a) A child weighing 65 pounds required a dose of 5 mg/kg of azithromycin. Given that a 5 ml dose is to be given, what volume of water must be added when the powder is reconstituted? Instruction on the label indicates that dilution to 22.5ml (be adding 12 mL) gives 200 mg azithromycin per 5 mL. (4 marks)

b) You are asked to prepare 30 mL of an eye drop with the following formula:

Atropine sulphate 0.5% (w/v)

Boric acid qs

Purified water qs

Make isotonic solution 30 mL

How many drops of 5% boric acid should be used in compounding the above eye drops?

(Sodium chloride equivalent of atropine sulphate = 0.13, boric acid = 0.52)

(4 marks)

c) A hospital pharmacist is requested to use three lots of ointment containing 30%, 20%, and 5% ichthammol, respectively, to prepare 500 g of an ointment containing 10% ichthammol. How many grams of each lot of ichthammol ointment should be used? (2 marks)

d) The recommended treatment dose of alteplase ("tPA") for acute ischemic stroke is 0.9 mg/kg (not to exceed 90 mg total treatment dose) infused over 60 minutes with 10% of the total treatment dose administered as an initial bolus over 1 minute.

Patient presents with acute ischemic stroke and the physician ordered standard dose of tPA. Patient weighs 102 kg.

i) The reconstituted solution contains 100 mg tPA in 100 mL. How much volume do you discard from the bottle?

ii) From the remaining infusion solution, you first draw up the initial bolus dose. What is the dose of the initial bolus dose?

iii) The remaining solution is for infusion. What is the appropriate infusion rate, in mL/h?

(3 marks)

e) Patient presents with hypokalaemia so potassium supplementation is needed. The prescription is potassium 20 mEq IV over 2 hours.

You have CONCENTRATED potassium chloride ("KCl") 14.9% (w/v) solution (10 mL/vial) for injection. Molecular weight of KCl is 74.5 g/mol.

i) What is the concentration of potassium ion in CONCENTRATED KCl solution, in MEq/mL?

ii) You prepare TWO 100ml bags for infusion, and each to be infused over one hour. Each dose is diluted in 100 mL of sterile water for injection ("SWFI"). For each dose, how much CONCENTRATED KCl solution is required, in mL?

iii) What is the approximate osmolarity of the solution, in mOsmol/L?

(3 marks)

f) Patient requires dopamine continuous infusion for shock resuscitation. Patient weighs 140.8 pounds. You pharmacy stocks dopamine 400 mg in D5W 250 mL premixed bags.

i) Physician orders dopamine to be infused at a rate of 5 mcg/kg/min. What is the infusion rate, in mL/h?

ii) What is the expected steady state plasma dopamine concentration, if the clearance is 50 mL/kg/min?

(2 marks)

g) A lady presents a prescription for amoxicillin 80 mg/kg/day divided Q12H for 10 days, for treatment of acute otitis media. The drug is available in 250 mg/5ml oral suspension.

i) The prescription is for her 12 kg boy. Your pharmacy has 5 mL, 10 mL and 20 mL oral syringes, all of them have calibration marks of 0.5mL. What is an appropriate volume to be taken for each dose?

ii) What is the total volume to be dispensed?

(2 marks)