This patient is receiving a medication for treatment of cardiac arrhythmia. An IV loading dose results...

This patient is receiving a medication for treatment of cardiac arrhythmia. An IV loading dose results in a peak serum concentration of 6.0 μg/mL. The therapeutic range for this medication is 4-8 μg/mL, and its half-life is 4 hours.

Four hours after the initial loading dose, another equivalent dose was given as a bolus. This resulted in a peak serum concentration of 7.5 μg/mL.

Questions:

1. Does the serum concentration after the second dose seem appropriate? If not, what would be the predicted serum concentration at this time?

2. What factors would influence the rate of elimination of this drug?

Expert Solution

Answer 1:

No, the serum concentration after the second dose seems inappropriate because the half life is about 4 hours and after 4 hours the quantity reduced from 6 μg/mL to 3 μg/mL and again if 6 μg/mL is again added after 4 hour of initial dose then the predicted serum concentration should be near about 8.7-9 μg/mL.

Answer 2:

The rate of elimination of this drug is affected by:

a) N-acetyl transferase conjugate with procainamide and help in renal excretion.

b) plasma concentration of procainamide and NAPA.

c) plasma concentration of cimetidine.

Nightingale answered 2 years ago

Phenytoin comes from the pharmacy as an IV solution of 500mg/100ml. A loading dose of 600...

Phenytoin comes from the pharmacy as an IV solution of 500mg/100ml. A loading dose of 600 mg has been ordered. How many milliliters must be given? Phenytoin (Dilantin) comes from the pharmacy as an IV solution of 1000mg/250 ml. A loading dose of 800 mg has been ordered at 40 mg/min. How many minutes will it take to deliver the drug Phenytoin (Dilantin) comes from the pharmacy as an IV solution of 500mg/100ml. A loading dose of 900 mg has...

The dose of ofatumumab (Arzerra) for a patient is 300 mg. In preparing an IV infusion,...

The dose of ofatumumab (Arzerra) for a patient is 300 mg. In preparing an IV infusion, a pharmacist draws the calculated volume of drug from a 50-mL vial containing 1 g of the drug. This quantity is then added to a 1-L bag of normal saline. The infusion is programmed to flow at a rate of drug of 3.6 mg per hour. (a) What volume (in mL) of the drug from the vial is needed for the patient's dose? (b)...

A 72 kg patient is started on a drug with an IV bolus dose of 180...

A 72 kg patient is started on a drug with an IV bolus dose of 180 mg. After 24 hours a dose of 80 mg is given, and after another 8 hours a dose of 120 mg is given. Using the principle of superposition determine the concentration of the drug 3 hours after the second dose and 2 hours after the third dose. The drug has a half-life of 9.2 hours and a volume of distribution of 0.105 L/kg. Elimination...

A client who weighs 175 pounds is receiving an IV bolus dose of Heparin 80 units/kg....

A client who weighs 175 pounds is receiving an IV bolus dose of Heparin 80 units/kg. The Heparin is available in a 2mL vial, labeled 10,000 units/mL. How many mL should the nurse administer? (If rounding, round to the nearest tenth). Please show your work.

A patient is to receive continuous infusion of a medication at a dose of 65 mg/kg/day....

A patient is to receive continuous infusion of a medication at a dose of 65 mg/kg/day. If patient weighs 170 lbs and you have a 2% solution of the drug, what would the infusion rate in drops/min, if tubing used to administer the IV is labeled as 60 drops/ml?

1. Medication order: Loading dose, mix magnesium sulfate 30 g in 1000 mL D5W. Infuse 6...

1. Medication order: Loading dose, mix magnesium sulfate 30 g in 1000 mL D5W. Infuse 6 g over 20 minutes, then maintain 1 g/hr. Maintain primary IV 1000 mL D5W at 60 mL/hr after magnesium sulfate loading dose. Available: Magnesium sulfate 50% in 10 mL vials Calculate the secondary rate for the loading dose. 2. Mix 12 units of oxytocin in 500 mL NS. Start infusion at 18 mL/hr. Increase by 5 mL/hr every 10 minutes until uterine contractions are...

The nurse is caring for a patient who is receiving a new antidysrhythmic medication intravenously. Explain...

The nurse is caring for a patient who is receiving a new antidysrhythmic medication intravenously. Explain the immediate nursing interventions and considerations (explain the rationale).

You are assigned to care for a patient receiving atropine. Prepare a medication card that describes...

You are assigned to care for a patient receiving atropine. Prepare a medication card that describes the therapeutic actions, indications, pharmacokinetics, contraindications, the most common adverse reactions, and the important drug–drug interactions of atropine.

Describe how an advanced practice nurse would alter the medication dose of Bactrim in a patient...

Describe how an advanced practice nurse would alter the medication dose of Bactrim in a patient with chronic kidney disease. Discuss the physiologic rationale for altering the dose and monitoring its effectiveness.

Aminophylline loading dose of 5.6 mg/kg to infuse over 30 minutes for a patient weighing 50...

Aminophylline loading dose of 5.6 mg/kg to infuse over 30 minutes for a patient weighing 50 kg followed by 0.6 mg/kg/hr maintenance dose for COPD. Supply: Aminophylline 500 mg in 500 mL of D5W . How many milliliters per hour will you set the IV pump for the loading dose? How many milliliters per hour will you set the IV pump for the maintenance dose?

Question