Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
A solution has a ratio strength of 1:10 000. You need 0.76 mg. Draw up the volume in the 10 mL syringe: what volume V is that?
Practice exercise (made-up values, not clinical guidance). You must prepare 200 mL of 25% dextrose by mixing 50% and 10% dextrose. How many mL V of the 10% solution do you need? Round to the nearest whole mL.
A child weighing 25 kg is prescribed 4 mg/kg of a drug. The stock solution contains 20 mg/mL. Draw up the dose: what volume V do you give?
An infusion contains 20000 units of a drug in 1000 mL. The prescription is 800 units per hour. At what rate R do you set the pump, in mL/h?
Practice exercise (made-up values, not clinical guidance). A patient has a lidocaine clearance of 700 mL/min. What infusion rate R in mg/min keeps the steady-state level at 2.5 mg/L?
Practice exercise (made-up values, not clinical guidance). A vancomycin infusion runs at 100 mg/h with no loading dose. The patient's clearance is 4 L/h and the half-life is 8 h. What is the level C after 20 h?
Answer: V = 7.6 mL
Strength to volume: turn the strength into mg per mL first. A w/v percentage is grams per 100 mL, so x% = 10x mg/mL. A ratio strength 1:n is 1 g in n mL. After reconstitution the concentration is the powder's dose over the final volume (diluent + powder volume). Then volume = dose/concentration.
Answer: V = 125 mL
Alligation: to mix a higher strength H and a lower strength L into a target strength T, take (T − L) parts of H and (H − T) parts of L. The parts are crossed: each stock gets the distance from the target to the other stock. Water or a plain base counts as 0%. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Check: 75 mL of 50% + 125 mL of 10% = 200 mL.
Answer: V = 5 mL
Drawing up a dose: volume = (prescribed dose/stock strength) × stock volume. Convert to the same units first, then check that the volume fits the syringe and lands on one of its graduations.
On this 10 mL syringe every small line is 0.2 mL.
Answer: R = 40 mL/h
Dose calculation: the amount to give equals what is prescribed divided by what you have, times the quantity it comes in: amount = (desired dose/stock strength) × stock volume. Always keep the units the same (convert g to mg, mg to mcg first) and check that the answer is sensible.
Answer: R = 1.75 mg/min
Clearance and volume: at steady state the dosing rate equals the elimination rate, so the maintenance rate = CL × Css. A loading dose is LD = Vd × C/(S × F), with S the salt factor (fraction of active drug in the salt) and F the bioavailability (1 for IV). From two levels, k = ln(C₁/C₂)/Δt; for an IV bolus Vd = dose/C₀ and CL = k × Vd. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: C = 20.58 mg/L
Designing a regimen: with rapid IV doses the level falls from peak to trough during the interval, so τ = ln(Cpeak/Ctrough)/k and the dose that restores the peak is Vd × (Cpeak − Ctrough). The average steady-state level is Css,avg = S·F·dose/(CL·τ). An infusion rises as C = (R/CL)(1 − e−kt). For a drug cleared by the kidneys, the dose is scaled with the creatinine clearance. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
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