PT160
What is an ampule? pg 217 math book
A sealed glass container that holds a single dose of medication
An oncologist ordered 5FU 15mg/kg IV qd x 4 d for a 180 # man. 5FU is available in 10 mL vials with a concentration of 40 mg/mL. How many mL will the patient need per dose?
180 lbs / 2.2 = 81.8kg x 15mg = 1227mg
1227mg x 1mL / 40mg = 30.7mL
What is used to calculate the BSA? pg 297 math book
A Nomogram
A 44-pound child is ordered ampicillin suspension 250mg/5mL, 25 mg/kg/day in four equally divided doses. How many mL are required per dose?
44lbs / 2.2 = 20kg x 25mg = 125mg
250mg/5mL 125mg/X = 2.5mL
How is the body surface area calculated? pg 297 math book
It is calculated by the weight and height and it is expressed in m2
A 8-month-old infant is ordered acetaminophen q6h for a high temperature. The usual adult dose is 325 mg q6h. The available acetaminophen is 160 mg/5 mL.
What volume of medication should the infant receive every 6 hours?
Fried's Rule
8 / 150 x 325mg = 17.3mg
17.3mg x 5mL / 160mg = 0.5mL q6h
A calculated dose between 1 mL and 3 mL would normally be rounded to what place value? pg 214/215 math book
ones, tenths, hundredths, or thousandths
tenths
Which rule uses a formula that estimates a child's dose using adult dose and weight in pounds?
Clark's Rule
A physician orders Zantac liquid for an 7-month-old infant. The adult dose is 125 mg bid. The stock strength is ranitidine 20 mg/mL. How many mg should the infant receive?
Fried's Rule
7 months/ 150 x 125mg = 5.8mg
5.8mg x 1mL / 20mg = 0.29mL or 0.3 if moodle rounds
A 90 lb child is being treated with diazepam for muscle relaxation. The recommended dose for the child is 0.1 mg/kg q8h prn. Diazepam is available as a 10mg/5 mL oral solution.
What volume of medication should the child receive per dose?
90 lbs / 2.2 = 40.9kg x 0.1mg = 4.09mg
4.09mg x 5mL / 10mg = 2mL
A child is 48″ tall and weighs 72 lb. A physician orders phenobarbital for the control of seizures. The normal adult dose is 100 mg tid. The available medication is 20 mg/5 mL. What is the approximate volume the child should receive per dose based on the adult dose?
Clarks Rule - inches are irrelevant
72 lbs / 150 x 100mg = 48mg
48mg x 5mL / 20mg = 12mL
A 9 year-old with leukemia is prescribed vincristine 1.5 mg/m2. His BSA is 0.6 m2. The medication is supplied as 1 mg/mL. How many mL are needed to supply this dose?
The age is irrelevant. 1.5mg x 0.6m2 = 0.9mg
0.9mg x 1mL / 1mg = 0.9mL
How does the accuracy of a measurement relate to the size of the syringe chosen? pg 215 math book
The accuracy of measurement of medications decreases as the syringe size increases which means The larger the syringe, the less accurate the measurement
What are the reasons a medication would be given parenterally? pg 13 math book
Parenteral/Injectable medications may be given if a person is unable to swallow solid medications, if a quicker effect is needed, if the person is combative, or if the particular medication would be degraded by stomach acid.
A 44 pound child is prescribed Zovirax (acyclovir) 15 mg/kg qid x 5 d for chickenpox.
Zovirax Oral Suspension is 200 mg/5 mL. How many mL are needed per dose?
The dose is 300mg. We would give the patient 7.5mL
A 6 year-old child has been prescribed Tofranil (imipramine) at bedtime for enuresis. A typical adult maintenance dose of Tofranil is 100 mg daily. The medication is available in 10mg, 35mg, and 50mg tablets. What is the approximate maintenance dose that can be administered to the child based on this information?
The dose is 33mg so we would give the 35mg tablet
An oncologist prescribes doxorubicin 70 mg/m2 IV every 21 days. How many mL need to be withdrawn from a 75 mL multi-dose vial with a reconstituted strength of 4 mg/2mL for a female with a BSA of 2.1 m2?
70mg x 2.1 m2 = 147mg
147mg x 2mL / 4mg = 73.5mL
A physician orders GARAMYCIN 5 mg/kg/day divided into three 50 mL piggybacks to be administered q8h to a 164-pound adult. The stock strength available is GENTAMICIN 40 mg/mL in 20-mL multi-dose vials.
How many mL should be added to each piggyback?
The 50mL piggyback is what you're going to put the dose in so it is irrelevant to the question.
164 lbs / 2.2 = 74.5kg x 5mg = 372.7mg/day
372.7mg / 3 doses = 124.2mg/dose
124.2mg x 1mL / 40mg = 3.1mL added to the IV bag
Which Rule would be used if given the childs age only and an adult dose?
Young's or Fried's
Parenteral medication doses of less than 1 mL are normally measured with a 1-mL TB syringe with the exception of which types of doses? pg 214 math book
U-100 insulin doses
An adult weighs 187 lb and is 5′9″ tall with a BSA of 2.3 m2. The physician ordered Oncovin 2 mg/m2 for chemotherapy treatment of a malignant tumor. Oncovin is supplied as 0.5mg/mL. What volume should the patient receive per dose?
The weight and height do not matter in this problem when you already have the BSA
2mg x 2.3 m2 = 4.6mg
4.6mg x 1 / 0.5mg = 9.2mL
A 30-pound child with epilepsy is prescribed Tegretol (carbamazepine) 25mg/kg/day, taken in four doses. Tegretol Suspension is 175 mg/5 mL. What is the volume of one dose of medication?
The dose is 340.9mg. The patient would receive 9.7mL
A 65 lb patient is ordered aminophylline 3 mg/kg po every 6 hours. The oral liquid is available as 100 mg/5 mL. What volume should be administered per dose?
65 lbs / 2.2 = 29.5kg x 3mg = 88.6mg
88.6mg x 5mL / 100mg = 4.4mL
A 84 lb child has a prescription for azithromycin oral suspension 15 mg/kg/day for the first day and then 10 mg/kg/day for 4 subsequent days.
Zithromax oral suspension is available in 200 mg/5 mL strength.
What volume of medication should the child receive on the first day?
What volume of medication should the child receive on each subsequent day?
What is the total dosage of medication that the child will receive over 5 days?
84lbs / 2.2 = 38.2kg x 15mg = 572.7mg
572.7mg x 5mL / 200mg = 14.3mL for the first day
84lbs / 2.2 = 38.2kg x 10mg = 381.8mg
381.8mg x 5mL / 200mg = 9.5mL thereafter
9.5mL x 4 days + 14.3mL = 52.3mL total in 5 days
A physician orders ibuprofen q6h prn fever for a 38-lb child. The usual adult dose is 350 mg q6h. Ibuprofen is available in 100 mg/5 mL strength.
What is the child's dose in mg?
What is the child's dose in mL?
If the medication is taken as ordered for 1 full day, how many mL are needed?
Approximately how many ounces of medication would be needed if the child continued to take doses as ordered for five days?
Clark's Rule
38 lbs / 150 x 350mg = 88.7mg
88.7mg x 5mL / 100mg = 4.4mL
4.4mL x 4 times per day = 17.6mL per day
17.6mL per day x 5 days = 88mL / 30mL (1 ounce) = 2.9 or 3 ounces