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Pharm Cal Dom 1 Cee
Pharm Cal Dom 1 Cee
OF DOSES:
● tsp = 5ml
● tbsp = 15ml
01. ● drop/gtt = 20drops/mL
General ● 1 pint = 473 mL
Considerations Formula:
● Number of doses = Total quantity/Size of Dose
● Size of the Dose = Total quantity/Number of Doses
TERMINOLOGY
● Total quantity = Number of Doses x Size of Dose
● Dose - quantitative amount of a drug administered or
taken for the intended medicinal effect
● Single Dose - amount taken at one time
● Daily Dose
1. If a pharmacist counted 40 drops of medication in
- total dose in a day filling a graduated cylinder to the 2.5 mark, how
- Daily dose can be taken in divided doses, two many drops/ml did the dropper deliver?
or more times per day depending on the 40 drops / 2.5 = 16 drops per mL
characteristics of the drug and the illness.
● Total Dose - amount taken during the course of
therapy Number of doses = Total quantity/Size of Dose
● Dosage regimen - schedule of dosing (4x a day for 7
days) 1. If the dose of a drug is 200mg, how many doses are
● Usual adult dose - amount of druug that ordinarily contained in 10g?
produces the (70 kg) medicinal effect intended for adult 10,000mg / 200mg = 50 doses
patients 2. If 1 tablespoon is prescribed as a dose,
● Usual pediatric dose - for the infant/child patient approximately, how many doses will be contained
● Usual dose range - quantitative range or amounts of in1pint of the medicine?
the drug that may be prescribed within the guidelines 1 pint = 473 mL
of usual medical practice 1 tbsp = 15 mL
● Median effective dose - amount of the drug that 473 mL/15 mL = 31.53 = 31 doses
produces the desired intensity of effect in 50%if
individuals tested
● median toxic dose - amount of the drug that produces Size of the Dose = Total quantity/Number of Doses
the toxic effects in 50%if individuals tested
● minimum effective concentration (MEC) - minimum 1. How many teaspoonfuls would be prescribed in
concentration determined that can be expected to each dose of an elixir if 180ml contained 18 doses?
produce the drug's desired effect in a patient 1 tsp = 5 mL
● minimum toxic concentration (MTC) - minimum 180 mL/18 doses = 10 mL/5mL = 2 teasponfuls
concentration determined that produces dose-related
2. How many drops would be prescribed in each dose
toxic effects
of a liquid medicine in 15ml contained to 60 doses?
The dispensing dropper calibrates 32drops/ml.
Max.EC = Min.TC
15mL / 60 doses = 0.25mL per dose
The difference between a drug and a poison is the dose.
0.25 x 32 drops = 8 drops
● Priming or Loading dose - dose that makes the body
realize that you are taking medication (Ex. Loperamide Total quantity=Number of Doses x Size of Dose
[taking 2 tablets first and then 1 tablet everyday]).
Basically the initial dose of a drug which is higher than
the maintenance dose 1. How many ml of liquid medicine would provide a
patient with 2 tablespoonfuls twice a day of 8 days?
● Maintenance Dose - for chronic diseases, to treat
symptoms (Starts at lowest dose) 1 tbsp = 15 mL
● Monotheraphy - One type of drug only to treat one 2 tbsp x 15 mL x 2 times a day x 8 days = 480 mL
condition. 2. How many grams ofadrug will be needed to prepare
● Adjunctive Therapy - Similar to polypharmacy, it is 72 dosage forms if each is to contain 30mg?
multiple medications (where one complements the 30 mg x 72 dosages = 2160 mg
main medication). It controls the effects of the first 2160 / 1000 = 2.16 g
drug.
● Prophylactic Dose - drugs to prevent individual for
potential disease due to risk exposure. (Ex. 100mg of
Doxycycline as preventive medicine for Leptospirosis)
● Therapeutic Dose - dose to treat your diagnosed
disease
CALCULATION
● In the neonate:
○ Biologic functions and systems are
underdeveloped. Renal function develops
02. OF DOSES: over the span of the first 2 years of life.
○ the most commonly used drugs in neonates,
PatientParameters infants, and young children are antimicrobial
agents, which are eliminated primarily
through the kidney.
● The usual dose of a drug is the amount that ordinarily ○ If the rate of drug elimination is not properly
produces the desired therapeutic response in the considered, drug accumulation in the body
majority of patients in a general, or otherwise defined, could occur, leading to drug overdosage and
population group. toxicity
○ Thus, the use of pharmacokinetic data (i.e.,
● The drug's usual dosage range is the range of dosage the rates and extent of drug absorption,
determined to be safe and effective in that same distribution, metabolism, and elimination),
population group. together with individual patient drug handling
- provides the prescriber with dosing guidelines characteristics and therapeutic response,
in initially selecting a drug dose for a provides a rational approach to pediatric drug
particular patient and the flexibility to change dosage calculations.
that dose as the patient's clinical response
warrants. Case in Point 8.1
● Usual doses and dosage regimens are based on the A hospital pharmacist is asked to determine the dose of
results of clinical studies conducted during the drug clindamycin for a 3-day-old neonate weighing 3lb.7oz. In
development process as well as on clinical information checking the literature, the pharmacist determines that the
gathered following the initial approval and marketing of dose is listed as follows:
the drug.
<1200g:10 mg/kg/day divided q12h.
● Patients requiring individualized dosage are <2000g and 0-7 days old:10 mg/kg/day divided q12h
- neonates and other pediatric patients, elderly <2000g and>7days old:15 mg/kg/day divided q8h
patients with diminished biologic functions, >2000g and 0-7 days old:15 mg/kg/day divided q8h
- individuals of all age groups with >2000g and>7days old:20 mg/kg/day divided q6h
compromised liver and/or kidney function (and
thus reduced ability to metabolize and Each divided dose is to be added to an intravenous infusion
eliminate drug substances), at the scheduled hour and infused over a period of 20
- critically ill patients, and patients being treated minutes.
with highly toxic chemotherapeutic agents. Clindamycin is available in an IV bag containing 600mg/50
mL of injectable solution. How many milliliters of this solution
● Certain drugs with a narrow therapeutic window often should be given for each divided dose?
require individualized dosing based on blood level
determinations and therapeutic monitoring. 1 kg = 2.2 lbs
- Digoxin at a blood level of 0.9 to 2ng/mL is 1 kg = 35.27 oz
considered therapeutic, but above 2 ng/mL it 3 lbs & 7oz = 1.56 kg
is toxic. 10mg x 1.56 = 15.6 / 2 (since 12h) = 7.8 mg x 50 / 600 = 0.65 mL
PEDIATRIC PATIENTS
Case in Point 8.2
● Pediatrics is the branch of medicine that deals with
disease in children from birth through adolescence A pediatric patient is being administered enalaprilat
○ Neonate (newborn): from birth to 1 month; (VASOTEC IV) every 12 hours by intravenous injection to
○ Premature: born at less than 37 weeks' manage hypertension and possible heart failure. Based on a
gestation. dose of 5mcg/kg, the patient is receiving 55 mcg of
○ Infant:1month to 1 year; enalaprilat per dose. The physician wishes to convert the
○ early childhood: 1 year through5years; patient to oral enalapril at a dosage of 100mcg/kg as asingle
○ late childhood: 6 years through 12 years; daily dose.The standard procedure is to crush a 2.5-mg
○ Adolescence:13 years through 17 years of tablet of enalapril, mix with sterile water to make 12.5 mL,and
age administer the appropriate dose using a calibrated oral
● Proper drug dosing of the pediatric patient depends on dispenser. Calculate the dose,in milliliters,to be administered
a number of actors: to this patient.
○ the patient's age and weight,
○ overall health status, 55 mcg/kg / 5 mcg/kg = 11 kg (weight of child)
○ the condition of such biologic functions as 1 mg = 1000 mcg
respiration and circulation, 1100 mcg / 1000 mcg = 1.1 mg
○ the stage of development of body systems for 1.1 mg/ x mL = 2.5 mg/ 12.5 mL
drug metabolism(e.g., liver enzymes)and drug x = 5.5 mL
elimination (e.g., renal system).
Examples:
15 mg/ kg/day =
5mg x 10 kg = 50 mg
50 / 5 = 10 ml
BSA of child:
(40 lbs x 32 in) / 3131 = 0.64 m2
(0.64 / 1.73m2) x 75mg = 27.75
BSA of child (in m2) x Dose per m2 = Approximate dose for child
0.64 BSA x 25 mg = 16 mg
CALCULATION:
Percentage Weight-in-Volume
Strengths
=> 0.05
Percent weight-in-volume
● measure of a liquid pharmaceutical preparation in
grams of solid active ingredient (solute) per 100 mL of
the product. It can be applied to Solutions, 2) How much potassium permanganate (in grams)
suspensions, lotions, and so on. should be used in compounding the following
prescription?
1% = 1g/100mL
1g/100 mL = xg / 240 mL
x = 2.4 g → 2400 mg
Droperidol
=> 0.008g / 100 mL x 100% = 0.008 % w/v
Rx Fentanyl Citrate
=> 20 ug/mL= CONVERT TO PERCENTAGE
STRENGTH g/100 mL
=>20 ug/mL x 1 mg/1000 mg x 1g/1000 mg
=0.00002g/ml a.) Volume of Active Ingredient in a Specific Volume, Given
Percentage Strength Volume-in-Volume
=>0.00002 g/mL x 100 % = 0.002 %
Example:
1) How much liquefied phenol (in milliliters) should be
c.Volume of Solution or Liquid Preparation, Given Percentage used in compounding the following prescription?
StrengthWeight-in-Volume and Weight of Solute
SOL’n:
=> 3% / 100 %
= 27 g/ x (cross multiply)
= 3 (x)= (100 %) x (27 g) 240 mL x 2.5 %= 6 mL
= 2700/3 L.P= 6 mL + C.L
=900 g
900 g= 900 mL 2) A lotion vehicle contains 15% (v/v) of Glycerin. How
much in grams of glycerin should be used in preparing
5 gallons of the lotion? (Specific gravity of glycerin is 1.25)
2) If an intravenous injections contains 20%
(w/v) of Mannitol, how many mL of the 5 gal x 3875 mL/ 1 gal = 18, 925 mL
injection should be administered to provide a 18,925 mL X 15 %= 2838.75 mL
patient with 100 g of Mannitol? => 2838.75 mL X 1.25 g/mL (cancel out ang ML lods)
=3548.4 g of glycerin
100 g -> mL
20% = 20 g/100 mL= 100 g/x (CROSS MULTIPLY MADS)
20 g (x)= 100 g (100 ml)
x = 500 mL
P.spirit volume? 2)
10ml (p.oil)/ 100 mL (solution)
100 mL (P. spirit) = 10 ml (p.oil)
X p. Spirit = 75 mL (p.oil)
=> 75 ml / 10 mL= 7.5 mL P.oil If benzoin tincture has a specific gravity of 0.88,
=> 7.5 x 100 calculate its percentage strength (w/w) in the mixture
= 750 mL (p. Spirit each containing of p. oil)
1 lb = 454 g -> mL
= 454g/ 1.10 g/mL = 412. 7 mL
Percent weight-in-weight
● measure of a pharmaceutical preparation in grams of
active ingredient per 100 grams of the preparation