IPS1-Pcal&Technique Student

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PHARMACY ENHANCEMENT SEMINAR

PREPARED BY:
REYSAN S. COSAS, RPH
Your Lecturer
Hi, class!
My name is Reysan S. Cosas, you call me Sir
Reysan.
I am a registered pharmacist. I started teaching in
CEU School of Pharmacy last 2015 handling
courses like Pharmacology, Therapeutics,
Pharmacotherapy, Biopharmaceutics, and
Pharmacokinetics. I also handle General
Pharmacology in the School of Optometry.
Currently, I am the Assistant to the Dean of the
School of Pharmacy and Adviser of Pharmacy
Student Council. I hope you will learn a lot in our
course. See you virtually!

Contact me:
via CEU Leaps inbox or email [email protected]
Step 1. Take the time necessary to carefully read and thoughtfully
consider the problem prior to engaging in computations.
Step 2. Estimate the dimension of the answer in both quantity and
units of measure (e.g., milligrams) to satisfy the requirements of the
problem.
Step 3. Perform the necessary calculations using the appropriate
method both for efficiency and understanding.
Step 4. Before assuming that an answer is correct, the problem should
be read again and all calculations checked.
Step 5. Consider the reasonableness of the answer in terms of the
numerical value, including the proper position of a decimal point, and
the units of measure.
• It is the area of study that applies the basic
principles of mathematics to the preparation and safe
and effective use of pharmaceuticals.
• The relative magnitude of two quantities is called their
ratio.

• A proportion is the expression of the equality of two ratios.


If 3 tablets contain 975 milligrams of aspirin, how many
milligrams should be contained in 12 tablets?
If 30 milliliters (mL) represent 1⁄6 of the volume of a
prescription, how many milliliters will represent 1⁄4 of the
volume?
A probiotic colon health product contains, in each capsule, 3
billion viable cells of Lactobacillus acidophilus and
Bifidobacterium longum. Express, by exponential notation, the
number of viable cells in a container of 30 capsules.
A liquid dietary supplement is packaged in 10-mL dropper
containers to deliver 2000 international units of vitamin D3 in
each drop (0.027 mL). Calculate the number of drops
delivered per milliliter.
• Also known as factor analysis, factor-label method, or
unit-factor method.

• This method involves the logical sequencing and placement


of a series of ratios (termed factors) into an equation.
1) A medication order calls for 1000 milliliters of a dextrose
intravenous infusion to be administered over an 8-hour
period. Using an intravenous administration set that
delivers 10 drops/milliliter, how many drops per minute
should be delivered to the patient?
The drug pramlintide (SYMLIN) is an antihyperglycemic agent for use in patients with
diabetes treated with insulin. A 5-mL vial contains 600 µg of pramlintide per milliliter.
A 0.05-mL dose measures 5 insulin units on the syringe used for injection and provides
30 µg of pramlintide.
Calculate the number of micrograms of pramlintide and The
corresponding measurement of insulin units on the syringe
with the administration of 0.075 mL of injection.
Digoxin (LANOXIN) pediatric elixir contains 0.05 mg
(milligram) of digoxin in each milliliter (mL) of elixir. If there
are 1000 µg (micrograms) in each milligram, how many
micrograms of digoxin would be delivered in each dose of 0.6
mL?
• The International System of Units (SI), formerly called
the metric system, is the internationally recognized decimal
system of weights and measures.

• Avoirdupois system of measure widely used in the United


States in measuring body weight and in selling goods by the
ounce or pound.

• Apothecary system of measure which was once the


predominant pharmacist’s system of volumetric and weight
measure
A capsule contains the following amounts of medicinal
substances: 0.075 g, 20 mg, 0.0005 g, 4 mg, and 500 mcg.
What is the total weight (g) of the substances in the capsule?
The fiber length of a sample of purified cotton is 6.35 mm.
Express the length in inches.
Convert 6.2 gr to milligrams.
Add 0.5 kg, 50 mg, and 2.5 dg. Reduce the result to grams:
Add 7.25 L and 875 cL. Reduce the result to milliliters:
Add 0.0025 kg, 1750 mg, 2.25 g, and 825,000 mcg, and express
the answer in grams:
Reduce 1.256 g to micrograms:
• A prescription is an order for medication issued by a
physician, dentist, or other properly licensed medical
practitioner.

• Medication order is an order for medication and


instructions written by the physician in hospitals and other
institutions
Parts of a prescription
Interpret the following Subscription (Ft. cap. #1. DTD
no.xxxvi N.R.) taken from a prescription:
A. Dispense thirty six such doses. Do not repeat.
B. Mix and make capsules. Dispense 48 such doses.

C. Make one capsule. Dispense 36 such doses. Do not repeat.


D. Mix and Make one capsule. Dispense 36 such doses. Do not repeat.
Interpret the following Signa (Appl. ung. left eye ad lib.)
taken from a prescription:
A. Apply ointment to the left eye as needed.
B. Apply ointment to the left eye immediately.

C. Apply eye cream to the left eye as as needed.


D. Apply eye drops to the left eye as immediately.
Interpret the following direction (AMBIEN 10 mg p.o.
qhs x 5 d) taken from a medication order:
A. AMBIEN 10 milligrams left eye at every bedtime for 5 days.
B. AMBIEN 10 milligrams right eye at every bedtime for 5 days.

C. AMBIEN 10 milligrams both eyes at every bedtime for 5 days.


D. AMBIEN 10 milligrams by mouth at every bedtime for 5 days.
Interpret each of the following Subscriptions
(directions to the pharmacist) taken from
prescriptions:

(a) Disp. supp. rect. no. xii


(b) M. ft. iso. sol. Disp. 120 mL.
(c) M. et div. in pulv. no. xl
(d) DTD vi. Non rep.
(e) M. et ft. ung. Disp. 10 g
Interpret each of the following Signas
(directions to the patient) taken from
prescriptions:

(a) Gtt. ii each eye q. 4 h. p.r.n. pain.


(b) Tbsp.i in1⁄3 gl.aq.q.6h.
(c) Appl. a.m. & p.m. for pain prn.
(d) Gtt. iv right ear m. & n.
(e) Tsp.i aq. q.4or5h.p.r.n.pain.
Interpret the underlined portions taken
directly from current product references:

(a) Dose of ritonavir when coadministered with


fluconazole: 200 mg q6h × 4d.
(b) Dose of epoetin alpha: 150 units/kg SC TIW.
(c) Dose of acetylcysteine: for patients >20 to <40 kg,
150 mg/kg.
(d) Pediatric dose of cefuroxime axetil: 30
mg/kg/day, divided dose (b.i.d.).
• Density (d) is mass per unit volume of a substance. It is
usually expressed as grams per cubic centimeter (g/cc).
• Specific gravity (sp gr) is a ratio, expressed decimally, of
the weight of a substance to the weight of an equal volume of
a substance chosen as a standard, both substances at the
same temperature or the temperature of each being known.
• Specific volume, in pharmaceutical practice, is usually
defined as an abstract number representing the ratio,
expressed decimally, of the volume of a substance to the
volume of an equal weight of another substance taken as a
standard, both having the same temperature.
It is defined as the mass per unit volume of a
substance. It is usually expressed as grams per cubic
centimeter (g/cc):
A. Density

B. Specific gravity

C. Specific volume

D. Specific mass
It is a ratio, expressed decimally, of the weight of a
substance to the weight of an equal volume of a
substance chosen as a standard, both substances at
the same temperature or the temperature of each
being known:
A. Density
B. Specific gravity
C. Specific volume
D. Specific mass
It is used as the standard for the determination of
specific gravities of liquids and solids:
A. 80% Ethyl alcohol
B. Water

C. Hexane
D. Octanol
It is considered most useful standard for the
determination of specific gravities of gases:
A. Hydrogen
B. Helium

C. Oxygen
D. Nitrogen
What is the representative specific gravity of water
at 25 degree Celsius?
A. 1.00
B. 0.96

C. 0.92
D. 0.91
In the United States Pharmacopeia, the standard
temperature for specific gravities is 25 degree Celsius,
except for that of alcohol, which is _ degree Celsius:
A. 15.65

B. 16.65

C. 16.56

D. 15.56
It is a special glass bottle used to determine specific
gravity of different substances:
A. Burette
B. Densiometer

C. Pycnometer
D. Plummet method
If 10 mL of sulfuric acid weighs 18 g, its density is?
If 54.96 mL of an oil weighs 52.78 g, what is the specific gravity of
the oil?
If a pint of a certain liquid weighs 601 g, what is the specific gravity
of the liquid?
Calculate the specific volume of a syrup, 91.0 mL of which weighs
107.16 g.
If 250 mL of alcohol weighs 203 g, what is its density?
A piece of copper metal weighs 53.6 g, and has a volume of 6
mL. Calculate its density.
If 150 mL of a sorbitol solution weigh 170 g, what is its specific
gravity?
• Percent weight-in-volume (w/v) expresses the number of
grams of a constituent in 100 mL of solution or liquid
preparation and is used regardless of whether water or
another liquid is the solvent or vehicle.
• Percent volume-in-volume (v/v) expresses the number of
milliliters of a constituent in 100 mL of solution or liquid
preparation.
• Percent weight-in-weight (w/w) expresses the number of
grams of a constituent in 100 g of solution or preparation.
• The concentrations of weak solutions are frequently expressed in
terms of ratio strength.
• The term milligrams percent (mg%) expresses the number of
milligrams of substance in 100 mL of liquid. It is used frequently
to denote the concentration of a drug or natural substance in a
biologic fluid, as in the blood.
• The strengths of very dilute solutions are commonly expressed in
terms of parts per million (ppm) or parts per billion (ppb).
How many grams of dextrose are required to prepare 4000 mL of a
5% solution?
What is the percentage strength (w/v) of a solution of urea, if 80 mL
contains 12 g?
If a veterinary liniment contains 30% v/v of dimethyl sulfoxide,
how many milliliters of the liniment can be prepared from 1 lb of
dimethyl sulfoxide (sp gr 1.10)?
How many grams of a drug substance are required to make 120 mL
of a 20% (w/w) solution having a specific gravity of 1.15?
If 5 g of boric acid is added to 100 mL of water, what is the
percentage strength (w/w) of the solution?
Express 0.02% as a ratio strength.
Express 1:4000 as a percentage strength.
Express 5 ppm of iron in water in percentage strength and ratio
strength.
• The dose of a drug is the quantitative amount administered or
taken by a patient for the intended medicinal effect.

• single dose
• total dose
• divided doses

• The schedule of dosing (e.g., four times per day for 10 days) is
referred to as the dosage regimen.
It is the amount that ordinarily produces the
medicinal effect intended in the adult patient:
A. Pediatric dose
B. Adult dose

C. Geriatric dose
D. Usual dose
It indicates the quantitative range or amounts of the
drug that may be prescribed within the guidelines of
usual medical practice:
A. Pediatric dose
B. Adult dose
C. Geriatric dose

D. Dosage range
It is the amount that produces the desired intensity
of effect in 50% of the individuals tested:
A. Median effective dose
B. Median toxic dose

C. ED50
D. A and C
It is the amount that produces toxic effects in 50%
of the individuals tested.
A. Median effective dose
B. Median toxic dose

C. TD50
D. B and C
It is the minimum concentration determined that
can be expected to produce the drug’s desired effects
in a patient:
A. Minimum safe concentration
B. Minimum effective concentration
C. Minimum toxic concentration

D. Therapeutic index
It is the base level of blood serum concentration that
produces dose-related toxic effects:
A. Minimum safe concentration
B. Minimum effective concentration

C. Minimum toxic concentration


D. Therapeutic index
A larger-than-usual initial dose required to achieve

the desired blood drug level is called:

A. Priming dose

B. Loading dose

C. Maintenance dose

D. A and B
Similar in amount to usual doses are administered
according to the dosage regimen to sustain the
desired drug blood levels or drug effects is known
as:
A. Priming dose
B. Loading dose
C. Maintenance dose
D. A and B
Certain dose of biologic or immunologic products,
such as vaccines, may be administered to protect
the patient from contracting a specific disease is
called:
A. Loading dose
B. Maintenance dose
C. Prophylactic dose
D. Therapeutic dose
Other products, such as antitoxins, may be
administered to counter a disease after exposure or
contraction:
A. Loading dose
B. Maintenance dose
C. Prophylactic dose

D. Therapeutic dose
The fabrication of a pharmaceutical product from
individual ingredients, carefully weighed, measured,
and mixed is called:
A. Filling
B. Manufacturing
C. Compounding

D. Dispensing
The following approximate equivalent of household
measures are correct, except:
A. A teaspoon measures 5 mL
B. A desert spoon measure 10 mL

C. A table spoon measures 15 mL


D. A glassful or cupful measures 250 mL
The following approximate equivalent of household
measures are correct, except:
A. An ounce measures 30 mL
B. A teacupful measures 180 mL

C. An official dropper measures 20 gtt/mL


D. A pint measures 250 mL
If the dose of a drug is 200 mg, how many doses are contained in 10
g?
If 1 tablespoon is prescribed as the dose, approximately how many
doses will be contained in 1 pint of the medicine?
How many teaspoonfuls would be prescribed in each dose of an elixir
if 180 mL contained 18 doses?
How many milliliters of a liquid medicine would provide a patient
with 2 tablespoonfuls twice a day for 8 days?
It is the amount that ordinarily produces the desired
therapeutic response in the majority of patients in a
general, or otherwise defined, population group:
A. Pediatric dose
B. Adult dose
C. Geriatric dose

D. Usual dose
It is the branch of medicine that deals with disease in
children from birth through adolescence:
A. Pediatrics
B. Geriatrics

C. Adulthood
D. Puberty
The following statements about pediatric patients
are correct, except:
A. Neonate is from birth to 1 month
B. Infant is 1 month to 1 year

C. Late childhood is 1 year through 5 years


D. Adolescence is 13 years to 17 years of age
A neonate is considered premature if born at less
than _ weeks’ gestation:
A. 35
B. 37

C. 38
D. 40
It is the field that encompasses the management of
illness in the elderly:
A. Pediatrics
B. Geriatrics

C. Adulthood
D. Puberty
It is the use of pharmacologically active substances
in the treatment of disease and illness:
A. Pharmacotherapy
B. Pharmacokinetics

C. Pharmacology
D. Pharmacodynamics
It involves the study of the rate and extent of drug
absorption, distribution, metabolism, and
elimination:
A. Pharmacotherapy
B. Pharmacology
C. Pharmacodynamics

D. Pharmacokinetics
It is the method of calculating drug doses that is
widely used for two types of patient groups: cancer
patients receiving chemotherapy and pediatric
patients:
A. Based on age
B. Based on weight
C. Body surface area
D. Body mass index
The average adult is considered to have a Body
surface are (BSA) of:
A. 1.73 m2
B. 1.72 m2

C. 1.73 m3
D. 1.72 m3
Calculations of dose based on age
!"# $ !%&'( %)*#
Young’s rule = !"#+,-

!"# .( /#$( 012(3%.4 $ !%&'( %)*#


Cowling’s rule = -5

!"# 1/ 6)/(3* $ !%&'( %)*#


Fried’s rule = ,78

9#1"3( 1/ '0 $ !%&'( %)*#


Clark’s rule = ,78
Drug dosage based on body weight

:2&" %)*# (6")


Patient’s dose (mg) = Patient’s weight (kg) x , (=")
Drug dosage based on body surface area
>.(1#/( ! * ?@! 6! A BCDE FGHI (6")
Patient’s dose = ,.KL 6!

3#1"3( M6 $ N#1"3( (=")


BSA (𝒎𝟐) = LO88

3#1"3( 1/ $ N#1"3( ('0)


BSA (𝒎𝟐 ) = L,L,
The usual initial dose of chlorambucil is 150 mcg/kg of body weight.
How many milligrams should be administered to a person weighing
154 lb.?
Calculate the BSA for a patient measuring 165 cm in height and
weighing 65 kg.
If the usual adult dose of a drug is 120 mg, what would be the dose
based on BSA for a person measuring 6 ft tall and weighing 200 lb.?
Calculate the dose using Clark’s rule of 11-year old child
weighing 70 lb with an adult dose of 500 mg.
Calculate the dose using Young’s rule of 10-year old child
weighing 60 lb with an adult dose of 250 mg.
The potency of antibiotics may also be designated in
terms of:
A. Microgram
B. Units of activity

C. TCID50
D. Lf Unit
The potency of many pharmaceutical products
derived from biological sources is based on:
A. Microgram
B. Units of activity

C. TCID50
D. Lf Unit
The strength of a viral vaccine is expressed most
commonly in terms of:
A. Microgram
B. Units of activity

C. TCID50
D. Lf Unit
The strength of a toxoid is generally expressed in
terms of:
A. Microgram
B. Units of activity

C. TCID50
D. Lf Unit
The potency of insulin preparation is generally
expressed in terms of:
A. Microgram
B. Units

C. TCID50
D. Lf Unit
How many milliliters of U-100 insulin should be used to obtain 40
units of insulin?
A physician prescribed 100 units of insulin to be added to 500 mL of
D5W in treating a patient with severe diabetic acidosis. How many
milliliters of insulin injection concentrate, U-500, should be used?
If neomycin sulfate has a potency of 600 mcg of neomycin per
milligram, how many milligrams of neomycin sulfate would be
equivalent in potency to 1 mg of neomycin?
A biologic contains 50 Lf Units of diphtheria toxoid in each 2.5 mL
of product. If a pediatric patient is to receive 10 Lf Units, how many
milliliters of product should be administered?
Measles Virus Vaccine Live is prepared to contain 1000 TCID50 per
0.5-mL dose. What is the TCID50 content of a 50-mL multiple dose
vial of the vaccine?
Creatinine clearance
• Creatinine is eliminated from the body essentially through
renal filtration, reduced kidney performance results in a
reduced creatinine clearance rate.

• The normal adult value of serum creatinine is 0.7 to 1.5


mg/dL.

• The creatinine clearance rate represents the volume of blood


plasma that is cleared of creatinine by kidney filtration per
minute. It is expressed in milliliters per minute.
Creatinine clearance
• By the Jelliffe equation:

For males:
98 – 0.8 𝑥 𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑎𝑔𝑒 𝑖𝑛 𝑦𝑒𝑎𝑟𝑠 – 20
𝐶𝑟𝐶𝑙 =
𝑆𝑒𝑟𝑢𝑚 𝑐𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛𝑒 𝑖𝑛 𝑚𝑔/𝑑𝐿

For females:
98 – 0.8 𝑥 𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑎𝑔𝑒 𝑖𝑛 𝑦𝑒𝑎𝑟𝑠 – 20
𝐶𝑟𝐶𝑙 = 𝑥 0.9
𝑆𝑒𝑟𝑢𝑚 𝑐𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛𝑒 𝑖𝑛 𝑚𝑔/𝑑𝐿
Creatinine clearance
• By the Cockcroft-Gault equation:

For males:
140 – 𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑎𝑔𝑒 𝑖𝑛 𝑦𝑒𝑎𝑟𝑠 𝑥 𝐵𝑜𝑑𝑦 𝑤𝑒𝑖𝑔ℎ𝑡 𝑖𝑛 𝑘𝑔
𝐶𝑟𝐶𝑙 =
72 𝑥 𝑆𝑒𝑟𝑢𝑚 𝑐𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛𝑒 𝑖𝑛 𝑚𝑔/𝑑𝐿

For females:
140 – 𝑝𝑎𝑡𝑖𝑒𝑛𝑡 𝑎𝑔𝑒 𝑖𝑛 𝑦𝑒𝑎𝑟𝑠 𝑥 𝐵𝑜𝑑𝑦 𝑤𝑒𝑖𝑔ℎ𝑡 𝑖𝑛 𝑘𝑔
𝐶𝑟𝐶𝑙 = 𝑥 0.85
72 𝑥 𝑆𝑒𝑟𝑢𝑚 𝑐𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛𝑒 𝑖𝑛 𝑚𝑔/𝑑𝐿
Determine the creatinine clearance rate for an 80-year-
old male patient weighing 70 kg and having a serum
creatinine of 2 mg/dL. Use both the Jelliffe and
Cockcroft-Gault equations.
When a solvent passes through a semipermeable
membrane from a dilute solution into a more
concentrated one, the concentrations become
equalized and the phenomenon is known as:
A. Diffusion

B. Osmosis
C. Active transport
D. Filtration
Colligative properties of solutions depend on the
number of particles in solution. It may include the
following, except:
A. Osmotic pressure
B. Vapor pressure
C. Melting point

D. Freezing point
The following statements about osmotic pressure are correct, except:

I. Two solutions that have the same osmotic pressure are termed isosmotic.

II. A solution having the same osmotic pressure as a specific body fluid is termed
isotonic.

III. Solutions of lower osmotic pressure than that of a body fluid are termed
hypotonic.

IV. Solutions having a higher osmotic pressure are termed hypertonic.


A. I only
B. II, III and IV
C. III and IV
D. None of the above
It is generally accepted that _ degree Celsius is the
freezing point of both blood serum and lacrimal
fluid:
A. -0.52
B. -0.53
C. -0.54

D. -0.55
It is a system, usually an aqueous solution, that
possesses the property of resisting changes in pH
with the addition of small amounts of a strong acid
or base:
A. Buffers

B. Buffer action
C. Buffer capacity
D. Buffer solution
Buffer equation was derived from:
A. Henderson-Hasselbalch equation

B. Noyes-Whitney equation
C. Fick’s law equation

D. Van Hoff ’s equation


Calculation of isotonic solutions with
sodium chloride equivalents

Step 1. Calculate the amount (in grams) of sodium chloride


represented by the ingredients in the prescription. Multiply the
amount (in grams) of each substance by its sodium chloride
equivalent.

Step 2. Calculate the amount (in grams) of sodium chloride, alone,


that would be contained in an isotonic solution of the volume
specified in the prescription, namely, the amount of sodium chloride
in a 0.9% solution of the specified volume. (Such a solution would
contain 0.009 g/mL.)
Calculation of isotonic solutions with
sodium chloride equivalents
Step 3. Subtract the amount of sodium chloride represented by the
ingredients in the prescription (Step 1) from the amount of sodium
chloride, alone, that would be represented in the specific volume of
an isotonic solution (Step 2). The answer represents the amount (in
grams) of sodium chloride to be added to make the solution isotonic.

Step 4. If an agent other than sodium chloride, such as boric acid,


dextrose, or potassium nitrate, is to be used to make a solution
isotonic, divide the amount of sodium chloride (Step 3) by the
sodium chloride equivalent of the other substance.
1. How many grams of sodium chloride should be used in
compounding the following prescription?
Rx
Pilocarpine Nitrate 0.3 g (0.23)
Sodium Chloride q.s.
Purified Water ad 30 mL
Make isoton. Sol.
Sig. For the eye.
2) How many grams of boric acid should be used in
compounding the following prescription?
Rx
Phenacaine Hydrochloride 1% (0.2)
Chlorobutanol 1⁄2% (0.24)
Boric Acid q.s.
Purified Water ad 60
Make isoton. sol.
Sig. One drop in each eye.
3) How many grams of potassium nitrate could be used to
make the following prescription isotonic?
Rx
Sol. Silver Nitrate 60
1:500 w/v
Make isoton. sol.
Sig. For eye use.
The dissociation constant of acetic acid is 1.75x10-5 at 25°C.
Calculate its pKa value.
What is the pH of a buffer solution prepared with 0.05 M sodium
borate and 0.005 M boric acid? The pKa value of boric acid is 9.24 at
25°C.
What is the pH of a buffer solution prepared with 0.05 M ammonia
and 0.05 M ammonium chloride? The Kb value of ammonia is
1.80x10-5 at 25°C.
What molar ratio of salt/acid is required to prepare a sodium
acetate-acetic acid buffer solution with a pH of 5.76? The pKa value
of acetic acid is 4.76 at 25C.
It is a unit of measurement of the amount of
chemical activity of an electrolyte:
A. Milliequivalent
B. Microgram

C. Milliosmole
D. Molar concentrations
International system of units expresses most clinical
laboratory values, including those of electrolytes in
terms of:
A. Milliequivalent
B. Microgram
C. Milliosmole

D. Molar concentrations
Osmotic pressure is proportional to the total
number of particles in solution. The unit used to
measure osmotic concentration is:
A. Milliequivalent
B. Microgram
C. Milliosmole

D. Molar concentrations
It is defined as the milliosmoles of solute per liter of
solution:
A. Normality
B. Molarity

C. Osmolarity
D. Osmolality
It is defined as the milliosmoles of solute per
kilogram of solvent:
A. Normality
B. Molarity

C. Osmolarity
D. Osmolality
Milliequivalence

!"#"$%&! ' (&#)*+)


mEq = ,-.!"+ .% /.#)+0#&% 1)"$2-
What is the concentration, in milligrams per milliliter, of a solution
containing 2 mEq of potassium chloride (KCl) per milliliter?
How many milliequivalents of potassium chloride are represented in
a 15-mL dose of a 10% (w/v) potassium chloride elixir?
How many milliequivalents of magnesium sulfate are represented in
1 g of anhydrous magnesium sulfate (MgSO4)?
A solution contains 5% of anhydrous dextrose in water for injection.
How many milliosmoles per liter are represented by this
concentration?
What is the concentration, in grams per milliliter, of a solution
containing 4 mEq of calcium chloride (CaCl2⋅2H2O) per
milliliter?
What is the percent (w/v) concentration of a solution
containing 100 mEq of ammonium chloride per liter?
These are sterile pharmaceutical solutions or
suspensions of a drug substance in an aqueous or
nonaqueous vehicle. They are usually administered
by needle into almost any part of the body:
A. Injections
B. Total parenteral nutrition
C. IV admixture
D. Enteral nutrition
It is defined as any medication route other than the
alimentary canal and thus includes all routes of
injection:
A. Oral
B. Rectal
C. Parenteral

D. Vaginal
The rapid injection of intravenous medications, as in
emergency or critical care situations, is termed,
except:
A. IV push
B. IV infusion
C. IV stat

D. IV bolus
A medication order calls for 1000 mL of D5W to be administered
over an 8-hour period. Using an IV administration set that delivers
10 drops/mL, how many drops per minute should be delivered to the
patient?
A physician orders enalaprilat (VASOTEC IV) 2 mg IVP for a
hypertensive patient. A pharmacist delivers several 1-mL
injections, each containing 1.25 mg of enalaprilat. How many
milliliters of the injection should be administered?
A physician orders midazolam hydrochloride (VERSED) 2 mg
IV Stat. A pharmacist delivers a vial containing midazolam
hydrochloride 5 mg/mL. How many milliliters should be
administered?
Calculate the daily infusion volume of D10W to be administered to a
neonate weighing 3 lb. 8 oz. on the basis of 60 mL/kg/day.
Using an administration set that delivers 60 drops/mL at 20 drops per
minute, calculate the total time for the above infusion.
Gentamicin sulfate, 2.5 mg/kg, is prescribed for a 1.5-kg
neonate. Calculate (a) the dose of the drug, and (b) when the
drug is placed in a 50-mL IV bag, the flow rate, in
mL/minute, if the infusion is to run for 30 minutes.
A medication order for a patient weighing 154 lb. calls for 0.25
mg of amphotericin B per kilogram of body weight to be added
to 500 mL of 5% dextrose injection. If the amphotericin B is to
be obtained from a constituted injection that contains 50
mg/10 mL, how many milliliters should be added to the
dextrose injection?
It is a method of providing nutritional support via
tubes inserted into the stomach or small intestine. It
finds application in patients who have an inability
or decreased ability to ingest nutrients by mouth:
A. Injections

B. Total parenteral nutrition


C. IV admixture
D. Enteral nutrition
It is the feeding of a patient by the intravenous
infusion of fluids and basic nutrients:
A. Parenteral nutrition
B. Intravenous hyperalimentation

C. Enteral nutrition
D. A and B
It is accepted as the clinical standard for judging
excessive weight and obesity. And, it is defined as
body weight in kilograms divided by the square of
height measured in meters:
A. Body mass index

B. Body surface area


C. Nomogram
D. Basal energy expenditure
• These are commonly used to estimate the basal energy expenditure
(BEE) requirements for nonprotein calories.
• The BEE is also referred to as the resting metabolic energy (RME)
or the resting energy expenditure (REE).

For males:
BEE = 66.67 + [13.75 x weight (kg)] + [5 x height (cm)] – [6.76 x Age (yr)]
For females:
BEE = 655.1 + [9.56 x weight (kg)] + [1.86 x height (cm)] – [4.68 x Age (yr)]
Calculate the parenteral nutrition and fluid requirements for a 58-year-old woman who
is 5 ft. 3 in. tall and weighs 140 lb., assuming that she has no disease states that would
alter her nutritional requirements.
The nutritional requirements for a 76-year-old male who is 6 ft. 2 in. tall
and weighs 201 lb. have been determined to be as follows:
Protein: 73.09 g/day
Lipids: 81.23 g/day
Carbohydrates: 266.34 g/day
Water: 2088.82 to 2740.91 mL/day
Total calories: 2088.82 kcal/day
ENSURE liquid is chosen for enteral nutrition for this patient. A quart
container provides 37 g protein, 143 g carbohydrates, 37 g lipids, and
1.06 kcal/mL.

How many milliliters of ENSURE should this patient receive daily to


meet his caloric requirements?
ENSURE liquid is chosen for enteral nutrition for this patient. A quart
container provides 37 g protein, 143 g carbohydrates, 37 g lipids, and
1.06 kcal/mL.

How many grams each of protein, carbohydrates, and lipids would this
volume provide?
ENSURE liquid is chosen for enteral nutrition for this patient. A quart
container provides 37 g protein, 143 g carbohydrates, 37 g lipids, and
1.06 kcal/mL.

If the product contains 85% free water, does it meet the patient’s daily
water requirement?
ENSURE liquid is chosen for enteral nutrition for this patient. A quart
container provides 37 g protein, 143 g carbohydrates, 37 g lipids, and
1.06 kcal/mL.

If the formula is to be delivered continuously over a 24-hour period, what


would be the flow rate in mL/hr?
• Body mass index (BMI) is accepted as the clinical standard for judging
excessive weight and obesity.
• BMI is defined as body weight in kilograms divided by the square of height
measured in meters.
• According to the National Institutes of Health (NIH) individuals with a BMI:
• less than 18.5 may be considered underweight;
• between 18.5 and 24.9 may be considered normal weight;
• between 25 and 29.9 are considered overweight;
• 30 and above are considered obese;
• over 40 are considered extremely obese.
N#1"3( (=")
BMI = 3#1"3( (6!)

N#1"3( '0 $ K85.7


BMI = 3#1"3( (1/!)

Calculate the BMI of a person 4 ft. 11 in. in height and weighing 98


lb. Describe its interpretation.
N#1"3( (=")
BMI = 3#1"3( (6!)

N#1"3( '0 $ K85.7


BMI = 3#1"3( (1/!)

Calculate the BMI of a person 6 ft. 0 in. in height weighing 182 lb.
Describe its interpretation.
• A calorie (spelled with a small c) is the amount of energy
needed to raise the temperature of 1 g of water 1C.
• Caloric values:
• carbohydrates yield 4 kcal/g;
• protein, 4 kcal/g; and
• fat, 9 kcal/g.
These are concentrated solutions of active or
inactive substances and are used by pharmacists as
a convenience to prepare solutions of lesser
concentration:
A. Stock solution
B. True solution
C. Alligation
D. Trituration
The strength of an official undiluted (concentrated)
acid is expressed as:
A. Percent weight-in-volume (w/v)
B. Percent volume-in-volume (v/v)

C. Percent weight-in-weight (w/w)


D. Percent volume-in-weight (v/w)
The strength of an official diluted acid is expressed
as:
A. Percent weight-in-volume (w/v)
B. Percent volume-in-volume (v/v)

C. Percent weight-in-weight (w/w)


D. Percent volume-in-weight (v/w)
These are dilutions of potent medicinal substances.
They were at one time official and were prepared by
diluting one part by weight of the drug with nine
parts of finely powdered lactose:
A. Stock solution

B. True solution
C. Alligation
D. Trituration
It is an arithmetical method of solving problems
that involves the mixing of solutions or mixtures of
solids possessing different percentage strengths:
A. Stock solution
B. True solution
C. Alligation

D. Trituration
This method may be used to determine the strength
of a common ingredient in a mixture of two or more
preparations:
A. Alligation medial
B. Alligation alternate
C. Reducing enlarging formula

D. Ratio and proportion


This method may be used to determine the
proportion or quantities of two or more components
to combine in order to prepare a mixture of a
desired strength:
A. Alligation medial

B. Alligation alternate
C. Reducing enlarging formula
D. Ratio and proportion
• The percentage or ratio strength (concentration) of a component in a
pharmaceutical preparation is based on its quantity relative to the
total quantity of the preparation. If the quantity of the component
remains constant, any change in the total quantity of the
preparation, through dilution or concentration, changes the
concentration of the component in the preparation inversely.
• An equation useful in these calculations is:
(1st quantity) x (1st concentration) = (2nd quantity) x (2nd concentration)
Q1 x C1 = Q2 x C2
If 500 mL of a 15% v/v solution are diluted to 1500 mL,
what will be the percentage strength (v/v)?
If 50 mL of a 1:20 w/v solution are diluted to 1000 mL,
what is the ratio strength (w/v)?
If a syrup containing 65% w/v of sucrose is evaporated to
85% of its volume, what percentage (w/v) of sucrose will it
contain?
How many grams of 10% w/w ammonia solution can be made
from 1800 g of 28% w/w strong ammonia solution?
How many milliliters of a 1:400 w/v stock solution should be
used to make 4 liters of a 1:2000 w/v solution?
How much water should be mixed with 5000 mL of 85% v/v
alcohol to make 50% v/v alcohol?
1) How many grams of a 1:10 trituration are required to
obtain 25 mg of drug?
1) What is the percentage strength (v/v) of alcohol in a mixture of 3000
mL of 40% v/v alcohol, 1000 mL of 60% v/v alcohol, and 1000 mL of
70% v/v alcohol? Assume no contraction of volume after mixing.
What is the percentage of zinc oxide in an ointment prepared by mixing
200 g of 10% ointment, 50 g of 20% ointment, and 100 g of 5% ointment?
What is the percentage strength of alcohol in a mixture of 500 mL of a
solution containing 40% v/v alcohol, 400 mL of a second solution
containing 21% v/v alcohol, and a sufficient quantity of a nonalcoholic
third solution to make a total of 1000 mL?
In what proportion should alcohols of 95% and 50% strengths
be mixed to make 70% alcohol?
In what proportion should 20% benzocaine ointment be mixed
with an ointment base to produce a 2.5% benzocaine ointment?
A hospital pharmacist wants to use three lots of zinc oxide
ointment containing, respectively, 50%, 20%, and 5% of zinc
oxide. In what proportion should they be mixed to prepare a
10% zinc oxide ointment?
In what proportions may a manufacturing pharmacist mix
20%, 15%, 5%, and 3% zinc oxide ointments to produce a 10%
ointment?
Reducing and Enlarging Formula
• Formula may be reduced or enlarged through the use of a
factor generated by the following equation and applied
consistently to each ingredient:

P&./(1(4 )Q Q)26&'. %#*12#%


Factor = P&./(144 )Q Q)26&'. "1R#/
From the following formula, calculate the quantity of each
ingredient required to make 240 mL of calamine lotion.

Calamine 80 gram
Zinc oxide 80 gram
Glycerin 20 gram
Bentonite magma 250 milliliter
Calcium hydroxide Topical solution, qs. 1000 milliliter
Calculate the quantity of each ingredient required to make
1000 g of the ointment.

Coal Tar 5 parts


Zinc Oxide 10 parts
Hydrophilic Ointment 50 parts
It encompasses the economic aspects of drugs, from
the costs associated with drug discovery and
development to the costs of drug therapy analyzed
against therapeutic outcomes:
A. Pharmacoeconomics

B. Pharmaceutical calculations
C. Pharmaceutical analysis
D. Pharmacokinetics
• FOR PREPARED DRUG
• List Price x %Discount = Discount
• List Price – Discount = Net Cost
• List Price x %Mark Up = Mark Up
• List Price + Mark Up = Selling Price
• FOR COMPOUNDED DRUG
• List Price + Mark Up + Professional Fee = Selling
Price
Freezer – between –25ºC and –10ºC
Cold – not exceeding 8ºC
Biorefrigerator – between 2ºC and 8ºC
Cool – between 8ºC and 15ºC
Controlled Room Temperature – between 20ºC and 25ºC
Warm – between 30ºC and 40ºC
Excessive heat – above 40ºC
°Fahrenheit = 1.80 °C + 32

°"#$%
°Celsius = &.()

Kelvin = °C + 273
1) Convert 26°C to corresponding degrees Fahrenheit
2) Convert 98.6°F to corresponding degrees centigrade
3) Convert 99°F to corresponding Kelvin
4) Convert 89°C to corresponding degrees Fahrenheit
5) Convert 100°F to corresponding degrees Centigrade
It is an aqueous solution containing 50% v/v of
absolute alcohol (100% v/v ethyl alcohol):
A. Proof spirit
B. Proof strength

C. Proof gallon
D. Phenol coefficient
It is twice the percentage strength of alcohol and
thus 50% v/v alcohol is 100 proof:
A. Proof spirit
B. Proof strength

C. Proof gallon
D. Phenol coefficient
• Proof Strength = 2 x (%V/v)

"
3"*) $&##.* ' (% )
• Proof Gallon = #
78%

3"*) $&##.* ' 9%..: ;-%)*$-2


• Proof Gallon = <88
1) How many proof gallons are contained in 5 gallons
of 75% v/v alcohol?

2) How many gallons of 20% v/v alcohol would be the


equivalent of 20 proof gallons?

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