and 6 ft 2 in tall needs an aldesleukin infusion over 4 days at a dose of 9 million international units (IU)/m2/day. Aldesleukin (Proleukin) is available as a lyophilized powder for reconstitution. Each vial contains 22 million IU, which, when reconstituted with 1.2 mL sterile water for injection, contains 18 million IU/mL of the reconstituted injection. Calculate the following: Questions 1. The dose required per day for the patient, using the BSA obtained from an adult nomogram. 2. The number of vials of lyophilized aldesleukin needed per day for the patient. 3. The volume of reconstituted injection needed to provide the dose.

16.8 million IUs/day; 1 vial; 0.9 mL

You are to mix this IV using the materials shown. You must ADD the volumes of the dextrose and NaCl to the 1000 ml of Sterile Water. Prescription: Sterile Water for Injection 1000 ml Dextrose 10 % Sodium chloride 60 mEq Administer over 24 hours Using the following supplies Sterile Water for Injection, 1000 ml Sod Chloride Inj, 23.4% (MW = 58.5) Dextrose 70% in Water Injection Question How many ml of the Dextrose 70% in Water Injection will you add to the sterile water?

169.17 mL

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question The IV set used to administer this solution delivers 12 drops per mL. What will be the flow rate to administer the solution at the dose ordered for this patient?

17 drops per minute

A patient is to receive 8 mEq of calcium. The pharmacy has calcium gluconate 10% in stock which provides 0.465 mEq/mL. How many milliliters of calcium gluconate should be added to the PN? Round to the nearest whole number.

17 mL calcium gluconate

A 152 lb patient requires cyclosporine orally 2.5 mg/kg/day in two divided doses. Calculate the following: Questions a. The total daily dose for the patient. b. The dose to be administered at a time. c. The volume required to provide a single dose if cyclosporine oral solution (Sandimmune) 100 mg/mL is to be used.

172.8 mg; 86.4 mg; 0.9 mL

Using the following formula, 15 g of a gel is to be prepared. Formula · Morphine sulfate 0.06% · Hydrogel base qs 100% Question Morphine sulfate injection, a preservative-free, antioxidant-free solution of 5 mg/10 mL strength, is available for compounding the gel. Calculate the volume of morphine sulfate injection that will provide the required dose.

18 mL

You receive an order for 500 mg of aminophylline in normal saline in a total volume of 250 ml. The patient weighs 132 pounds. The aminophylline is to be administered at a dose of 0.3 mg per kg per hour. Aminophylline Injection is supplied in vials with 25 mg per ml. The IV set you will use delivers 60 drops per ml. How many milligrams of theophylline will the patient receive each hour?

18 mg/hr

A patient (weight, 176 pounds) in cardiology is receiving a heparin drip, currently running at 15 units per kilogram per hour. The concentration of heparin in the IV drip is 10,000 units per 100 mL and the IV set delivers 15 drops per mL. The most recent partial thromboplastin time (PTT) indicates that the patient is being under dosed and that the heparin rate should be increased by 20% according to the hospital's weight based heparin protocol. Question What will be the new dosage in units per kilogram per hour?

18 units/kg/hr

Tamsulosin (Flomax) was prescribed to a patient to treat benign prostatic hyperplasia (BPH). The dose required was 0.8 mg once daily, to be taken orally approximately 30 minutes after the same meal every day. The patient needs a 3 month supply. How many tablets have to be dispensed? The tamsulosin preparation available is a 0.4 mg tablet.

180 tablets

This formulation is for 24 hours of a total parenteral nutrition (TPN) formulation. Dextrose provides 3.4 calories (or kilocalories or kcals) per gram and Amino Acids provide 4 calories per gram. The electrolytes and vitamins do not provide any calories. (Fat provides 9 calories per gram.) Total Parenteral Nutrition Formula · Dextrose Injection, 50% = 1000 ml · Amino Acids, 10% = 400 ml · Electrolytes / Vitamins = 200 ml · Sterile Water = 800 ml Question How many calories, from all sources, will the patient receive in 24 hours?

1860 cals per day

A topical solution is to be compounded using the following formula: Formula · Phenylephrine 10% ophthalmic solution = 20 mL · NS qs ad 400 mL Question How many milliliters of phenylephrine 10% ophthalmic solution are necessary to prepare one gallon of the solution?

189.25 mL

The 8 AM medications scheduled for a patient include Tygacil dosed at 6 mg/kg. The patient weighs 142 pounds. The nurse has Tygacil labeled 500 mg/50 mL NS. The dose will be administered over thirty minutes. The IV tubing in the unit delivers 15 drops per milliliter. What is the correct rate of flow in drops per minute? Round to the nearest drop.

19 drops/min for 30 minutes

A physician writes an order for aminophylline 500 mg IV, dosed at 0.5 mg per kg per hour for a female patient (185 pounds, 5'1''). There is only theophyllin in stock. How many milligrams (mg) of theophylline will the patient receive per hour? Round to the nearest whole number.

19 mg/hour of theophylline

TE is a 35-year-old female who is receiving 325 grams of dextrose, 85 grams of amino acids, and 300 mL of 10% lipids via her PN therapy. WHat percentage of total calories is provided by the protein content? Round to the nearest whole number.

19%

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL What percentage of the total calories from the PN are represented by the protein component? Round to the nearest whole number.

19%

If 200 capsules contain 500 mg of an active ingredient, how many milligrams of the active ingredient will 76 capsules contain?

190 mg

Prescription Tetracycline HCL 2% NaCl to isotonicity qs 30 mL Sig: 2 drops into OS QID Question You have tetracycline HCl powder and sodium chloride crystals. How much sodium chloride will you need to add to make the final 30 ml volume isotonic? E value for tetracycline HCl = 0.12

198 mg NaCl needed

Acetylcholine intraocular solution (Miochol E) is prepared by diluting 20 mg of sterile lyophilized acetylcholine powder contained in a vial with manufacturer-supplied 2 mL electrolyte diluent. Express the final strength of the reconstituted solution as a ratio strength. (Ignore any volume changes upon admixture.)

1:100

The strength of an EpiPen is given as 0.3 mg/0.3 mL. Calculate the ratio strength.

1:1000

Express the concentration of NaCl in NS as a ratio strength.

1:111

If 0.1 mL of a 1:1000 epinephrine injection was mixed with 20 mL of lidocaine 1% injection, calculate the new ratio strength of epinephrine in the admixture. (Ignore the volume change produced when both injections are mixed.)

1:200,000

You dilute 1 ml of Fungizone Injection (50 mg per 10 ml) to one liter. The concentration in the diluted solution will be (express as N:XXXX, such as 1:1000)

1:200,000

The strength of an EpiPen Jr. is given as 0.15 mg/0.3 mL. Calculate the ratio strength.

1:2000

A vial of levothyroxine sodium for injection contains 200 µg lyophilized levothyroxine sodium powder. When it is reconstituted with 5 mL NS, the resultant solution has a concentration of 40 µg levothyroxine sodium per milliliter of the solution. Calculate the ratio strength.

1:25,000

What is the ratio strength (w/v) of 50 mL containing 1:20 (w/v) ammonia solution diluted to 1 liter?

1:400

Each vial of 5 mL glycopyrrolate injection USP contains 1 mg glycopyrrolate. Express its concentration as a ratio strength.

1:5000

You receive the following parenteral nutrition order: Clinimix (5/15) with electrolytes: Amino acids 5%/Dextrose 15% Infuse: Daily How many liters of this PN should be ordered to provide 1,420 kcals per day? Round to the nearest whole number.

2 L

How many grams of sodium hydroxide (NaOH; 40 g/mol) should be used to prepare 100 mL of 0.5 M aqueous NaOH?

2 g

Instead of 4 grams of tetracaine hydrochloride 4% gel, an 8% gel was compounded by mistake. How many grams of the 8% gel and a gel base must be mixed to get 4 grams of a 4% gel?

2 g of 8% gel and 2 g of gel base

A patient was receiving Drug B for 1 week. The drug was held on June 1st due to an elevated serum concentration. Based on the serum concentrations obtained on June 1st after the drug was held (shown below). What is the half-life of Drug B? 1400: 12 mcg/mL 1500: 8.5 mcg/mL 1600: 6 mcg/mL 1700: 4.3 mcg/mL 1900: 2.1 mcg/mL

2 hours

The serum concentration of Drug A over time is shown below. What is the half-life of Drug A? Hour 1: 0 mcg/mL Hour 2: 12 mcg/mL Hour 3: 9 mcg/mL Hour 4: 6 mcg/mL Hour 5: 4.5 mcg/mL Hour 6: 3 mcg/mL Hour 7: 2 mcg/mL

2 hours

How many milliliters of Mylanta suspension are contained in each dose of the prescription below? Round to the nearest whole number. Belladonna Tincture: 10 mL Phenobarbital: 60 mL Mylanta susp. qs. ad.: 120 mL Sig. 5 mL BID

2 mL Mylanta per dose

A 64-year-old female patient, 5 ft 4 in tall and weighing 135 lb, is receiving meropenem 1 g every 8 hours. When the infusion was started, her SCr was 0.84. The manufacturer recommends CrCl-based dosing modifications as follows: · CrCl > 50 mL/min: No dosage adjustment necessary. · CrCl 26-50 mL/min: Administer the recommended dose as indicated every 12 hours. · CrCl 10-25 mL/min: Administer one-half the recommended dose as indicated every 12 hours. · CrCl < 10 mL/min: Administer one-half the recommended dose as indicated every 24 hours. Later, her SCr increased to 1.54. The manufacturer's recommendation for reconstitution is as follows: Vial size --> Diluent added (mL) 500 mg --> 10 mL 1 g --> 20 mL The infusion vials were reconstituted with an appropriate volume of NS (as per the table above) from a 500 mL IV bag and added back to the bag. Question Calculate the concentration of meropenem in the IV bag, in mg/mL, after admixture.

2 mg/mL

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question Linezolid is dosed at 600 mg twice daily through an IV. Zyvox 600 mg/300 mL is used. Calculate the strength of this drug in mg/mL and % w/v.

2 mg/mL and 0.2% w/v

A patient is taking clozapine and is at the clinic for a routine visit. Today's labs include WBC = 4,300 cells/mm3 with 48% segs and 2% bands. Calculate this patient's ANC.

2,150 cells/mm3

GG is a 57-year-old female admitted to the hospital with bowel obstruction. She will be NPO for the next 5-7 days. The decision was made to start PN therapy. She weighs 65 kg. Her SCr is 1.3 mg/dL. Calculate GG's daily fluid requirements.

2,400 mL/day

How many moles of anhydrous magnesium sulfate (MW = 120.4) are present in 250 grams of the substance? Round to the nearest hundredth.

2.08 mols

A patient is receiving Dextrose 5% in 0.45% Sodium Chloride Injection and 40 mEq of potassium chloride in a total volume of 1000 mL through an IV set that delivers 15 drops per mL. The IV fluid has been running at a rate of 12 drops per minute for 15 hours. Molec Weights: Dextrose = 180, Na = 23, K = 39, Cl = 35.5 Question How many grams of KCl have been administered over the 15 hour period?

2.1456 grams

The density of glycerin is 1.26 g/cc at 20°C. Calculate the dose of glycerin delivered, in milliliters, if one pediatric glycerin suppository contains 2.8 g glycerin.

2.2 mL

An extended release buprenorphine transdermal patch 7.5 µg/h has the dimensions 58 mm by 45 mm. Express the dimensions in inches.

2.28 in by 1.77 in

A 10 mL vial of 10% calcium gluconate (molecular weight = 430.4) injection was admixed with NS to prepare a 100 mL infusion. How many millimoles of calcium and of gluconate are present in this infusion?

2.3 mmol calcium, 4.6 mmol gluconate

Regular insulin is to be given as an infusion to treat a child (52 lb) with diabetic ketoacidosis. The infusion rate to be used is 0.1 units/kg/h. A dilution is to be prepared such that 50 units of insulin is present per 50 cc of NS. Calculate the dose of insulin the child will receive per hour. Calculate the volume of Novolin R (100 units/mL) and the volume of NS to be used to compound 100 mL of the infusion.

2.4 units/h; 1 mL Novolin R; 99 mL NS

TPN formula · Dextrose = 200 grams · HepatAmine = 60 grams · Sodium Chloride = 50 mEq · Potassium Chloride = 40 mEq · Sodium Acetate = 20 mEq · Magnesium Sulfate = 10 mEq · Sodium Phosphate = 9 mMol · Potassium Acetate = 15 mEq · Calcium Chloride = 2 mEq · Multivitamins = 12 5 ml · Trace Elements = 5 1 mL · Vitamin K = 1 0.5 mg · Pepcid = 10 mg · Regular Insulin = 20 units · Sterile Water qs ad 960 ml · Flow Rate = 80 ml per hour Question Magnesium sulfate is available as a 50% solution of magnesium sulfate heptahydrate (7 waters of hydration). What volume of this injection is needed for this formula? Mg = 24, S = 32, H = 1, 0 = 16

2.46 mL needed

Metronidazole gel 1% (Metrogel) is a topical gel used in the treatment of inflammatory lesions of rosacea. What quantity of the gel will contain 25 mg metronidazole?

2.5 g

A 25 mg dose of propofol is to be administered to a patient from propofol emulsion 1%. How many milliliters of the emulsion is required to give the dose?

2.5 mL

Prescription Indomethacin 0.05% Boric Acid qs Water qs ad 15 mL Question You have boric acid in a saturated solution that is 5.5% boric acid. What volume of this solution will you need to use to obtain the needed amount of boric acid?

2.68 mL needed

A newborn in the NICU weighed 5.9 lb and measured 18.3 inches in length. Express the child's weight in kilograms and length in centimeters.

2.7 kg; 46.5 cm

Lactated Ringer's Injection contains 20 mg of calcium chloride dihydrate per 100 ml of IV fluid. How many mEq of calcium are present in one liter of Lactated Ringer's Injection? Molecular weights: Ca = 40, Cl = 35.5, H = 1, O = 16

2.72 mEq per liter

The plasma level of phencyclidine (PCP) in a patient who was presented at the ER following a motor vehicle accident was 2.9 ng/mL. Express the concentration in PPB.

2.9 PPB

Pluronic lecithin organogel (PLO) was prepared using the following formula: Formula · Lecithin-isopropyl palmitate liquid = 20 mL · Pluronic 20% gel = 80 mL Question What is the percent v/v of lecithin-isopropyl palmitate liquid in the organogel?

20%

A 500 mg dose of gentamicin is administered to a patient, and a blood sample is drawn. The concentration of gentamicin is measured as 25 mcg/mL (which is the same as 25 mg/L). What is the volume of distribution of gentamicin in this patient?

20 L

A topical gel is to be prepared using the following formula: Formula · Isopropyl alcohol (IPA) 70% v/v, 62% w/w · Gel base qs 100% Question Calculate the volume of IPA 70% required to prepare 30 g of the gel if the specific gravity of IPA 70% v/v is 0.93.

20 mL

How many mL of the 40 mg per mL Dopamine Injection should be added to a 500 mg bag of IV fluid to prepare the double concentration? (Ignore volume of the dopamine injection.)

20 mL needed

A cough syrup contains 4 grams of brompheniramine maleate per liter. How many milligrams are contained in one teaspoonful of the elixir?

20 mg

For adults, the maximum daily dose from a Beclovent Inhaler is 840 micrograms. A Beclovent Inhaler contains 8.4 milligrams of deliverable drug in 200 puffs. What is the maximum number of Beclovent puffs a patient may use in one day?

20 puffs per day

Sodium acetate concentrate for injection USP contains 16.4 g sodium acetate (anhydrous) in a 50 mL vial. How many milliliters of this injection contain 50 mEq acetate? (Molecular weight of anhydrous sodium acetate = 136.1 g/mol.)

20.7 mL

SJ is a female patient in the internal medicine unit receiving treatment following a motor vehicle accident. Her medications include lorazepam, morphine and phenytoin. Her serum albumin is 1.8 g/dL and her phenytoin level is 9.6 mcg/mL. Calculate SJ's corrected phenytoin level using the formula provided. Round to the nearest one decimal place.

20.9 mg/L

A pediatric patient (body weight 26 lb) is to receive 700 mg phenytoin over 30 minutes as an infusion. Phenytoin sodium USP is available in a strength of 250 mg/5 mL. If an appropriate volume of this injection was diluted to 100 mL with NS, calculate the infusion rate, in mg/kg/min, that must be used to deliver the medication. If a drip set calibrated to 60 drops/mL is used to administer the infusion, what drip rate, in drops/min, should be used?

200 drops/min

A loading dose of lacosamide (Vimpat) was administered as an infusion over 50 minutes at an infusion rate of 4 mL/min. If the infusion had a strength of 1 mg/mL, calculate the loading dose that was given to the patient.

200 mg

Ipratropium bromide and albuterol inhalation spray 4 mL (Combivent Respimat) has 0.06% strength with respect to ipratropium bromide and 0.3% strength with respect to albuterol. If one cartridge of the spray contains 120 actuations, what is the amount of albuterol, in micrograms, that a patient receives with two actuations of the spray?

200 µg

An alkaline stock solution was prepared by dissolving 50 g sodium carbonate in purified water USP to prepare a 1 L solution. How many milliliters of 2.5% sodium carbonate can be prepared from the stock solution?

2000 mL

A 48-year-old male patient who fell off scaffolding at a construction site and is recovering from trauma related to multiple fractures and dislocations needs enteral feeding. A total caloric intake of 25 kcal/day has been recommended. If the patient is bedridden and 6 ft tall and weighs 178 lb, calculate the patient's total caloric intake, protein requirement, and fluid needs.

2022.5 kcal/day; 161.8 g/day; 2427 mL/day

A pediatric patient was prescribed to take calcitriol 0.75 μg daily for four weeks. Calcitriol solution is available at a strength of 1 μg/mL in 15 mL containers. How many micrograms of calcitriol will the patient receive over four weeks? How many milliliters of the solution are necessary to provide a single dose? What volume of the solution is necessary to provide all the doses needed over four weeks?

21 µg; 0.75 mL; 21 mL

A 46-year-old female with radiation enteritis is receiving 1,800 kcal from her parenteral nutrition. The solution contains amino acids, dextrose and electrolytes. There are 84.5 grams of protein in the PN and it is running at 85 mL/hour over 24 hours. What is the final concentration of dextrose in the PN solution? Express the answer as a percentage. Round to the nearest whole number.

21%

JB is a patient receiving Osmolite (a high-protein, low-residue formula) enteral nutrition through a PEG tube. It has the following nutritional facts: Serving size: 8 fl oz Calories: 285 kcal Total fat: 9.2 g Total protein: 13.2 g Total carbs: 37.4 g The nurse was administering 1 can (8 fl oz.) of Osmolite to JB when she accidentally spilled 2 fl oz. on the floor. The remaining amount in the can was accurately delivered to the patient. How many calories did he actually receive? Do not round the answer.

213.75 kcal

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question How many mLs of Dextrose Injection, 700 mg/mL, will be needed to prepare one liter of the formula?

214.3 mL

Calculate the total energy need for an ambulating male patient 56 years old, 5 ft 9 in tall, and 173 lb in weight.

2141 kcal/day

A medication order is received to give heparin at 1100 units/h. The infusion to be used is heparin 25,000 units in 500 mL D5W. If the infusion set to be used delivers 60 drops/mL, what drip rate, in drops/min (gtts/min), must be used?

22 drops/min

An order is written for 10 mL of a 10% calcium chloride injection and 10 mL of multivitamin injection (MVI) to be added to 500 mL of D5W. The infusion is to be administered over 6 hours. The IV set delivers 15 drops/mL. What should be the rate of flow in drops/minute to deliver this infusion? Round to the nearest whole number.

22 drops/min

A pharmacist will prepare an amoxicillin suspension to provide a 1500 mg daily dose for a child with an otitis media infection. The dose will be divided BID. To prepare amoxicillin 200 mg/5 mL the pharmacist should add 76 mL of water to the powder for a final volume of 100 mL. The pahrmacist mistakenly adds too much water and finds that the final volume is 110 mL. The pharmacy has no other bottles of amoxicillin , so the pharmacist will dispense the bottle with the extra water added. How many milliliters should the patient take twice daily to receive the correct dose? Round to the nearest whole number.

22 mL

WT is needing a protein shake with the following nutrition facts, what percent of calories will WT receive from the protein component? Round to the nearest whole number. Calories: 356 kcal Total fat: 17.8 g Protein: 19.6 g

22%

A penicillin V 250 mg tablet equals 400,000 units of penicillin activity. A patient is taking penicillin V 500 mg tablets QID for 7 days. How much penicillin activity, in units will this patient receive in the total prescription?

22,400,000 units

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question Calculate the amikacin dose required in one infusion.

222.5 mg

Tc 99m sestamibi injection was prepared to provide a dose of 15 µCi at 9 AM for myocardial imaging in a patient. If the half-life of Tc 99m is 6.03 hours, what original dose must be prepared and dispensed at 5 AM? If the patient was delayed by an hour and was ready to receive the dose at 10 AM, how much of the drug may be expected to remain at that time?

23.8 µCi, 13.4 µCi

A 100 mL bottle of metronidazole 100 mg/mL suspension is available in your pharmacy. Calculate the volume of this suspension needed to be diluted with cherry syrup to prepare 60 mL of a 4% metronidazole suspension.

24 mL

Prescription: Resperine Liquid (1mg/mL) Disp: 60 mL Sig: 0.01 mg per kg per dose. One dose twice a day You have tablets that contain 0.25 mg of reserpine per tablet. You can mix ground up reserpine tablets in cherry syrup to make a liquid that will be stable for at least 3 months. The patient is a child that weighs 22 pounds. How many reserpine tablets will be needed to compound the prescription?

24 tabs needed

Your patient is receiving lithium carbonate (Li CO ) capsules but needs 3 657 to change to a liquid form (lithium citrate; Li C H O ). Molecular weights: lithium = 7, carbon = 12, hydrogen = 1, oxygen = 16 If the patient's dose of lithium carbonate was 300 mg three times a day, how many millimoles of lithium did the patient receive in a day?

24.3 mMoles per day

Calculate the BMI of a person 6 ft 2 in tall and weighing 195 lb.

24.5

You have a vial that contains 5 gms of drug and the chart below for mixing the drug for use. Nurses want to mix the vial so that it comes out with 200 mg per ml and ask you how much diluent they should add to make that concentration. Diluent Added --> Concentration Resulting 9.6 ml 500 mg per ml 19.6 ml 250 mg per ml 49.6 ml 100 mg per ml

24.6 ml of diluent to add to make 200 mg/ml

Diclofenac sodium gel 1% (Voltaren gel) comes with a dosing card marked with a 2-gram line and a 4-gram line. The daily dosing of diclofenac sodium should not exceed 320 mg over all affected areas. If a patient uses 4 grams of gel six times daily, how many milligrams of the drug will be provided per day?

240 mg

Acetaminophen oral dosing in pediatric patients is shown below. Weight (lb) --> Age --> Dose (mg) 6-11 --> 0-3 mo --> 40 12-17 --> 4-11 mo --> 80 18-23 --> 1-2 y --> 120 24-35 --> 2-3 y --> 160 36-47 --> 4-5 y --> 240 48-59 --> 6-8 y --> 320 60-71 --> 9-10 y --> 400 72-95 --> 11 y --> 480 Questions The use of weight to select dose is preferred. When weight is not available, age can be used. Doses may be repeated 4 times daily, with a maximum of 5 doses over 24 hours. Calculate the following for a 5-year-old child weighing 43.8 lb: a. The dose, in milligrams of acetaminophen, that can be administered. b. If acetaminophen suspension 160 mg/5 mL is to be used, the volume of suspension required to administer the dose. c. The maximum daily dose for the patient.

240 mg; 7.5 mL; 1200 mg

A physician orders 15 units of regular insulin to be added to a liter of D5W to be given over 10 hours. What is the infusion rate, in drops/minute, if the IV set delivers 15 drops/mL? Do not include the insulin volume in the calculation.

25 drops/min

How many grams of dextrose are present in 500 mL of D5W?

25 g

The pharmacist has an order for heparin 25,000 units in 250 mL D5W to infuse at 1,000 units/hour. How many hours will it take to infuse the entire bag?

25 hours

A 64-year-old female patient, 5 ft 4 in tall and weighing 135 lb, is receiving meropenem 1 g every 8 hours. When the infusion was started, her SCr was 0.84. The manufacturer recommends CrCl-based dosing modifications as follows: · CrCl > 50 mL/min: No dosage adjustment necessary. · CrCl 26-50 mL/min: Administer the recommended dose as indicated every 12 hours. · CrCl 10-25 mL/min: Administer one-half the recommended dose as indicated every 12 hours. · CrCl < 10 mL/min: Administer one-half the recommended dose as indicated every 24 hours. Later, her SCr increased to 1.54. The manufacturer's recommendation for reconstitution is as follows: Vial size --> Diluent added (mL) 500 mg --> 10 mL 1 g --> 20 mL The infusion vials were reconstituted with an appropriate volume of NS (as per the table above) from a 500 mL IV bag and added back to the bag. Question How many times dilute is the meropenem concentration in the IV bag after admixture compared to the concentration in the vial after reconstitution?

25 times

In one protocol for testing endotoxins in a compounded sterile preparation (CSP), a 1:80 dilution of the CSP is to be prepared with 2 mL water supplied with the endotoxin testing kit. How many µL of the CSP should be used to prepare the dilution?

25 µL

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question The amikacin sulfate injection USP's product label says the strength of the injection is 1 g/4 mL. Express the strength in % w/v.

25% w/v

A balance has a sensitivity of 5 milligrams. What is the least amount you can weigh on this balance if you need to work with an accurary of 2%?

250 mg

A patient is to receive Flagyl at a rate of 12.5 mg/min. The pharmacy has a 5 mL (100 mg/mL) Flagyl injection vial to be diluted in 100 mL of NS. How much drug in milligrams will be the patient receive over 20 minutes?

250 mg

Calculate the amount of boric acid, in milligrams, needed to prepare 25 mL of 1:100 aqueous boric acid solution.

250 mg

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL The PN order calls for 12 mEq of calcium. The pharmacy has calcium gluconate 10% (0.465 mEq/mL) in stock. How many milliliters of calcium gluconate 10% should be added to the PN? Round to the nearest whole number.

26 mL calcium gluconate 10%

JY is a 58-year-old male hospitalized for a total knee replacement. He was given unfractionated heparin and developed heparin-induced thrombocytopenia (HIT). Argatroban was ordered at a dose of 2 mcg/kg/min. The pharmacy mixes a concentration of 100 mg argatroban in 250 mL of D5W. JY weighs 187 lbs. At what rate (mL/hour) should the nurse infuse argatroban to provide the desired dose? Round to the nearest whole number.

26 mL/hr

Calculate the BMI for a male who is 6' tall and weighs 198 lbs. Round to the nearest tenth. Is the patient underweight, normal weight, overweight or obese?

26.9 kg/m2, overweight

You receive an order for 30 grams of 0.1 percent hydrocortisone cream for use on an infant. You have available 1 percent hydrocortisone cream and cold cream that can be mixed with the hydrocortisone. How many grams of the cold cream will be needed to fill the order?

27 grams of cold cream needed

TPN formula · Dextrose = 200 grams · HepatAmine = 60 grams · Sodium Chloride = 50 mEq · Potassium Chloride = 40 mEq · Sodium Acetate = 20 mEq · Magnesium Sulfate = 10 mEq · Sodium Phosphate = 9 mMol · Potassium Acetate = 15 mEq · Calcium Chloride = 2 mEq · Multivitamins = 12 5 ml · Trace Elements = 5 1 mL · Vitamin K = 1 0.5 mg · Pepcid = 10 mg · Regular Insulin = 20 units · Sterile Water qs ad 960 ml · Flow Rate = 80 ml per hour Question Sodium Phosphate is being added as Na PO . How many mEq's of sodium will be added as a result of using sodium phosphate? Na = 23, P = 31, O = 16

27 mEq of sodium added with the Na phosphate

A medication order is received for an 8 µg/kg/min IV drip of dopamine for a 198 lb patient. The infusion to be used is dopamine 800 mg in 500 mL D5W. Calculate the infusion rate in mL/h. If an infusion set calibrated to 20 drops/mL is used, calculate the drip rate in drops/min.

27 mL/h; 9 drops/min

Calculate the CrCl for a 76-year-old female patient, 5 ft 2 in tall and weighing 120 lb, if her SCr is 1.4 mg/dL.

27 mL/min

You receive an order for 500 mg of aminophylline in normal saline in a total volume of 250 ml. The patient weighs 132 pounds. The aminophylline is to be administered at a dose of 0.3 mg per kg per hour. Aminophylline Injection is supplied in vials with 25 mg per ml. The IV set you will use delivers 60 drops per ml. How many hours will the 250 ml last if administered at the correct dose?

27.77 hrs

A nurse is hanging a 4% lidocaine drip for a patient. If the dose ordered is 6 mg/min, how many hours will a 250 mL bag last? Round to the nearest hundredth.

27.8 hours

A 52-year-old female patient comes to a compounding pharmacy to get a 90-day supply of diclofenac sodium 50 mg, which she takes three times daily. She also needs a 90-day supply of the levothyroxine sodium/liothyronine sodium 75/5 μg SR capsules that she takes once a day and an ounce of DHEA 1.3% cream. The formula for Levothyroxine sodium/liothyronine sodium 75/5 μg SR capsules is as follows: · Levothyroxine sodium 2% stock powder blend - TBD as needed · Liothyronine sodium 0.5% stock powder blend - TBD as needed · Hydroxypropyl methyl cellulose (4000 CPS) USP - 200 mg · Microcrystalline cellulose NF - 50 mg ~ 255 mg fill volume in size #1 capsule shells. Formula for DHEA 1.3% cream DHEA 1.3% Commercial cream base qs Question Calculate the total number of diclofenac sodium tablets to be dispensed.

270 tablets

MH is a 72-year-old male patient hospitalized with decompensated heart failure and fever. Cultures are positive for aspergillosis. MH weighs 110 kg and will receive 0.25 mg/kg per day of amphotericin B (reconstituted and diluted to 0.1 mg/mL) by IV infusion. How many milliliters of amphotericin solution are required to deliver the daily dose?

275 mL

A 1000 mL partial-fill container holds 500 milliliters of 50% dextrose injection USP. Express the concentration of dextrose (molecular weight = 180.2 g/mol) in mOsm/L.

2775 mOsm/L

SJ was recently admitted to the ICU with a pH of 7.27. Below is her laboratory data. Calculate SJ's anion gap. Na: 144 Cl: 95 BUN: 68 Glucose: 414 K: 3.22 CO2: 21 SCr: 2.1

A male patient comes to the pharmacy and tells the pharmacist he is 6'7'' tall and 250 pounds. The waist circumference is 43 inches. Calculate his BMI. Round to the nearest whole number. Is the patient underweight, normal weight, overweight or obese?

28 kg/m2, overweight

You need to prepare 30 grams of 0.25% triamcinolone in Cold Cream. Triamcinolone is available in a suspension of 40 mg per ml that has a specific gravity of 1.0. How many grams of the Cold Cream will be needed?

28.125 grams of cold cream needed

Your patient is receiving lithium carbonate (Li CO ) capsules but needs 3 657 to change to a liquid form (lithium citrate; Li C H O ). Molecular weights: lithium = 7, carbon = 12, hydrogen = 1, oxygen = 16 Lithium citrate syrup is available as 300 mg of lithium citrate per 5 ml of syrup. How many milliliters of syrup will be required per day to provide the dose calculated in No. 26?

28.35 mL per day

A prescription calls for dispensing 1 oz of phenytoin sodium 5% w/w ointment. Hydrophilic petrolatum is to be used as the ointment base. How many grams of hydrophilic petrolatum must be mixed with 1.5 grams phenytoin sodium to compound and dispense the ointment in the requested strength?

28.5 g

A patient is receiving Dextrose 5% in 0.45% Sodium Chloride Injection and 40 mEq of potassium chloride in a total volume of 1000 mL through an IV set that delivers 15 drops per mL. The IV fluid has been running at a rate of 12 drops per minute for 15 hours. Molec Weights: Dextrose = 180, Na = 23, K = 39, Cl = 35.5 Question How many mEq of potassium chloride have been administered so far? K = 39; Cl = 35.5; Na = 23; Dextrose = 180

28.8 mEq KCl

Aminophylline Injection is supplied as 25 mg per ml. What volume of Aminophylline Injection will the pharmacist need to obtain the dose in Number 43 above?

28.8 mL

A patient is receiving Dextrose 5% in 0.45% Sodium Chloride Injection and 40 mEq of potassium chloride in a total volume of 1000 mL through an IV set that delivers 15 drops per mL. The IV fluid has been running at a rate of 12 drops per minute for 15 hours. Molec Weights: Dextrose = 180, Na = 23, K = 39, Cl = 35.5 Question How many millimoles of KCl have been administered over the 15 hour period?

28.8 millimoles

A prescription reads: "take 2 tsp PO Q6H x 7 days." How many milliliters must be dispensed to complete 7 days of therapy?

280 mL

TPN formula · Dextrose = 200 grams · HepatAmine = 60 grams · Sodium Chloride = 50 mEq · Potassium Chloride = 40 mEq · Sodium Acetate = 20 mEq · Magnesium Sulfate = 10 mEq · Sodium Phosphate = 9 mMol · Potassium Acetate = 15 mEq · Calcium Chloride = 2 mEq · Multivitamins = 12 5 ml · Trace Elements = 5 1 mL · Vitamin K = 1 0.5 mg · Pepcid = 10 mg · Regular Insulin = 20 units · Sterile Water qs ad 960 ml · Flow Rate = 80 ml per hour Question You have dextrose available as a 70% solution. What quantity will be needed to provide the required amount?

285.7 mL

Naphazoline hydrochloride 0.1% eye drops are to be made. How many milliliters of NS are needed to make 30 mL of eye drops isotonic? The NaCl equivalent of naphazoline HCl is 0.27.

29.1 mL

1 fluid ounce = ______ milliliters

29.57 milliliters exactly, 30 mL routinely used

How many milligrams of triamcinolone should be used in preparing the following prescription? Round to the nearest whole number. Triamcinolone (w/v): 5% Glycerine qs: 60 mL Sig. Two drops in the right ear own daily

3 g or 3,000 mg

Concentrated Acetic Acid is supplied at a concentration of 90% weight/weight and has a specific gravity of 1.11. What volume is needed to obtain enough acetic acid to prepare 60 mls of Acetic Acid Solution, 5% (e.g., vinegar)?

3 grams needed, if concentration is 1 gm/mL, then need 3 mL

A patient is to receive 600,000 units of penicillin G potassium in 100 mL D5W. A vial of penicillin G potassium 1,000,000 units is available. The manufacturer states that when 4.6 mL of diluent is added, a 200,000 units/mL solution will result. How many milliliters of reconstituted solution should be withdrawn and added to the bag of D5W?

3 mL

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL Calculate the amount of magnesium sulfate (4 mEq/mL) that should be added to the PN.

3 mL magnesium sulfate

An intravenous infusion contains 2 mL of a 1:1000 (w/v) solution of epinephrine and 250 mL of D5W. At what flow rate (mL/min) should the infusion be administered to provide 0.3 mcg/kg/min of epinephrine to an 80 kg patient? Round to the nearest whole number.

3 mL/min

A patient received 4 mg of IV morphine. What is an equivalent dose of oral hydromorphone? Round to the nearest whole number. (10 mg of IV morphine is equivalent to 7.5 mg of oral hydromorphone)

3 mg oral hydromorphone

A patient is being seen at the oncology clinic today after her first round of chemotherapy one week ago. A CBC with differential is ordered and reported back as WBC = 14.8 x 10^3 cell/mm3, segs 10% and bands 11%. Calculate this patient's ANC.

3,108 cells/mm3

A pharmacist receives an order for sodium chloride 4 mEq/kg/day for a patient who weighs 165 pounds. Using 1/2NS, how many liters will the patient require per day? Round to the nearest tenth. (MW of Na = 23, MW of Cl = 35.5)

3,900 mL or 3.9 L

Busulfan is to be given to a 43-year-old female patient, who weighs 141 lb and is 5 ft 9 in tall, at a dose of 1.8 mg/m2/day. Calculate the dose required using the BSA obtained from the BSA equation.

3.2 mg

Calculate the pH of a 100 mL buffer prepared by mixing 28 mL of 0.3 M citric acid solution and 72 mL of 0.3 M sodium citrate solution. (The pKas of citric acid are as follows: pKa1 = 3.13, pKa2 = 4.76, pKa3 = 6.4.)

3.5

A 40-year-old female patient weighing 152 lb was treated for acetaminophen poisoning with an acetyl cysteine infusion. The 21-hour IV (Acetadote) regimen consists of 3 doses as follows: · Loading dose: 150 mg/kg (maximum = 15 g) infused over 1 h · Second dose: 50 mg/kg (maximum = 5 g) infused over 4 h · Third dose: 100 mg/kg (maximum = 10 g) infused over 16 h 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W Question The second dose in grams and the volume of Acetadote required to provide it.

3.5 g; 17.5 mL

If 3.5 mL of a midazolam injection of strength 10 mg per 10 mL was mixed with enough NS to prepare a 25 mL infusion, calculate the dose of midazolam that a patient would receive from the infusion. (Round your answer to one decimal place.)

3.5 mg

3.6 drops/min

The density of 1N hydrochloric acid (HCl; 37% w/v) is 1.017 g/cc at 25°C. What is the volume of 1N HCl, in milliliters, required to make 100 mL of 0.1 N HCl?

3.6 mL

3.6 mL/min

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL How many milliliters of dextrose 70% should be added to the PN? ROund to the nearest whole number.

357 mL of dextrose 70%

Foscarnet sodium is to be given as an infusion to a 134.6 lb patient at a dose of 60 mg/kg every 8 hours for 14 days. Calculate the following: Questions a. The dose required for the patient per infusion. b. The volume required per infusion to provide the dose if foscarnet sodium injection 24 mg/mL is to be used. c. The total amount of foscarnet the patient will receive daily.

3672 mg; 153 mL; 11 g

Prescription Morphine Sulfate 7.5 mg Acetaminophen 325 mg DTD: XX caps Sig: one cap q 4 hrs prn pain Question If each morphine tablet weighed a total of 100 mg, what would be the weight of material in one capsule?

375 mg per capsule

1 US gallon = ______ mL

3785 mL

Don Smith is a 35 year old male who has been diagnosed with AIDS. Mr. Smith is 5 feet, 8 inches tall and weighs 180 pounds. Mr. Smith's physician wants to use Epivir and knows the drug must have its dose adjusted based on a patient's renal function. Mr. Smith's serum creatinine is 2.6 mg/dL and has held at that same level for 5 days. Calculate Mr. Smith's creatinine clearance.

38.3654 mL/min

A patient's body temperature was recorded as 101.9 °F. Express the temperature in °C.

38.8 °C

JR is receiving 97 grams of protein in an Aminosyn 8.5% solution on day 8 of his hospitalization. How many calories are provided by this amount of protein?

388 kcal of protein

A patient is to receive 8 mCi of fludeoxyglucose F-18 (FDG) injection for a PET scan at 8 AM. A multidose vial containing 20 mCi/mL is to be used during compounding. How many milliliters of FDG have to be used if the radiopharmaceutical is compounded and dispensed at 2 AM? Fluorine F-18 has a half-life of 109.7 minutes.

4 mL

Lactated Ringer's Injection contains 20 mg of calcium chloride dihydrate per 100 ml of IV fluid. How many milliOsmoles of calcium chloride are present in one liter of Lactated Ringer's Injection? Molecular weights: Ca = 40, Cl = 35.5, H = 1, O = 16

4 milliosmoles

4 min

A patient is to prepare one liter of a 1:5000 potassium permanganate (KMnO ) solution as a foot soak. 4 You have a stock solution of KMnO , 5%. How many milliliters of the stock solution must be used to prepare one liter of the foot soak?

4 ml needed

A patient has been receiving oral Aminophylline Tablets. Aminophylline is 80% theophylline. The doctor wants to change giving oral theophylline. If the patient has been receiving 500 mg of aminophylline, and theophylline is available in tablets of 100 mg. How many tablets will the patient need per dose? (NOTE: Bioavailability will be the same for both.)

4 tabs

Onabotulinumtoxin A (Botox) is available in a 100-unit vial for reconstitution. 2.5 mL of sterile preservative-free NS was added to this vial and reconstituted. How many units of Botox are present in 0.1 mL of the dilution? (Ignore any volume changes during reconstitution.)

4 units

A solid ingredient was weighed in a torsion balance, and the recorded weight was 200 mg. When the same ingredient was weighed in a high-precision electronic balance, the weight was recorded as 191.9 mg. Calculate the percent error with respect to the accurate weight obtained from the electronic balance.

4.1%

How many grains of aspirin will be contained in each capsule? Round to the nearest tenth. Aspirin: 6 g Phenacetin 3.2 g Caffeine 0.48 g M. ft. no. 20 caps Sig. One capsule Q6H PRN pain

4.6 grains/capsule

A formulation for an oral liquid of sumatriptan succinate (Imitrex - for migraine headaches) indicates that the final product should have a pH between 4.2 and 5.3. What pH would represent the middle of this range?

4.75

A table of pKa values gives 4.75 as the pKa for acetic acid. Use the Henderson-Hasselbach Equation to calculate the relative molar ratios of sodium acetate and acetic acid required to prepare a pH 4.75 buffer.

4.75

In 2001, the EPA adopted a lower standard for arsenic in drinking water by replacing the old standard of 50 µg/L with 10 µg/L. Calculate the difference in PPB between the old and new standards.

40 PPB

Formula · Scopolamine hydrobromide 200 mg · NS qs 100 mL Question Using the above formula for a nasal spray, calculate the quantity of scopolamine hydrobromide needed to compound 20 mL of the spray.

40 mg

Ipratropium bromide and albuterol inhalation spray 4 mL (Combivent Respimat) has 0.06% strength with respect to ipratropium bromide and 0.3% strength with respect to albuterol. If one cartridge of the spray contains 120 actuations, what is the amount of ipratropium bromide, in micrograms, that a patient receives with two actuations of the spray?

40 µg

Each vial of 10 mL magnesium sulfate injection USP contains magnesium sulfate (heptahydrate) at a concentration of 50%. How many milliequivalents of magnesium are present in the 10 mL vial? (Molecular weight of magnesium sulfate heptahydrate = 246.5 g/mol.)

40.6 mEq

Sterile NS was mixed with 300 mL of a stock solution of potash of alum to prepare 3 L of 1% alum irrigation. Calculate the quantity of potash of alum needed to prepare 4 L of the potash of alum stock solution.

400 g

A physician has found a new formula for an IV fluid to be administered after surgery that can be described as "TPN Lite". The formulation is shown in the box to the right. Use the formula provided to answer the following question. Formula · Dextrose, 15% · Amino Acids, 4% · Sod Chloride, 0.75% · Pot Chloride, 0.2% · MVI-12, 10 mL · Sterile Water qs ad 1000 mls · Flow Rate = 1 mL per kg per hour Question How many mLs of Amino Acids Injection, 10% will be needed to prepare one liter of the formula?

400 mL

How many milliliters of 5% dextrose solution can be prepared from 200 g of dextrose USP?

4000 mL

How many milliosmoles of CaCl2 (M.W. = 111) are represented in 150 mL of a 10% (w/v) calcium chloride solution? Round to the nearest whole number.

405 mOsmol

41.67 liters

In question number 30, you calculated the number of ml of 23.4% NaCl to make the 3% NaCl solution. How many milliequivalents of sodium chloride did you add to the bag? Molecular weights sodium = 23, chlorine = 35.5

411.6 mEq of NaCl

Over 6 hours, 1000 mL of D5W is to be infused. If the infusion set to be used is calibrated to 15 drops/mL, calculate the drip rate in drops/min.

42 drops/min

How many grams of sodium chloride (MW = 58.5) should be used to prepare this solution? Do not round the answer. Methylprednisolone: 0.5 g NaCl solution: 60 mL Each 5 mL should contain 0.6 mmols of NaCl

421.2 mg

If 1 ounce = 30 mL, how many milliliters of sterile water will remain after 50 mL are used from a 16 ounce bottle?

430 mL of sterile water will remain

How many calories are provided by 108 grams of protein?

432 kcal of protein

A PN order calls for 475 calories to be provided by lipids. The pharmacy has 10% lipid emulsion in stock. How many milliliters shlould be administered to the patient? Round to the nearest whole number.

432 mL

WT is needing a protein shake with the following nutrition facts, what percent of calories are derived from the fat component? Round to the nearest whole number. Calories: 356 kcal Total fat: 17.8 g Protein: 19.6 g

45%

45.4%

You told your assistant to make a 3 percent morphine solution but something got misunderstood and the result is 80 mL of a 20 percent solution. How much water must you add to the 80 mL to reduce the concentration to 3 percent?

453.33 mL

1 avoirdupois pound = _____ grams

454 grams (exact is 453.6 grams)

A patient is receiving Dextrose 5% in 0.45% Sodium Chloride Injection and 40 mEq of potassium chloride in a total volume of 1000 mL through an IV set that delivers 15 drops per mL. The IV fluid has been running at a rate of 12 drops per minute for 15 hours. Molec Weights: Dextrose = 180, Na = 23, K = 39, Cl = 35.5 Question What is the total osmolarity of the IV fluid being administered? Express your answer as milliosmoles, rounded to the nearest whole number, per 1000 mL.

489.38

A pharmacist receives a prescription for a 1.5% (w/w) hydrocortisone cream using cold cream as the base. She will use hydrocortisone injection (100 mg/mL, SG 1.5) to prepare the prescription because she has no hydrocortisone powder in stock. How many grams of cold cream are required to compound 60 grams of the preparation? Round to the nearest one decimal place.

46.5 g of cold cream

1 US pint = _____________ milliliters

473 mL

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL The PN calls for 18 mmol of phosphate and 12 mEq of calcium (provided by 26 mL of calcium gluconate 10%, as calculated in the previous problem) in a volume of 960 mL. There are 2 mEq PO4/mmol. Confirm that the sum of the cacium and phosphorus do not exceed 45 mEq/L.

48 mEq/0.96 L = 50 mEq/L, which is greater than 45 mEq/L

You are to mix this IV using the materials shown. You must ADD the volumes of the dextrose and NaCl to the 1000 ml of Sterile Water. Prescription: Sterile Water for Injection 1000 ml Dextrose 10 % Sodium chloride 60 mEq Administer over 24 hours Using the following supplies Sterile Water for Injection, 1000 ml Sod Chloride Inj, 23.4% (MW = 58.5) Dextrose 70% in Water Injection Question After all of the ingredients are mixed, what will be the flow rate in milliliters per hour?

49.34 mL/hr

Using 20% Smoflipid, how many milliliters are required to meet 989 calories? Round to the nearest whole number.

495 mL

A patient is currently receiving 400 mg of gentamicin IV once daily and, based on measured serum concentrations, the AUC is determined to be 80 mg x hr/L. Calculate the patient's gentamicin clearance.

5 L/hr

A physician wants to put 10 mEq of calcium into a 500 ml bag of Normal Saline Solution and administer the calcium at a rate of 0.5 mEq per hour. You have Calcium Chloride Dihydrate, 10% Injection in 10 mL vials. Ca = 40, Cl = 35.5, H = 1, O = 16 Question You have an IV set that delivers 12 drops per mL. At what flow rate (drops per minute) will the IV fluid be administered to give the desired dose?

5 drops per minutes

Clindamycin vaginal cream USP has a labeled potency of 2% w/w. How many grams of the ointment should be administered intravaginally to provide a dose of 100 mg?

5 g

5 mL; 495 mL

A solution contains 200 mg Ca ions per liter. How many milliosmoles are represented in the solution? M.W = 40.

5 mOsmol

Calculate the least weighable quantity in an electronic balance whose sensitivity requirement is 0.1 mg when the permitted error is 2%.

5 mg

The ratio strength of a 10 mL vial of neostigmine methylsulfate injection USP is 1:2000. Calculate the amount of neostigmine methylsulfate, in milligrams, contained in the 10 mL vial.

5 mg

How many milliliters are in 5 liters?

5,000 mL

How many grams of hydrocortisone cream 2.5% must be mixed with 10 grams of hydrocortisone cream 0.2% to prepare hydrocortisone cream 1%?

5.3 g

Prescription Aspirin 300 mg Caffeine 30 mg Codeine 15 mg DTD 15 caps SIG: 1 cap q 4 hrs PRN pain Question What will be the total final weight, in grains, of ingredients for one capsule?

5.3 grains per capsule

Amikacin Injection is supplied as 500 mg in 2 ml. Mr. Johns weighs 198 lbs and is to receive a dose of 15 mg per kg. How many milliliters will be needed for the dose?

5.4 mL

The dosing recommendation for Alteplase when used to treat acute ischemic stroke is as follows: Patients ≤100 kg: Loading dose of 0.09 mg/kg (10% of an 0.9 mg/kg dose) as an IV bolus over 1 minute, followed by 0.81 mg/kg (90% of an 0.9 mg/kg dose) as a continuous infusion over 60 minutes. Patients >100 kg: Loading dose of 9 mg (10% of 90 mg) as an IV bolus over 1 minute, followed by 81 mg (90% of 90 mg) as a continuous infusion over 60 minutes. Questions Calculate the following for a patient weighing 137.8 lb: a. The patient's loading dose. b. The maintenance dose to be given as a continuous infusion.

5.6 mg; 50.7 mg

A 68 kg patient is receiving a drug in a standard concentration of 400 mg/250 mL of 1/2 NS running at 15 mL/hr. Calculate the dose in mcg/kg/min. Round to the nearest hundredth.

5.88 mcg/kg/min

A 64-year-old female patient, 5 ft 4 in tall and weighing 135 lb, is receiving meropenem 1 g every 8 hours. When the infusion was started, her SCr was 0.84. The manufacturer recommends CrCl-based dosing modifications as follows: · CrCl > 50 mL/min: No dosage adjustment necessary. · CrCl 26-50 mL/min: Administer the recommended dose as indicated every 12 hours. · CrCl 10-25 mL/min: Administer one-half the recommended dose as indicated every 12 hours. · CrCl < 10 mL/min: Administer one-half the recommended dose as indicated every 24 hours. Later, her SCr increased to 1.54. The manufacturer's recommendation for reconstitution is as follows: Vial size --> Diluent added (mL) 500 mg --> 10 mL 1 g --> 20 mL The infusion vials were reconstituted with an appropriate volume of NS (as per the table above) from a 500 mL IV bag and added back to the bag. Question Calculate the concentration of meropenem, in mg/mL, in the infusion vial after reconstitution.

50 mg/mL

Seasonal trivalent influenza vaccine (Fluzone) contains thiomersal as a preservative. The amount of equivalent mercury in the vaccine was determined to be 12.5 µg per 0.25 mL dose of the vaccine. Express this concentration in PPM.

50 PPM

Sodium Bicarbonate Injection is an 8.4% solution. How many milliequialents of sodium are in a single vial of 50 ml? Na = 23, C = 12, O = 16, H = 1

50 mEq

If 50 mg of drug are added to a 500 mL bag, what rate of flow, in milliliters per hour, will deliver 5 mg of drug per hour?

50 mL/hour

A drug product has 0.05% active drug. If the dose is one-half (½) teaspoonful four times a day for ten days. How many milligrams will be consumed in total?

50 mg

A patient receives 200 mg of a drug with a half-life of 5 hours. How much of the drug remains after 10 hours?

50 mg of the drug remains after 10 hours

A 2% v/v solution of glacial acetic acid is to be prepared. How many milliliters of this solution can be prepared using 10 mL glacial acetic acid?

500 mL

How many milliliters of a 1:2,500 (w/v) solution of aluminum acetate can be made from 100 mL of a 0.2% solution?

500 mL

JB is a patient receiving Osmolite (a high-protein, low-residue formula) enteral nutrition through a PEG tube. It has the following nutritional facts: Serving size: 8 fl oz Calories: 285 kcal Total fat: 9.2 g Total protein: 13.2 g Total carbs: 37.4 g What percent of calories will JB receive from the carbohydrate component? Round to the nearest whole number.

52%

A PN order is written to add 800 mL of 10% amino acid solution. The pharmacy only has 15% amino acid solution in stock. Using the 15% amino acid solution instead, how many milliliters should be added to the PN bag? Round to the nearest whole number.

533 mL

55.8 mL/min

A patient is receiving 500 mL of 10% lipids. How many calories is the patient receiving from the lipids? Round to the nearest whole number.

550 kcal

Calculate the osmolar concentration, in milliosmoles, represented by 1 liter of a 10% (w/v) solution of anhydrous dextrose (M.W. = 180) in water. Round to the nearest one decimal place.

555.6 mOsmol

ML is a 165-pound male receiving a premixed dopamine drip (400 mg/240 mL) in the ICU. The order states that the drip can be titrated to a maximum dose of 20 mcg/kg/min. What is the maximum rate (mL/hr) at which the drip can be run? Round to the nearest whole number.

56 mL/hr

What is the weight of 0.5 L of polyethylene glycol 400 (SG = 1.13).

565 grams

A pharmacokinetic study of an investigational drug was conducted in health volunteers. Following an IV bolus dose of 15 mg, the AUC was determined to be 4.2 mg x hr/L. Subjects were later given an oral dose of 50 mg and the AUC was determined to be 8 mg x hr/L. Calculate the absolute bioavailability of the investigational drug. Round to the nearest whole number.

57%

A dose of gentamicin is given to a patient, adn urine is collected from the patient for 4 hours after drug administration. It is determined that 300 mg of gentamicin was eliminated during that time period, and the measured plasma concentration at the midpoint of the collection was 12.5 mg/L. Calculate the patient's gentamicin clearance.

6 L/hr

A pharmacist receives a prescription for "Vigamox 0.5%. Dispense 3 mL. 1 gtt tid ou x 7d." How many drops will the patient use per day?

6 drops

Mr Shirrah is very ill and needs antibiotic therapy for an infection. The microbiology lab reports that the infecting agent will require a higher than normal blood level to be effective. The attending physician asks you to determine exactly how often each dose of the antibiotic should be administered to keep the blood level at, or above, the determined minimum inhibitory concentration (MIC) You receive the following pharmacokinetic data on Mr. Shirrah for a drug eliminated 100% by the kidney. Mr Shirrah has normal renal function. Pharmacokinetic Data IV bolus dose:0.5 gram; Peak level: 12 mcg/mL; Trough level at 12 hrs: 0.75 mcg/ml Therapeutic MIC level: 3 mcg/ml Question How often should a dose of the drug be administered in order to maintain the drug level at, or above, the therapeutic level? Use the half-life calculated in No. 97.

6 hours time between doses

One 2 mL vial of 0.5 mg/2 mL bumetanide injection USP was added to sufficient quantity of NS to make a 100 mL infusion. 40 mL of this infusion was administered to a 50 lb pediatric patient over 90 minutes. Calculate the infusion rate in µg/kg/h.

6 µg/kg/h

A pharmacist adds 5.3 grams of hydrocortisone to 150 grams of a 2.5% hydrocortisone ointment. What is the percentage (w/w) of hydrocortisone in the finished product? Round to the nearest whole number.

What is the percent ionization of naproxen, a weak acid with a pKa of 4.2, in the stomach at a pH of 3? Round to the nearest whole number.

Simulated gastric fluid without enzymes is 0.1 M HCl (0.1 N HCl). How many milliliters of concentrated HCl (37% w/w, specific gravity 1.19) is necessary to prepare 750 mL of the acid solution? The molecular weight of HCl is 36.5 g/mol.

6.2 mL

Prescription Atropine Sulfate 0.4 mg Morphine Sulfate 5 mg Acetaminophen 325 mg DTD: 20 caps SIG: 1-2 caps q 4 hrs prn Question How many grams of acetaminophen will you need for the 20 capsules?

6.5 grams

You receive the following PN recipe: Dextrose 70%: 250 g Amino acids: 50 g Sodium chloride (MW 58.5): 44 mEq Sodium acetate (MW 82): 20 mEq Potassium: 40 mEq Magnesium sulfate: 12 mEq Phosphate: 18 mmol Calcium: 12 mEq MVI-12: 5 mL Trace elements-5: 1 mL Vitamin K-1: 0.5 mg Famotidine: 10 mg Regular insulin: 20 units Sterile water qs ad: 960 mL If the pharmacist adds 6 mL of potassium phosphate (3 mmol of phosphate and 4.4 mEq of potassium/mL) to the 2-in-1 product, how much potassium chloride (2 mEq/mL), in milliliters, should be added to fulfill the order? Round to the nearest tenth.

6.8 mL KCl

A 40-year-old female patient weighing 152 lb was treated for acetaminophen poisoning with an acetyl cysteine infusion. The 21-hour IV (Acetadote) regimen consists of 3 doses as follows: · Loading dose: 150 mg/kg (maximum = 15 g) infused over 1 h · Second dose: 50 mg/kg (maximum = 5 g) infused over 4 h · Third dose: 100 mg/kg (maximum = 10 g) infused over 16 h 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W Question The third dose in grams and the volume of Acetadote required to provide it.

6.9 g; 34.5 mL

A patient received a potassium chloride infusion at a rate of 10 mEq/h for 6 hours. How many millimoles of potassium did the patient receive during this infusion? (Molecular weight of KCl = 74.6.)

60 mmol

1 grain = ________ milligrams

64.8 mg exactly or 65 mg approximately

A 40-year-old female patient weighing 152 lb was treated for acetaminophen poisoning with an acetyl cysteine infusion. The 21-hour IV (Acetadote) regimen consists of 3 doses as follows: · Loading dose: 150 mg/kg (maximum = 15 g) infused over 1 h · Second dose: 50 mg/kg (maximum = 5 g) infused over 4 h · Third dose: 100 mg/kg (maximum = 10 g) infused over 16 h 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W Question If a drip set calibrated to deliver 60 drops/mL was used to deliver the third dose, calculate the infusion rate needed, in drops/min.

66 drops/min

Prescription Atropine Sulfate 0.4 mg Morphine Sulfate 5 mg Acetaminophen 325 mg DTD: 20 caps SIG: 1-2 caps q 4 hrs prn Question What will be the total weight of ingredients, in milligrams, to prepare the entire quantity?

6608 mg

375 g of dextrose is to be added to a TPN solution using an appropriate quantity of dextrose injection USP 70% (specific gravity 1.24). How many grams of D70W will provide the required amount of carbohydrate?

664 g

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question If the amikacin dose is 15 mg/kg/day every eight hours, calculate the total amount of amikacin the patient will receive over 24 hours.

667.5 mg/day

A patient is receiving PN containing 540 mL of 12.5% amino acids per day. How many grams of nitrogen is the patient receiving? Round to the nearest tenth.

67.5 g of protein

The USP defines controlled room temperature (CRT) as the range from 20 to 25 °C. Express the range in °F.

68 to 77 °F

A patient received two adalimumab injections, each SC (40 mg/0.8 mL), on day 1 and day 2. On day 15, another two SC injections (40 mg/0.8 mL) were given. Starting day 29, the patient received one SC injection (40 mg/0.8 mL) every other week. How many milligrams of adalimumab did the patient receive in 180 days?

680 mg

A physician wants to put 10 mEq of calcium into a 500 ml bag of Normal Saline Solution and administer the calcium at a rate of 0.5 mEq per hour. You have Calcium Chloride Dihydrate, 10% Injection in 10 mL vials. Ca = 40, Cl = 35.5, H = 1, O = 16 Question How many mLs of this injection must you add to the bag of IV fluid to make the desired product?

7.35 mL needed

Calculate the pH of a buffer made by mixing 30 mL of sodium biphosphate (Na2HPO4) 0.07 M solution and 70 mL of sodium phosphate (Na3PO4) 0.07 M solution. (Phosphoric acid's pKa values are as follows: pKa1 = 2.15, pKa2 = 7.09, pKa3 = 12.32.)

7.5

Prescription Indomethacin 0.05% Boric Acid qs Water qs ad 15 mL Question Indomethacin is available in an injection of 1 mg powder for solution per vial. How many vials will you need to obtain the needed amount of indomethacin?

7.5 (technically 8) vials are needed

If the IV set delivers 15 drops per mL, what will be the flow rate for the dose ordered?

7.5 drops per minute

Gentamicin Injection is supplied in a concentration of 80 mg per 2 ml vial. How many milliliters are needed to give a single dose of 4 mg per kg to a patient weighing 165 pounds?

7.5 mL needed

A 2-liter PN solution is to contain 60 mEq of sodium and 30 mEq of acetate. The pharmacy has in stock sodium chloride (4 mEq/mL) and sodium acetate (2 mEq/mL). WHat quantity, in milliliters, of each solution should be added to the PN? Round to the nearest tenth.

7.5 mL of NaCl

Lidocaine, a weak base, has a pKa of 7.8. Calculate the percent of the drug ionized in blood (pH 7.4).

72%

A patient is to receive IV theophylline 24 mg every hour. If aminophylline is 80% theophylline, how much aminophylline must the pharmacist use to prepare a 24 hr supply?

720 mg of aminophylline needed

A compounding formula for preparing 50 capsules is given below. Convert the weight of codeine sulfate to milligrams and the weights of the other excipients to grams. Formula · Codeine 11½ grains · Silica gel 0.01 oz (avoir.) · Lactose monohydrate 0.025 lb (avoir.)

747.5 mg, 0.3 g, 11.35 g

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question If a drip set calibrated to 15 drops/mL is used, calculate the infusion rate in drops/min.

75 drops/min

JB is a patient receiving Osmolite (a high-protein, low-residue formula) enteral nutrition through a PEG tube. It has the following nutritional facts: Serving size: 8 fl oz Calories: 285 kcal Total fat: 9.2 g Total protein: 13.2 g Total carbs: 37.4 g How many calories will JB receive from the carbohydrate component if he receives 4 fl oz? Round to the nearest whole number.

75 kcal

An order is written for a dopamine drip in the ICU. The order reads: "Start dopamine drip at 3 mcg/kg/min, titrate by 5 mcg/kg/min Q5 minutes to achieve SBP > 100 mmHg. Page the critical care resident for additional orders if maximum dose of 20 mcg/kg/min is reached." The patient weighs 165 pounds and the ICU stocks premixed dopamine drips (400 mg/250 mL) in the automated dispensing cabinet (ADC). What rate (mL/hr) should the dopamin drip be started at? Round to the nearest whole number.

8 mL/hr

A patient is to receive 1.5 liters of NS running at 45 gtts/min using a 15 gtts/mL IV tubing set. Calculate the total infusion time in hours. Round to the nearest tenth.

8.3 hours

A magnesium sulfate injection vial has a labeled strength of 0.5 g/mL. How many millimoles of magnesium will be delivered if a patient receives a 2 mL intramuscular dose of the injection? (Molecular weight of magnesium sulfate = 120.4.)

8.3 mmol

Lidocaine is to be administered as an IV infusion at a dose of 1 mg/kg to a 192 lb patient. How many milliliters of lidocaine 1% injection USP should be mixed with 150 mL D5W to provide the required dose?

8.7 mL

The pharmacist is making PN that needs to contain 80 mEq of sodium and 45 mEq of acetate. The available pharmacy stock solutions contain 4 mEq/mL sodium as sodium chloride and 2 mEq/mL sodium as sodium acetate. The final volume of the PN will be 2.5 liters to be infused at 100 mL/hr. What quantity, in millilters, of each stock solution should be added to the PN to meet the requirements? Round to the nearest hundredth.

8.75 mL of sodium chloride

Ms Thomas wants to take one gram of elemental calcium every day and thinks calcium citrate is the best way to do so. She is confused, however, by instructions on the container she is purchasing that say each tablet contains 560 mg of Calcium Citrate Tetrahydrate (20% calcium) and she should take three tablets 3 times a day to obtain 1 gram of elemental calcium daily. Ms Thomas thinks this is a very great overdose and wants you to explain the dose to her and tell her how much calcium the recommended dose would provide.

8.93(or nine) tablets per day

A gaseous blend of nitric oxide and nitrogen (INOmax) is available in a strength of 0.08% nitric oxide (NO) and 99.92% nitrogen. Express the strength of NO in PPM.

800 PPM

A 4-year-old child (22 lb) received a heparin (UFH) infusion at a rate of 20 units/kg/h for 4 hours. Calculate the total amount of heparin received by the child during the 4-hour period.

800 units

A patient was asked to take albendazole 800 mg daily in two divided doses for 10 days. Albendazole 200 mg (Albenza) tablets are available in the pharmacy. How many milligrams of albendazole will the patient receive over 10 days? How many tablets have to be dispensed?

8000 mg; 40 tablets

Using 50% dextrose in water, how many milliliters are required to fulfill a PN order for 405 grams of dextrose?

810 mL

Bupivacaine, a weak base, has a pKa of 8.1. Calculate the percent of the drug ionized in blood (pH 7.4).

83%

A 40-year-old female patient weighing 152 lb was treated for acetaminophen poisoning with an acetyl cysteine infusion. The 21-hour IV (Acetadote) regimen consists of 3 doses as follows: · Loading dose: 150 mg/kg (maximum = 15 g) infused over 1 h · Second dose: 50 mg/kg (maximum = 5 g) infused over 4 h · Third dose: 100 mg/kg (maximum = 10 g) infused over 16 h 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W 20% acetyl cysteine 30 mL vials were used when preparing the infusions. Diluents were used as follows: Loading dose: 200 mL D5W Second dose: 500 mL D5W Third dose: 1 L D5W Question If a drip set calibrated to deliver 20 drops/mL was used to infuse the loading dose and the second dose, calculate the infusion rates needed, in drops/min.

84 drops/min; 44 drops/min

How many milligrams of aminophylline will Mike receive per day based on the order in the profile? Round to the nearest whole number. Patient Name: Mike Kelly Age: 22 Sex: Male Race: Caucasian Weight: 150 pounds Height: 5'9'' Allergies: NKDA Order: aminophylline 0.5 mg/kg/hour

848 mg/day

Acetazolamide is a weak acid and has a pKa of 7.2. Calculate the percent of the drug ionized in the small intestine (pH 8).

86%

You receive an order for 500 mg of aminophylline in normal saline in a total volume of 250 ml. The patient weighs 132 pounds. The aminophylline is to be administered at a dose of 0.3 mg per kg per hour. Aminophylline Injection is supplied in vials with 25 mg per ml. The IV set you will use delivers 60 drops per ml. What will be the flow rate, in drops per minute, to administer the dose ordered?9

9 drops per minute

How many grams of sodium chloride (NaCl) are necessary to prepare 1 L of normal saline?

9 g

Two milliliters of sterile lidocaine 1% injection was removed from a 20 mL vial and replaced with 2 mL of 8.4% sodium bicarbonate injection to reduce pain on injection during epidural anesthesia. Calculate the concentration of lidocaine, in mg/mL, in the admixture after the sodium bicarbonate was mixed in.

9 mg/mL

Oral potassium chloride 20% solution contains 40 mEq of potassium per 15 milliliters of solution. A patient needs 24 mEq of potssium daily. HOw many milliliters of 20% potssium chloride should the patient take? Round to the nearest tenth.

9.4 mL

Calculate the corrected calcium value for a patinet with the following lab values: Calcium (mg/dL): 7.6 (reference value: 8.5-10.5) Albumin (g/dL): 1.5 (reference value: 3.5-5)

9.6 mg/dL

A 14-year-old child, 3 ft 7 in tall and weighing 55 lb, needs carmustine (BiCNU) infusion. The dose is 100 mg/m2. Each BiCNU package includes a vial containing 100 mg BiCNU and an ampule containing 3 mL sterile diluent (dehydrated alcohol injection USP). After dissolving the BiCNU vial in 3 mL diluent, 27 mL of sterile water for injection is added. The resulting admixture contains 3.3 mg BiCNU per mL. This mixture can be further diluted with D5W if needed. Calculate the following: a. The dose required, using the patient's BSA obtained from the BSA equation. b. The volume of the BiCNU admixture that will provide the dose.

90 mg; 27.3 mL

How many milliliters of 0.2 M boric acid and 0.05 M sodium borate must be used to prepare 100 mL of a buffer of pH 7.6? The pKa of boric acid is 9.2.

91 mL boric acid and 9 mL sodium borate

The waist circumference of a patient was measured to be 36⅛ in. Express this measure in centimeters.

91.76 cm

Ofloxacin, a weak acid, has a pKa of 5.5. Calculate the percent of the drug ionized in tears or the eye (pH 7).

97%

Labs Total WBC Count = 14,000/mm3 Bands = 5 Segs = 65 Basophils = 1 Eosinophils = 2 Lymphocytes = 24 Monocytes = 3 Question What will be the absolute neutrophil count for a patient with the WBC result shown above?

9800 neutrophils cells

The total energy expenditure (TEE) for a critically ill patient is 2,435 kcal/day. The patient is receiving 1,446 kcal from dextrose and 810 kcal from protein. In this critical care unit, clinicians do not include protein calories in the TEE estimation. How many kcal should be provided by the lipids?

989 kcal remaining from lipids

Labetalol, a weak base, has a pKa of 9.3. Calculate the percent of the drug ionized in blood (pH 7.4).

99%

What is the percent ionization of amitryiptyline, a weak base with a pKa = 9.4, at a physiologic pH of 7.4?

99%

To what IV fluid should the dopamine be added? A. Dextrose 5% in Water B. Sodium Bicarbonate Injection, 5% in Water C. Sodium Chloride Injection, 3% D. Sterile Water E. Amino Acids Injection, 10%

A. Dextrose 5% in Water

Six misoprostol 0.4 mg suppositories are to be prepared according to the following formula: Formula · Misoprostol 0.4 mg · Cocoa butter NF qs 3 g Question Ignore the suppository base displacement by misoprostol. Commercially available misoprostol 200 µg tablets are available for compounding. Calculate the total amount of misoprostol needed to compound the suppositories, and determine the number of tablets needed.

Amount of misoprostol needed = 2.4 mg; 12 tablets

Using the following formula, 30 g of a gel is to be prepared: Formula · Lidocaine 4% · Epinephrine 1:2000 · Tetracaine 0.5% · Gel base qs 100% Question Calculate the quantities of each ingredient required to compound the gel.

Amounts: lidocaine = 1.2 g; epinephrine = 0.015 g; tetracaine = 0.15 g; gel base = 28.635 g

To prepare eight lorazepam 2 mg lollipops in an eight-cavity lollipop mold, the following formula is recommended: Formula · Lollipop base 60 g · Flavor 3% · Color PRN 1 to 2 drops Question Calculate the amounts of each ingredient required to prepare 4 lollipops.

Amounts: lorazepam = 8 mg; lollipop base = 30 g; flavor = 0.9 g

A cream to treat scabies is to be prepared using the following formula: Formula Permethrin = 5% Stearyl Alcohol = 22.5% Cetyl Alcohol = 5% BHT = 0.2% PEG 300 = 20% Na Lauryl SO4 = 0.7% Preserved H2O = q.s. Question Calculate the quantities of each ingredient required to prepare 50 g of the cream.

Amounts: permethrin = 2.5 g; stearyl alcohol = 11.25 g; cetyl alcohol = 2.5 g; BHT = 0.1 g; PEG 300 = 10 g; Na Lauryl SO4 = 0.35 g; preserved water = 23.3 g

Using the following formula (for one capsule), 90 capsules are to be prepared: Formula · Thyroxine 0.05 mg · Triiodothyronine 0.0125 mg · Lactose monohydrate 100 mg Question Calculate the amounts of each ingredient required to compound the capsules.

Amounts: thyroxine = 4.5 mg; triiodothyronine = 1.125 g; lactose monohydrate = 9000 mg

NK is receiving a furosemide infusion at 5 mg/hr. The nurse notices her urine output has decreased in the last hour. Laboratory values are drawn and the patient has a SCr of 1.5 mg/dL and a BUN of 26 mg/dL. The nurse wants to know if she should stop the furosemide infusion due to the patient becoming dehydrated. What is the correct assessment of the patient's hydration status? A. The patient appears to be too hydrated given the laboratory results B. The patient is not experiencing dehydration given the laboratory results C. The patient is experiencing dehydration and may need to be started on fluids D. The patient has objective information indiciating dehydration but the patient needs to be assessed subjectively as well E. None of the above are correct

B. The patient's BUN:SCr ratio is 26/1.5 = 17.3:1, which is < 20:1. Continue to monitor the patient.

Labs Total WBC Count = 14,000/mm3 Bands = 5 Segs = 65 Basophils = 1 Eosinophils = 2 Lymphocytes = 24 Monocytes = 3 Question This patient is most likely to have what type of infection - bacterial, viral, fungal? I. Bacterial II. Viral III. Fungal A. I only B. III only C. I and II only D. II and III only E. I, II and III only

Bacterial - due to the increased number of neutrophils

A pharmacist receives a call from a provider asking for assistance with two patients in the clinic. Both patients have a seizure disorder and are taking phenytoin, Patient A is seizure free, but is experiencing symptoms of toxicity. Patient B has a higher phenytoin level and is doing find. Both patient's have normal renal function. Which of the following statements is/are true of this scenario? (Select ALL that apply.) Labs for Patient A Phenytoin level (total): 14.3 (10-20 mcg/mL) Albumin: 2.1 (3.5-5 g/dL) Labs for Patient B Phenytoin level (total): 17.8 (10-20 mcg/mL) Albumin: 4.2 (3.5-5 g/dL) A. Patient B's corrected phenytoin level will be lower than the total level reported. B. Patient A's corrected phenytoin level will be lower than the total level reported. C. Patient A's corrected phenytoin level will be higher than the total level reported. D. Patient A has a greater percentage of bound phenytoin. E. Patient A has a greater percentage of unbound phenytoin.

C and E

Ms. Roberta Snagg has a recurring mycotic infection of the bladder. Her physician wants to use a bladder irrigation of amphotericin B to be continuously run through the bladder for at least 24 hours. You are to prepare a 2 liter bag of amphotericin B irrigation solution, 1:5000 concentration, that will be administered at a rate of 80 mL per hour. You have vials of amphotericin B, 50 mg, that, when properly reconstituted, contain 50 mg of amphotericin B in a total volume of 10 mL. Question What type of catheter will be inserted into the patient's bladder and used for administration of the amphotericin B bladder irrigation? A. Swan-Ganz catheter B. PICC catheter C. Foley catheter D. Central catheter E. Robinson catheter

C. Foley catheter

Levofloxacin, dosing per pharmacy, is ordered for an 87-year-old female patient (height 5'4'', weight 103 pounds). Her labs include BUN 22 mg/dL and SCr 1 mg/dL. Choose the correct dosing regimen based on the renal dosage adjustments from the package labeling below. Levofloxacin dose based on CrCl: > 50 mL/min: 500 mg Q24H 20-49 mL/min: 250 mg Q24H < 20 mL/min: 250 mg Q48H

CrCl: 29, 250 mg Q24H

A 50-year-old male patient (height 6'1'', weight 177 pounds) has HIV and is being started on tenofovir, emtricitabine and efavirenz therapy. His laboratory values include: K 4.4 mEq/L, BUN 40 mg/dL, SCr 1.8 mg/dL and CD4 cound of 455 cells/mm3. Using the renal dosage recommendations from the package labeling below, what is the correct dose of tenofovir for this patient? Tenofovir dose based on CrCl: > 50 mL/min: 300 mg daily 30-49 mL/min: 300 mg Q48H 10-29 mL/min: 300 mg Q72-96 hours < 10 mL/min: 300 mg weekly

CrCl: 55 mL/min, 300 mg daily

A 64-year-old female patient (height 5'5'', weight 205 pounds) is hospitalized with a nosocomial pneumonia which is responding to treatment. Her current antibiotic medications include ciprofloxacin, Primaxin and vancomycin. Her morning laboratory values include: K 4 mEq/L, BUN 60 mg/dL, SCr 2.7 mg/dL and glucose 222 mg/dL. Based on the renal dosage recommendations from the package labeling below, what is the correct dose of Primaxin for this patient? Primaxin dose based on CrCl: > 71 mL/min: 500 mg IV Q6H 41-70 mL/min: 500 mg IV Q8H 21-40 mL/min: 250 mg IV Q6H 6-20 mL/min: 250 mg IV Q12H

Crcl: 23.75, 250 mg IV Q6H

Patient profile Name: Carolyn Hoydt Age 37 Sex F Race Caucasian Height 5'6'' Weight 175 pounds Diagnosis: DVT confirmed by ultrasound On 11/15 Lovenox 1 mg/kg SC Q12H was ordered Labs on 11/15: Na: 142 K: 5.2 Cl: 105 HCO3: 26 BUN: 22 SCr: 1.4 Glu: 120 Hgb: 13.6 Hct: 41 The pharmacist reviews Ms. Hoydt's Lovenox order and labs in teh profile. At this hospital, pharmacists have the authority to make renal dosage adjustments per package labeling when necessary. What is the correct Lovenox dose for Ms. Hoydt? A. 175 mg SC Q12H B. 175 mg SC once daily C. 80 mg SC once daily D. 80 mg SC Q12H E. 60 mg SC Q12H

Patient profile Name: Jeremy Ross Age 41 Sex M Race Hispanic Height 6'1'' Weight 70 kg Diagnosis: Depression, Dyslipidemia, HIV Ordered on 12/1: Bactrim 20 mg TMP/kg/day IV divided Q6H Labs on 12/1: WBC: 10.7 CD4: 187 Na: 139 K: 3.7 Cl: 109 HCO3: 24 BUN: 7 SCr: 0.6 Glu: 120 The pharmacist reviews the order for IV Bactrim and the labs for Mr. Ross in the profile. What dose should Mr. Ross receive given the renal dosage recommendations below? Bactrim dose based on CrCl: > 30 mL/min: No dosage adjustment required 15-30 mL/min: Administer 50% of the recommended dose < 15 mL/min: Use is not recommended A. 1400 mg TMP IV Q6H B. 700 mg TMP IV Q6H C. 400 mg TMP IV Q12H D. 350 mg TMP IV Q6H E. Mr. Ross should not receive Bactrim

A patient (weight, 176 pounds) in cardiology is receiving a heparin drip, currently running at 15 units per kilogram per hour. The concentration of heparin in the IV drip is 10,000 units per 100 mL and the IV set delivers 15 drops per mL. The most recent partial thromboplastin time (PTT) indicates that the patient is being under dosed and that the heparin rate should be increased by 20% according to the hospital's weight based heparin protocol. Question Once the heparin drip was stopped, the physician wanted to change to a subcutaneous agent for further anticoagulation. A possible drug for this purpose would be A. Warfarin B. Alteplase C. Argatroban D. Daltaparin E. Lepirudin

D. Dalteparin

Looking at the laboratory values below, make an assessment of the patient's hydration status. BUN: 54 mg/dL (7-20 mg/dL) Creatinine: 1.8 mg/dL (0.6-1.3 mg/dL) A. The patient appears to be well hydrated B. The patient appears to be too hydrated C. The patient is not experiencing dehydration D. The patient is experiencing dehydration and may need to be started on fluids E. The patient has subjective information indiciating dehydration but the patient needs to be assessed objectively as well

D. The patient's BUN:SCr ratio is 54/1.8 = 30:1. Since 30:1 > 20:1, the BUN is disproportionately elevated relative to the creatinine, indicating that the patient is dehydrated.

A 52-year-old female patient comes to a compounding pharmacy to get a 90-day supply of diclofenac sodium 50 mg, which she takes three times daily. She also needs a 90-day supply of the levothyroxine sodium/liothyronine sodium 75/5 μg SR capsules that she takes once a day and an ounce of DHEA 1.3% cream. The formula for Levothyroxine sodium/liothyronine sodium 75/5 μg SR capsules is as follows: · Levothyroxine sodium 2% stock powder blend - TBD as needed · Liothyronine sodium 0.5% stock powder blend - TBD as needed · Hydroxypropyl methyl cellulose (4000 CPS) USP - 200 mg · Microcrystalline cellulose NF - 50 mg ~ 255 mg fill volume in size #1 capsule shells. Formula for DHEA 1.3% cream DHEA 1.3% Commercial cream base qs Question Calculate the quantities of the ingredients required to compound the DHEA 1.3% cream.

DHEA = 369 mg, cream base = 28 g

Prescription · Aspirin 300 mg · Caffeine 30 mg · Codeine 15 mg · DTD 15 caps · SIG: 1 cap q 4 hrs PRN pain Question How many milligrams of codeine will be needed to compound the prescription?

DTD means the formula is for one capsule 225 mg needed MPJE Law Note: You probably would use C-II codeine to prepare the product, but after mixing the codeine with other drugs you would now have a C-III product (equivalent to Tylenol No. 2 tablets.) BUT, If you simply dissolve codeine in water, cherry syrup or some other diluent with no active ingredients, then the product would remain a C-II because codeine only converts to a CIII or C-V when mixed with other active ingredients that limit abuse of the codeine.

A formula requires 0.5 mL HCl. If a 10 mL graduated cylinder marked with 1 mL divisions is available, use the aliquot method and water as the diluent to measure the desired quantity of HCl.

Dilute 1 mL HCl with water to the 2 mL marking. Then, measure out 1 mL of the dilution.

A patient has been using phenytoin 100 mg three times daily. The phenytoin level was drawn and found to be 8.8 mcg/mL (reference range 10-20 mcg/mL). The prescriber doubled the dose to 200 mg three times daily. The patient started to slur her words, felt fatigued and returned to the clinic. The level was repeated the most likely reason for the change in phenytoin level? A. Phenytoin half-life is reduced to higher doses. B. Phenytoin volume of distribution increases at higher doses C. The patient's serum albumin level likely increased. D. Phenytoin bioavailability can decrease at higher doses. E. Phenytoin metabolism can become saturated at higher doses.

A babysitter brings a 7-year-old boy to the Emergency Department. He is unarousable. Labs are ordered and an ABG is drawn. The ABG results are as follows: 6.72/40/89/12/94%. What acid base disorder does the child have?

Metabolic acidosis

The patient is female, 48 years old, 5 ft 1 in tall, and 98 lb in weight. The nurse read her temperature using a digital thermometer and recorded it as 38.8 °C. Her SCr was determined to be 0.93. She was started on piperacillin/tazobactam (Zosyn), linezolid, and amikacin. The dose of Zosyn used was 3.375 g every 6 h infused over 30 min. According to the manufacturer's instructions for Zosyn: · CrCl > 40 mL/min: No dosage adjustment necessary. · CrCl 20-40 mL/min: Administer 2.25 g every 6 h. · CrCl < 20 mL/min: Administer 2.25 g every 8 h. 2.25 g, 3.375 g, and 4.5 g Zosyn should be reconstituted with 10 mL, 15 mL, and 20 mL of diluent, respectively. Swirl until dissolved. Reconstituted Zosyn solution should be further diluted (recommended volume per dose of 50 mL to 150 mL) in a compatible intravenous diluent solution listed below (NS). Infuse over 30 minutes every 6 to 8 hours normally. Question Determine whether the patient's Zosyn dose has to be adjusted.

No dose adjustment

An elderly female is admitted to the hospital after a motor vehicle accident. She suffered a head injury and is in the ICU. An ABG is obtained and the results aree as follows: 8.25/29/97/26/98%. What acid base disorder does the patient have?

Respiratory alkalosis

The laboratory values of a patient included the following: SCr = 1.5 mg/dL Albumin = 2.7 g/dL Total bilirubin = 2.8 mg/dL Question Express each concentration as mg/mL.

SCr = 0.015 mg/mL; albumin = 27 mg/mL; total bilirubin = 0.028 mg/mL

Determine the actual quantities, in grams, for a buffer that uses one mole of sodium acetate 232 242 (NaC H O ) and the corresponding amount of acetic acid (C H O ). Molecular Weights: Na = 23, C = 12, H = 1, O = 16

Sodium Acetate: 83 grams = one mole Acetic acid: 60 grams = one mole

A pharmacist in an oncology clinic receives the following prescription for a patient with Hodgkin's lymphoma: "Prednisone 40 mg/m2/day PO on days 1-14." The patient is 5'1'' and weighs 116 pounds. The hospital uses the following formulat for BSA (m2) = 0.007184 x height (cm)^0.725 x weight(kg)^0.425. How many 20 mg prednisone tablets should be dispensed to the patient?

The patient will take 60 mg of prednisone (three 20 mg tablets) per day for 14 days. The pharmacist should dispense 42 of the 20 mg prednisone tablets.

In a balance with a 6 mg sensitivity requirement, 3 mg of liothyronine is to be weighed with an error not greater than 5%. Using the method of aliquots and lactose as the diluent, explain how the drug will be weighed.

Weigh 4680 mg lactose and 120 mg liothyronine, and combine them into a homogeneous mixture. A 120 mg aliquot of the liothyronine-lactose mixture will contain 3 mg liothyronine.

I have 10 ml of a solution that contains one gram per 5 ml. How many ml of water must I add to the 10 ml to make a solution that is 1:5000 in strength?

You must add 9,990 mL of water

A 61-year-old, 5'6" female who weighs 165 lb needs parenteral nutrition. Calculate her PN nutrition requirements and fluid needs assuming that she is recovering from a mild infection and is bedridden.

total calorie requirement = 1623.1 kcal/day; protein: 75 g/day; protein calories: 300 kcal/day; lipids: 63.1 g/day; lipid calories: 568.1 kcal/day; carbohydrate: 263.8 g/day; carbohydrate calories: 1055 kcal; fluid: 1947.7 mL/day

A patient will be started on daily oral digoxin for management of atrial fibrillation. The following pharmacokinetic parameters for oral digoxin are known: F = 0.6, Vd = 500 L and Cl = 120 L/day. When would steady state be reached? Round to the nearest day.

~ 14 days

How many grams of NaCl are in 500 mL of 1/2NS? Round to the nearest hundredth.

2.25 g

A pharmacist is compounding a vancomycin oral suspension. The master formulation record says to reconstitute a 5 g vial of vancomycin powder with 50 mL of sterile water, then dilute with sterile water to 200 mL. What is the final percentage strength of the compounded product (% w/v)?

2.5%

A pharmacist dissolves 6 tablets. Each tablet contains 250 mg of metronidazole. The pharmacist will put the drug into a liquid base to prepare 60 mL of a topical solution. What is the percentage strength (w/v) of metronidazole in the prescription? Round to the nearest tenth.

2.5% w/v

A 20 mL vial is labeled potassium chloride (2 mEq/mL). How many grams of potassium chloride (MW: 74.5) are present? Round to the nearest hundredth.

2.98 g

Calculate the milliequivalents of a standard ammonium chloride (MW - 53.5) 21.4 mg/mL sterile solution in a 500 mL container

200 mEq

A patient requires 410.9 mg of a drug daily. The daily dose will be divided for BID administration. How many milligrams will the patient receive BID? Round to the nearest whole number.

205 mg BID

The E value for ephedrine sulfate is 0.23. How many grams of sodium chloride are needed to compound the following prescription? Round to 3 decimal places. Ephedrine sulfate: 0.4 g Sodium chloride: q.s. Purified water qs: 30 mL Make isotonic solution Sig. For the nose

0.178 g of NaCl are needed to make an isotonic solution

Calculate the E value for mannitol (M.W. = 182). Roudn to the nearest hundredth.

0.18

Digoxin injection is supplied in ampules of 500 mcg per 3 mL. How many milliliters must a nurse administer to provide a dose of 0.2 mg?

0.8 mL

A 45 milliliter nasal spray delivers 20 sprays per milliliter of solution. Each spray contains 1.5 mg of active drug. How many milligrams of drug are contained in the 45 mL package?

1,350 mg

Nitroglycerin has a specific gravity of 1.59. How much would 1 quart weigh in grams? Use 1 quart = 946 mL. Round to the nearest whole number.

1,504 g

Using the Harris-Benedict equation, calculate the basal energy expenditure for a 66-year-old male with major trauma (stress factor 1.5). He weighs 174 pounds and is 5'10''. Activity factor is 1.2. Round to the nearest whole number.

1,597 kcal/day

A pharmacist is asked to prepare 1 gallon of tincture containing 5.5% iodine. The pharmacy has 3% iodine tincture and 8.5% iodine tincture in stock. HOw many milliliters of the 3% and 8.5% iodine tincture should be used? (Use 1 gallon = 3,785 mL)

1,720 mL of the 8.5% iodine tincture 2,065 mL of the 3% iodine tincture

What is the specific gravity of 150 mL of glycerin weighing 165 grams? Round to the nearest tenth.

1.1

A pharmacist must prepare 100 grams of a 50% hydrocortisone powder using the 25% and 75% powders that she has in stock. How much of each is required?

10.417 mL (double check)

How many millimoles of calcium chloride (MW = 147) are represented in 147 mL of a 10% (w/v) calcium chloride solution?

100 mmols

A prescription reads as follows: "Prepare a 3% w/w coal tar preparation; qs with petrolatum to 150 grams." How many grams of petrolatum are required to compound the prescription? Round to the nearest tenth.

145.5 g of petrolatum

A mouth rinse contains 1/12% (w/v) of chlorhexidine gluconate. How many grams of chlorhexidine gluconate should be used to prepare 18 liters of mouth rinse? Round to the nearest whole number.

15 g

A 74-year-old male takes Lithobid (lithium carbonate, Li2CO3) 450 mg PO BID, but complains of difficulty swallowing the capsules. How many milliliters of lithium citrate syrup provide an equivalent daily dose of lithium? Round to the nearest whole number (MW of lithium carbonate = 74)

15 mL of lithium citrate per day

How many grams of bacitracin and nystatin are required to prepare 150 g of a 2:3 topical bacitracin:nystatin ointment

150 g of 2:3 bacitracin:nystatin ointment

Using 20 grams of a 9% boric acid ointment base, the pharmacist will manufacture a 5% ointment. How much diluent is required?

16 g diluent required

How many milliequivalents of potassium chloride are present in a 12 mL dose of a 10% (m/v) potassium chloride (MW - 74.5) elixer? Round to 1 decimal place.

16.1 mEq

A solution contains 373 mg Na ions per liter. How many milliosmoles are represented in the solution? M.W. = 23. Round to the nearest tenth.

16.2 mOsmol

How many milliequivalents of MgSO4 (MW = 120.4) are represented in 1 gram of anhydrous magnesium sulfate? Round to the nearest tenth.

16.6 mEq

There are 50 mg of drug in 50 mL of solution. Express the concentration as a ratio strength.

1:1,000

Express 0.04% as a ratio strength.

1:2,500

What is the concentration, in ratio strength, of a trituration made by combining 150 mg of albuterol sulfate and 4.05 grams of lactose?

1:28

A 10 mL mixture contains 0.25 mL of active drug. Express the concentration as a percentage strength (% v/v) and a ration strength.

1:40

A 76-year-old, 154 pound patient is NPO and needs hydration. She is afebrile and does not have HF, renal disease or ascites. What volume of fluid should the patient receive per day?

2,500 mL/day

Calculate the total energy expenditure for a majjor trauma patient (stress factor is 1.5, activity factor is 1.2) who is a 66-year-old male, weighing 174 pounds and measuring 5'10'' in height. (Use the BEE calculated from teh patient in the previous problem.) Round to the nearest whole number.

2,875 kcal/day

Express 0.00022% w/v as PPM. Round to the nearest tenth.

2.2 PPM

A pharmacist has tablets that contain 0.25 mg of levothyroxine per tablet. The tablets will be crushed and mixed with glycerol and water to prepare a prescription for a 36-pound child. How many levothyroxine tablets will be needed to compound the following prescription?

24 tabs of levothyroxine needed

If 12 grams of lanolin are combined with 2 grams of white wax and 36 grams of petrolatum to make an ointment, what is the percentage strength (w/w) of lanolin in the ointment?

24% w/w

How many milligrams of iodine should be used in compounding the following prescription? Iodine: 1:400 Hydrophilic ointment qs ad: 10 g Sig. Apply as directed

25 mg

How many milligrams of codeine will be contained in each capsule? Codeine sulfate: 0.6 g Guaifenesin: 1.2 g Caffeine: 0.15 g M. ft. caps. no. 24 Sig. One capsule TID PRN cough

25 mg of codeine/capsule

The pharmacist is consulted to convert a patient from prednisone 10 mg PO BID to an equivalent dose of oral dexamethasone given once daily. What is the equivalent daily dose? Prednisone 5 mg = dexamethasone 0.75 mg.

3 mg of dexamethasone daily

SS is a 79-year-old female with dry mouth and dry eyes from Sjogren's syndrome. She is picking up the prescription below. What is the maximum milligrams of milocarpine she will receive per day? Pilocarpine: 1% (w/v) Sodium Chloride qs ad: 15 mL Sig: 2 gtts (0.05 mL/gtt) po TID prn up to 5 days for dry mouth

3 mg pilocarpine

HT is a 16-year-old female who complains of weakness, fatigue and heavy menstrual periods. She is diagnosed with anemia. HT takes ferrous sulfate 220 mg once daily. How many milligrams of elemental iron does HT receive from the supplement? Ferrous sulfate is 20% elemental iron.

44 mg elemental iron

How many milliliters of polysorbate 80 (SG = 1.08) are needed to prepare a prescription that includes 49 grams of the surfactant/emulsifier (polysorbate)? Round to the nearest hundredth.

44.44 mL

How many grams of petrolatum (diluent) should be added to 250 grams of a 20% ichthammol ointment to make a 7% ichthammol ointment? Round to the nearest tenth.

464.3 g petrolatum required

Convert 5,000 mL to liters.

5 L

If one 10 mL vial contains 0.05 g of diltiazem, how many milliliters should be administered to provide a 25 mg dose of diliazem?

5 mL

How many nanograms are equal to 5 kg?

5 trillion ng (or 5 x 10¹² ng)

How many milliequivalents of sodium are in a 50 mL vial of 8.4% sodium bicarbonate (MW = 84)?

50 mEq

A patient's blood contains 0.085 PPM of selenium. How many micrograms of selenium does the patient's blood contain if the blood volume is 6 liters?

510 mcg

If 1,250 grams of a mixture contains 80 grams of a drug, what is the percentage strength (w/w) of the mixture? Round to the nearest tenth.

6.4%

Enoxaparin 56.5 mg was ordered for a patient. The hospital rounds enoxaparin doses to the nearest 10 mg. What dose should be dispensed?

60 mg

How many millimoles of sodium phosphate (MW 138) are present in 90 g of the stubstance? Round to the nearest whole number.

652 mmols

A hospice pharmacist receives a prescription for 1% morphine sulfate oral solution. She has a 120 mL bottle of morphine sulfate labeled 20 mg/5 mL and a 240 mL bottle of morphine sulfate labeled 100 mg/5 mL. How much of 100 mg/5 mL product must be mixed with the contents of the 20 mg/5 mL morphine sulfate bottle to prepare the desired percentage strength for the patient?

72 mL of 2% morphine sulfate

A pharmacist has an order for parenteral nutrition that includes 550 mL of D70%. The pharmacist checks the supplies and finds the closest strength he has available is D50%. How many milliliters of D50% will provide an equivalent energy requirement?

770 mL of D50%

A patient weighs 176 pounds. What is the patient's weight in kilograms?

80 kg

MK is a 62-year-old female who has been admitted with enteritis and pneumonia. She has a history of Crohn's disease and COPD. Her IBW is 54.7 kg. The staff gastroenterologist has ordered PN therapy with 1.5 g/kg IBW/day of protein. How many grams of protein will MK receive per day? Round to the nearest whole number.

82 g protein/day

The pharmacist receives an order for 10 mL of tobramcyin 1% ophthalmic solution. He has tobramycin 40 mg/mL solution. Tobramcyin does not dissociate and has a MW of 468. Find the E value for tobramycin and determine how many milligrams of NaCl are needed to make the solution isotonic. Round to two decimal places.

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