Quantities To Be Dispensed Or Administered

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1

A 4-year-old male (weight 18 kg) is diagnosed with acute otitis media. Medical history: none significant; allergies: none known. Current medications: none. Labs: not available/required. The pediatrician prescribes amoxicillin 90 mg/kg/day by mouth divided every 12 hours for 10 days. The suspension available is amoxicillin 400 mg/5 mL. Calculate the volume to be dispensed to complete the full 10-day course (in mL, rounded to the nearest mL).

102 mL

225 mL

180 mL

203 mL

Explanation

This question tests pediatric weight-based antibiotic dosing calculations and volume determination. The key patient-specific factor is the child's weight of 18 kg, which determines the total daily dose. The correct answer (B, 203 mL) is calculated as follows: 90 mg/kg/day × 18 kg = 1,620 mg/day; 1,620 mg ÷ 2 doses = 810 mg per dose; 810 mg ÷ (400 mg/5 mL) = 10.125 mL per dose; 10.125 mL × 2 doses/day × 10 days = 202.5 mL, rounded to 203 mL. Option A (102 mL) represents approximately half the needed volume, possibly calculating for once-daily dosing. Option C (225 mL) and Option D (180 mL) represent calculation errors in either the dose or volume conversion. When calculating pediatric liquid medications: first determine total daily dose (mg/kg/day × weight), divide by number of doses, convert to volume using the concentration, then multiply by total doses for the treatment course.

2

A 61-year-old woman (weight 74 kg) is prescribed doxycycline 100 mg by mouth every 12 hours for 7 days for sinusitis. Medical history: seasonal allergies; current medications: cetirizine 10 mg daily. Allergies: none known. Labs: SCr 0.9 mg/dL, AST/ALT within normal limits. Doxycycline is available as 100 mg capsules. Calculate the total quantity to be dispensed.

10 capsules

7 capsules

28 capsules

14 capsules

Explanation

This question tests the calculation of total quantity for doxycycline over 7 days. The key patient-specific factor is the fixed 100 mg every 12 hours dose. Option C is correct because 2 capsules/day × 7 days = 14 capsules. Option A (7) once daily, B (10) misdays, D (28) 14 days. Formula: total = doses/day × days. For tetracyclines.

3

A 72-year-old female (weight 60 kg) with atrial fibrillation is prescribed apixaban 5 mg by mouth twice daily. Medical history: hypertension, osteoarthritis; allergies: sulfonamides (hives). Current medications: hydrochlorothiazide 25 mg daily, acetaminophen 650 mg every 6 hours as needed. Labs: SCr 1.1 mg/dL, AST/ALT within normal limits. Calculate the total quantity to be dispensed for a 30-day supply (number of 5 mg tablets).

60 tablets

90 tablets

30 tablets

120 tablets

Explanation

This question tests the calculation of tablet quantities for chronic medication therapy with twice-daily dosing. The key factor is the fixed dosing regimen of 5 mg twice daily, with no dose adjustments needed based on the patient's renal function (SCr 1.1 mg/dL is within acceptable range for full-dose apixaban). The correct answer (C, 60 tablets) is calculated as: 2 tablets/day × 30 days = 60 tablets. Option A (30 tablets) incorrectly calculates for once-daily dosing. Option B (90 tablets) may represent a calculation error or confusion with three-times-daily dosing. Option D (120 tablets) doubles the correct quantity, possibly confusing a 30-day supply with a 60-day supply. For chronic medications, always multiply the daily tablet count by the number of days supplied, and verify that no dose adjustments are needed based on organ function or drug interactions.

4

A 45-year-old female (weight 62 kg) presents with an uncomplicated urinary tract infection. Past medical history: type 2 diabetes mellitus; allergies: none known. Current medications: metformin 1000 mg twice daily, empagliflozin 10 mg daily. Labs: hemoglobin A1c 7.4%, SCr 0.8 mg/dL, AST/ALT within normal limits. She is prescribed nitrofurantoin monohydrate/macrocrystals 100 mg by mouth twice daily for 5 days. Calculate the total quantity to be dispensed for this prescription (number of capsules).

14 capsules

10 capsules

5 capsules

20 capsules

Explanation

This question tests the calculation of total capsules needed for a fixed-dose antibiotic regimen. The key factor is the straightforward dosing schedule of 100 mg twice daily for 5 days, with no weight-based adjustments needed. The correct answer (A, 10 capsules) is calculated by multiplying: 2 capsules/day × 5 days = 10 capsules total. Option B (14 capsules) incorrectly calculates for a 7-day course instead of 5 days. Option C (20 capsules) doubles the correct answer, possibly confusing twice-daily dosing with the total number of capsules. Option D (5 capsules) represents only one capsule per day instead of two. For fixed-dose medications, the formula is simple: doses per day × number of days = total doses needed. Always verify the duration of therapy and frequency to avoid dispensing errors.

5

A 67-year-old male (weight 78 kg) is being treated for acute deep vein thrombosis and is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours for 7 days. Medical history includes hypertension and hyperlipidemia; allergies: penicillin (rash). Current medications: lisinopril 20 mg daily, atorvastatin 40 mg nightly, aspirin 81 mg daily. Labs: serum creatinine (SCr) 0.9 mg/dL, AST/ALT within normal limits. Enoxaparin is supplied as 80 mg/0.8 mL prefilled syringes. Calculate the total quantity to be dispensed for the full 7-day course (number of 80 mg/0.8 mL syringes).

14 syringes

28 syringes

7 syringes

10 syringes

Explanation

This question tests the calculation of total medication quantity needed for a weight-based dosing regimen over a specified treatment duration. The key patient-specific factor is the patient's weight of 78 kg, which determines the daily enoxaparin dose. The correct answer (B, 14 syringes) is calculated as follows: 78 kg × 1 mg/kg = 78 mg per dose; 78 mg × 2 doses/day × 7 days = 1,092 mg total; 1,092 mg ÷ 80 mg/syringe = 13.65 syringes, rounded up to 14 syringes. Option A (7 syringes) incorrectly calculates for once-daily dosing instead of twice-daily. Option C (28 syringes) doubles the correct answer, possibly confusing the number of doses with the number of syringes. Option D (10 syringes) underestimates the total quantity needed. When calculating quantities for weight-based medications, always multiply: weight × dose/kg × doses/day × days, then divide by the strength per unit to determine units needed, rounding up to ensure adequate supply.

6

A 47-year-old man (weight 88 kg) is prescribed amoxicillin/clavulanate 875 mg/125 mg by mouth every 12 hours for 10 days for acute bacterial sinusitis. Medical history: hypertension; current medications: hydrochlorothiazide 25 mg daily. Allergies: none known. Labs: SCr 0.9 mg/dL, AST/ALT within normal limits. The pharmacy stocks amoxicillin/clavulanate 875/125 mg tablets. Calculate the total quantity to be dispensed.

28 tablets

10 tablets

20 tablets

14 tablets

Explanation

This question tests the concept of calculating the total quantity of medication to dispense based on the prescribed dosing frequency and treatment duration. The key patient-specific factors include normal renal function (SCr 0.9 mg/dL) and body weight (88 kg), but no dose adjustments are required for amoxicillin/clavulanate in this adult patient with acute bacterial sinusitis. The correct answer, 20 tablets, is calculated as follows: the prescription is for one 875 mg/125 mg tablet every 12 hours (twice daily) for 10 days, so total doses = 2 doses/day × 10 days = 20 tablets. Option A (10 tablets) is incorrect as it underestimates the quantity by assuming once-daily dosing for 10 days or twice-daily for only 5 days. Option B (14 tablets) is wrong because it might mistakenly calculate for a 7-day course instead of 10 days, and option D (28 tablets) overestimates by assuming a 14-day course. A transferable principle is to always multiply the daily dose frequency by the total treatment days to determine the quantity needed, ensuring no adjustments unless indicated by patient factors like renal impairment. For similar scenarios, use the formula: total quantity = (doses per day) × (number of days), and verify against the stocked formulation to confirm dispensing accuracy.

7

A 63-year-old man (weight 72 kg) with chronic kidney disease is prescribed gabapentin 300 mg by mouth three times daily. Medical history: diabetic neuropathy, CKD; current medications: insulin lispro with meals, insulin glargine 24 units nightly. Allergies: none known. Labs: SCr 2.4 mg/dL (elevated; normal ~0.6–1.2). The prescriber requests a 30-day supply. Gabapentin is available as 300 mg capsules. Calculate the total quantity to be dispensed for 30 days.

120 capsules

30 capsules

90 capsules

60 capsules

Explanation

This question tests the calculation of total quantity for a 30-day supply of thrice-daily gabapentin. The key patient-specific factor is renal function, but dose is given as 300 mg TID without adjustment noted. Option C is correct because 3 capsules/day × 30 days = 90 capsules. Option A (30) assumes daily, B (60) twice daily, D (120) four times. Formula: total = doses/day × days. Essential for neuropathic pain meds like pregabalin.

8

A 66-year-old woman (weight 55 kg) with heart failure is prescribed furosemide 40 mg by mouth twice daily. Medical history: heart failure with reduced ejection fraction, hypertension; current medications: carvedilol 25 mg twice daily, losartan 50 mg daily, spironolactone 25 mg daily. Allergies: none known. Labs: SCr 1.1 mg/dL, potassium 4.6 mEq/L (normal ~3.5–5.0). Calculate the total quantity of furosemide 40 mg tablets to dispense for a 30-day supply.

30 tablets

60 tablets

90 tablets

45 tablets

Explanation

This question tests the calculation of total quantity for a 30-day supply of twice-daily furosemide. The key patient-specific factor is the fixed 40 mg twice daily dose, independent of weight. Option C is correct because 2 tablets/day × 30 days = 60 tablets. Option A (30) is incorrect, assuming once daily. Options B (45) and D (90) wrong; B might use 1.5/day, D triples. Formula: total = doses/day × days. Transferable to loop diuretics like torsemide.

9

A 50-year-old woman (weight 62 kg) is prescribed metronidazole 500 mg by mouth every 12 hours for 7 days for bacterial vaginosis. Medical history: none significant; current medications: none. Allergies: none known. Labs: AST/ALT within normal limits, SCr 0.8 mg/dL. The pharmacy has metronidazole 500 mg tablets. Calculate the total quantity to be dispensed.

21 tablets

7 tablets

14 tablets

10 tablets

Explanation

This question tests the calculation of total quantity for metronidazole over 7 days. The key patient-specific factor is the fixed 500 mg every 12 hours dose. Option C is correct because 2 tablets/day × 7 days = 14 tablets. Option A (7) once daily, B (10) miscalculates days, D (21) three times daily. Formula: total = doses/day × days. Applies to anaerobe coverage drugs.

10

A 3-year-old girl (weight 15 kg) has nausea and vomiting and is prescribed ondansetron 0.15 mg/kg per dose by mouth every 8 hours as needed. Medical history: none significant; current medications: none. Allergies: none known. Labs: not applicable. Ondansetron oral solution concentration is 4 mg/5 mL. What volume (mL) should be administered per dose?

4.2 mL per dose

5.6 mL per dose

2.8 mL per dose

1.4 mL per dose

Explanation

This question tests the calculation of volume for a weight-based dose of ondansetron oral solution. The key patient-specific factor is the child's weight of 15 kg. Option B is correct because 0.15 mg/kg × 15 kg = 2.25 mg/dose, and at 4 mg/5 mL, volume = (2.25 / 4) × 5 = 2.8125 ≈ 2.8 mL. Option A (1.4 mL) is incorrect, likely from halving the dose. Options C (4.2 mL) and D (5.6 mL) are wrong; C uses 0.225 mg/kg, D doubles weight. For oral solutions, use: dose (mg) = rate (mg/kg) × weight (kg), volume (mL) = (dose / concentration mg) × unit mL. This method applies to antiemetics like promethazine.

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