Oral Dosages of Drugs

Question 1

Formula used to calculate drug dosages.

Answer 1

D / H x Q = X

Question 2

Medications for oral administration are supplied in a variety of forms, such as tablets, capsules, and liquids. They are usually ordered to be administered ___, or ___, the abbreviation for the Latin phrase “___.”

Answer 2

by mouth / PO / per os

Question 3

When a liquid form of a medication is unavailable, children and older patients may need to have a tablet ___ or a capsule ___ and ___ with a small amount of food or fluid to enable them to swallow the medication. Many of these crushed medications and oral liquids may also be ordered to be given enterally, or into the gastrointestinal tract using a specially placed tube. Such tubes and their associated enteral routes are the nasogastric (NG) tube from ___ to ___, the nasojejunal (NJ) tube from ___ to ___, the gastrostomy tube (GT) placed directly through the ___ into the ___, and the percutaneous endoscopic gastrostomy (PEG) tube.

Answer 3

crushed / opened / mixed / nares / stomach / nares / jejunum / abdomen / stomach

Question 4

Some solid-form medications, such as acetylsalicylic acid (ASA), are ___-coated (___-coated acetylsalicylic acid ECASA) and also considered a ___-release formulation. This protective barrier allows the drug to dissolve in the ___, avoiding the adverse effect of irritation to the stomach lining. ___-release technology (or sustained-release, extended-release, controlled-release, and so on) allows tablets and capsules to be released over time, which results in a slow, steady release of the drug into the ___, and allows for dosing at less frequent intervals. Consequently, ___-coated and ___-release drugs should not be crushed or divided.

Answer 4

enteric x2 / delayed / duodenum / time / bloodstream / enteric / time

Question 5

Consult a drug reference or the pharmacist if you are in doubt about the safety of crushing tablets or opening capsules. The Institute for Safe Medication Practices (ISMP) Canada has a “___” list: To access this list, visit the website: https://www.ismp.org/recommendations/do-not-crush.

Answer 5

Do Not Crush

Question 6

Do not crush, break, or chew enteric-coated (EC) products. They are formulated to dissolve in the ___ to reduce ___ irritation and to prevent irritation of the mouth, staining of the teeth and oral mucosa, or ___ of the drug by ___ acid.

Answer 6

intestine / gastric / destruction / stomach

Question 7

Sustained-release products—controlled-release (CR), extended-release (ER or XL), long-acting (LA), sustained-release (SR), and other products—are formulated to deliver the drug over a ___-hour period. Crushing these formulations may lead to an initial ___ followed by ___ drug levels to maintain the intended therapeutic effect.

Answer 7

24 / overdose / insufficient

Question 8

When a drug name lacks a suffix that identifies it as a sustained-release product, do ___ assume that the product works by immediate release.

Answer 8

not

Question 9

Always check with the published list of drugs that should not be crushed, on ___ (ISMP)-Canada if unsure.

Answer 9

The Institute for Safe Medication Practices

Question 10

When necessary, ___ tablets (those marked for ___) can be divided into halves or quarters. Only scored tablets are intended to be divided. Use of a ___ should be used to split the tablet accurately. If unit dose drugs are supplied by the pharmacy, they are already scored and in a package.

Answer 10

scored / division / pill cutter

Question 11

A ___ system includes the preparation and provision of patient-specific oral and injectable medications in a quantity and formulation that is ready to administer to the patient, as indicated in the prescription requirements.

Answer 11

unit-dose

Question 12

It is safest and most accurate to give the ___ number of ___, ___ tablets possible.

Answer 12

fewest / whole / undivided

Question 13

Three-Step Approach to Dosage Calculations Using Formula Method

Answer 13

1) Convert
2) Think
3) Calculate

Question 14

Ensure that all measurements are the same unit of measurement. If not, ___ before proceeding.

Answer 14

convert

Question 15

Estimate a reasonable amount of the drug to administer.

Answer 15

Think

Question 16

Apply the formula D (desired dose) / H (dose on hand) x Q (quantity) = X amount.

Answer 16

Calculate

Question 17

D

Answer 17

Desired dose

Question 18

H

Answer 18

Dose on hand

Question 19

Q

Answer 19

Quantity

Question 20

X

Answer 20

Amount

Question 21

Expressed in mg, g, mcg, or units.

Answer 21

D (desired dose)

Question 22

Expressed in number of tablets or volume in millilitres (mL).

Answer 22

Q (quantity)

Question 23

In most cases, it is more practical to change to the ___ unit (such as grams to milligrams). This requires multiplication and usually eliminates the decimal or fraction, keeping the calculation in whole numbers.

Answer 23

smaller

Question 24

Both H and Q constitute the ___ found on the label of the drug available.

Answer 24

supply dosage

Question 25

When solving dosage problems for drugs supplied in tablets or capsules, Q (quantity) is always ___ because the supply dosage is per ___ tablet or capsule.

Answer 25

1 / one

Question 26

Tablets will never be in ___ unless it is ___.

Answer 26

decimals / half

Question 27

There will never be more than ___ tablets given.

Answer 27

3

Question 28

Use the formula as a calculation tool to validate the dose amount you ___ should be given, rather than the reverse. If your reasoning is sound, you will find the dosages you calculate make sense and are accurate.

Answer 28

anticipate

Question 29

Recheck your calculation if the dose seems ___. Although not impossible, amounts less than 1/2 a tablet or greater than 3 tablets or capsules are uncommon and should be ___. Please note there may be exceptions, for example, the prescriber could order methylprednisolone (Prednisone) 40 mg. Prednisone may be dispensed in 5 mg tablets to allow for ___ the dose, so you may initially need to give 40 mg (8 tablets of 5 mg tablets), which is a large number of pills.

Answer 29

unreasonable / reassessed / tapering

Question 30

Oral liquids are supplied in ___ form and contain a specific amount of drug in a given amount of ___ to give a specific concentration.

Answer 30

solution x2

Question 31

For medications supplied in liquid form, you must calculate the ___ of the liquid that contains the prescribed dosage of the ___. The ___ noted on the label may indicate the amount (dosage) of drug per 1 millilitre, such as 5 mg per 1 mL or per multiple millilitres of solution, such as 10 mg per 2 mL, 125 mg per 5 mL, or 1.2 g per 30 mL.

Answer 31

volume / drug / supply dosage

Question 32

Humulin R

Answer 32

Short-acting

Question 33

Novolin ge NPH

Answer 33

Intermediate-acting

Question 34

Levemir Penfill

Answer 34

Long-acting

Question 35

NovoPen

Answer 35

Long-acting