Hospital pharmacy III part 1

Question 1

Hospital Specific
___________handbook
__________ conversion toolkit
IV Medication Administration Guideline
___________ per pharmacy protocols

Answer 1

Renal dosing handbook

Opioid conversion toolkit

Dosing per pharmacy protocols

Question 2

Hospital Specific
Pros

Follows hospital __________
Easy to access

Answer 2

protocols

Question 3

Hospital Specific
Cons

Not all __________
May vary __________
Not updated as frequently

Answer 3

not all inclusive

may vary slightly

Question 4

Lexidrug

Pros
Frequent __________
Includes ________ references
May integrate _____________

Answer 4

frequent updates

guideline references

hospital formulary

Question 5

Lexidrug
Cons

Need to know where to _______

Answer 5

Need to know where to look

Question 6

UptoDate

Pros
__________overviews
Often what _________ will use

Answer 6

General

providers will use

Question 7

UptoDate
Cons

Does not include _________

Answer 7

does not include specifics

Question 8

Clinical Pharmacology
Pros
Includes lists such as Do Not Crush, Beers Criteria
Allow for clinical ___________
Monitoring parameters in _______form
Includes ____________

Answer 8

comparison

list form

IV compatibilty

Question 9

Clinical Pharmacology
Cons
Not all institutions have __________

Answer 9

not all institutions have access

Question 10

Micromedex
Pros
Great for _________
Includes __________
Quick answers vs in depth answers
Extravasation resource

Answer 10

neonates
toxicology

Question 11

Micromedex
Cons
Not all institutions have access
________ list when searching by med name

Answer 11

Long list

Question 12

Natural Medicines

Pros
Ability to check ___________/OTCs

One of a kind resource!

Cons
Need to be familiar with their _______scales

Answer 12

supplements

Need to be familiar with their rating scales

Question 13

Pharmacy Calculations
Used daily for the preparation of _________ orders

Operations & Clinical

Units often play an important role!

Answer 13

medication orders

Question 14

Pharmacy Calculations

Medication doses: mg/kg, mcg/kg/min

Medication concentrations: mg/mL

Infusion rates: mL/hr

Question 15

1kg=_____lbs

Answer 15

2.2lbs

Question 16

1 inch=______cm

Answer 16

2.54cm

Question 17

1g=1000mg

Question 18

1mg=1000mcg

Question 19

Weight Based Medication Dosing

What are some examples of medications that are dosed based on weight?
____________
Insulin
__________ drips
Enoxaparin
__________
Pediatrics

Important to know which weight each medication dose is based off of!
Ideal BW
Actual BW
Adjusted Body Weight

Answer 19

vancomycin

heparin drips

TPN

Question 20

Vancomycin

Often individual hospitals have their own protocols

Loading dose may be the same as ___________regimen, or loading dose may be higher

Not only weight based, also need to account for ________function

Answer 20

maintenance regimen

renal function

Question 21

Vancomycin Examples

60 year old patient with MRSA + pneumonia
CrCl = 55 mL/min

Wt = 100 kg

Starting dose for 60 yr old pt would be 2,000mg or 2g because we are going to multiple 100kg times 20 to get a dose of 2000mg

100x20=2,000mg (loading dose)
1000x15mg/kg (maintenance dose)=1,500mg pt would need every 12 hr dosing

Question 22

Vancomycin Examples

85 year old patient with MRSA +SSTI
CrCl = 23 mL/min
Wt = 40 kg

40kgx20mg/kg=800mg which would be 750 mg

40kgx15mg/kg=600mg which would be 500mg

Question 23

Opioid Conversions

Some institutions have their own protocols

Conversion Formula:
current opioid dose(mg),route x desired opioid/current opioid=desired opioid dose (mg), route