Question

1. Use the prescription below to answer this question:

Amoxicillin pharmacy to dose

Dx: acute otitis media

Patient: 12month old female

Wt: 20lb 8 oz

Dosing per Lexicomp:

“Otitis media, acute (AOM): Infants ≥2 months and Children: Oral: 80 to 90 mg/kg/day in divided doses every 12 hours; variable duration of therapy, if <2 years of age or severe symptoms (any age): 10-day course; if 2 to 5 years of age with mild to moderate symptoms: 7-day course; ≥6 years of age with mild to moderate symptoms: 5- to the 7-day course; some experts recommend initiating with 90 mg/kg/day (AAP [Lieberthal 2013]; Red Book [AAP 2015]); a maximum dose is not provided in the Guidelines for The Diagnosis and Management of Acute Otitis Media (AAP [Lieberthal 2013]); however, some experts suggest a maximum daily dose of 4,000 mg/day for high-dose amoxicillin therapy (Bradley 2015).”

1. What dose (in mg), frequency, and duration would you recommend for this patient? Round to the nearest hundreth

2. You have 125mg/5ml in stock. How many mL will the patient need for the duration of therapy? Round to the nearest whole mL

3. What volume (mL) should the patient take for each dose? Round to the nearest whole mL

4. You have the following reconstitution containers (80mL, 100mL, 125mL). Which one would you dispense for this prescription?

5. What amount (mL) should the patient discard? Round to the nearest whole mL

6. The patient has a copay of $15. How much is the patient paying per dose?

Please show your work

Answer 1

1. What dose (in mg), frequency, and duration would you recommend for this patient? Round to the nearest hundredth

Duration = 10days

Frequency = BID

Patient weight = 20lb 8 oz = 9.43kg

Dose = Weight * ( 80-90 mg)/frequency

          = 9.43* (80 -90)/2

         = 375 to 425 mg per dose

Consider higher side 425 mg as per dose

2. You have 125mg/5ml in stock. How many mL will the patient need for the duration of therapy? Round to the nearest whole mL

Available stock = 125mg/5ml

Per day requirement = 425mg *2 = 850mg

Per day required ml = (850/125)* (5) = 6.8*5 =34 ml

Tottal requirement for whole duration = 34*10days = 340 ml

3. What volume (mL) should the patient take for each dose? Round to the nearest whole mL

Available stock = 125mg/5ml

Per dose requirnent = 425 mg

Each dose requirement of ml = (425/ 125) * 5 = 17ml

4. You have the following reconstitution containers (80mL, 100mL, 125mL). Which one would you dispense for this prescription?

125 ml

5. What amount (mL) should the patient discard? Round to the nearest whole mL

125 * 4 – 425 = 75 ml