MATH 102 WEEK 02 SESSION 02 AGENDA SU 09 Professor Luke Papademas papademas@aol.com ● ● ● ● Welcome to MATH 102 Medical Mathematics Meet: Mondays - Thursdays 6 PM Room 2109 Meet: Wednesdays 6 PM Room 1836 ( Professor James ) Sometimes in the PC Lab Room ( Wednesday ) Avoir Du Pois Extra Credit ( consider cereal boxes and balance weights ) Online Web site: http://www.papademas.net/occ/MATH102 Quiz 2 tomorrow Wednesday ( Midterm Quiz ) Covers up to Chapter 6 Tomorrow – a sample quiz will be available today Lab Projects Tomorrow ( MS Excel – calculations, MS Internet Explorer – interactive Web applications ) Review Chapter 6 ( Calculation of Oral Medication Solids and Liquids ) Cover Chapter 7 ( Liquids for Injection ) Review Chapter 8 ( Calculations of Basic IV Drip Rates ) Graded work tonight / tomorrow ( webcourses@aol.com ) Thursday’s Deliverables include: Homework 4 and 5 Monday’s Deliverables include: Homework 6 and 7, possibly 8 ● ● ● ● ● Chapter 6 Review ( Calculation of Oral Medication Solids and Liquids ) Example Page 106 ( Lanoxin ) Three Methods Formula Method Proportions ( Ratios ) Proportions ( Fractions ) Order: Supply: Lanoxin 0.125 mg po every – day ( qd but deprecated ) 250 mcg D ( desired dose or order ) = H ( on hand or have ) = S ( supply ) = x ( unknown amount or amount of drug to give ) S __ H = x __ D Since the order is for mg, convert 250 mcg to mg 250 mcg / 1000 = 0.250 mg Proportions with Fractions Method 1 tablet __ 0.25 mg = x __ 0.125 mg Or 1 tablet _____ 0.25 mg * 0.125 mg = x 1 / 2 tablet = x Proportions with Ratios Method S:H::x:D 1 tablets : 0.250 mg : : x : 0.125 mg Equate: Means = Extremes H*x =S*D x = S * D / H = ( 1 tablet ) * 0.125 mg / 0.250 mg x = 1 / 2 tablet Formula Method x = ( D / H ) * S = 0.125 mg / 0.250 mg * ( 1 tablet ) x = 1 / 2 tablet Example Page 106 ( Amoxil ) Amoxicillin Tablets D ( desired dose or order ) = 1 g by mouth every 6 hours H ( on hand or have ) = 500 mg S ( supply ) = 1 tablet x ( unknown amount or amount of drug to give ) x = ( D / H ) * S = 1000 mg / 500 mg * ( 1 tablet ) x = 2 tablets Page 111 D ( desired dose or order ) = Lopressor 25 mg PO bid H ( on hand or have ) = 50 mg S ( supply ) = 1 tablet x ( unknown amount or amount of drug to give ) x = ( D / H ) * S = 25 mg / 50 mg * ( 1 tablet ) x = 1 / 2 tablets Self Test 1 1. Order: Decadron 1.5 mg po bid Supply: tablets labeled 0.75mg D=1.5mg H=0.75mg S=1 tablet X=unknown amount x = ( D / H ) * S = 1.5 mg / 0.75 mg * ( 1 tablet ) x = 2 tablets 14. Order: Capares 400mcg po every day Supply: tablets labeled 0.2mg D=0.4mg H=0.2mg S=1 tablets X= unknown amount x = ( D / H ) * S = 0.4 mg / 0.2 mg * ( 1 tablet ) x = 2 tablets Oral Liquids – 114 Order: Zithromax oral susp 400mg po every day x 4 days Supply: Read the label D=400mg H=200mg S=5mL (5cc) X= unknown amount x = ( D / H ) * S = 400 mg / 200 mg * ( 5mL ) x = 10mL S:H::x:D 5mL : 200 mg : : x : 400 mg 200mgx=2000mg-mL X=2000mL/200 X=10mL 2/3tbsp 2tsp Self-Test 2 –Page 119 15. Order: Phenobarbital 100mg po hs Supply: elixir labeled 20mg/5mL D=100mg H=20mg S=5mL X=unknown amount S:H::x:D 5mL : 20mg : : x : 100mg 20mgx=500mg-mL X=500mL/20 X=25mL (5/6oz) Self-Test 3 – page 120 Order (D) 9. 0.01g (10mg) Supply (S) (scored tablets) 20mg Answer ½ tablet 10. 11. 12. 13. 14. 650mg 500mg gr i (1grain=60mg) 50mg 4mg 325mg 250mg 60mg 0.1g (100mg) 2mg 2 tablets 2 tablets 1 tablet ½ tablet 2 tablets Supply (S) 10mg/5mL 250mg/5mL 10mg/4mL Answer 10mL 10mL 6mL Self-Test 4 – page 121 1. 3. 9. Order (D) 20mg 0.5g (500mg) 15mg Page 123 Proficiency Test 1. Order: KCL elixir 20 mEq po bid Supply: liquid labeled 30 mEq / 15 mL Answer: ( 2 / 3 ) * 15 mL Mark the cup Chapter 7 Review ( Liquids for Injection ) Page 141 Example Order: Stelazine ( trifluoperazine ) 1.5 mg IM q6h prn Supply: Read the Label The Label Says 2 mg / mL ( 10 mL multi-dose vial ) D= 1.5 mg H= 2 mg S= 1 mL ( use a 1 mL syringe ) Page 142 X=unknown amount x = ( D / H ) * S = 1.5 mg / 2 mg * ( 1 mL ) x = 0.75 mL ( use a 1 mL syringe – marked between 0.74 and 0.76 the markings are in 2 / 10 ) Page 142 Example Order: Supply: Demerol ( meperidine HCL ) 75 mg IM q4h prn Read the Label The Label Says 50 mg / mL ( 10 Carpuject sterile cartridge units each are 1 mL ) X = 1.5 cartridges Page 146 Example Order: Supply: X= Phenergan ( promethazine ) 12.5 mg IV q4 – 6h prn Read the Label The label says 25 mg / mL ( single – dose ) For IV / IM use 1 / 2 of the single dose x = ( D / H ) * S = 12.5 mg / 25 mg * ( 1 mL ) Page 147 Self – Test 1 ( Calculation of Liquids for Injection ) 3. Order: Vitamin B12 ( cyanocobolamin ) 1 mg IM every day Supply: vial of liquid labeled 1000 mcg / mL x = ( 1 mg / 1 mg ) * 1 mL = 1 mL Special Types of Problems Page 149 Example: Adrenalin 1 : 1000 Ratios are always interpreted in the metric system as grams per milliliter. Hence 1 : 1000 means 1 g in 1000 mL Self – Test 2 Ratios Ratio ? g per ? mL ? g = ? mL ? g / ? mL 1 : 20 1 g per 20 mL 1 g = 20 mL 1 g / 20 mL 2 : 25 2 g per 25 mL 2 g = 25 mL 2 g / 25 mL Example Page 150 Order: Epinephrine 1 mg subcutaneous stat Supply: ampule labeled 1 : 1000 Equivalent: 1 : 1000 means 1 g per 1000 mL x = ( 1 mg / 1000 mg ) * 1000 mL = 1 mL Sample Quiz 2 Measurements Given the following equivalents for liquids (metric, household and apothecary) 1 tsp = 5 mL 1 tbsp =15 mL = ½ fluid oz = 4 drams 1 oz = 30 mL = 2 tbsp = 1 fluid oz = 8 drams 1 pt = 500 mL 1 qt = 1000 mL 4 qt = 1 gal 2.2 lb = 1 kg Given that Liquid equivalents in the apothecary system are 1 m = 1 gtt 1 dr = 4 mL 8 dr = 1 oz ℥ i = 32 mL Given the following equivalents for solids 15 grains = 1000 mg 1 grain = 60 mg (or 1 grain = 65 mg) (1) 15,000 mg Convert 15 g to mg. (2) 1.7 gr Convert 100 mg to gr. 1 gr / 60 mg = x / 100 mg (3) 6 gr Convert gr vi to gr. (4) 20 mL Convert 4 tsp to mL. (5) 5m Convert 5gtt to m. (6) 0.31 ℥ Convert 10 mL to ℥. (7) 5 x 10 6 mcg What is the mcg equivalent of 5 g? State the answer in scientific notation. (8) 48 L 12 gal = ? L (9) False True or False? A vial is not normally used for administration of powders. (10) True True or False? It is not acceptable to touch mucous membranes with a medicine dropper. 10 mL / 32 mL 1 gal = 4 L (11) Read the volume of the liquid contained in this graduated cylinder. The volume markings are in mL. 6.2 mL (12) What are the units placed on this syringe? Ounces and cubic centimeters (14) On the 10-mL syringe below, use arrows to mark the following doses: (a) 2.0 mL (b) 4.0 mL (c) 4.5 mL (d) 8.5 mL (e) 1.31 mL Mix and Match Match the numbered problem with the corresponding letter . 1) ________ Gel 2) ________ Insulin Syringe 3) ________ Tincture 4) ________ Magma 5) ________ Precision Syringe 6) ________ Elixir 7) ________ short needle 8) ________ 22 gauge 9) ________ 14 gauge 10) ________ Long needle Prescription Preparations, Routes of Administration a) Order: Erythromycin susp 0.50 g po qid Supply: liquid labeled 125 mg/mL D= H= S=