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Miss A has been taking Morphgesic SR 60mg tablets every 12 hours. She has now been admitted to hospital and is having difficulty swallowing. The consultant would like to start her on an equivalent dose of subcutaneous morphine sulfate to be given over 24 hours. You have available to you vials of morphine sulfate 100mg/50mL solution for infusion.
Calculate the infusion rate in mL/hour that Miss A needs. Give your answer to two decimal places.
Mr B, who weighs 98kg, is being administered a 0.9% sodium chloride infusion after having a major fall at work. The flow rate of the infusion is set at 1.5ml/hour.
The atomic mass of sodium is 23.
The atomic mass of chloride is 35.5.
How many mmols of sodium will Mr B receive after 18 hours? Give your answer to two decimal places.
Mr C presents to you with the following prescription:
Flixonase Aqueous Nasal Spray 100 mcg twice a day for 1 week, then 50 micrograms once a day, 1 pack (1P)
He informs you that the doctor has prescribed this medication for the management of rhinitis.
How many days will the Flixonase Aqueous Nasal Spray pack last Mr C?
Mrs D was admitted to hospital in the afternoon for an infection. Following assessments, she was started on amoxicillin 500mg capsules every 8 hours, receiving two doses on the day of admission. The next day after one dose of amoxicillin in the morning, she was discharged to home. She was instructed to continue taking the amoxicillin at the same dose and frequency to complete a ten day course. She was provided with a supply of 28 amoxicillin 250mg capsules upon discharge along with a prescription for amoxicillin 500mg to be dispensed by her community pharmacy for the remainder of the course.
How many amoxicillin 500mg capsules would the community pharmacy need to supply to Mrs D?
Mr E is a 68 year old man in hospital for a genital tract infection. He has renal impairment, with a creatinine clearance of 42 mL/min/1.73 m². The consultant has initiated treatment with ciprofloxacin IV 200mg IV q 12 hours as Mr E cannot currently take medication by mouth. It will be infused in a 100mL bag.
How many mLs per minute should be administered to Mr E? Give your answer to one decimal place.
Ms F is a 61 year old woman being seen at the outpatient nephrology clinic to evaluate her declining renal function and if necessary modify the doses of her medications. She is 5 feet 4 inches tall and her biochemistry results are provided below.
Ideal Body Weight, kg, Men = 50 + (2.3 for every inch over 5 feet)
Ideal Body Weight, kg, Women = 45.5 + (2.3 for every inch over 5 feet)
Cockcroft and Gault Formula
Estimated Creatinine Clearance = (140-age) x Weight (kg) x Constant /In mL/min
Serum Creatinine (micromol/L)
Constant = 1.23 Men; 1.04 Women
Test | Results | Units | Reference Range |
Serum urea | 7.6 | mmol/L | 2.5-7.5 |
Serum creatinine | 105 | micromol/L | 46-92 |
What is Ms F’s estimated creatinine clearance?
You are working for a pharmaceutical company and are involved in developing a new tablet which is film coated. Each tablet is coated by an average of 5mcg of coating material and the current film coating technique is set up to coat 1250 tablets per hour. A 5% excess of coating material is produced to ensure there is sufficient supply for the entire process.
What is the minimum amount of coating material in mg that is needed to complete a seven hour production? Give your answer to one decimal place.
You are required to prepare 8L of a solution containing both sodium and potassium as chlorides, in concentration of 150mmol/L of sodium and 40mmol/L potassium.
The molecular mass of sodium chloride is 58.5.
The molecular mass of potassium chloride is 74.5.
What is the amount in grams of sodium chloride required? Give your answer to two decimal places.
You are asked to aseptically mix 50 mL glucose 6%, 145 mL glucose 20% and 355 mL of sodium chloride together.
What is the glucose percentage concentration (%w/v) in the resulting mixture? Give your answer to one decimal place.
Mr J, a 61-year-old man, is in hospital for a life threatening gram positive infection. He was empirically treated with an antibiotic, but did not improve. Sensitivities show the infection is a staphylococci resistant to many antibiotics, but susceptible to vancomycin. He is to start intravenous vancomycin stat at a dose of 1 gram q 12 hours. The dispensary stocks 1 gram vials. To reconstitute, the nurse adds 20ml of water for injections to the 1g vial. This is the further diluted in 250mL of 0.9% sodium chloride intravenous infusion and administered over 60 minutes.
How many mL of the infusion will Mr J receive per minute? Give your answer to one decimal place.
A family of two adults and two children, are going on an 11 day holiday and need to purchase malaria prophylaxis. Malarone® is appropriate for the area they are travelling to. They are to start Malarone® 1 day before travel and continue for 1 week after leaving. The children are 7 and 12 years old and weigh 23 and 41 kg respectively. There are 12 tablets per pack and the pharmacy will not sell split packs. The family has 5 tablets of Malarone® 250 mg/100 mg left over from their last holiday and would like to use these to save on costs.
How many packs of Malarone® 250 mg/100 mg film-coated tablets will they need to purchase?
Mr G presents you with a prescription for warfarin tablets of varying strengths. He needs to take 6 mg at 6pm this evening, followed by alternating daily doses of 3 mg and 4 mg, starting with 3mg. He informs you that he wishes to take the minimum number of tablets possible per day. You only have warfarin 1mg and 3mg tablets available.
Assuming that his INR remains in range, what is the number of warfarin 1mg tablets that Mr G would require for a 28-day supply?
Master K, an 8 year old boy weighing 66 pounds, is to be treated for a bacterial infection. He is otherwise in good health and has no known drug allergies. He is prescribed amoxicillin 40mg/kg/day in three divided doses for one week. The pharmacy only has amoxicillin 125mg/5mL 60mL bottles in stock.
How many bottles are needed to complete the course?
Mrs L is a 54 year old woman with ovarian cancer. She has had surgery and is now to receive chemotherapy. She will be treated with paclitaxel in combination with cisplatin. The paclitaxel is dosed at 175mg/m^{2}. She is 155cm tall and her current weight is 121 pounds.
The Body Surface Area formula is given below:
Using the provided formula, what is Mrs L’s dose? Give your answer to the nearest whole number.
You are working as an aseptic pharmacist and are required to make a 50ml dose of a morphine sulfate 2% solution isotonic. 1% w/v morphine sulfate solution freezes at -0.08^{o}C while 1% w/v sodium chloride solution freezes at -0.576^{o}C and isotonic solution freezes at -0.52^{o}C
What is the mass of sodium chloride in mg required to make a 50ml dose of morphine sulfate 2% solution isotonic? Give your answer to one decimal place.
You have been asked to evaluate the cost effectiveness of two drugs. Drug Y is the current formulary recommended treatment and drug Z is a new drug.
Drug Y reduces 1-year mortality from 28% to 18% at a cost of £2000.
Drug Z reduces 1-year mortality from 28% to 13% at a cost of £2500.
[cost Z –cost Y]
Incremental cost-effectiveness = __________________________________
[effect Z – effect Y]
What is the incremental cost effectiveness ratio of Drug Z compared to Drug Y? Give your answer to the nearest whole pound.
An unstable drug for the treatment of eczema needs to be prepared immediately before use. The preparation is provided to the patient as 1.8g of drug powder, 3.2mL of solvent and 52g of carrier base. For preparation, the patient needs to dissolve the powder in the solvent and immediately combine this with the carrier base and stir rapidly for 3 minutes.
Given that the active drug powder and the solvent combination weighs 4.4g, what is the exact concentration of the drug in the final product? Give your answer to one decimal place.
Mr M is being treated with intravenous methotrexate. Following administration, a plasma concentration of 68mcg/ml is measured.
Given that methotrexate has a half life of 6.5 hours, what will the plasma concentration of methotrexate be after 26 hours of administration? Give your answer to two decimal places.
Mrs N, a 36 year old woman is being treated in hospital for an acute infection with an intravenous infusion of co-trimoxazole at dose of 960mg every 12 hours. The co-trimoxazole is infused in Glucose 5% and the duration of each infusion is 60 minutes.
How much trimethoprim in mg/min will Mrs N be receiving with each infusion? Give your answer to two decimal places.
You are required to mix together 75g of 0.5%w/w hydrocortisone cream and 50g of 0.25% w/w salicylic acid cream.
What would be the concentration of hydrocortisone in the final product? Give your answer to one decimal place.