Formula sheets, the key method steps for every topic and 6 practice problems, with full solutions at the back.
Practice exercise (made-up values, not clinical guidance). A vial contains ceftriaxone 1000 mg as a powder. The practice label says to add 9.6 mL of sterile water; the powder adds 0.4 mL to the volume. The prescribed dose is 250 mg. What volume V do you draw up? Round to one decimal place.
A vial holds 1000 mg of powder. You add 3.2 mL of diluent, and the powder adds 0.8 mL of volume. The prescription is 575 mg. Draw up the dose: what volume V do you give?
A patient weighs 15 kg. The prescribed dose is 30 mg/kg per day, given in 4 equal doses. How many milligrams D are given per dose?
A child weighing 20 kg is prescribed 15 mg/kg per dose of an oral suspension that contains 40 mg in 1 mL. What volume V do you give?
Practice exercise (made-up values, not clinical guidance). A patient receives an IV bolus of 130 mg of tobramycin. The level back-extrapolated to time zero is 8 mg/L and the half-life is 3 h. Find the clearance CL in L/h.
Practice exercise (made-up values, not clinical guidance). A 69 kg patient has a theophylline level of 5 mg/L; the target is 10 mg/L. The drug is given intravenously as aminophylline (S = 0.8), and the volume of distribution is 0.5 L/kg. What extra loading dose LD raises the level to the target?
Answer: V = 2.5 mL
Reconstitution: the powder takes up space, so the final volume is the diluent plus the powder volume. Concentration = drug in the vial/final volume, and the volume to give = dose/concentration. On a multi-strength label, use the concentration that belongs to the amount of diluent you actually added. The numbers are for practice only; at the bedside always follow local protocols and have high-risk doses double-checked.
Answer: V = 2.3 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: D = 112.5 mg
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: V = 7.5 mL
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: CL = 3.755 L/h
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: LD = 215.6 mg
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.
In practice the dose is rounded to a convenient amount.
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