Adulting with Meds
Convert
80 kg -> lbs
80 lbs -> kg
176 lbs
36.4 kg
Pt is 5 y/o and weighs 20 kg. What is the amoxicillin dose (45 mg/kg/day in divided doses every 8 hours)?
20 kg x 45 mg/kg/day -> 900 mg
900 mg / 3 times daily -> 300 mg per dose
Pt receives 2.5 L of IV solution over 5 hours. What is the flow rate in mL/hr?
2500 mL / 5 hours = 500 mL/hr
T / F
Pharmaceutical equivalents must each have the same inactive ingredients, same strength, same dosage form, and be intended to be taken by the same route
False - must be the same active ingredients
ADME (means)
Absorption
Distribution
Metabolism
Elimination
Pt weighs 150 kg and is ordered a medication that is 10 mg/kg once daily. What is the daily dose (mg)?
1500 mg daily
Pt weight 25 kg and the adult dose of a medication is 200 mg. I used Clark's rule and got the following child dose 33.3 mg. What did I do wrong?
Used kg instead of lbs. The correct dose is 73.3 mg
How much Normal Saline (NS) is needed to run 15 hours at 200 mL/hr?
3000 mL or 3 L
The book to look up therapeutic equivalents.
Orange Book
Liver
Pt weighs 264 lbs and is ordered a medication that is 20 mg/kg. That dose is split into twice daily. What is the dose per administration?
264/2.2 = 120 kg
2400 mg / 2 = 1200 mg per dose
Pts age is 12 and weighs 50 kg. He is ordered a medication that a pediatric dose is not available. Use Young's rule to calculate their dose based on the adult dose of 500 mg.
Pt dose 250 mg
A medication is ordered to be administered at 175 mL/hr. The hospital administration set is calibrated to deliver 15 gtts/mL. What is the gtts/min that the nurse should administer?
175 mL/hr / 60 min = 2.92 mL/min
2.92 mL/min x 15 gtts/mL = 43.8 gtts/min ->
44 gtts/min
AMITRIPTYLINE HYDROCHLORIDE
AB - ACCORD HLTHCARE 10 mg
AB - Chemistry HLTH 10 mg
Are the two therapeutically equivalent?
Primary method of medication elimination.
Pt weighs 125 lbs and is ordered an oral suspension 12.5 mg/kg BID. What volume of medication should be administered per dose if the concentration is 50 mg/mL?
125 lbs -> 56.8 kg
56.8 kg x 12.5 mg/kg -> 710 mg
710 mg / 50 mg/mL -> 14.2 mL
Using Clark's Rule calculate the pediatric dose:
adult dose is 750 mg, patient is 10 y/o and weighs 95 lbs
Dose = 475 mg
600 mg of jenitenjamolol is diluted in 1000 mL NS. The order states 600 mg will be administered at 75 mg/hr. We have an administration set calibrated to 60 gtts. Calculate the mL/min and gtts/min.
600mg/1000mL = 75 mg/x
x= 125 ml/hr
125 mL/hr x 60 min/1hr = 2.1 mL/min
2.1mL/min x 60 gtts/mL = 126 gtts/min
Provide a simple definition of bioavailability
Rate and extent active ingredient becomes available
Process in which medications are taken orally that pass through the liver before distribution is called.
First-pass effect
A physician orders a dopamine drip at a rate of 5 mcg/kg/min for a patient weighing 70 kg. The concentration of the dopamine solution is 400 mg in 250 mL of D5W. Using a microdrip set (60 gtt/mL), what is the drip rate in gtts/min?
350 mcg/min to 0.35 mg/min
0.35 mg/min -> 0.21875 mL/min
0.21875 mL/min * 60 gtt/mL= 13.125 gtts/min
A 5-year-old child weighing 40 pounds needs a medication with an adult dose of 500 mg. Calculate the child's dose using both Young's and Clark's Rule.
Young's:
Child's dose ≈ 147.06 mg
Clark's:
Child's dose ≈ 133.33 mg
Pencillin G 4,000,000 units are added to a 100 mL bag of NS for a total volume of 108 mL. The order is to be administered in 30 minutes. What is the flow rate in mL/hr and gtt/min? (set is 15gtts/mL)
108 mL / 0.5 hr -> 216 mL / hr
216mL/hr x 1 hr/60min = 3.6 mL/min
3.6 mL/min x 15 gtts/mL = 54 gtts/min
What percentage must a study achieve to be considered bioequivalent?
It must be 20% less to 25% over the standard drug’s availability.
What order of kinetics follows as the concentration goes up so does the rate of elimination
First Order Kinetics