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RX 351 Lab - Module 5 Assignment (28pts) Name _______________________________________________________________ Complete and submit on Canvas. You must show all work to receive full credit. Do not leave off units and make sure to use leading zeros. Dropping units in your answer or failure to use a leading zero in an answer will result in no credit for that answer, even if the number itself is correct. 1. (4pts) A 70.5lb pediatric patient is ordered cefazolin 550mg IV q8h x 5 days to treat a case of cellulitis. Use the dosing regimen here (copied from the drug monograph) to determine if this dosing regimen is appropriate for this patient. Skin and soft tissue infections, S. aureus, methicillin susceptible (mild to moderate): Infants, Children, and Adolescents: S. aureus, methicillin susceptible skin and soft tissue infections including pyomyositis: IV: 50 mg/kg/day divided every 8 hours; maximum dose: 1,000 mg/dose; higher doses may be required in severe cases; duration of therapy at least 5 days, but longer may be necessary in some cases, e.g., febrile and neutropenic patients: 7 to 14 days; pyomyositis: 14 to 21 days As ordered by prescriber, patient would receive _________mg/kg/day of cefazolin divided q ______hours for _______ days. Initial here if daily dose (on mg/kg basis), frequency, and duration fall within the recommended guidelines: _____________ (Acceptable is within 5% of recommended dose, in this scenario.) If dose is not acceptable, explain here: Answer the following questions and process the med order for patient David Lee’s intermittent infusion. Med Orders (adult patient with NKDA) D5 ½ NS @ 50ml/h Clindamycin 600mg IV q6h 2. (2pts) What is the concentration of the two ingredients in this patient’s primary IV solution? 3. (1pt) What size(s) of this IV solution are available in your storeroom? 4. (2pts) If the first IV bag is started at 0500 this AM, what day/time would the second bag be started? What day/time would the third bag be started? Express in military time. Go to Lexi-Comp and find information regarding PREPARATION and ADMINISTRATION of clindamycin. DRUG INFORMATION: 5. (1pt) Acceptable Diluents (circle one or both) : D5WNS 6. (1pt) Acceptable Diluent Volume (list all IV bag sizes that are acceptable): 7. (1pt) Choose an IV bag from the storeroom list to use for this order (list diluent and size of bag). 8. (2pts) What is the recommended time for infusing a dose of this medication? ______________________ CALCULATIONS: You will use the vial pictured here to prepare a 24-hour supply of doses (you may need more than one vial.) 9. (2pts) Dose Volume = __________ml (volume of drug solution to prepare one dose) 10. (2pts) Based on the recommended time for infusion, calculate a flow rate for administering this drug. Flow Rate: ____________ml/h 11. (5pts) Complete the instructions for compounder to prepare three doses of clindamycin. Round volume appropriately based on calibration of syringe. Include specific information regarding supplies in innstructions (size of syringe, diluent solution, size of IV bag, etc). Instructions for Compounder: 12. (5pts) Complete the required information on the IV label (that would be attached to each of the three IV bags). Use the information from the IOI Part 3 slide set to guide you. MR# MR42222 General Hospital David Lee DOB: 3/8/20xx 22yo M Provider: Manuel Bachman, MD Dose: Route: IV First Dose Due: Frequency: Alerts: All: NKDA Storage: Expiration Date: Manufacturer/Lot#: Pharmacist: Instructions: 1 Pharmaceutical Calculations 15 https://t.me/MedicalBooksStore Pharmaceutical Calculations 15 h Edit ion 0002593971.INDD 1 11/27/2015 2:36:05 PM 0002593971.INDD 2 11/27/2015 2:36:06 PM H war C. A sel, Phd Professor and Dean Emeritus College of Pharmacy University of Georgia Athens, Georgia Shelly J. S ck , Phd, RPh Professor College of Pharmacy Southwestern Oklahoma State University Weatherford, Oklahoma Pharmaceutical Calculations 15 h Edit ion 0002593971.INDD 3 11/27/2015 2:36:08 PM Senior Acquisitions Editor: Tari Broderick Product Development Editor: Stephanie Roulias Production Project Manager: Priscilla Crater Designer: H olly McLaughlin Manufacturing Coordinator: Margie Orzech Marketing Manager: Lisa Zoks Prepress Vendor: SPi Global 15th Edition Copyright © 2017 Wolters Kluwer Copyright © 2013 Wolters Kluwer H ealth | Lippincott Williams & Wilkins. Copyright © 2010, 2006, 2001, 1996, 1991, 1986 by Lippincott Williams & Wilkins. All rights reserved. T his book is protected by copyright. N o part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without writ- ten permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employ- ees are not covered by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
[email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication D ata N ames: Ansel, H oward C., 1933- , author. | Stockton, Shelly J., author. T itle: Pharmaceutical calculations / H oward C. Ansel, Shelly J. Stockton. Description: 15th edition. | Philadelphia : Wolters Kluwer, [2016] | Includes bibliographical references and index. Identifiers: LCCN 2015039620 | ISBN 9781496300713 (alk. paper) Subjects: | MESH : Drug Dosage Calculations. | Pharmaceutical Preparations—administration & dosage. Classification: LCC RS57 | N LM Q V 748 | DDC 615.1/401513—dc23 LC record available at http:/ / lccn.loc. gov/2015039620 T his work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work. T his work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to the patient. T he publisher does not provide medi- cal advice or guidance and this work is merely a reference tool. H ealthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. Given continuous, rapid advances in medical science and health information, independent professional verifica- tion of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. W hen prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work. LW W.com 0002593971.INDD 4 11/27/2015 2:36:08 PM v Preface T he 15th edition of Pharmaceutical Calculations marks the introduction of Professor Shelly Stockton as co-author. Professor Stockton’s experience in pharmacy practice and her exper- tise in teaching pharmaceutics and pharmacy calculations are reflected in her substantial contributions to this textbook. Combined with the many progressive changes recom- mended by a select review team of pharmacy students, practitioners, and educators, this new edition maintains the standard for today’s academic and basic practice requirements in the subject area of pharmaceutical calculations. Each chapter has been thoroughly revised with the focus directed toward providing basic pharmaceutical calculations along with supporting explanations of the pharmaceutical or clinical purpose underpinning each type of calculation. H undreds of new problems have been added to include many current products encountered in pharmacy practice. Relevance is further demonstrated by the inclusion of select product labels directly linked to example problems. N ew in this edition are Authors’ Extra Points that provide brief explanations of select underlying subjects, as: pharmacopeias, electronic prescriptions, drug names, and the regu- lation of pharmacy compounding. A section on equianalgesic dosing for narcotic analgesics has been added to Chapter 10 along with dosing tables related to the subject. All of the valued features of the previous edition have been retained and enhanced, including the following: in-chapter example problems with step-by-step solutions; end-of- chapter practice problems with answers; Case-in-Point features that provide clinical or phar- maceutical case studies; Calculations Capsules that provide boxed summaries of chapter calculations; CalcQuiz sections that provide a limited number of unsolved problems, useful as homework, quiz, or assessment exercises; and, the Comprehensive Review Problems at the end of the book that provide multipart solved problems for student use as a final self-assessment. T hroughout its history, this textbook has served as a valuable resource in meeting the instructional needs of pharmacy students in the area of pharmaceutical calculations. T his new edition is expected to continue to meet that need. Compan on Web s te Pharmaceutical Calculations, 15th edition, includes additional resources for both instructors and students, available on the book’s companion Web site at http://thePoint.lww.com/Ansel15e. Resources for Students • Interactive math calculations Q uiz Bank, with more than 400 review problems and detailed solutions Resources for instructors • CalcQ uiz Solutions • Searchable Full Text Online See the inside front cover for more details, including the passcode you will need to gain access to the Web site. 0002593971.INDD 5 11/27/2015 2:36:09 PM 0002593971.INDD 6 11/27/2015 2:36:09 PM vii Acknowledgments T he author gratefully acknowledges the contributions to this revision by the following per- sons: Tom Schoenbachler, for insights into contemporary community pharmacy practice; Deborah Elder, for contributions in the area of pharmacy compounding; Ken Duke, for problems in the area of nuclear pharmacy; Warren Beach, for some Case-in-Point calcula- tions; Flynn Warren, for a host of problems including many relating to institutional phar- macy practice; Michael Ansel and Catherine Chuter, for information on the verification and data processing of electronic prescriptions; Les Ramos and Margaret Ramos, for their input in various areas of clinical calculations; H ardeep Saluja and Sarai Flynn for contributions to the chapter on bioavailability and pharmacokinetics; Patra Kositchaiwat and Ryan Varghese for their input in the area of electrolyte solution calculations; and Loyd V. Allen, Jr. for his continued courtesy in allowing use of formulas published in the International Journal of Pharmaceutical Compounding. Gratitude is expressed to the following reviewers, whose experience was drawn upon during the planning process and whose thoughtful analysis and constructive comments led to many of the changes in this revision: Stacy Cairns, Kimberly Daugherty, David Dubins, H eather Gegenhuber, N ancy Kleiman, William Kolling, Kimberly N guyen, and T ien Phan. Particular thanks are offered to Tari Broderick, Senior Acquisitions Editor, and Stephanie Roulias, Product Development Editor, for their support and guidance during the revision process and to the other exceptional people at Wolters Kluwer H ealth | Lippincott Williams & Wilkins for their work in the design, preparation, and production of this revi- sion. Finally, special appreciation is extended to Tom Conville for his expertise in copyedit- ing and assistance in resource development. Howard C. Ansel Athens, Georgia Shelly J. Stockton Weatherford, Oklahoma 0002593971.INDD 7 11/27/2015 2:36:09 PM 0002593971.INDD 8 11/27/2015 2:36:09 PM ix Preface v Acknowledgments vii Introduction xi 1 Fundamentals of Pharmaceutical Calculations .........................................................1 2 International System of Units .................................................................................17 3 Pharmaceutical Measurement .................................................................