Calculation of Medication Doses

Question 1

BSA

Answer 1

Body Surface Area

Question 2

CrCl

Answer 2

Creatine Clearance

Question 3

IBW

Answer 3

Ideal Body Weight

Question 4

PRN

Answer 4

Pro re nata

Question 5

Play an integral role within the pharmacy profession and are an essential fundamental component of professional degree knowledge.

Answer 5

Pharmacy calculations

Question 6

Quantitative amount administered or taken by a patient for the intended medicine effect.

Answer 6

Dose

Question 7

Types of doses (4)

Answer 7

1. Single dose
2. Daily dose or Total dose
3. Divided dose
4. Dosage regimen

Question 8

The amount of dose taken at one time

Answer 8

Single dose

Question 9

The amount of dose taken during the course of therapy. A daily dose may be subdivided and taken in divided doses

Answer 9

Daily dose or Total dose

Question 10

Two or more times per day depending on the characteristics of the drug and illness

Answer 10

Divided dose

Question 11

The schedule of dosing (4x a day for 10 days)

Answer 11

Dosage regimen

Question 12

The dose of a drug is based on its ___ and ___ , its ___ and ___ , the ___ used, the ___ and ___ .

Answer 12

biochemical and pharmacologic activity; physical and chemical properties; dosage form, route of administration, and various patient factors

Question 13

Hutton (2009) devised five-step approach in dealing with drug calculations:

Answer 13

1. Extract the relevant information from the prescription
2. Check if the available medicine is in the same units as the prescribed dose
3. For the dose prescribed, estimate whether you need more or less than the medicine on hand
4. Calculate the dose to be given
5. Check that your answer is around the estimate amount and is a sensible amount to be given by the prescribed route.

Question 14

Body weight unit

Answer 14

mg/kg

Question 15

Body surface area unit

Answer 15

mg/m2

Question 16

Using ___ estimate is more accurate, since any physical phenomena are more closely related to it.

Answer 16

Body Surface Area (BSA)

Question 17

BSA is a better indicator of ___ than body weight because it is less affected by abnormal adipose mass.

Answer 17

metabolic mass

Question 18

BSA can be applied as follows:

___ is usually divided by the BSA to gain an appreciation of the true required glomerular filtration rate (GFR)

Answer 18

Renal clearance

Question 19

BSA can be applied as follows:

___ is often dosed according to the patient’s BSA

Answer 19

Chemotherapy

Question 20

BSA can be applied as follows:

___ can also be expressed in terms of BSA for calculating maintenance doses or to compare high dose use with maintenance requirement

Answer 20

Glucocorticoid dosing

Question 21

To find the BSA of a patient, first measure the patient’s ___ and ___ . Then, the BSA can be calculated using a formula or ___

Answer 21

height and weight; nomograms

Question 22

A nomogram typically has three columns:

Answer 22

1. Height based in both centimeters and inches
2. Body surface area in m2
3. Weight based in both kilograms and pounds

Question 23

To use a nomogram, the height and weight of the patient are marked on the nomogram and then a straight line is drawn connecting the two values. The BSA for that patient is found where the line ___ the BSA column.

Answer 23

intersects

Question 24

Most patient the ___ is the weight to be considered for dosing drugs.

Answer 24

Actual body weight (ABW) or Total body weight (TBW)

Question 25

Obese

Answer 25

BMI greater than 30

Question 26

In the case of obese patients, they may receive an ___ . The reason for this is that ___ plays virtually no part in metabolism (including drug clearance). Using ___ may be more appropriate.

Answer 26

artificially high dose; fat tissues; Ideal Body Weight

Question 27

Geriatric patients are generally classified as persons over ___ years of age.

Answer 27

60

Question 28

Some patients may have geriatric symptoms at ___ years of age or even younger.

Answer 28

50

Question 29

___ and ___ functions are major concerns when dosing medications in elderly patients.

Answer 29

Kidney and liver

Question 30

Drug determination for elderly patients frequently require consideration of some or all of the following: Therapy is often initiated with a ___ compared to adult dose

Answer 30

lower dose

Question 31

Drug determination for elderly patients frequently require consideration of some or all of the following: ___ may be required based on the therapeutic response

Answer 31

Dose adjustments

Question 32

Drug determination for elderly patients frequently require consideration of some or all of the following: The patient's ___ may determine the drug dose and the route of administration applied.

Answer 32

physical conditions

Question 33

Drug determination for elderly patients frequently require consideration of some or all of the following: The dose may be determined, in part, on the patient's ___ , ___ , ___ and ___ , and ___

Answer 33

weight, body surface area, health and disease status, and pharmacokinetic factors

Question 34

Drug determination for elderly patients frequently require consideration of some or all of the following: ___ may affect drug/dose effectiveness

Answer 34

Concomitant drug therapy

Question 35

Drug determination for elderly patients frequently require consideration of some or all of the following: A drug's dose may produce ___ and may affect patient compliance

Answer 35

undesired adverse effect

Question 36

Drug determination for elderly patients frequently require consideration of some or all of the following: ___ may affect patient compliance

Answer 36

Complex dosage regimen of multiple drug therapy

Question 37

___ is a major consideration in drug dosing in the elderly because its reduced function results in drug elimination.

Answer 37

Kidney function

Question 38

___ diminishes nearly 1% per year after age 30, making the cumulative decline in most persons 60 to 70 years of age about 30% to 40% a value that is even greater in older persons

Answer 38

Renal blood flow

Question 39

___ is greatly affected by kidney function.

Answer 39

Drug elimination

Question 40

___ is derived from metabolism of ___ in skeletal muscles and from dietary meat and releases into the circulation at a relatively constant rate with a stable plasma concentration and freely filtered across glomerulus.

Answer 40

Creatinine

Question 41

Reduced ___ function results in reduced creatinine clearance rate

Answer 41

kidney

Question 42

___ are classified as persons under the age of 18

Answer 42

Pediatric patient

Question 43

Pediatric patients should be dosed based on their ___ or ___

Answer 43

weight or BSA

Question 44

Toxicity also occur at smaller doses. Weight is still the best way to dose when the ___ is unknown. When done by weight, the drug product tells you the dosing guidelines.

Answer 44

BSA

Question 45

Types of Pediatric Patients: (4)

Answer 45

1. Neonatal 2. Infant 3. Child 4. Adolescent

Question 46

Neonatal

Answer 46

Birth to 1 month

Question 47

Infant

Answer 47

1 month to 2 years

Question 48

Child

Answer 48

2 years to 12 years

Question 49

Adolescent

Answer 49

13 years to 17 years

Question 50

Formulas to determine a child's dose: (3)

Answer 50

1. Fried's Rule (For infants up to 2 years old) 2. Young's Rule (For children 2 years and above) 3. Clark's Rule (For 2 years old and older children)

Question 51

Are very potent, hazardous chemicals that cause cell death.

Answer 51

Chemotherapy agents

Question 52

Often, ___ is used with more than a single treatment modality included in a patient's treatment plan (e.g., radiation and chemotherapy). The ___ plans often include: ___ , ___ , and ___

Answer 52

Combination therapy; Two-agents regimen Three-agents regimen Four-agents regimen

Question 53

Chemotherapeutic agents act by destroying cancer cells through their effects on ___ or function

Answer 53

DNA synthesis

Question 54

The major categories of chemotherapeutic agents include: (5)

Answer 54

Alkylating agents Antimetabolites Plant alkaloids Antitumor antibiotics Steroid hormones

Question 55

Chemotherapeutic agents most often are administered ___ , by ___ , or by ___ ; however, other routes of administration are used as required, including ___ , ___ , or ___ , or administration to a specific site, such as the ___ , the ___ , the ___ , or others.

Answer 55

orally intravenous injection continuous intravenous infusion; intra-arterial (artery) intrathecal (spinal column) intramuscular injection; lungs (intrapleural) abdomen (intraperitoneal) skin (topical)

Question 56

Cancer chemotherapy therapy is unique in the following ways: 1. It may include ___ or ___ of well-established drug therapy regimens or protocols, or it may involve the use of investigational drugs as part of a clinical trial.

Answer 56

single or multiple drugs

Question 57

Cancer chemotherapy therapy is unique in the following ways: 2. Combination of drugs may be given by the same or different routes of administration, most often ___ and/or ___

Answer 57

oral; intravenous

Question 58

Cancer chemotherapy therapy is unique in the following ways: 3. The drugs may be administered ___ or ___ on the same or different days during a prescribed treatment cycle.

Answer 58

concomitantly or alternatively

Question 59

Cancer chemotherapy therapy is unique in the following ways: 3. The days of treatment generally follow a prescribed format of written instructions: D for ___ , followed by the ___ of treatment cycle; With a dash meaning ___ and a comma for ___

Answer 59

Day/s; "To" "And"

Question 60

Cancer chemotherapy therapy is unique in the following ways: 4. The drugs used in combination chemotherapy often fit into a standard drug/dosage regimen identified by ___ or ___ .

Answer 60

abbreviation and acronyms

Question 61

Cancer chemotherapy therapy is unique in the following ways: 4. Treatment for BLADDER CANCER referred to as MVAC consists of ~

Answer 61

Methotrexate + Vinblastine + Doxorubicin (or Actinomycin) + Cisplatin

Question 62

Cancer chemotherapy therapy is unique in the following ways: 4. Treatment for COLORECTAL CANCER called FU/LU consists of ~

Answer 62

Fluorouracil + Leucovorin

Question 63

Cancer chemotherapy therapy is unique in the following ways: 4. Treatment for LUNG CANCER called PC consists of ~

Answer 63

Paclitaxel + Carboplatin

Question 64

Cancer chemotherapy therapy is unique in the following ways: 4. Treatment for OVARIAN CANCER called CHAD consists of ~

Answer 64

Cyclophosphamide + Hexamethylmelamine + Adriamycin + Diamminedichloroplatinum (cisplatin)

Question 65

Cancer chemotherapy therapy is unique in the following ways: 5. In addition to the use of abbreviations for the drug therapy regimens, the drugs themselves are commonly abbreviated in medication orders, such as MTX for ___ , DOX for ___ , VLB for ___ , and CDDP for ___ .

Answer 65

Methotrexate Doxirubicin Vinblastine Cisplatin

Question 66

Cancer chemotherapy therapy is unique in the following ways: 6. For systemic action, chemotherapeutic agents are usually dose based either on ___ or ___ . Often, the drug doses stated in standard regimens must be reduced based on particular patient's diminished kidney or liver function and, thus, his or her ability to metabolize and eliminate the drug(s) from the body.

Answer 66

body weight or body surface area

Question 67

Cancer chemotherapy therapy is unique in the following ways: 7. For some patients, ___ is used to kill tumor cells.

Answer 67

high-dose chemotherapy