Pharm2 5 Dosing Calcs pt1

Question 1

Pediatric doses are mainly (but not solely) based on:

Answer 1

weight (in kg)

Question 2

One class of drugs not FDA to be prescribed for kids are Quinolones. Why? how do we know that?

Answer 2

– b/c they affect their growth plates. How do we know that? B/c it was tested on beagles.

Question 3

Generally, When do we go to adult dosing?

Answer 3

when they go over 100 pounds. (45.45kg)

Question 4

T/F: there are adults who get pediatric doses if they are small enough

Answer 4

True

Question 5

Patient presents with a cat bite on their skin. What bacteria are you concerned about? How would you treat it?

Answer 5

Pasteurella multocida

Amox/clav

Question 6

Identify the terms from these definitions:
the amount of medication in units to be administered (i.e., mg or a volume of fluid)
the amount of medication in units of measurement (i.e., 250 mg/5 ml)
the length of treatment in units of time (i.e., over 1 hour)
the total quantity of medication to be given by the pharmacist of a prescription

Answer 6

Dose
Concentration
Duration
Dispense

Question 7

Dispense #40: means

Answer 7

40 tablets wll be disepensed in all

Question 8

Do these conversions
grams into ml
ml to cc to tsp
how many cc's are in a liter
1 fluid ounce to mL
liters into kg

Answer 8

1 gram of water = 1 ml of water
5 ml = 5 cc = 1 TSP
1,000 cc = 1,000 ml = 1 liter
1 fluid ounce = 30 ml = 30 cc
1 liter = 1 kg

Question 9

Define admin rate:

IV bolus

Answer 9

administered intravenously over a relatively brief period (usu. 2-3 seconds)

Question 10

Define admin rate:

IV push

Answer 10

administered intravenously as rapidly as possible without jeopardizing the intravenous site

Question 11

Define admin rate:

Slow IV

Answer 11

administered intravenously over a specified period of time, from 10 to 60 seconds

Question 12

Define admin rate:

IV drip

Answer 12

administered intravenously using an IV pump and/or an IV macrodrip administration set in units of drug per time (i.e., mcg/kg/min)

Question 13

How is an IV Bolus done with in a child?

Answer 13

You can’t give a child 500ml as an IV bolus, can’t be done in 2-3 seconds. So it’s given as fast as possible w/o jeopardizing the blood vessel/vein.

Question 14

You want to order 50 mg to be administered IM of dipenhydramine to your patient with an allergic reaction
Dipenhydramine comes 50 mg/1 ml in a unit dose vial
How much would you administer?

Answer 14

1 ml b/c it contains 50 mg of the drug

Question 15

Adult dosing tends to be ___

Answer 15

identical

Example: Amoxicillin 875 mg tabs, give 1 tab by mouth twice daily for 10 days

Question 16

Peds dosing tends to be __

Answer 16

customized
Example: Amoxicillin 45 mg/kg divided into BID dosing and given by mouth for 10 days
Peds dosing not only varies by weight; the drugs in pediatric forms exist in multiple doses.

Question 17

A child has an otitis media
You elect to prescribe amoxicillin 45 mg/kg divided into BID dosing and given by mouth for 10 days
Your patient weights 24 pounds
Amoxicillin comes in multiple pediatric strengths including 50 mg/1 ml, 125 mg/5 ml, 250 mg/5 ml, 400 mg/5 ml
How do we proceed?

Answer 17

Convert 24 pounds to 11 kg
45 mg/k x 11 kg = 495 mg of amoxicillin daily
Remember: This is to be divided into two equal doses and administered twice daily
495 mg daily divided by 2 = 243 mg of amoxicillin per dose

Question 18

After figuring out that this patient should get 243 mg of amox at a time, you choose the closest existing formulation, which is 250 mg. It’s usually “close enough.” So how would you write this order?
Knowing you want to administer ~ 250 mg…
and knowing you want to do this twice daily…
and knowing you want to do this for 10 days…
and knowing that amoxicillin comes in 250 mg/5 ml…

Answer 18

Amoxicillin suspension 250 mg/TSP
Sig: 1 TSP PO BID x 10 days
Disp #100 ml

Question 19

30 pound patient getting Amox at 45 mg/kg

once you calculate the closest formulation is 400 mg/5 ml
How do you prescribe this?

Answer 19

Amoxicillin Suspension 400 ml/TSP
Sig: ¾ TSP PO BID x 10 Days
Disp #75 ml

Question 20

Your 34 pound child is having an asthma exacerbation and you elect to send the patient home with Ora-Pred for 5 days
The recommended dosing is 2 mg/kg once daily
Ora-Pred comes in 15 mg/TSP
Please write your order

Answer 20

Ora-Pred Suspension 15 mg / TSP
Sig: 2 TSP PO QD x 5 Days
Disp # 50 ml