calculations test 2
How many milliliters of U-100 insulin zinc suspension should be used to obtain 18 units of insulin?
0.18 mL U-100 insulin zinc suspension (ch 9 #1)
Using Table 8.2 and a daily dose of 2 mg/kg, how many 20-mg capsules would a 176-lb patient be instructed to take per dose if the daily dose is to be taken in divided doses, q.i.d.?
2 capsules (ch.8)
HUMALOG contains 100 units of insulin lispro (rDNA origin) per milliliter. How many complete days will a 3-mL HUMALOG PEN last a patient whose dose is 35 units bid?
4 days ch.9
A blood sample taken from a 113-lb patient 6 hours after heparin therapy is initiated shows an aPTT of 24 seconds. Calculate (a) the bolus dose and (b) the infusion rate, in mL/h, according to the heparin protocol (Fig. 10.1).
4109.09 units 11.3 mL/h ch.10
For a 22-lb pediatric patient, the dose of cefdinir (OMNICEF) was determined to be 7 mg/kg. What quantity of an oral suspension containing 125 mg of cefdinir in each 5 mL should be administered? a. 2.8 mL b. 5.6 mL c. 8.9 mL d. 13.6 mL
(a) 2.8 mL cefdinir oral suspension (ch.8)
A hospital pharmacy order calls for 5000 units of heparin to be administered to a patient, twice daily, subcutaneously, for the prevention of thrombi. The pharmacist has on hand a vial containing 10,000 Heparin Units/mL. How many milliliters of the injection should be administered for each dose?
0.5 mL heparin injection ch.10- #1
A 10-mL graduate weighs 42.745 g. When 5 mL of distilled water is measured in it, the combined weight of the graduate and water is 47.675 g. By definition, 5 mL of water should weigh 5 g. Calculate the weight of the measured water and express any deviation from 5 g as percentage of error.
1.4% ch.3-13 (not assigned)
If a diabetic patient injects 20 units of insulin twice daily, how many days will a 10-mL vial of the U-100 product last the patient?
25 days (ch9)
Fluconazole tabs 100 mg Disp. ______ tabs Sig: tab ii stat, then 3 mg/kg b.i.d. × 7 days thereafter. Calculate the number of tablets to dispense to a patient weighing 147 lb.
30 tablets (ch.8)
A pharmacist attempts to weigh 120 mg of codeine sulfate on a balance with a sensitivity requirement of 6 mg. Calculate the maximum potential error in terms of percentage.
5% ch.3-10 (not assigned)
A patient is receiving morphine sulfate intravenously via a patient controlled analgesia (PCA) pump. The concentration of the solution is 15 mg/mL and is being infused at a rate of 0.1 mL/h. The patient may access a 2-mg bolus dose every hour for breakthrough pain and is currently using an average of 8 doses per day. The patient's caregiver requests that the patient be converted to a fentanyl transdermal patch (DURAGESIC) for a "more safe dosage form". What strength of fentanyl patch would be most effective for this patient?
75-mcg/h transdermal patch ch.10
A formula calls for 0.6 mL of a coloring solution. Using a 10-mL graduate calibrated from 2 to 10 mL in 1-mL units, how could you obtain the desired quantity of the coloring solution by the aliquot method? Use water as the diluent. Measure 3 mL agent; Use 2 mL as aliquot
Measure 3 mL coloring agent Dilute to 10 mL water Measure/use 2 mL solution ch.3 #7
A prescription balance has a sensitivity requirement of 6.5 mg. Explain how you would weigh 20 mg of a substance with an error not greater than 2%. Weigh 400 mg drug; Use 400 mg as aliquot
Weigh 400 mg substance Dilute with 7600 mg inert powder to make 8000 mg mixture Weigh/use 400 mg mixture ch.3-5
If a biologic product contains 7.5 Lf Units of diphtheria toxoid per 0.5 mL, how many flocculating units would be present in a 7.5-mL multiple-dose vial?
112.5 Lf Units diphtheria toxoid (ch-9 #28 not assigned)
The dose of mitomycin injection is 20 mg/m2/day. Determine the daily dose for a patient who weighs 144 lb and measures 68 inches in height.
35.4 mg mitomycin (ch.8)
If the dose of a drug is 10 mg/m2/day, what would be the daily dose, in milligrams, for a child weighing 30 lb and measuring 26 inches in height?
4.5 mg (ch.8)
The chemotherapy regimen "CAF" during a 21-day cycle is: Cyclophosphamide 500 mg/m2, D1 Doxorubicin 50 mg/m2, D1 5-Fluorouracil 500 mg/m2, D1,8 Calculate the dose of each drug/cycle for a patient with a BSA of 1.9 m2.
1900 mg 5-fluorouracil 95 mg doxorubicin 950 mg cyclophosphamide (ch.8)
ALFERON N injection contains 5 million international units of interferon alpha-n3 per milliliter. How many units will an injection of 0.05 mL deliver?
250,000 international units (ch9)
The oncolytic agent lapatinib (TYKERB) is administered in the treatment of breast cancer in daily doses of 1250 mg for 21 consecutive days in combination with the drug capecitabine (XELODA), which is administered in doses of 1000 mg/m2/day during days 1 to 14 of the 21-day treatment cycle. Calculate the total quantity of each drug to be administered during the treatment cycle to a 5-feet 2-inch woman weighing 110 lb.
26.25 g lapatinib and 20.72 g capecitabine (ch.8)
The drug carboplatin for ovarian carcinoma is administered intravenously at a dose of 360 mg/m2 except in patients with impaired kidney function, in which case the dose is reduced by 30%. How many milligrams of the drug should be administered to a renally impaired patient measuring 5 feet 2 inches and weighing 110 lb?
372.96 mg carboplatin (ch.8)
The literature states the pediatric dose of the antibiotic clarithromycin as "7.5 mg/kg q12h." Calculate the daily dose in milligrams for a child weighing 55 lb.
375 mg clarithromycin (ch.8- 53; not assigned)
A 142-lb patient was receiving filgrastim (NEUPOGEN) in doses of 10 mcg/kg/day when, as a result of successful blood tests, the dose was lowered to 6 mcg/kg/day. Using an injection containing 0.3 mg filgrastim per 0.5 mL, calculate the previous and new dose to be administered. a. 17.7 mL and 64.6 mL b. 5.23 mL and 3.14 mL c. 1.08 mL and 0.65 mL d. 3.87 mL and 2.3 mL
(c) 1.08 mL and 0.65 mL filgrastim injection (ch.8)
A patient has been taking acetaminophen 300 mg with codeine 30 mg (TYLENOL with CODEINE #3) tablets and wishes to switch to acetaminophen/hydrocodone tablets due to nausea and constipation caused by the codeine. The patient has been taking one tablet every 4 to 6 hours. What would be the most appropriate dose and dosage regimen for the acetaminophen/hydrocodone tablets? a. One 2.5-mg hydrocodone/325-mg acetaminophen tablet every 4 to 6 hours b. One 5-mg hydrocodone/300-mg acetaminophen tablet every 4 to 6 hours c. One 7.5-mg hydrocodone/300-mg acetaminophen tablet every 6 hours d. One 10-mg hydrocodone/325-mg acetaminophen tablet every 6 hours
(b) One 5-mg hydrocodone/300-mg acetaminophen tablet every 4 to 6 hours ch.10
The starting pediatric dose of ritonavir is 250 mg/m2 twice daily. Calculate the single dose, in milliliters, of an oral solution containing 600 mg of ritonavir in 7.5 mL of solution, for a child with a body surface area of 0.64 m2.
2 mL ritonavir oral solution (ch.8-58; not assigned)
the adult dose of a liquid medication is 0.1 mL/kg of body weight. How many teaspoonfuls should be administered to a person weighing 220 lb?
2 tsp. (ch.8)
Betty Smith Age: 4 years Weight: 52.8 lb Erythromycin ethylsuccinate (EES) 200 mg/5 mL Disp. 300 mL Sig:_______ mL q.i.d. until gone a. If the dose of EES is 50 mg/kg/day, how many milliliters would provide each dose? b. How many days would the prescription last the patient?
7.5 mL 10 days (ch.8)
A 25-lb child is to receive 4 mg of phenytoin per kilogram of body weight daily as an anticonvulsant. How many milliliters of pediatric phenytoin suspension containing 30 mg per 5 mL should the child receive?
7.58 mL phenytoin suspension (ch.8)
FOSAMAX PLUS D contains 70 mg alendronate and 140 mcg of vitamin D3, the latter equivalent to 5600 international units of vitamin D. At a once-a-week dose, calculate the daily intake of vitamin D3 in milligrams and units.
800 units and 0.02 mg/day ch.9
A patient who is 6 feet tall and weighs 187 lb has been given 170 mg of a medication based on a 2 mg/kg basis. Calculate the same dose, based on mg/m2. Use the BSA equation as needed.
81.8 mg/m2 (ch.8-65; not assigned)
The biotechnology-derived product interferon beta-1b contains 32 million international units per milligram. Calculate the number of international units present in a vial containing 0.3 mg of interferon beta-1b.
9,600,000 units interferon beta 1-b (ch9)
Prior to hip replacement surgery, a patient receives an injection of an anticoagulant drug at a dose of 30 mg. Following the patient's surgery, the drug is injected at 1 mg/kg. For a 140-lb patient, calculate the total of the pre- and postsurgical doses.
93.64 or 94 mg (ch.8)
EPOGEN injection is available containing in each milliliter, 2000, 3000, 4000, or 10,000 units of epoetin alfa. If the staring dose for a 160-lb patient is prescribed at 50 units/kg, which of the following would provide that dose? a. 4 mL of 2000 units/mL b. 1 mL of 3000 units/mL c. 0.9 mL of 4000 units/mL d. 0.8 mL of 10,000 units/mL
(c) 0.9 mL of 4000 units/mL ch.9
Diproex sodium is available in 250 mg and 500 mg strength tablets. From the information in the previous problem, what strength tablet and quantity could a pharmacist recommend for an initial dose?
Four 500-mg tablets, initial dose (ch.8-56; not assigned)
If the recommended dose of tobramycin for a premature infant is 4 mg/kg/day, divided into two equal doses administered every 12 hours, how many milligrams of the drug should be given every 12 hours to a 2.2-lb infant?
2 mg tobramycin (ch.8)
The pediatric dose of cefadroxil is 30 mg/kg/day. If a child was given a daily dose of 2 teaspoonfuls of a pediatric suspension containing 125 mg of cefadroxil per 5 mL, what was the weight, in pounds, of the child?
18.33 lb (ch.8)
A physician orders 1500 units of heparin to be administered by intravenous infusion per hour. The pharmacy provides a heparin intravenous bag containing 25,000 units of heparin in 250 mL of D5W. How many milliliters should be administered per minute?
0.25 mL/min ch.10
Each 0.01 mL of a mumps vaccine contains 400 TCID50 of the mumps virus. If the usual dose contains 20,000 TCID50, how many milliliters of vaccine should be administered?
0.5 mL mumps vaccine (ch-9 #27 not assigned)
If a 5-mL vial of HUMATROPE, a biosynthetic somatropin of rDNA origin, contains 5 mg of somatotropin equivalent to 13 IU, how many milligrams of somatotropin and how many IU would be administered in a 0.6-mL dose?
0.6 mg, and 1.56 or 1.6 IU somatropin ch.9
Somatropin (NUTROPIN) contains 5 mg of drug equivalent to approximately 15 IU of drug in a vial to prepare 10 mL of injection. If the starting adult dose is 0.006 mg/kg, calculate the dose (a) in units and (b) in milliliters for a 132-lb patient.
1.08 units somatropin 0.72 mL somatropin injection ch.9
three-agent dosage regimen, termed VAD, for the treatment of multiple myeloma includes the following drugs taken over a 28-day cycle: Vincristine 0.4 mg/day, CIVI, D 1-4 Doxorubicin 9 mg/m2/day, CIVI, D 1-4 Dexamethasone 40 mg/day, PO, D 1-4, 9-12, 17-20 Calculate the total quantity of each drug administered over the course of the treatment cycle for a patient with a BSA of 1.65 m2.
1.6 mg vincristine 59.4 mg doxorubicin 480 mg dexamethasone (ch.8)
A physician's hospital medication order calls for a patient to receive 1 unit of insulin injection subcutaneously for every 10 mg/dL of blood sugar over 175 mg/dL, with blood sugar levels and injections performed twice daily in the morning and evening. The patient's blood sugar was 200 mg/dL in the morning and 320 mg/dL in the evening. How many total units of insulin injection were administered?
17 units insulin ch.9
Calculate the quantities of each drug administered to a patient on day 2 of the ELF protocol if the patient's BSA is 1.64 m2.
196.8 mg etoposide 246 mg leucovorin 820 mg 5-fluorouracil (ch.8)
A medication order calls for tobramycin sulfate, 1 mg/kg of body weight, to be administered by IM injection to a patient weighing 220 lb. Tobramycin sulfate is available in a vial containing 80 mg per 2 mL. How many milliliters of the injection should the patient receive?
2.5 mL tobramycin injection (ch.8)
The loading dose of digoxin in premature infants with a birth weight of less than 1.5 kg is 8 mcg/kg administered in three unequally divided doses (½, ¼, ¼) at 8-hour intervals. What would be the initial dose for an infant weighing 1.2 kg?
4.8 mcg digoxin (ch.8)
The dose of the drug ixabepilone is 40 mg/m2, but if a patient's BSA is above 2.2 m2, the dose is calculated based on 2.2 m2. Using Figure 8.3, determine which dose parameter should be used for a patient who is 6 feet tall and weighs 200 lb.
40 mg/m2 (ch.8-60; not assigned)
A vial for preparation of 100 mL of injection of the drug alteplase (ACTIVASE) contains 100 mg of drug equivalent to 58 million international units to be administered by intravenous infusion. Calculate (a) the units administered to a 176-lb patient at a dose of 0.9 mg/kg and (b) the milliliters of injection to use.
41.76 million units alteplase 72 mL alteplase injection ch.9
A physician prescribes 2.5 million units of penicillin G potassium daily for 1 week. If 1 unit of penicillin G potassium equals 0.6 mg, how many tablets, each containing 250 mg, will provide the prescribed dosage regimen?
42 penicillin G potassium tablets ch.9
During cholecystography to determine gallbladder function, the contents of one bottle of cholecystokinin containing 75 units is dissolved in physiological saline solution to make 7.5 mL. Then, 1 unit per kilogram of body weight is administered by slow intravenous injection. Calculate the dose, in units, and the volume, in milliliters, to be administered to a patient weighing 154 pounds.
70 Units/dose and 7 mL/dose (ch-9 #24 not assigned)
A two-agent dosage regimen, termed MP, for the treatment of multiple myeloma is as follows: Melphalan 0.25 mg/kg, PO, D1-4/week × 6 weeks Prednisone 2 mg/kg, PO, D1-4/week × 6 weeks a. Calculate the total milligrams each of melphalan and prednisone taken per week by a patient who weighs 165 lb. b. If melphalan is available in 2-mg tablets, how many tablets are required to dose this patient for the entire treatment cycle? c. If the patient prefers prednisone oral solution to prednisone tablets, how many milliliters of the solution (5 mg/mL) should be dispensed weekly?
75 mg melphalan and 600 mg prednisone 225 tablets 120 mL prednisone oral solution (ch.8)
A patient weighing 120 lb was administered 2.1 g of a drug supposed to be dosed at 30 mg/kg. Was the dose administered correct, or was it an overdose, or was it an underdose?
Overdose (ch.8)
The oral dose of topotecan in the treatment of small cell lung cancer is 2.3 mg/m2/day once daily for 5 consecutive days, repeated every 21 days. The medication is available in 0.25 mg and 1 mg capsules. Recommend the strength and number of capsules to dispense for the initial course of treatment of a patient who weighs 165 lb and measures 5 feet 11 inches in height. Use the BSA equation.
Twenty 1-mg topotecan capsules (4/day) and ten 0.25 mg topotecan capsules (2/day) (ch.8-64; not assigned)
Each 1-mL adult dose of hepatitis A vaccine contains 1440 EL.U. of viral antigen. What would be the pediatric dose of this vaccine if 360 EL.U. of viral antigen are to be administered? a. 0.8 mL b. 0.25 mL c. 4 mL d. 0.4 mL
(b) 0.25 mL (ch-9 #26 not assigned)
A graduate weighs 35.825 g. When 10 mL of water is measured in it, the weight of the graduate and water is 45.835 g. Calculate the weight of the water, and express any deviation from 10 g as percentage of error.
0.1% ch.3-14 (not assigned)
Cefixime, an anti-infective agent, is available in oral suspensions of the following strengths: 100 mg/5 mL, 200 mg/5 mL, and 500 mg/5 mL. The pediatric dose is 8 mg/kg/day, administered in divided dosage. Calculate (a) the daily dose of cefixime for a 55-lb patient, (b) the most appropriate product strength to dispense, and (c) the quantity of oral suspension, in milliliters, required for a 10-day course of treatment.
200 mg cefixime 100 mg/5 mL 100 mL cefixime suspension (ch.8-67; not assigned)
If the dose of etoposide for a patient on the CAE protocol is increased to 120 mg/m2, calculate the increase in the dose, in milligrams, if the patient measures 150 cm and weighs 48 kg.
29.7 mg etoposide (ch.8)
The drug cabazitaxel is used treating prostate cancer in doses of 25 mg/m2. Calculate the dose for a patient measuring 73 inches in height and weighing 190 lb.
52.7 mg cabazitaxel (ch.8)
Beractant intratracheal sterile suspension may be administered to premature neonates within 15 minutes of birth, as indicated, for the prevention and treatment of respiratory distress syndrome. The suspension is available in 4-mL and 8-mL vials containing 25 mg of drug per milliliter. The dose is 100 mg/kg of birth weight. Calculate the dose of the suspension for a newborn weighing 1800 g.
7.2 mL beractant suspension (ch.8-59; not assigned)
The pediatric starting dose of ritonavir (NORVIR) is 250 mg/m2 by mouth twice daily. The available oral solution contains 600 mg of ritonavir in each 7.5 mL of solution. The correct volume and corresponding quantity of ritonavir to be administered to a child with a body surface area of 0.75 m2 per dose is: a. 5.6 mL (450.4 mg) b. 2.8 mL (450.4 mg) c. 2.8 mL (225.2 mg) d. 2.3 mL (187.5 mg)
d. 2.3 mL (187.5 mg) (ch.8)
Erythromycin ethylsuccinate 400 mg/5 mL Disp. 100 mL Sig._______ tsp. q.i.d. until all medication is taken. If the dose of erythromycin ethylsuccinate is given as 40 mg/kg/day What would be the proper dose of the medication in the signa, if the prescription is for a 44-lb child? How many days will the prescribed medication last?
½ tsp. (2.5 mL) erythromycin ethylsuccinate 10 days (ch.8)
A high-dose treatment of osteosarcoma includes the use of methotrexate at a starting dose of 12 g/m2 as a 4-hour intravenous infusion. For a patient having a BSA of 1.7 m2 and weighing 162 lb, calculate the dose on the basis of mg/kg/min.
1.15 mg/kg/min methotrexate (ch.8)
A male patient weighing 76 kg is placed on heparin therapy for the prevention of deep vein thrombosis after surgery. How many milliliters of a heparin injection containing 5000 units/mL should be administered for a loading dose of 80 units/kg? What should be the infusion rate, in mL/h, using a solution that contains heparin 25,000 units/500 mL, to administer 18 units/kg/h? Six hours after heparin therapy is initiated, the patient's aPTT is found to be 75 seconds. Adjust the infusion rate, in mL/h, according to the heparin protocol (Fig. 10.1).
1.22 mL heparin injection 27.36 mL/h 24.32 mL/h ch.10
The recommended dosage of lapatinib for metastatic breast cancer is 1250 mg given orally once daily on days 1 to 21, in combination with capecitabine 2000 mg/m2/day given orally on days 1 to 14 of a 21-day cycle. How many 250-mg tablets of lapatinib and 150-mg or 500-mg tablets of capecitabine should be dispensed for each cycle of therapy for a patient with a calculated BSA of 1.75 m2? (Also, refer to the package inserts online and think about the possible prescription-labeling instructions for the patient.).
105 250-mg lapatinib tablets and 98 500-mg capecitabine tablets (ch.8-66; not assigned)
A hepatitis B immune globulin contains 312 IU/mL. If the dose is 0.06 mL/kg for certain at-risk persons, calculate the dose (a) in units and (b) in milliliters for a 132-lb person.
1123.2 IU hepatitis B immune globulin 3.6 mL hepatitis B immune globulin ch.9
the daily dose of diphenhydramine HCl for a child may be determined on the basis of 5 mg/kg of body weight or on the basis of 150 mg/m2. Calculate the dose on each basis for a child weighing 55 lb and measuring 40 inches in height.
125 mg diphenhydramine HCl 120 mg diphenhydramine HCl (ch.8)
The content of a vial of penicillin G potassium weighs 600 mg and represents 1 million units. How many milligrams are needed to prepare 15 g of an ointment that is to contain 15,000 units of penicillin G potassium per gram?
135 mg penicillin G potassium ch.9
The recommended initial once-a-day dose of the neurologic drug divalproex sodium is 25 mg/kg/day, to be increased as indicated to an absolute maximum dose of 60 mg/kg/day. Calculate these quantities for a 182-lb patient.
2068.2 mg divalproex sodium, initial dose 4963.6 mg divalproex sodium, maximum dose (ch.8-55; not assigned)
Calculate the dose for a child 4 years of age, 39 inches in height, and weighing 32 lb for a drug with an adult dose of 100 mg, using the following: (a) Young's rule, (b) Cowling's rule, (c) Clark's rule, and (d) BSA (use the BSA equation).
25 mg 20.83 mg 21.33 mg 36.57 mg (ch.8)
The usual pediatric dose of acyclovir is 20 mg/kg administered by infusion and repeated every 8 hours. What would be the single dose, in milligrams, for a child weighing 33 lb?
300 mg acyclovir (ch.8)
Cod liver oil is available in capsules containing 0.6 mL per capsule. Using Table 9.1, calculate the amounts, in units, each of vitamins A and D in each capsule. The specific gravity of cod liver oil is 0.92.
331.2 to 1380 units of vitamin A 33.12 to 138 units of vitamin D ch.9
The initial maintenance dose of vancomycin for infants less than 1 week old is 15 mg/kg every 18 hours. a. What would be the dose, in milligrams, for an infant weighing 2500 g? b. How many milliliters of an injection containing 500 mg per 25 mL should be administered to obtain this dose?
37.5 g vancomycin 1.875 mL vancomycin injection (ch.8)
the pediatric dose of nelarabine is 650 mg/m2 administered intravenously over a period of 1 hour daily for 5 consecutive days. The drug is available in vials containing nelarabine, 250 mg/50 mL. Using Figure 8.2, calculate (a) the daily dose of drug, in milligrams, for a child weighing 15 kg and measuring 100 cm in height, and (b) the total volume of injection to infuse per treatment period.
416 mg nelarabine 416 mL nelarabine injection (ch.8-63; not assigned)
A four-agent dosage regimen, termed MOPP, for the treatment of Hodgkin's lymphoma includes the following drugs taken over a 28-day cycle11: Mechlorethamine 6 mg/m2, IV, D 1,8 Vincristine 1.4 mg/m2, IV, D 1,8 Procarbazine 100 mg/m2/day, PO, D 1-14 Prednisone 40 mg/m2/day, PO, D 1-14 Calculate the total number of 20-mg tablets of prednisone and 50-mg tablets of procarbazine to dispense to treat a patient with a BSA of 1.5 m2 during the course of one treatment cycle.
42 procarbazine tablets 42 prednisone tablets (ch.8)
The recommended pediatric dose of leuprolide acetate suspension for intramuscular injection is 7.5 mg, once per month, for a child weighing 25 kg. What is the equivalent dose, based on mg/m2, for this child measuring 36 inches in height? Use the BSA equation as needed.
9.4 mg/m2 (ch.8-57; not assigned)
Cyclosporine is an immunosuppressive agent administered before and after organ transplantation at a single dose of 15 mg/kg. How many milliliters of a 50-mL bottle containing 100 mg of cyclosporine per milliliter would be administered to a 140-lb kidney transplant patient?
9.55 mL cyclosporin (ch.8)
Levothyroxine sodium tablets may be crushed and suspended in water and administered by spoon or drop to infants and children who cannot swallow intact tablets. From the information in the previous problem, should a 25-mcg tablet, a 50-mcg tablet, or a 75-mcg tablet be crushed and suspended for administration to a 10-month-old infant weighing 17 lb?
A 50-mcg levothyroxine sodium tablet (ch.8-62; not assigned)
Penicillin G potassium 5000 units/mL Isotonic sodium chloride solution ad 15 mL Using soluble penicillin tablets, each containing 200,000 units of crystalline penicillin G potassium, explain how you would obtain the penicillin G potassium needed in compounding the prescription.
Dissolve 1 tablet in enough isotonic sodium chloride solution to make 8 mL, and take 3 mL of the dilution. ch.9
A hospital pharmacist is asked to determine the dose of clindamycin for a 3-day-old neonate weighing 3 lb 7 oz. In checking the literature, the pharmacist determines that the dose is listed as follows4: <1200 g: 10 mg/kg/day divided q12h <2000 g and 0 to 7 days old: 10 mg/kg/day divided q12h <2000 g and >7 days old: 15 mg/kg/day divided q8h >2000 g and 0 to 7 days old: 15 mg/kg/day divided q8h >2000 g and >7 days old: 20 to 30 mg/kg/day divided q12h Each divided dose is to be added to an intravenous infusion at the scheduled hour and infused over a period of 20 minutes. The product shown in Figure 8.1 was used to prepare an IV bag containing 600 mg/50 mL of injectable solution. How many milliliters of this solution should be given for each divided dose?
case-in-point 8.1 The metric weight of a 3-lb 7-oz neonate is calculated: 1 lb = 454 g; 1 oz = 28.35 g 3 lb × 454 g/lb = 1362 g 7 oz × 28.35 g/oz = 198.45 g 1362 g + 198.45 g = 1560.45 g, weight of the neonate According to the dosing table, the dose for a 3-day-old neonate weighing less than 2000 g is 10 mg/kg/day divided every 12 hours. dose: 15.6 mg clindamycin/day Since the daily dose is administered in two divided doses, each divided dose is: 7.8 mg every 12 hours The volume of injectable solution is then calculated: 0.65mL
in compounding a prescription, a pharmacist weighed 0.05 g of a substance on a balance insensitive to quantities smaller than 0.004 g. What was the maximum potential error in terms of percentage?
8% ch.3-11 (not assigned)
If, in the previous problem, the medication is administered as a suspension containing 125 mg clarithromycin/5 mL, what volume should be administered for each single dose?
7.5 mL clarithromycin suspension (ch.8-54; not assigned)
The recommended pediatric dose of epinephrine for allergic emergencies is 0.01 mg/kg. If a physician, utilizing this dose, administered 0.15 mg, what was the weight of the patient in pounds?
0.33 lb (ch.8)
An intratracheal suspension for breathing enhancement in premature infants is dosed at 2.5 mL/kg of birth weight. How many milliliters of the suspension should be administered to a neonate weighing 3 lb?
3.41 mL (ch.8)
Using a 10-mL graduate calibrated in 1-mL units, explain how you would measure 1.25 mL of a dye solution by the aliquot method. Use water as the diluent. Measure 5 mL dye; Use 2 mL as aliquot
Measure 5 mL dye Dilute to 8 mL water Measure/use 2 mL solution ch.3-8
TC is a 52-year-old female patient who is receiving 0.5 mL of a 50 mcg/mL injection of fentanyl citrate (SUBLIMAZE) every 2 hours following surgery to manage her pain. Her physician wants to change to oral oxycodone hydrochloride given every 4 hours so she can be discharged from the hospital. What strength of oxycodone hydrochloride tablets should be used for this patient? a. 20-mg tablets b. 15-mg tablets c. 10-mg tablets d. 5-mg tablets
(c) 10-mg tablets ch.10
Zoster Vaccine Live (ZOSTAVAX) contains about 29,850 plaque-forming units (PFU) of attenuated virus per 0.1 cL. Approximately how many PFUs would be contained in each 0.65-mL dose? a. 45,900 PFU b. 4590 PFU c. 1940 PFU d. 19,400 PFU
(d) 19,400 PFU (ch-9 #29 not assigned)
How many milliliters of an injection containing 1 mg of drug per milliliter of injection should be administered to a 6-month-old child weighing 16 lb to achieve a dose of 0.01 mg/kg?
0.073 ml (ch.8)
Insulin glargine (LANTUS) injection is available in 10-mL vials, containing 100 units/mL. How many milliliters would a patient administer for (a) a starting dose of 10 units and (b) a maintenance dose of 4 units?
0.1 mL insulin glargine 0.04 mL insulin glargine (ch9)
A physician desires a dose of 10 mcg/kg of digoxin for an 8-lb newborn child. How many milliliters of an injection containing 0.25 mg of digoxin per milliliter should be given?
0.15 mL digoxin injection (ch.8)
Enoxaparin sodium (LOVENOX) injection, a low-molecular-weight heparin, contains 150 mg/mL in 0.8-mL prefilled syringes. The recommended dose for knee replacement surgery is 30 mg every 12 hours. How many milliliters of the injection should be administered per dose?
0.2 mL enoxaparin sodium injection ch.10
The loading dose of indomethacin in neonates is 0.2 mg/kg of body weight by intravenous infusion. a. What would be the dose for a neonate weighing 6 lb 4 oz? b. How many milliliters of an injection containing 1 mg of indomethacin per 0.5 mL should be administered to obtain this dose?
0.57 mg indomethacin 0.28 mL indomethacin injection (ch.8)
If a 3-year-old child weighing 35 lb accidentally ingested twenty 81-mg aspirin tablets, how much aspirin did the child ingest on a milligram per kilogram basis?
101.83 mg/kg aspirin (ch.8)
If the administration of gentamicin at a dose of 1.75 mg/kg is determined to result in peak blood serum levels of 4 mcg/mL, calculate the dose, in milligrams, for a 120-lb patient that may be expected to result in a blood serum gentamicin level of 4.5 mcg/mL.
107.39 mg gentamicin (ch.8)
Among the single chemotherapeutic agents for breast cancer is docetaxel (TAXOTERE), which is administered @ 60 mg/m2 IV every 3 weeks. Calculate the dose for a 5-feet-4-inch patient who weighs 160 lb.
108.7 mg docetaxel (ch.8)
The dose of a drug is 500 mcg/kg of body weight. How many milligrams should be given to a child weighing 55 lb?
12.5 mg (ch.8)
The dose of gentamicin for premature and full-term neonates is 2.5 mg/kg administered every 12 hours. What would be the daily dose for a newborn weighing 5.6 lb?
12.73 mg gentamicin (ch.8)
If the pediatric dose of dactinomycin is 15 mcg/kg/day for 5 days, how many micrograms should be administered to a 40-lb child over the course of treatment?
1364 mcg dactinomycin (ch.8)
Intravenous digitalizing doses of digoxin in children are 80% of oral digitalizing doses. Calculate the intravenous dose (in mcg) for a 5-year-old child weighing 40 lb if the oral dose is determined to be 10 mcg/kg.
145.5 mcg digoxin (ch.8)
Jimmy Jones Age: 8 years Wt: 88 lb Metronidazole suspension 7.5 mg/kg/day M.ft. dose = 5 mL Sig: 5 mL b.i.d. × 10 days a. How many milligrams of metronidazole will the patient receive per dose? b. How many milliliters of the prescription should be prepared and dispensed? c. If metronidazole is available in 250-mg tablets, how many tablets will be needed to fill the prescription?
150 mg metronidazole 100 mL 12 metronidazole tablets (ch.8)
The prophylactic dose of tetanus antitoxin is 1500 units for persons weighing less than 65 lb and 3000 to 5000 units for persons weighing more than 65 lb. The antitoxin is available in dose vials of 1500 units, 3000 units, 5000 units, and 20,000 units. Which vial should a pharmacist provide for administration to a patient weighing 25 kg?
1500-unit vial (ch-9 #20 not assigned)
How many capsules, each containing 250 mg of clarithromycin, are needed to provide 50 mg/kg/day for 10 days for a person weighing 176 lb?
160 (ch.8)
Based on the dose calculated in the above problem, how many milliliters of an injection containing 80 mg/2 mL docetaxel would be administered per dose?
2.7 mL docetaxel injection (ch.8)
NT is taking two PERCOCET tablets each containing 7.5 mg of oxycodone and 325 mg of acetaminophen every 4 hours to manage his pain. His physician wants to switch him to oxymorphone extended-release tablets (OPANA ER) for improved pain control. Oxymorphone extended-release tablets are available in strengths of 5, 7.5, 10, 15, 20, 30, and 40 mg to be given every 12 hours. What should be the dose and dosage regimen for this patient?
20-mg tablet every 12 hours ch.10
The dose of gentamicin for patients with impaired renal function is adjusted to ensure therapeutically optimal dosage. If the normal daily dose of the drug for adults is 3 mg/kg/day, administered in three divided doses, what would be the single (8-hour) dose for a patient weighing 165 lb and scheduled to receive only 40% of the usual dose, based on renal impairment?
30 mg gentamicin (ch.8)
If the pediatric dosage of chlorothiazide (DIURIL) is 10 to 20 mg/kg of body weight per day in a single dose or two divided doses, not to exceed 375 mg/day, calculate the daily dosage range of an oral suspension containing 250 mg chlorothiazide per 5 mL that should be administered to a 48-lb child.
4.4 to 7.5 mL chlorothiazide oral suspension (ch.8)
If the daily dose of a drug is given in the literature as 8 mg/kg of body weight or 350 mg/m2, calculate the dose on each basis for a patient weighing 150 lb and measuring 5 feet 8 inches in height.
545.5 mg and 630 mg (ch.8)
Pertuzumab, for the treatment of late-stage breast cancer, is administered at an initial dose of 840 mg by intravenous infusion. It is coadministered every 3 weeks with trastuzumab 8 mg/kg and docetaxel 75 mg/m2. Calculate the doses of trastuzumab and docetaxel, for a patient who is 60 inches in height and weighs 158 lb. Use the BSA equation as needed.
574.5 mg trastuzumab and 130.8 mg docetaxel (ch.8-68; not assigned)
A pharmacist weighed 475 mg of a substance on a balance of dubious accuracy. When checked on a balance of high accuracy, the weight was found to be 445 mg. Calculate the percentage of error in the first weighing.
6.32% ch.3-12 (not assigned)
A pharmacist attempts to weigh 0.375 g of morphine sulfate on a balance of dubious accuracy. When checked on a highly accurate balance, the weight is found to be 0.400 g. Calculate the percentage of error in the first weighing.
6.67% ch.3-15 (not assigned)
A physician's hospital medication order calls for isophane insulin suspension to be administered to a 136-lb patient on the basis of 1 unit/kg per 24 hours. How many units of isophane insulin suspension should be administered daily?
61.82 units isophane insulin ch.9
IH is a 42-year-old male patient suffering from chronic back pain due to a workplace injury. He is currently taking one-half of a 2-mg levorphanol tartrate tablet every 6 hours to manage his pain but consults his doctor about switching to BUTRANS weekly buprenorphine transdermal patches for convenience. BUTRANS transdermal delivery systems are available in strengths of 5, 7.5, 10, 15, and 20 mcg/h. What strength of patch should be used for this patient?
Based on the levorphanol dose, the patient should receive 12.5 mcg/hr of buprenorphine. He should begin with a 10-mcg/hr patch and increase if his pain is not adequately controlled. ch.10
In a clinical trial of ciprofloxacin (CIPRO), pediatric patients were initiated on 6 to 10 mg/kg intravenously every 8 hours and converted to oral therapy, 10 to 20 mg/kg, every 12 hours. Calculate the ranges of the total daily amounts of ciprofloxacin that would have been administered intravenously and orally to a 40-lb child.
IV: 327.3 to 545.5 mg ciprofloxacin Oral: 363.6 to 727.3 mg ciprofloxacin (ch.8)
The formula for 100 mL of pentobarbital sodium elixir calls for 0.75 mL of orange oil. Using alcohol as a diluent and a 10-mL graduate calibrated in 1-mL units, how could you obtain the desired quantity of orange oil? Measure 3 mL oil; Use 2 mL as aliquot
Measure 3 mL orange oil Dilute to 8 mL alcohol Measure/use 2 mL solution ch.3-9
A prescription balance has a sensitivity requirement of 0.006 g. Explain how you would weigh 0.012 g of a drug with an error not greater than 5%, using lactose as the diluent. Weigh 120 mg drug; Use 150 mg as aliquot
Weigh 120 mg drug Dilute with. 1380 mg inert powder to make 1500 mg mixture Weigh/use 150 mg mixture ch.3-2
A torsion prescription balance has a sensitivity requirement of 0.004 g. Explain how you would weigh 0.008 g of a substance with an error not greater than 5%. Weigh 160 mg drug; Use 200 mg as aliquot
Weigh 160 mg substance Dilute with 3840 mg inert powder to make 4000 mg mixture Weigh/use 200 mg mixture ch.3-4
A torsion prescription balance has a sensitivity requirement of 4 mg. Explain how you would weigh 5 mg of hydromorphone hydrochloride with an error not greater than 5%. Use lactose as the diluent. Weigh 80 mg drug; Use 100 mg as aliquot
Weigh 80 mg hydromorphone hydrochloride Dilute with 1520 mg lactose to make. 1600 mg mixture Weigh/use 100 mg mixture ch.3-3
A hospitalist prescribed dimenhydrinate to treat a 48-lb child. The labeled dose of the drug is 1.125 mg/kg. The available oral solution contains dimenhydrinate, 12.5 mg/5 mL. Prior to administering the solution, the floor nurse decides to check her calculated dose of 9.8 mL with the hospital pharmacist. Were her calculations correct?
Yes, calculations were correct. (ch.8)
A pediatric patient is being administered enalaprilat (VASOTEC IV) every 12 hours by intravenous injection to manage hypertension and possible heart failure.4 Based on a dose of 5 mcg/kg, the patient is receiving 55 mcg of enalaprilat per dose. The physician wishes to convert the patient to oral enalapril at a dosage of 100 mcg/kg as a single daily dose. The standard procedure is to crush a 2.5-mg tablet of enalapril, mix with sterile water to make 12.5 mL, and administer the appropriate dose using a calibrated oral dispenser. Calculate the dose, in milliliters, to be administered to this patient.
case-in-point 4.2 weight of patient: 11kg oral dose: 1.1 mg oral dose: 5.5mL
A hospital pharmacist is called to a pediatric nursing station to calculate the quantity of an injection to administer to a pediatric patient. The daily dose of the injection for the child's weight is stated as 15 mg/kg/day, divided into three equal portions. The child weighs 10 kg. The injection contains 5 mg/mL of the prescribed drug. How many milliliters of injection should be administered?
case-in-point 4.3 10 mL
A hospital pharmacist is consulted on the appropriate dose of lopinavir/ritonavir (KALETRA) oral solution in the treatment of an HIV-1 infection in a 12-month-old pediatric patient. The oral solution contains, in each milliliter, 80 mg of lopinavir and 20 mg of ritonavir, expressed as "KALETRA 80/20." According to the pharmacy's protocol, the pediatric dose for patients greater than 6 months of age, not receiving other concomitant therapy, may be calculated based on either BSA or body weight as follows: 230/57.5 mg/m2, administered twice daily 12/3 mg/kg for patients <15 kg, administered twice daily 10/2.5 mg/kg for patients >15 kg administered twice daily The patient measures 28 inches in length and weighs 22 lb. Calculate the single dose, in mg, using the BSA equation. Translate the calculated single dose from (a) into corresponding milliliters of the oral solution. Calculate the daily dose, in mg, based on the patient's weight. Translate the daily dose from (c) into corresponding milliliters of oral solution.
case-in-point 8.4 28 inches × 2.54 cm/1 inch = 71.12 cm 22 lb × 1 kg/2.2 lb = 10 kg BSA= 0.44 m2 230 mg (lopinavir) × 0.44 m2 = 101.2 mg 57.5 mg (ritonavir) × 0.44 m2 = 25.3 mg Thus, 101.2 mg (lopinavir) and 25.3 mg (ritonavir) (b) 101.2 mg × 1 mL/80 mg = 1.27 mL 25.3 mg × 1 mL/20 mg = 1.27 mL Thus, 1.27 mL or 1.3 mL oral solution (administered by calibrated oral syringe). (c) KALETRA, 12/3 mg/kg 12 mg (lopinavir)/kg × 10 kg = 120 mg (lopinavir, single dose) 3 mg (ritonavir)/kg × 10 kg = 30 mg (ritonavir, single dose) Thus, 120 mg × 2 (doses/day) = 240 mg (lopinavir), and 30 mg × 2 (doses/day) = 60 mg (ritonavir) (d) 240 mg (lopinavir) × 1 mL/80 mg = 3 mL 60 mg (ritonavir) × 1 mL/20 mg = 3 mL Thus, 3 mL oral solution, daily dose (administered by calibrated oral syringe). It should be noted that since the ratio of lopinavir to ritonavir in the oral solution is fixed, that is, 80 mg:20 mg (or 4 mg:1 mg), the calculation of one component will automatically yield the quantity of the second component.
A prescription calls for 50 mg of chlorpheniramine maleate. Using a prescription balance with a sensitivity requirement of 6 mg, explain how you would obtain the required amount of chlorpheniramine maleate with an error not greater than 5%. Weigh 150 mg drug; Use 200 mg as aliquot
ch.3 #1 Weigh 150 mg chlorpheniramine maleate Dilute with. 450 mg lactose to make 600 mg mixture Weigh/use 200 mg mixture
Verify the correctness of a physician's order for the dispensing of 100-mcg tablets to be taken once a day by a 6-year-old child weighing 48 lb. 0-3 months, 10-15 mcg/kg/day 3-6 mo, 8-10 mcg/kg/day 6-12 mo, 6-8 mcg/kg/day 1-5 years, 5-6 mcg/kg/day 6-12 yrs 4-5 mcg/kg/day
correct (ch.8-61; not assigned)
Calcitonin is available as an injection containing 200 international units per milliliter. Adult doses of up to 32 units per kilogram have produced no adverse effects. On this basis, if a 120-lb patient were administered 0.75 mL of injection, would adverse effects be anticipated?
no ch.9
The product CREON (pancrelipase) contains 3000 units of lipase, 9,500 units of protease, and 15,000 units of amylase in delayed-release capsules. The capsules are to be swallowed whole or the contents added uncrushed to food immediately prior to administration. The dose should not exceed 2500 lipase units/kg of body weight. If the contents of one capsule are added to 120 mL of the feeding formula for a 12-lb infant, is the dose within accepted limits?
yes (ch-9 #21- not assigned)