PHCL Midterms - Lesson 1 (Calculation of Doses General Consideration)

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PHARMACEUTICAL CALCULATIONS AND  Sublingual (under the tongue) – Tablets

TECHNIQUES
 Parenteral (injection) - Solutions and suspensions
Midterms - Lesson 1 (Calculation of Doses:
General Consideration)  Epicutaneous/transdermal (skin) - Ointments,
creams, powders, lotions, aerosols, and patches

TERMINOLOGIES  Conjunctival (eye) - Solutions, suspensions, and


ointments
 Daily Dose - may be subdivided and taken in divided
doses, two or more times per day depending on the  Intra-nasal (nose) - Solutions, sprays, and ointments
characteristics of the drug and the illness.
Intra-respiratory (lungs) - Aerosols and inhalant
 Usual Dose - amount of drug that ordinarily produces
solutions
the medicinal effect intended in adults.
 Rectal (rectum) - Ointments, creams, suppositories,
 Usual pediatric dose - amount of drug used for infant
solutions, and suspensions
or child.
 Vagina (vagina) - Ointments, creams, tablets,
 Usual dosage range - for a drug indicates the
suppositories, gels, solutions, and emulsion foams
quantitative range or amounts of the drug that may
prescribed within the guidelines of usual medical  Urethral (urethra) - Solutions and suppositories
practice.

 Usual initial dose priming or loading dose - Amount


DETERMINING THE DOSE OF THE DRUG
required to achieve the desired blood drug level.
Dosage Regimen - The schedule of dosing (e.g., four
 Median Effective Dose - The amount of a drug that
times per day for 10 days). Number of doses in a
produces the desired intensity of effect in 50% of the
specified amount of medicine.
individuals tested.
Total amount
 Minimum Effective Concentration (MEC) - Refers Number of doses=
¿ dose
to the average blood serum concentration of a drug that
Example:
represents the minimum concentration that can be
1. If the dose of a drug is 200 mg, how many doses are
expected to produce the drug’s desired effects in a
contained in 10 g?
patient.

 Minimum Toxic Concentration (MTC) - The base


level of blood serum concentration that produces 2.
dose-related toxic effects. If 1

ROUTES OF DRUG/DOSE
ADMINISTRATION AND DOSAGE FORMS

 Oral (mouth, GI tract) - Tablets, capsules, lozenges, tablespoonful is prescribed as the dose, approximately
solutions, drops, syrups, and suspensions
how many doses will be contained in 1 pint of the
medicine? DETERMINING THE TOTAL QUANTITY OF
PRODUCT
Total quantity = number of doses x size of dose

Example:
1. How many milliliters of a liquid medicine would
provide a patient with 2 tablespoonfuls twice a day for 8
DETERMING THE SIZE OF DOSE

- The size of the dose is expressed in whatever


denomination is chosen for measuring the given
total quantity.

days?
2. How many grams of a drug will be needed to prepare
72 dosage forms if each is to contain 30 mg?
Example:

1. How many teaspoonfuls would be prescribed in each LOW DOSE AND HIGH DOSE THERAPIES
dose of an elixir if 180 mL contained18 doses?
- The administration of doses that are much smaller or
much larger than the usual dose of a drug.

 Low dose therapy

2. How many drops would be prescribed in each dose of


a liquid medicine if 15 mL contained 60 doses? The
dispensing dropper calibrates 32 drops/mL. Example:
• The use of aspirin in 81-mg amounts (rather than
the usual dose of 325 mg) to lower the risk of heart
attack and clot-related stroke.
• Low-dose oral contraceptive use and low-dose
postmenopausal hormone therapy.

 High dose therapy


Example:
• Commonly associated with the chemotherapeutic = An additional prescription or 12.5 mg o
treatment of cancer, in which there is an attempt, through hydrochlorothiazide or individual prescriptions or 80 mg
increased dose intensity, to kill tumor cells. of valsartan and 25 mg of hydrochlorothiazide may be
• Use of progestin in the treatment of endomtriosis written.
and the high-dose influenza vaccination of the elderly.
CALCULATION BASED ON SPECIAL DO-
SING REGIMEN
Example:
Certain drugs have unique dosing regimens.
1. If a patient is changed from a daily standard-dose Example: chemotherapeutic and oral contraceptives
postmenopausal product containing 0.625 mg of Example:
conjugated estrogens (CE) to a low-dose formulation 1.The following are the recommended doses for a certain
containing 0.35 mg CE, how many milligrams less of CE nicotine patch
would the patient take per week? - One 21 mg dose per day for 6 weeks
- One 14 mg dose per day for 2 weeks
= 0. 625 mg − 0 .35 m g = 0. 27 5 m g × 7 (days) = - One 7 mg dose per day for 2 weeks
1 .925 mg conjugated estrogens Determine the total quantity of nicotine, in grams, that
a patient would receive during the course of therapy.
FIXED-DOSE COMBINATION PRODUCTS
• A variety of prescription and nonprescription 2.
products are available containing two or more
therapeutic agents.
• An advantage of combination products is that two or
more needed drugs may be taken in a single dose, which
may be more convenient, enhance compliance, and be
less expensive or the patient than taking the same drugs The following are the components of a triphasic birth

individually. control pill:


• A disadvantage is the relative inflexibility in dosing - Phase 1 - 6 tablets 0.05 mg levonogestrel 0.03 mg

compared with individual drug dosing. ethinyl estradiol


- Phase 2 - 5 tablets 0.075 mg levonogestrel 0.04 mg

Example: ethinyl estradiol

1. Valsartan and hydrochlorothiazide tablets are - Phase 3 - 10 tablets 0.125 mg levonogestrel 0.03 mg

available separately or in combination in strengths of 80 ethinylestradiol

mg/12.5 mg, 160 mg/12.5 mg, 160 mg/25 mg, and 320 - 7 tablets – Inert

mg/12.5 mg. If a patient was receiving the lowest-dose


combination product and the physician wished to double
the dose of hydrochlorothiazide, what is the option?
If the direction is to take one tablet by mouth every day,
what is the total amount of levonorgestrel and ethinyl
estradiol taken by the patient during the 28-day therapy?

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