# Pharmacy Calculations Assignment

## Pharmacy Calculations Assignment

Pharmacy Calculations Assignment

Pharmacy calculations are very important for prescribing, especially in regards to renal function and pediatric dosing. This assignment will focus on calculating renal function and medication doses for pediatric patients. Review the information below and then follow the subsequent instructions.

Upon successful completion of the course material, you will be able to:

Successfully calculate dosing for renal functions
Background Information

Renal function

Renal function can be calculated different ways but the most common ways are using the Cockcroft-Gault and CKD-EPI equations (see below). If adjustments to dosing are required due to decreased renal function, it is important to know which equation should be used. This can be found in a drug reference or the package insert for a particular medication. In general, if renal cutoffs are expressed as mL/min the Cockcroft-Gault equation should be used but if renal cutoffs are expressed in mL/min/1.73m2 then the CKD-EPI equation should be used. Different equations are necessary to calculate renal function in the pediatric population.

The Cockcroft-Gault equation is as follows:

CrCl = [(140-age) (ideal body weight)]/[(72) (SCr)] x 0.85 (if female)
age is expressed in years
weight is expressed in kg [ideal body weight (IBW) should be used except for obese patients, in which case adjusted body weight is typically used]
SCr is serum creatinine expressed in mg/dL
IBW (male) = 50kg + 2.3 kg for each inch of height over 5 feet
IBW (female) = 45.5kg + 2.3 kg for each inch of height over 5 feet
Adjusted body weight = IBW + [0.4 x (actual body weight – IBW)]
The CKD-EPI equation is as follows:

eGFR = 141 x min(SCr/κ, 1)α x max(SCr /κ, 1)-1.209 x 0.993Age x 1.018 [if female] x 1.159 [if Black]
eGFR (estimated glomerular filtration rate) = mL/min/1.73 m2
SCr is serum creatinine expressed in mg/dL
κ = 0.7 (females) or 0.9 (males)
α = -0.329 (females) or -0.411 (males)
min = indicates the minimum of SCr/κ or 1
max = indicates the maximum of SCr/κ or 1
age = years
Pediatric Dosing

In general, medication dosing for pediatric patients is based on weight. This makes it particularly important to be able to calculate doses appropriately. The most basic calculation is dose (ie. mg/kg) times weight (in kg).

Example

Cefdinir (Omnicef®) for acute otitis media is 14 mg/kg/day in 1-2 divided doses
What would the recommended dose be for a 22 lb patient?
First, lbs must be converted to kg.
22 lb x (1 kg/2.2 lb) = 10 kg
Now, the dose can be calculated.
14 mg/kg x 10 kg = 140 mg
Based on the dosing recommendation above, this could be given 2 different ways:
140 mg once daily
70 mg two times daily
For liquids or suspensions, medication doses are often given as the volume to be given to the patient. One must be aware of the available concentrations for a particular medication.

Example

Cefdinir (Omnicef®) is available in the following concentrations:
125 mg/5 mL
250 mg/5 mL
Using the example above, how many mL would be needed for 140 mg daily?
[140 mg / 125 mg] x 5 mL = 5.6 mL
[140 mg / 250 mg] x 5 mL = 2.8 mL
Often, we have to round to the nearest 0.5 mL to make it easier to administer using an oral syringe. Rounding the first option to 5.5 mL would give the patient 137.5 mg (5.5 mL x 125 mg/ 5 mL)
Instructions

Print out the Calculations Quiz.
Complete each question by hand and show your work.
Scan the completed quiz and submit via the Assignment.
This assignment is worth 50 Points

Access the Assignment submission page

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Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
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I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
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Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
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Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.