Basic / John Larsen Med Math Questions 1. Problem type: Unit conversion + Dosage calculation Medication: Fish oil, @ home PROBLEM Mr. Larsen’s general practitioner advised him to take 2 g of fish oil per day. The capsule
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Basic / John Larsen Med Math Questions 1. Problem type: Unit conversion + Dosage calculation Medication: Fish oil, @ home PROBLEM Mr. Larsen’s general practitioner advised him to take 2 g of fish oil per day. The capsules Mr. Larsen purchased are 1,000 mg. How many fish oil capsules should he take each day? HINT There are 1000 mg in one gram. SAMPLE SOLUTION 1. Convert the doctor’s recommendation of 2 grams into milligrams. 2 g x 1000 mg = 2000 mg 1 g 2. Determine how many fish oil capsules Mr. Larsen should take to ingest 2000 mg. 1 capsule x 2000 mg = 2 capsules 1000 mg ANSWER Number: 2 Units: capsules 2. Problem type: Dosage calculation Medication: Tramadol @ home PROBLEM Before his surgery, Mr. Larsen was taking tramadol, prescribed as 50 mg by mouth every 6 hours as needed for pain. If he took every available dose in a 24¬hour period, how many mg of tramadol would he ingest? HINT Start by figuring out how many doses Mr. Larsen would take in a single day. SAMPLE SOLUTION 1. Determine how many times in 24 hours Mr. Larsen took a dose. 24 hours x 1 dose = 4 doses 6 hours 2. Multiply the number of doses by the number of milligrams per dose. 4 doses x 50 mg = 200 mg 1 dose ANSWER Number: 200 Units: mg 3. Problem type: Dosage calculation + Stock on hand Medication: Atorvastatin @ hospital PROBLEM While in the hospital, the orders call for Mr. Larsen to take atorvastatin 20 mg, 1 tab, by mouth once a day. However, the pharmacy only carries 10 mg tablets. How many tablets of atorvastatin should be administered to him? HINT You can use the equation below, where X is the number of tablets that should be administered. D (ordered dose) x Quantity = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 20 mg H (dose on hand) = 10 mg Q (quantity) = 1 tablet 2. Plug into the equation and solve. D (20 mg) x 1 tablet = X H (10 mg) X = 2 tablets ANSWER Number: 2 Units: tablets 4. Problem type: Dosage calculation + Stock on hand Medication: Lisinopril @ hospital PROBLEM While in the hospital, the orders call for Mr. Larsen to take lisinopril 10 mg, 1 tab, by mouth once a day. The pharmacy only stocks 5 mg tablets of lisinopril. How many tablets of lisinopril should be administered to him? HINT You can use the equation below, where X is the number of tablets that should be administered. D (ordered dose) x Quantity = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 10 mg H (dose on hand) = 5 mg Q (quantity) = 1 tablet 2. Plug into the equation and solve. D (10 mg) x 1 tablet = X H (5 mg) X = 2 tablets ANSWER Number: 2 Units: tablets 5. Problem type: Unit conversion + Dosage calculation Medication: Acetaminophen @ hospital PROBLEM The Davis’s Drug Guide reports a potential drug¬drug interaction with acetaminophen and warfarin. If a patient is taking warfarin, more than 2 g/day of acetaminophen may increase bleeding. Because Mr. Larsen is ordered both, he should receive no more than 2 g/day of acetaminophen. IfMr. Larsen takes acetaminophen 325 mg, 2 tabs, by mouth every 4 hours for mild pain, what is the maximum number of tablets you can give him so that he doesn’t exceed 2 g/day? (Assume you will only give him whole tablets.) HINT There are 1000 mg in one gram. SAMPLE SOLUTION 1. Determine how many milligrams are in 2 grams. 2 g x 1000 mg = 2000 mg 1 g 2. Determine how many 325 mg tablets go into 2000 mg. 2000 mg x 1 tablet = 6.15 tablets 325 mg 3. Consider that the dosage may not exceed 2,000 mg, and you may only administer whole tablets. Round down to a whole number of tablets = 6 ANSWER Number: 6 Units: tablets Citation: DDG. “Drug¬Drug: Chronic high-dose acetaminophen (>2 g/day may ↑ bleeding with warfarin (INR should not exceed 4).” 6. Problem type: Dosage calculation Medication: Acetaminophen @ hospital At 0800, Mr. Larsen reports a moderate pain level of 5, and so you administer oxycodone 5 mg / acetaminophen 325 mg, 1 tab, by mouth. At 1200, Mr. Larsen reports mild pain rated 3, so you administer acetaminophen 325 mg, 2 tabs, by mouth. At this point, how much acetaminophen has Mr. Larsen taken? HINT Determine how many mg of acetaminophen were given at 0800 and 1200, and add the amounts to determine the total mg. SAMPLE SOLUTION 1. Determine how many mg of acetaminophen Mr. Larsen has taken each time. Mg given at 0800: 1 tab oxycodone 5 mg/ acetaminophen 325 mg = 325 mg Mg given at 1200: 2 tab acetaminophen 325 mg = 650 mg 2. Add the two amounts together. 325 mg + 650 mg = 975 mg ANSWER Number: 975 Units: mg 7. Problem type: Dosage calculation Medication: Enoxaparin @ hospital PROBLEM In Mr. Larsen’s orders, the enoxaparin is prescribed for prophylaxis of DVT following knee replacement surgery, and he is ordered 30 mg by subcutaneous injection every 12 hours. Suppose the pharmacy stocks multi¬use vials of 300 mg/3 mL enoxaparin. How much will you need to draw up to administer a 30 mg dose? HINT You can use the equation below, where X is the number of mL that should be administered. D (ordered dose) x 1 = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 30 mg H (dose on hand) = 300 mg / 3 mL 2. Remember that: 1 = 3 mL 300 mg / 3 mL 300 mg 3. Plug into the equation and solve. 30 mg x 3 mL = 0.3 mL 300 mg ANSWER Number: 0.3 Units: mL 8. Problem type: Unit conversion + Weight¬based dosage Medication: Enoxaparin @ hospital For patients with unstable angina, a potential treatment is enoxaparin administered by subcutaneous injection 1 mg/kg every 12 hours. Suppose Mr. Larsen were being treated for unstable angina. If Mr. Larsen weighs 227 lbs, how much enoxaparin should be administered? Round your answer to the nearest whole number. HINT Convert pounds to kilograms, and multiply the weight by the dosage. SAMPLE SOLUTION 1. Convert pounds (lbs) to kilograms (kg). 227 lbs x 1 kg = 103.18 kg 2.20 lb 2. Multiply dosage by the number of kilograms. 1 mg x 103.18 kg = 103.18 mg, rounded to 103 mg kg ANSWER Number: 103 Units: mg 9. Problem type: Unit conversion + Weight¬based dosage ¬ Hypothetical Medication: Enoxaparin @ hospital PROBLEM For patients with unstable angina, a potential treatment is enoxaparin administered by subcutaneous injection 1 mg/kg every 12 hours. Suppose Mr. Larsen were being treated for unstable angina. If Mr. Larsen weighed 180 lbs, how much enoxaparin should be administered? Round your answer to the nearest whole number. HINT Convert pounds to kilograms, and multiply the weight by the dosage. SAMPLE SOLUTION 1. Convert pounds (lbs) to kilograms (kg). 180 lbs x 1 kg = 81.81 kg 2.20 lb 2. Multiply dosage by the number of kilograms. 1 mg x 81.81 kg = 81.81 mg, rounded to 82 kg ANSWER Number: 82 Units: mg 10. Problem type: Unit conversion + Weight¬based dosage ¬ Hypothetical Medication: Enoxaparin @ hospital PROBLEM For patients with deep vein thrombosis or pulmonary embolism, a potential treatment is enoxaparin administered 1.5 mg/kg once daily by subcutaneous injection. Suppose Mr. Larsen were being treated for a pulmonary embolism, and weighed 227 lbs. How much enoxaparin should he be administered each day? Round your answer to the nearest whole number. HINT Convert pounds to kilograms, and multiply the weight by the dosage. SAMPLE SOLUTION 1. Convert pounds (lbs) to kilograms (kg). 227 lbs x 1 kg = 103.18 kg 2.20 lb 2. Multiply dosage by the number of kilograms. 1.5 mg x 103.18 kg = 154.77 mg, rounded to 155 mg kg ANSWER Number: 155 Units: mg Citation: DDG. “Treatment of DVT/PE (inpatient)¬¬¬1.5 mg/kg once daily.” 11. Problem type: Total daily dose calculation Medication: Oxycodone @ hospital PROBLEM For moderate pain, Mr. Larsen is able to take oxycodone 5 mg/acetaminophen 325 mg, 1 tab, every 4 hrs. Suppose he takes all available doses in 24 hours. How many mg of oxycodone will he have ingested? HINT Start by figuring out how many doses Mr. Larsen would take in a single day. SAMPLE SOLUTION 1. Determine how many tablets Mr. Larsen would take in 24 hours. 24 hours x 1 dose = 6 doses 4 hours 2. Multiply the dosage of oxycodone by the number of tablets. 6 tablets x 5 mg = 30 mg ANSWER Number: 30 Units: mg 12. Problem type: Total daily dose calculation Medication: Oxycodone @ hospital PROBLEM Suppose Mr. Larsen is in severe pain, and the prescriber’s order allows oxycodone 5 mg/acetaminophen 325 mg, 2 tabs, every 4 hrs. He takes all available doses in 24 hours. How many mg of oxycodone will he have ingested? HINT Start by figuring out how many doses Mr. Larsen would take in a single day, and multiply by the number of tablets. SAMPLE SOLUTION 1. Determine how many doses Mr. Larsen would take in 24 hours. 24 hours x 1 dose = 6 doses 4 hours 2. Multiply the dosage by the number of tablets per dose. 6 doses x 2 tablets = 12 tablets 1 dose 3. Multiply the dosage of oxycodone by the number of tablets. 12 tablets x 5 mg = 60 mg 1 tablet ANSWER Number: 60 Units: mg 13. Problem type: Dosage calculation + Stock on hand Medication: Warfarin @ hospital PROBLEM Mr. Larsen is ordered 2 mg of warfarin. The pharmacy only stocks 1 mg tablets. How many tablets of warfarin should be administered to him? HINT You can use the equation below, where X is the number of tablets that should be administered. D (ordered dose) x Quantity = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 2 mg H (dose on hand) = 1 mg Q (quantity) = 1 tablet 2. Plug into the equation and solve. D (2 mg) x 1 tablet = X H (1 mg) X = 2 tablets ANSWER Number: 2 Units: tablets 14. Problem type: Dosage Calculation + Unit conversion ¬ Hypothetical Docusate sodium @ hospital PROBLEM Mr. Larsen reports constipation. The attending physician prescribes docusate sodium syrup 100 mg PO BID. The concentration is 50 mg / 5 mL. How many mL of docusate sodium syrup should you administer to Mr. Larsen? HINT You can use the equation below, where X is the number of mL that should be administered. D (ordered dose) x 1 = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 100 mg H (dose on hand) = 50 mg/5 mL 2. Remember that: 1 = 5 mL 50 mg / 5mL 50 mg 3. Plug into the equation and solve. 100 mg x 5 mL = 10 mL 50 mg ANSWER Number: 10 Units: mL 15. Problem type: Dosage calculation ¬ Hypothetical Medication: Acetaminophen @ home PROBLEM Mr. Larsen returns home, and starts to come down with a cough. He would like to take Mucinex Cold & Flu syrup, which contains acetaminophen 650 mg / guaifenesin 400 mg / phenylephrine HCl 10 mg per 20 mL dose. Assume that Mr. Larsen takes two 20 mL doses of Mucinex per day. How many mg of acetaminophen will he have ingested from the Mucinex? HINT Multiply the dosage of acetaminophen by the number of doses taken. SAMPLE SOLUTION 1. Multiply the dosage of acetaminophen by the number of doses taken. 650 mg x 2 doses taken = 1300 mg 1 dose ANSWER Number: 1300 Units: mg 16. Problem type: Dosage calculation ¬ Hypothetical Medication: Acetaminophen @ home PROBLEM Suppose Mr. Larsen has taken two 20 mL doses of Mucinex Cold & Flu, which contains a total of 1300 mg of acetaminophen. He would like to take an additional acetaminophen for pain. He has extra strength acetaminophen tablets, 500 mg each. How many tablets of acetaminophen can he take without exceeding 2 g/day? Assume he will only take whole tablets. HINT Calculate how many mg of acetaminophen Mr. Larsen has left to take, and compare that to the maximum allowed value. SAMPLE SOLUTION 1. Determine how many more available mg of acetaminophen Mr. Larsen could take. Amount allowed ¬ Amount taken 2000 mg ¬ 1300 mg = 700 mg 2. Determine how many 500 mg tablets Mr. Larsen can take. 1 tablet = 500 mg 2 tablets = 1000 mg Because 1000 mg is already greater than 700 mg, Mr. Larsen can only take 1 tablet. ANSWER Number: 1 Unit: tablet Citation: Amount of acet. In Mucinex Cold & Flu. 17. Problem type: Dosage calculation + Unit conversion Medication: Acetaminophen @ home PROBLEM Mr. Larsen’s home medication list includes acetaminophen, PO, as needed. He has extra strength acetaminophen tablets at home, which are 500 mg per tablet. He is not to exceed 2 g/day. How many total tablets of acetaminophen can he take each day? HINT There are 1000 mg in one gram. SAMPLE SOLUTION 1. Determine how many milligrams are in 2 grams. 2 g x 1000 mg = 2000 mg 1 g 2. Determine how many 500 mg tablets go into 2000 mg. 2000 mg x 1 tablet = 4 tablets 500 mg ANSWER Number: 4 Units: tablets 18. Problem type: Dosage calculation ¬ Hypothetical Medication: Atorvastatin @ home PROBLEM Suppose the attending physician would like to increase Mr. Larsen’s dose of atorvastatin to 40 mg. The pharmacy stocks 10 mg tablets. How many 10 mg tablets of atorvastatin should he be administered? HINT You can use the equation below, where X is the number of tablets that should be administered. D (ordered dose) x Quantity = X H (dose on hand) SAMPLE SOLUTION 1. Determine what information you have. D (ordered dose) = 40 mg H (dose on hand) = 10 mg Q (quantity) = 1 tablet 2. Plug into the equation and solve. D (40 mg) x 1 tablet = X H (10 mg) X = 4 tablets ANSWER Number: 4 Units: tablets
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