Hospital Pharmacy PP-501: Clinical Calculations

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Questions and Answers

What is the purpose of the allegation method in pharmacy?

  • To assess pharmaceutical strengths.
  • To calculate patient dosages.
  • To prepare a mixture of an intermediate desired strength. (correct)
  • To interpret medication labels.

Which of the following is NOT a component involved in the pharmaceutical calculations covered in this course?

  • Interpretation of prescription notations.
  • Compounding pharmaceutical ingredients.
  • Calculating proportional parts.
  • Patient counseling techniques. (correct)

When preparing a liter of D12.5W using D70W and D5W, what does D stand for?

  • Determined
  • Dosage
  • Dilute
  • Dextrose (correct)

What is required to calculate the average of the calculated proportional parts?

<p>The individual strengths of each component. (C)</p> Signup and view all the answers

In the context of pharmaceutical calculations, what does 'high conc.individual strengths' refer to?

<p>The contributions of each ingredient in a mixture. (C)</p> Signup and view all the answers

Which of the following describes the function of compounding in hospital pharmacy?

<p>Customizing medication formulations for specific needs. (D)</p> Signup and view all the answers

What preparatory step is essential before performing pharmaceutical calculations?

<p>Identifying the components of the prescription. (A)</p> Signup and view all the answers

Which calculation would most likely be used to combine D70W and D5W?

<p>Alligation calculation. (C)</p> Signup and view all the answers

What is the total volume required by the physician in the given prescription?

<p>8 ml (A)</p> Signup and view all the answers

How many tablets of Prednisone should be dispensed according to the prescription?

<p>42 tablets (B)</p> Signup and view all the answers

Pharmaceutical equivalents must contain identical amounts of what?

<p>The same active drug ingredient in the same dosage form (D)</p> Signup and view all the answers

What does 'qid' indicate in a prescription?

<p>Four times a day (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of pharmaceutical equivalents?

<p>Same inactive ingredients (A)</p> Signup and view all the answers

How many total doses of 10 mg are prescribed for the first two days in the example?

<p>30 mg (C)</p> Signup and view all the answers

What is the main focus of the prescription notation interpretation?

<p>Correctly determining dosage frequency (D)</p> Signup and view all the answers

What kind of drug products qualify as pharmaceutical equivalents?

<p>Identical in dosage form and active ingredient (A)</p> Signup and view all the answers

What is the appropriate method to prepare a 1 liter of 20% alcohol solution using 90% and 10% alcohol solutions?

<p>Combine 222 mL of 90% and 778 mL of 10% solutions. (A)</p> Signup and view all the answers

How many milliliters of 50% dextrose solution must be added to 250 mL of a 10% solution to create a 12.5% solution?

<p>16.7 mL (C)</p> Signup and view all the answers

What is the total amount of cortisone acetate in mg that must be present in 8 mL of an ophthalmic solution as prescribed?

<p>100 mg (A)</p> Signup and view all the answers

Which concentration of cortisone acetate is available for preparation in the provided ophthalmic solution?

<p>2.5% stock solution (B)</p> Signup and view all the answers

What volume of the 2.5% cortisone acetate stock solution is required to achieve the desired 100 mg in 8 mL?

<p>3.5 mL (C)</p> Signup and view all the answers

What final concentration should be achieved when mixing the specified dextrose solutions?

<p>12.5% dextrose solution (A)</p> Signup and view all the answers

When preparing a solution, which denotation is typically used for a percentage solution?

<p>W/V% indicates weight per volume. (A)</p> Signup and view all the answers

What is the initial concentration of the dextrose solution mentioned when determining how much 50% dextrose to add?

<p>10% dextrose solution (B)</p> Signup and view all the answers

What is typically indicated by the first letter of a generic medication name on a label?

<p>It is usually lowercase. (B)</p> Signup and view all the answers

What is the generic name of Lantus Solostar?

<p>Insulin Glargine (rDNA origin) (A)</p> Signup and view all the answers

What information is NOT typically included in the most important aspects of a medication label?

<p>Name of the pharmacist. (D)</p> Signup and view all the answers

What is the route of administration for Augmentin, based on the label example?

<p>Oral suspension. (A)</p> Signup and view all the answers

Which route is used for the administration of Lantus Solostar?

<p>Subcutaneous injection (C)</p> Signup and view all the answers

What is the total amount of drug in a Lantus Solostar container?

<p>3 ml (C)</p> Signup and view all the answers

Which instruction is specified for the storage of Augmentin after reconstitution?

<p>Refrigerate and use within 10 days. (B)</p> Signup and view all the answers

What should you do with Lantus Solostar after opening it?

<p>Use within 28 days (A)</p> Signup and view all the answers

What is the total amount of drug in the Augmentin container after reconstitution?

<p>75 ml. (D)</p> Signup and view all the answers

How should prefilled pens of Lantus Solostar be stored?

<p>Refrigerated at 2°C to 8°C (A)</p> Signup and view all the answers

What does the unit dose on the medication label for Augmentin indicate?

<p>5 ml per millilitre. (D)</p> Signup and view all the answers

Which of the following is a crucial step in the preparation of Augmentin?

<p>Ensure the inner seal is intact. (C)</p> Signup and view all the answers

What type of names are provided on medication labels?

<p>Both generic and proprietary names. (D)</p> Signup and view all the answers

What defines pharmaceutical alternatives?

<p>Drugs containing the same therapeutic moiety but not necessarily in the same amount or form. (A)</p> Signup and view all the answers

Which statement accurately describes therapeutic equivalents?

<p>They must demonstrate bioequivalence and have the same clinical effects. (A)</p> Signup and view all the answers

Which of the following medications are considered pharmaceutical equivalents?

<p>Extended-release and immediate-release formulations of the same drug. (A), Tetracycline hydrochloride and tetracycline phosphate complex. (D)</p> Signup and view all the answers

Bioequivalence is characterized by which of the following?

<p>Similar rate and extent of absorption to the site of action. (C)</p> Signup and view all the answers

What is required for drug products to be evaluated as therapeutically equivalent?

<p>Demonstrated bioequivalence along with the same clinical safety profile. (B)</p> Signup and view all the answers

What is NOT true about therapeutic equivalents?

<p>They must all be from the same manufacturer. (C)</p> Signup and view all the answers

Which is an example of pharmaceutical alternatives?

<p>Different strengths of the same immediate-release medication. (C)</p> Signup and view all the answers

Which product would NOT be considered a therapeutic equivalent?

<p>Two generic forms of the same brand medication with no bioequivalence data. (C)</p> Signup and view all the answers

Flashcards

Allegation

A method for mixing solutions of different known strengths to create a solution of a desired intermediate strength.

Allegation Method

Used for combining multiple preparations of known strengths to create a mixture with a desired intermediate strength.

Individual Strengths

The known concentration strengths of the different solutions to be mixed.

Desired Strength

The target concentration strength of the final mixture being prepared.

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Proportional Parts

The relative amounts of each solution needed to achieve the desired final concentration.

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High Concentration

A solution with a high concentration of the active ingredient.

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Low Concentration

A solution with a low concentration of the active ingredient.

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D12.5W

A solution with an intermediate concentration of the active ingredient.

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Prescription Notation

A way of writing instructions on a prescription for a patient, specifying dosage, frequency, and duration of medication use.

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qid

Abbreviation for "quater in die", meaning four times a day.

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tid

Abbreviation for "ter in die", meaning three times a day.

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bid

Abbreviation for "bis in die", meaning twice a day.

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Pharmaceutical Equivalent

Different drug products containing the same active ingredient, dosage form, and route of administration, but may vary in inactive ingredients.

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Inactive ingredients

Substances in a drug product that don't have pharmacological effects, used for taste, texture, or stability.

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Therapeutic Moiety

The portion of a drug molecule responsible for its pharmacological activity.

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Modified-release dosage forms

Drug formulations designed to release the active ingredient over a longer period, like extended-release or sustained-release.

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Mixing alcohol solutions

Calculating the volume of 90% and 10% alcohol solutions needed to prepare a 20% solution.

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Dextrose solution concentration

Determining the volume of 50% dextrose solution required to achieve a 12.5% solution when mixed with 10% dextrose solution.

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Opthalmic Cortisone Acetate Calculation

Calculating the volume of a 2.5% cortisone acetate stock solution needed to prepare an ophthalmic solution containing 100mg of cortisone acetate in 8mL of NS.

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Generic Name

The general, non-proprietary name of a drug, usually written in lowercase. It describes the chemical makeup of the drug (e.g., Amoxicillin/Clavulanate potassium).

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Percentage to mass conversion

Converting a percentage concentration to a mass concentration.

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Mixing dextrose solutions

Calculating the volume of 50% dextrose solution to mix with 250 ml of 10% dextrose solution, to get 12.5% dextrose solution.

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Trade Name

The brand or proprietary name given to a drug by the manufacturer, usually capitalized. It's the name you see on the package (e.g., Augmentin).

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Cortisone Acetate calculation

Calculate milliliters of 2.5% cortisone acetate stock solution to obtain the required 100mg cortisone acetate in 8mL NS.

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Route of Administration

The way a drug is delivered into the body (e.g., oral, intravenous, topical, etc.).

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Unit Dose

The amount of medication per single administration (e.g., 5 ml of Augmentin suspension).

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Ophthalmic solution preparation

Preparing an ophthalmic solution that contains a specific amount of cortisone in a particular volume of NS.

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Drug concentration calculation

Determining the amount of drug required for a given concentration in a specified volume.

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Total Amount of Drug

The total amount of medication in the container (e.g., 75 ml of Augmentin suspension after reconstitution).

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Instructions for Preparation

Steps needed to get the medication ready for use, if required (e.g., reconstituting a powder for oral use).

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Instructions for Storage

How to store the medication properly to maintain its stability and effectiveness (e.g., refrigerate after reconstitution).

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Expiration Date

The date after which the medication is no longer considered safe or effective to use.

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Pharmaceutical Alternative

Drugs with the same active ingredient but differ in dosage form, strength, or salt/ester form.

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Therapeutic Equivalents

Drugs that provide the same clinical effect and safety profile because they have the same active ingredient, dosage form, and are bioequivalent.

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Bioequivalence

When two drugs have similar rates and extents of absorption, meaning they reach the bloodstream at comparable speeds and amounts.

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What does the 'Orange Book' contain?

A FDA-approved list of therapeutic equivalents for various drugs. This helps healthcare professionals determine safe substitution options.

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Why are therapeutic equivalents important?

They allow healthcare providers to safely substitute one drug product for another, offering patients affordable and effective treatment options.

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What is the difference between pharmaceutical equivalents and alternatives?

Equivalents are identical in strength and quality, while alternatives may differ in their dosage forms or strengths. Both contain the same active ingredient.

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What is the significance of bioequivalence for therapeutic equivalents?

Bioequivalence ensures that therapeutic equivalents have comparable rates and extents of absorption, leading to the same clinical effect and safety profile.

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Insulin Glargine

A long-acting insulin analog used to manage diabetes, it is administered once daily and works by regulating blood sugar levels.

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Subcutaneous Injection

A method of administering medication by injecting it into the fatty layer beneath the skin.

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Lantus Solostar

A pre-filled pen containing insulin glargine, commonly used for subcutaneous injection. It allows for easy and accurate dosing.

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Refrigerate

Storing medication in a refrigerator, typically at a temperature between 2°C to 8°C. This is crucial for maintaining the potency of some medications, like insulin.

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Study Notes

Hospital Pharmacy (PP-501)

  • Course: Third Level - First Semester (Clinical Pharmacy PHARMD)
  • Academic Year: 2024 - 2025
  • Institution: Mansoura National University
  • Lab 1 Topic: Pharmaceutical and clinical calculations

Pharmaceutical and Clinical Calculations

  • Includes topics on:
    • Allegation
    • Interpretation of Prescription Notations
    • Interpretation of compounding instructions
    • Pharmaceutical alternative & equivalent
    • Interpretation of medication labels

Allegation

  • A method for mixing preparations of known strengths to prepare a mixture of an intermediate desired strength
  • Useful for creating intermediate concentrations
  • Calculates strengths proportionally

Prescription Notations

  • Includes abbreviations like:
    • Q (Every)
    • QOD (Every other day)
    • QD (Once a day)
    • BID (Twice a day)
    • QID (Four times a day)
    • TID (Three times a day)
    • PRN ("as needed")
    • MD (Maintainance dose)
    • LD (Loading dose)
    • D/C (Discontinue on discharge)
    • PO (Per-mouth)
    • NPO (Nothing per oral)
    • NS (Normal saline)
    • 1/2 NS (Half normal saline)
    • 1/4 NS (Quarter saline)
    • D5W (5% dextrose in water)
    • D20W (20% dextrose in water)
    • LR (Lactated ringers)

Pharmaceutical Alternatives & Equivalents

  • Equivalents: Identical dosage forms and routes; contain identical amounts of the same active drug ingredient (salt or ester)
  • Alternatives: Identical therapeutic moiety (or precursor), but not necessarily same dosage form, salt, ester

Medication Labels

  • Crucial information:
    • Name (generic & proprietary)
    • Dosage route
    • Unit dose (per mL, tablet, or capsule)
    • Total drug amount
    • Preparation instructions
    • Storage instructions
    • Expiration date
    • Batch number

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