CALCULATIONS

(2013 march q3) Q1. A 5-month-old baby is hospitalised with chickenpox. The baby weighs 7 kg, has a body surface area (BSA) of 0.36 m2 and is not immunocompromised. The baby is prescribed a 5-day course of intravenous aciclovir. How many milligrams of aciclovir will be administered per day assuming the baby has no renal insufficiency? A. 90 mg B. 180 mg C. 270 mg D. 360 mg E. 450 mg

(2013 jan q37) Q2. Mr J, a 56-year-old man, is admitted to hospital with chest pains of two hours duration. A myocardial infarction is diagnosed and Mr J is started on an accelerated regimen of treatment with alteplase. Mr J weighs 85 kg. How many units of alteplase will he receive in total? A. 48.8 million B. 50.0 million C. 52.2 million D. 56.4 million E. 58.0 million

(2011 q36) Q3. A patient with atrial fibrillation is started on amiodarone. The medical practitioner prescribes the usual stabilising regime, followed by the usual maintenance dose. Given that other medication taken by the patient does not interact with amiodarone, how many amiodarone 200 mg tablets would you need to supply for the first 28 days of treatment? A 28 B 49 C 56 D 63 E 84

Directions for questions below: A if 1, 2 and 3 are correct D if 1 only is correct

B if 1 and 2 only are correct E if 3 only is correct

C if 2 and 3 only are correct

(2013 feb q6) Q4. You are asked to prepare an AmBisome (amphotericin B) solution for infusion for a 65-year-old woman who weighs 50 kg. She has been prescribed AmBisome at a daily dose of 2.5 mg/kg body weight to be administered as an intermittent infusion in glucose 10% over 30 minutes at a concentration of 2 mg/mL . Each 50 mg vial of AmBisome should be reconstituted with 12 mL water for injections, to produce a preparation containing 4 mg/mL amphotericin B. Which of the following statements is/are correct? 1. Each reconstituted vial of AmBisome results in a preparation containing 0.4% w/v amphotericin B 2. The volume of glucose 10% solution for infusion required to produce a final concentration of 2 mg/mL amphotericin B is 31.25 mL 3. The infusion rate should be set at 125 mL/hour

(Pg 50 q59 MCQs in Pharmaceutical Calculations) Q5. Which of the following statements is/are correct? 1. 2 L of a solution is to be given to a patient over an 8-hour period. If 10 drops equal 0.5 mL the solution should be given at a rate of 100 drops/min 2. 2 1 L of a solution is to be given to a patient over a 2-hour period. If one drop equals 0.1 mL the solution should be given at a rate of 25 drops/min 3. 5 L of a solution is to be given to a patient over a 10-hour period. If one drop equals 0.2 mL the solution should be given at a rate of 2500 drops/h

CALC ANSWERS

Q1. C See BNF for Children section 5.3.2 250 mg/m2 every 8 hours = 250 x 0.36 x 3 = 270 mg aciclovir per day

Q2. E BNF section 2.10.2 100 mg = 58.0 million units alteplase

Q3. B BNF section 2.3.2 monograph for amiodarone Dose = 200 mg 3 times daily for 1 week reducing to 200 mg twice daily for a further week; maintenance dose, usually 200 mg daily. 1 tablet tds for 7 days = 21 tablets 1 tablet bd for 7 days = 14 tablets 1 tablet od for 14 days = 14 tablets Total = 49 tablets

Q4. A 1. Each reconstituted vial contains 4 mg/mL = 400 mg in 100 mL = 0.4 g/100mL = 0.4% w/v 2. 2.5 mg/kg x 50 kg = 125 mg dose. Concentration 4 mg/mL therefore volume = 31.25 mL. Final concentration is 2 mg/mL therefore require addition of 31.25 mL glucose 10% 3. Total volume to be infused is 62.5 mL over 30 minutes = 125 mL per hour

Q5. E 1 2 L over 8 hours = 2000 mL/8 h = 250 mL/h 10 drops = 0.5 mL, so 250 mL = 500 drops/h So 1 is false. 2 1 L over 2 h = 1000 mL/2 h = 500 mL/h 25 drops/min = 2.5 mL/min = 1500 mL/h So 2 is false. 3 5 L over 10 h = 5000 mL/10 h = 500 mL/h So 3 is true. Therefore, the correct answer is E.