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Clinical Calculations

Michael Gerges Started: 16 May 2008 16:36 Questions: 6 1. (Points: 1) Cytotoxic drugs are often dosed according to Body Surface Area (BSA). The following equation by Mosteller is often used to calculate BSA: (Reference: Clinical Pharmacy, A Practical Approach) BSA (m2) = What is the body surface area (m2) for a 32 year old patient who weighs 84 kg and is 178 cm tall?

a. 2.0 m2 b. 1.3 m2 c. 0.9 m2 d. 4.2 m2 e. 1.6 m2

Save Answer 2. (Points: 1) Drug dosage in renal failure is often manipulated according to the equation: (Reference: APF) Df = Dn(1 - fe(1 ))

Where: Df = dose for 24 hours in renal failure Dn = normal dose in 24 hours (non-renal failure) fe = fraction excreted unchanged in the urine Est.ClCR = estimated creatinine clearance in mL/min For a patient with an estimated creatinine clearance of 42 mL/min the daily dose requirement of drug "B", allowing for renal function, was determined to be 128 mg (rounded to the nearest whole number). What would be the usual 8 hourly dose of drug "B" for a patient with normal renal function? Data: drug "B" is cleared 50% by the kidneys and 50% by the liver.

a. 180 mg b. 91 mg c. 30mg d. 60 mg e. 540 mg

Save Answer 3. (Points: 1) As a pharmacist in the sterile room of a major hospital you receive an order to prepare a 1 litre TPN bag containing: Ca2+ Zn2+ Folic Acid Mg2+ SO42Glucose Cl5 mmol 0.04 mmol 15 mg 10 mmol 10 mmol 250 g Not to exceed 11 mmol

You have at your disposal: - 10 mL Calcium Chloride (CaCl2, MW = 111) 10% ampoules - 2 mL Zinc Chloride (ZnCl2, MW = 136.3; Zn2+, MW = 65.38) ampoules containing 5.1 mg of elemental zinc in each ampoule - 5 mL Magnesium Sulfate (MgSO4, MW = 120.5) 50% ampoules - 1 mL, 15 mg/mL Folic Acid ampoules - 500 mL Dextrose 50% IV solution - Water For Injection (WFI) 100 mL vials To the nearest mL, what volume of WFI will you require to make the bag up to 1 litre?

a. 493 mL b. 496 mL c. 487 mL d. 490 mL

e. 484 mL

Save Answer 4. (Points: 1) Cytotoxic drugs are often dosed according to Body Surface Area (BSA). The following equation by Mosteller is often used to calculate BSA: (Reference: Clinical Pharmacy, A Practical Approach) BSA (m2) = What is the BSA (in cm2) of a patient who is 1.2 m tall and weighs 48 lb? Data: 1 kg = 2.2 lb

a. 0.85 cm2 b. 850 cm2 c. 8.5 cm2 d. 8500 cm2 e. 0.13 cm2

Save Answer 5. (Points: 1) The antineoplastic platinum compound cisplatin may be used as a single agent or in combination therapy via IV infusion at a dose of 20 mg/m2 daily for 5 days (5 days = 1 course). The following equation by DuBois & DuBois is often used to calculate BSA: (Reference: Clinical Pharmacy, A Practical Approach) BSA (m2) = weight (kg)0.425 * height (cm)0.725 * What is the total dose of cisplatin that a 72 year old patient receives if they weigh 81 kg, are 171 cm tall, and receive one course of therapy?

a. 38.7 mg

b. 184 mg c. 193 mg d. 36.7 mg e. 156 mg

Save Answer 6. (Points: 1) You are the pharmacist on the intensive care ward of a children's hospital. You are required to supply a haemofiltration bag of approximately 5 litres for one of your patients. The bag must contain a total of 145 mmol/L Na+, 0.5 mmol/L H2PO4-, 35 mmol/L HCO3- and 2 mmol/L K+, but may contain other ingredients. The amount of acetate added to the bag is unimportant. You have at your disposal a 5 litre proprietary bag containing: Dextrose Sodium Calcium Magnesium Chloride Acetate 0.18 % 110 mmol/L 1.67 mmol/L 0.8 mmol/L 109.7 mmol/L 3 mmol/L

You also have: - Sodium bicarbonate (NaHCO3, MW = 84.1) 8.4% ampoules - Potassium dihydrogen phosphate (KH2PO4, MW = 136.1) ampoules containing 1 mmol/mL KH2PO4 - Potassium acetate (CH3COOK, MW = 98.14) ampoules containing 2.45 g CH3COOK in 5 mL What volume of each ampoule will you add to the 5 litre bag in order to fulfil the order? Given a change in bag volume of +/- 5% is considered insignificant, assume the volume added to the bag from each ampoule does not change the bag volume significantly.

a. 175.2 mL NaHCO3, 2.5 mL KH2PO4, 1.5 mL CH3COOK b. 175.2 mL NaHCO3, 2.5 mL KH2PO4, 2.5 mL CH3COOK c. 184.2 mL NaHCO3, 2.5 mL KH2PO4, 1.5 mL CH3COOK d. 2.5 mL NaHCO3, 175.2 mL KH2PO4, 1.5 mL CH3COOK

e. 184.2 mL NaHCO3, 2.5 mL KH2PO4, 1.5 mL CH3COOK

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