A 55-year-old male patient weighs 74 kg and has several comorbidities. The doctor wishes to estimate his creatinine clearance before starting venlafaxine for his depression. His serum creatinine is 170 micromole/L. Calculate his creatinine clearance (in L/hr) using the Cockroft-Gault equation. Give your answer to two decimal places.

A 34-year-old female patient, diagnosed with stage IV breast cancer, is to be given meptazinol 75 mg intramuscularly every 2 hours for acute pain. The nurse will administer the dose using U100 (100 units) insulin 1 mL syringes. How many units should be administered to the patient for a single dose? Give your answer to the nearest whole number.

A 70-year-old female weighing 58 kg has been on phenytoin.

Assuming:

• Vmax = 6 (6-8 mg/kg/day)
• Km = 6 (5.4-6.8 mg/L)
• CL = 20 L/day [calculated initially for this patient with the given dose]

The doctor would like to know if she is in the therapeutic range using the equation for Michaelis–Menten model.

where Vmax is the maximum metabolic capacity (mg/day) and Km is the plasma concentration at which the rate of metabolism is half the maximum (mg/L). Calculate the serum concentration (in microgram/mL) of phenytoin in this patient using the given pharmacokinetic parameters. Give your answer to one decimal place.

A GP practice-based pharmacist is preparing a presentation on the cost impact of steroid therapy in the practice. Prescribing data indicates that 65 patients are currently on prednisolone 10 mg tablets (one tablet daily). If these patients are switched to two 5 mg tablets of prednisolone once daily, what would be the cost reduction for the practice in one year (365 days)? Give your answer to the nearest whole number. 

DT price of prednisolone 5mg tablet (28 tablet pack is £1.00)

DT price of prednisolone 10mg tablet (28 tablet pack is £9.66)

 A 24-year-old patient took three instead of one 300 mg tablet of theophylline this morning at 7 AM because of the worsening of his asthma symptoms. He realises that the GP asked him to be extra careful with the dosing of this medicine. He rushes to the nearest A&E to see any physician as the surgery is close at this time. The physician orders serum level of theophylline which is found to be 48 mg/L. At what time the levels are likely to be in the therapeutic range for this patient? Give your answer to the nearest whole number.

Theophylline therapeutic range: 10-15 mg/L

Theophylline half-life: 8 hours

You have received an order in the hospital to prepare a 1000 mL infusion containing 40 mEq of KCl in dextrose 5% and 0.9% sodium chloride. The infusion is to run at the rate of 15 drops/min for 12 hours. The IV set provides 20 drops/mL. How many mmoL of KCl this patient will receive? Give your answer to the nearest whole number.

[Molecular weight of KCL: 74.5]

A 54-year-old woman has been started on warfarin for deep venous thrombosis. She has been prescribed the following regimen:

Warfarin 5 mg for the first three days

Then warfarin 4 mg and 3 mg on the alternative days

You have warfarin 1 mg tablets and warfarin 3 mg tablets in stock. Using 3 mg tablets wherever possible, how many 1 mg and 3 mg tablets you would dispense for 4 weeks, provided her INR remains constant? Give your answers to the nearest whole numbers.

A 58-year-old patient, weighing 65 kg, is due to receive 2 mEq/kg of sodium chloride. What volume (in millilitres) of 0.9% w/v sodium chloride must be administered? Give your answer to the nearest whole number.

[Molecular weight of sodium chloride: 58.5]

The doctor wants you to prepare 2.5 L of ferrous sulfate 2% w/v oral solution. How many grams of ascorbic acid would be required if you are to prepare this order using the above formula? Give your answer to the nearest whole number.

Due to unavailability, the dermatologist wishes to switch from DIPROSONE cream to BETNOVATE cream for a 24-year-old patient with eczema. She asks you how many grams of BETNOVATE 0.1% cream will be equivalent to 30 g of DIPROSONE cream. Give your answer to the nearest whole number.

[Molecular weight of betamethasone dipropionate: 504.576

Molecular weight betamethasone valerate: 476.566]

A 74-year-old woman (weight: 68 kg) has been admitted to the hospital for bacterial meningitis. She is to be started on IV infusion of meropenem as an empirical therapy. Her serum creatinine is found to be 140 micromole/L. Based on the Cockroft-Gault equation and using the resource provided, calculate how many vials of meropenem 1000 mg will be required for 2 days. Give your answer to the nearest whole number.

How many 1 g sucralfate tablets should be used in preparing this order? Give your answer to the nearest whole number.

You have received an order to prepare 40 clotrimazole pessaries using 2g mold. Each pessary must contain 100 mg clotrimazole. The displacement value of clotrimazole is 0.5. To allow for the wastage, it is recommended that you prepare an additional 20%. How many grams of the base would be required to prepare this order? Give your answer to one decimal place.

A 30-year-old has been prescribed Sodium Chloride Compound Mouthwash BP for oral mucositis 20 mL to be used for gargling every 4 hours for three days. The order needs to be prepared using the formula in the given table.

You realise that you have run out of double-strength chloroform water. How much chloroform concentrate (in millilitres) you would need to dispense this order? Give your answer to the nearest whole number.

A 2-year-old requires 150 mcg of adrenaline intramuscularly for anaphylaxis. What volume (in millilitres) of 1 in 1000 solution of adrenaline should be given? Give your answer to two decimal places.

You are required to prepare a stock solution of 1.5 L potassium permanganate to supply to the patient, such that when 50 mL of this stock solution is diluted with water to 3 L, the resulting solution is 1 in 1000. Calculate the percentage strength w/v of the stock solution and the dilution factor. Give your answers to the nearest whole numbers.