calculation and scheduling medication doses Flashcards
the total quantity of a drug that is to be given to a patient
dose
a dose relative to the patient’s body weight
relative dose
the frequency at which a dose is administered
dosage
the specific way a therapeutic drug is to be taken
dosage regimen
amounts of drug that may be prescribed within the work of usual medical practice
dosage range
other name for adult dose
usual dose
the amount that may be expected to produce, in adults, the medicinal effect for which it is intended
adult dose
aka usual dose
other names for initial dose
- priming dose
- loading dose
is the amount required to attain the desired concentration of the drug in the blood or tissues
initial dose
dose that is administered to children
pediatric dose
dose applicable to patient’s 65 years and above
geriatric dose
dose required to maintain clinical effectiveness or therapeutic concentration according to dosage regimen
maintenance dose
the amount administered to a patient before exposure or contraction of the illness
prophylactic dose
the amount which is administered to a patient after the exposure or contraction of an illness
therapeutic dose
importance of calculation and proper scheduling of doses
- patient safety
- patient compliance
- prevent toxicity and suboptimal therapy
what is the “5 rights”?
- right drug
- right patient
- right dose
- right route
- right time
defined as patient understanding and adherence to the directions for use
patient compliance
is defined as failing to follow a practitioner’s or labeled instructions for self-administration of any medication
patient noncompliance
examples of patient noncompliance
- underdosing, overdosing
- inconsistent, sporadic dosing
- incorrect treatment duration
- drug abuse
- medication misadventure
pharmaceutical dispensing and compounding calculations use _____
simple arithmetic
TRUE OR FALSE
the errors that may arise often are due to carelessness, as in improper placing of decimal points, incorrect conversion from one system of measurement to another, or uncertainty over the system of measurement to be used
true
very dangerous because of undesirable effect and toxicity
overdose
decrease effectivity of the drug to the patient
underdose
specific patient parameters in which certain drugs for certain patients are based of
- patient’s age & weight
- body surface area
- nutritional and functional status
- pharmacokinetic
TRUE OR FALSE
for adults that have normal condition, usual dose or the adult dose is already appropriate that means dose calculation is not required
true
dose individualization is required to:
- neonates/pediatric px
- elderly px with diminished biologic functions
- individuals of all age groups with compromised liver and/or kidney fxn
- critically ill px
- px being treated with highly toxic chemotherapeutic agents
- certain drugs with a narrow therapeutic window
the branch of medicine that deals with disease in children from birth through adolescence
birth to 18 years
pediatrics
if born at less than 37 weeks gestation
premature
newborn
from birth to 1 month
neonates
1 month to 1 year
28 days to 23 months
infant
2 years to 5 years
early childhood
6 years to 11 years
late childhood
12 years to 18 years
adolescence
factors in dosing pediatrics:
- patient’s age and weight
- overall health status
- stage of development of body systems for drug metabolism
TRUE OR FALSE
neonates can metabolize drugs in liver and eliminate drugs in renal system
false
these biologic functions and systems are underdeveloped in neonates
examples of devices needed to promote compliance to medication in pediatric patients
- calibrated medicine dropper
- premeasured teaspoon (5 mL)
- nebulizer for inhalation products
the field that encompasses the management of illness in the elderly
geriatric medicine
or geriatrics
65 to 75 years
young old
75 to 85
old
85 years and older
old old
TRUE OR FALSE
age-based dosing has demonstrated to be a safe and effective approach
true
the primary organ for excretion
kidney
is a buildup of toxins in your blood that occurs when the kidneys stop filtering toxins out through your urine
uremia
the result from acute diseases or trauma to the kidney
uremia
accumulation of excessive fluid & blood nitrogenous products in the body
uremia
TRUE OR FALSE
impaired glomerular filtration = ↓ drug excretion = ↑ half life
true
is a commonly used clinical diagnostic laboratory test for renal disease
BUN
blood urea nitrogen
pharmacokinetic changes caused by kidney disease
- oral bioavailability
- reduction in total body clearance
the volume of blood plasma that is cleared of creatinine by kidney filtration per minute
unit: mL/min
creatinine clearance
formulas to compute creatinine clearance
- cockroft and gault
- jellife (for adults with unstable renal fxn)
- schwartz equation (for children)
CREATININE CLEARANCE DESCRIPTION
above 90 mL/min
normal GFR
CREATININE CLEARANCE DESCRIPTION
60-89 mL/min
mild decrease in GFR
CREATININE CLEARANCE DESCRIPTION
30-59 mL/min
moderate decrease in GFR
CREATININE CLEARANCE DESCRIPTION
15-29 mL/min
severe decrease in GFR
CREATININE CLEARANCE DESCRIPTION
less than 15 mL/min
requires dialysis
ESRD
end-stage renal disease
the problem-solving method illustrated in solving pharmaceutical problems
dimentional analysis
based on ratio and proportion
this is widely used in many scientific disciplines and offers a consistent way to solve problems
dimentional analysis
TRUE OR FALSE
dimentional analysis can overcomes many difficulties students and pharmacy practitioners have in problem interpretation and provides a well-defined, consistent starting point in the solution of pharmaceutical problems
true
TRUE OR FALSE
the basis for dimensional analysis is the formation of relationships between quantities, multiplication and canceling units until only the units of the desired answer remain
true
TRUE OR FALSE
dimensional analysis can be used to solve most pharmaceutical problems, regardless of complexity, using a consistent procedure
true
is the frequency and duration of a drug’s prescribed or recommended use
medication schedule
or dosing schedule
includes all maintenance doses administered according to a standard, repeated cycle of frequency
scheduled medications
includes early or delayed administration of maintenance doses of greater than 30 minutes before or after the scheduled dose
time-critical scheduled medications
TRUE OR FALSE
time-critical scheduled medications may cause harm or result in substantial sub-optimal therapy or pharmacological effect
true
TRUE OR FALSE
time-critical scheduled medications are administered at the exact time indicated when necessary or within 30 minutes before or 30 minutes after the scheduled time
true
includes those that were early or delayed administration within a specified range of either 1 or 2 hours should not cause harm or result in substantial sub-optimal therapy or pharmacological effect
non-time-critical scheduled medications
TRUE OR FALSE
non-time-critical scheduled medications cannot be administered within 2 hours before or after the scheduled time
false
can be administed within 2 hours before or after the scheduled time
are responsible in hospitals for ensuring that medication is administered to patients at the appropriate time by following the medication order
nurses
monitor the adherence to standard drug administration schedules based on the prescribed dosing frequency whenever possible
pharmacists
outpatients must be instructed on how and when to take their medication by ____ or _____
prescribers or pharmacists
TRUE OR FALSE
the standard administration time are generally set by the institution
true
STANDARD ADMINISTRATION TIME
Q24
same time the medication was started, not unless specified
STANDARD ADMINISTRATION TIME
Q12
- 6 AM-6 PM (before meals)
- 9 AM-9 PM (after meal
STANDARD ADMINISTRATION TIME
Q8
6 AM-2 PM-10 PM (with or without food)
STANDARD ADMINISTRATION TIME
Q6
6 AM-12 PM-6 PM-12 AM
if given at 12:01 onwards, the dose will be charted for the ff day
STANDARD ADMINISTRATION TIME
Q4
4 AM-8 AM-12 PM-4 PM-8 PM-12 AM
calculation based on BSA is widely use for
- cancer patients
- pediatric patients
