PHARMACEUTICS

(CALCULATIONS, COMPOUNDING AND FORMULATIONS, DOSAGE FORMS,

MANUFACTURING, QA)

MCQ 71
SHORT QUESTIONS 80
LONG QUESTIONS(SCENARIOS) 50
TOTAL 201
PART I MCQs ( 71 QUESTIONS)
1. Mrs C has been receiving 40 mg morphine sulphate oral solution every 4 h. Her doctor now
wants to change her to 24-hourly MXL (morphine sulphate modified-release) capsules.
What daily dose of MXL capsules will provide an equivalent dose of morphine for Mrs C?
a) 60 mg every 24 h
b) 90 mg every 24 h
c) 120 mg every 24 h
d) 2 × 120 mg every 24 h
e) 150 mg and 30 mg every 24 h
2. If 1200 mg potassium permanganate is dissolved in 4 L water, what is the percentage
strength of the resulting solution?
a) 0.003%
b) 0.015%
c) 0.03%
d) 0.15%
e) 0.3%
3. The recommended intravenous injection dose of gentamicin for the treatment of
septicaemia for a child aged between 1 month and 12 years is 2.5 mg/kg every 8 h. What
volume of gentamicin 40 mg/mL should be given every 8 h to a 10-year-old girl weighing
30 kg?
a) 2.5 mL
b) 2.225 mL
c) 2.0 mL
d) 1.875 mL
e) 1.7 mL
4. Drug E has been prescribed for a 6-month-old baby with a body surface area of 0.42 m2.
Drug E should be given as a daily dose of 2 mg/m2 in two divided doses. It is formulated as
a syrup with a 500 microgram/mL concentration. Which of the following is an appropriate
single dose ofdrug E syrup for this baby?
a) 0.4 mL
 b) 0.84 mL
c) 1.68 mL
d) 8 mL
e) 40 mL
5. Which of the following amounts of chlorhexidine gluconate is required to make 20 mL of a
stock solution, such that, when the stock solution is diluted 30 times with water, a final
solution of 0.2% w/v chlorhexidine gluconate is produced?
A 0.2 g
B 0.4 g
C 0.8 g
D 1.2 g
E 1.8 g
6. Mrs Japhet is prescribed oxygen at a high flow rate of 4 L/min. How many complete days
of therapy will she have been dispensed if she is dispensed three size F (1360 L) cylinders
of oxygen to use for 6 h/day?
A 1 day
B 2 days
C 3 days
D 4 days
E 5 days
7. Which of the following is the amount of erythromycin lactobionate in a vial containing the
equivalent of 500 mg erythromycin for reconstitution? (RMM: erythromycin, C37H67NO13 =
733.9 g/mol; erythromycin lactobionate, C37H67NO13.C12H22O12 = 1092.2 g/mol.)
A 604.12 mg
B 500.00 mg
C 1.49 g
D 7.44 g
E 744.11 mg
8. The half-life for the first-order decomposition of an experimental antibiotic in aqueous
solution is found to be 14 days at 20°C. If the original concentration of the drug in solution
 was 125 mg/5 mL, which of the following is the concentration remaining after 42 days’
storage at 20°C.
A 30.450 mg/5 mL
B 18.450 mg/5 mL
C 31.250 mg/5 mL
D 62.500 mg/5 mL
E 15.625 mg/5 mL
9. A vial containing 200 mg hydrocortisone sodium succinate powder for injection is to be
reconstituted to produce 4 mL of injection. Which of the following is the amount of Water
for Injections, BP that should be added to the powder? The displacement volume of
hydrocortisone sodium succinate is 0.05 mL/100 mg.
A 2.0 mL
B 2.5 mL
C 3.5 mL
D 3.9 mL
E 4.0 mL
10. Alupent syrup contains 10 mg/5 mL orciprenaline sulphate and Mucodyne oral liquid
contains 125 mg/5 mL carbocisteine. Which of the following are the total daily doses of
orciprenaline sulphate and carbocisteine received by a patient treated with 10 mL of the
mixture below three times daily? Alupent syrup/Mucodyne oral liquid 50/50 mix
A 25 mg orciprenaline sulphate and 250 mg carbocisteine
B 25 mg orciprenaline sulphate and 375 mg carbocisteine
C 30 mg orciprenaline sulphate and 375 mg carbocisteine
D 30 mg orciprenaline sulphate and 250 mg carbocisteine
E 40 mg orciprenaline sulphate and 250 mg carbocisteine
11. Which of the following are the correct amounts of diclofenac sodium and misoprostol
required to prepare 25 tablets according to the formula for an individual tablet given
below?
Diclofenac sodium 50 mg
Misoprostol 200 micrograms
Lactose q.s. (sufficient quantity)
 A 1250 mg diclofenac sodium and 50 mg misoprostol
B 1250 mg diclofenac sodium and 0.5 mg misoprostol
C 250 mg diclofenac sodium and 5 mg misoprostol
D 125 mg diclofenac sodium and 0.5 mg misoprostol
E 1250 mg diclofenac sodium and 5 mg misoprostol
12. Which of the following is the amount of 20% w/w benzocaine ointment required to be
added to a suitable diluent ointment to prepare 5 kg of a 2.5% w/w benzocaine ointment?
A 2 kg
B 6.25 g
C 62. 5 g
D 625.0 g
E 2.5 kg
13. Which of the following is the number of furosemide 20 mg tablets required to prepare
sufficient 50 mg/5 mL furosemide oral suspension to last 12 days for an infant taking 25
mg furosemide once daily?
A5
B 10
C 15
D 20
E 25
14. Your sterile manufacturing unit has been asked to supply eye drops with the following
formula:
Dorzolamide hydrochloride 2% w/v
Timolol maleate 0.5% w/v
Which of the following are the correct amounts of the two drugs required to prepare 25
mL?
A 5.000 mg dorzolamide hydrochloride and 0.125 mg timolol maleate
B 500 mg dorzolamide hydrochloride and 12.5 mg timolol maleate
C 125 mg dorzolamide hydrochloride and 500 mg timolol maleate
D 12.5 mg dorzolamide hydrochloride and 500 mg timolol maleate
E 500 mg dorzolamide hydrochloride and 125 mg timolol maleate
15. Which of the following is the correct number of spironolactone 25 mg tablets required to
prepare 200 mL of a paediatric oral suspension containing 5 mg/mL spironolactone?
A 40
B 20
C 30
D 10
E 50
16. Mrs A is currently taking Mucogel suspension at a daily dose of 10 mL after her three
meals and at bedtime. How much magnesium hydroxide will Mrs A have taken after 5 days
of compliant use of Mucogel?(Mucogel contains magnesium hydroxide 195 mg and dried
aluminium hydroxide 220 mg/5 mL.)
A 7.8 mg
B 780 mg
C 3900 mg
D 5.85 g
E 7.8 g
17. A 10-year-old boy (weighing 30 kg) has been prescribed Rimactane150 mg capsules
(rifampicin) for the management of brucellosis at a dose of 10 mg/kg twice daily for 4
weeks. How many of these capsules should be dispensed for this patient to cover the 4
weeks?
A 108 capsules
B 110 capsules
C 112 capsules
D 114 capsules
E 116 capsules
18. Sele, a 5-year-old boy (weight 18 kg) with epilepsy, currently takes Epanutin suspension
(phenytoin 30 mg/5 mL) at a dose of 5 mg/kg twice daily. How many millilitres of
Epanutin suspension will Sele take during the month of October? You can assume that he is
fully compliant and no spillages or medication loss occurs during the month of October.
A 155 mL
B 450 mL
C 465 mL
D 900 mL
E 930 mL
19. A patient weighing 70 kg is prescribed drug C to be given intravenously at a dose of 4
mg/kg per h. Drug C is available as a 10 mg/2 mL intravenous solution. Which of the
following is a suitable flow rate for administering drug C to this patient?
A 1 mL/min
B 2 mL/min
C 14 mL/h
D 28 mL/h
E 56 mL/h
20. Emma, a 10kg, 1-year-old girl, is to be administered drug M as an intravenous (IV)
infusion 2 hours before surgery at a dose of 7.5 mg/kg. Drug M is available as a 5 mg/mL
intravenous infusion and should be administered at a rate of 5 mL/min. How long should
Emma’s IV infusion last?
A 1.5 min
B 3 min
C 15 min
D 150 s
E 300 s
21. Niferex elixir (polysaccharide–iron complex) is to be administered to a 10-day-old baby
boy at a dose of 1 drop (approximately 500 micrograms iron) per 450 g body weight three
times a day. The baby boy weighs 2.7 kg, so which of the following is a suitable dose of
Niferex elixir?

A 1 drop three times daily

B 3 drops three times daily
C 6 drops daily
D 6 drops twice daily
E 6 drops three times daily
22. George has been prescribed Solaraze gel (diclofenac sodium 3% in a sodium hyaluronate
basis) for the management of actinic keratosis. He has to apply the gel twice daily for 60
days using 8 g of the gel daily. Over the course of the 60 days how much diclofenac
sodium will he have applied to his skin?

A 14.4 g
B 28.8 g
C 57.6 g
 D 480 g
E 960 g

23. A patient is to be administered 3 L, 5% glucose over 4 h. The giving set that will be used
for this administration delivers 2 drops/mL. Which of the following is a suitable drop rate
for this administration?

A 62.5 drops/min
B 25 drops/min
C 12.5 drops/min
D 6.25 drops/min
E 1.5 drops/min
24. A patient is to be administered lidocaine hydrochloride as an infusion after an initial bolus
injection. He is to receive the infusion initially at a dose of 4 mg/min for 30 min, then at a
dose of 2 mg/min for 2 h, and then 1 mg/min for another 10 h. During this infusion the
patient will have received how much lidocaine hydrochloride?
A 250 mg
B 300 mg
C 370 mg
D 840 mg
E 960 mg
25. While in cardiac arrest a patient is administered a 10 mL dose adrenaline (as acid tartrate) 1
in 10 000. What amount of adrenaline (as acid tartrate) has this patient been given?
A 0.0001 kg
B 0.1 g
C 1 mg
D 10 mg
E 10 000 micrograms
26. A patient is administered potassium chloride as a slow infusion over 150 min at a rate of
0.1 mmol potassium/kg per h. If 15 mmol potassium is delivered during the infusion what
weight is the patient?
A 50 kg
B 55 kg
C 60 kg
D 65 kg
E 75 kg
27. The recommended oral dose for pericyazine for children aged between 1 and 12 years is
initially 500 micrograms daily for 10-kg child, increased by 1 mg for each additional 5 kg
to maximum total daily dose of 10 mg. Which of the following initial doses is within these
guidelines?
A 0.25 mL pericyazine 10 mg/5 mL syrup daily for a 10 month old weighing 10 kg
B 0.5 mL pericyazine 10 mg/5 mL syrup daily for a 14 month old weighing 10 kg
C 1.75 mL pericyazine 10 mg/5 mL syrup daily for a 10 year old weighing 25 kg
D 2.5 mL pericyazine 10 mg/5 mL syrup daily for a 12 year old weighing 35 kg
E 7 mL pericyazine 10 mg/5 mL syrup daily for a 12 year old weighing 45 kg
28. A 9-year-old patient with asthma is being transferred from terbutaline sulphate 1.5 mg/5
mL syrup to terbutaline sulphate 5 mg tablets. The patient is currently taking 8 mL of the
syrup three times a day. Which of the following is the most appropriate dosage as tablets
for this patient? The tablets are scored and not coated.
A Half a tablet three times daily
B Half a tablet twice daily
C One tablet daily
D One tablet three times daily
E One tablet twice daily
29. You are presented with a prescription for allopurinol tablets 100 mg at a dose of 300 mg
each day for 14 days, reducing to 200 mg for a further 7 days. How many packs of 28
tablets should you supply?
A Two
B Three
C One
D Four
E One and a half
30. You mix together 50 g of 0.5% w/w hydrocortisone cream and 25 g of 2% w/w sulphur
cream (the creams are compatible). What is the final concentration of each of the two
drugs?
A 0.5% w/w hydrocortisone cream and 2.0% w/w sulphur
B 0.25% w/w hydrocortisone cream and 1.00% w/w sulphur
C 0.33% w/w hydrocortisone cream and 0.67% w/w sulphur
D 0.67% w/w hydrocortisone cream and 0.33% w/w sulphur
E 0.33% w/w hydrocortisone cream and 0.33% w/w sulphur
31. A patient is prescribed a reducing oral dose of prednisolone as follows:
Day 1: 10 mg
 Day 2: 8 mg
Day 3: 6 mg
Day 4: 4 mg
Day 5: 3 mg
Day 6: 2 mg
Day 7: 1 mg
Prednisolone is supplied as 5 mg and 1 mg tablets. Prednisolone tablets cannot be split.
Therefore, the patient needs to take a number of whole tablets. How many of each tablet
strength would it be most appropriate to supply?
A Four 5 mg tablets and fourteen 1 mg tablets
B Fourteen 5 mg tablets and four 1 mg tablets
C Five 5 mg tablets and fifteen 1 mg tablets
D Fifteen 5 mg tablets and five 1 mg tablets
E One 5 mg tablet and twenty 1 mg tablets
32. Chemical M residues are sometimes found in drinking water in rural areas. For compound
Z, the safe limit for drinking water is 9 ppm. Analytical results for the amount of
compound Z in the drinking water of various villages are given below. Which of the
following villages has drinking water that is safe to drink?
A Mpwapwa: 24.6 micrograms/mL
B Kongwa: 0.3 mg/L
C Gairo: 0.009% w/v
D Kibaigwa: 0.041% w/v
E Kondoa: 1 in 100 000

33. J and B pharmaceuticals produces a batch of compressed tablets every fortnight containing
450 mg active ingredient with a mean tablet weight of 0.9 g. Which of the following is the
weight of active ingredient that will be required for a total batch size of 6000 kg?
A 6000 kg
B 4000 kg
C 3000 kg
D 2500 kg
E 1800 kg
34. You have in your pharmacy an unopened 30 g tube of Locoid Lipocream (hydrocortisone
butyrate 0.1%). Which of the following is the amount of Lipobase cream required for
diluting 10 g Locoid Lipocream to a concentration of 0.0025% hydrocortisone butyrate?
A 250 g
B 390 g
C 450 g
D 575 g
E 600 g

35. How much active substance is required to manufacture a batch of granules for a
compressed tablet with a batch size of 420 kg, to produce tablets with a mean weight of
700 mg and an active substance content of 600 mg?
A 400 kg
B 380 kg
C 378 kg
D 360 kg
E 265 kg
36. A tablet labelled to contain 350 mg active ingredient has acceptable limits of 90–110% of
that amount. Which of the following indicates the limits of content?
A 300–400 mg
B 310–390 mg
C 315–385 mg
D 320–380 mg
E 340–360 mg
37. A manufacturer wishes to produce a batch of compressed tablets each containing 800 mg
active ingredient, with a mean table weight of 1.2 g. Which of the following is the weight
of active ingredient that will be required for a total batch size of 720 kg?
A 600 kg
B 400 kg
C 250 kg
D 480 kg
E 420 kg
38. A patient has been prescribed 60 g of 0.2% w/w glyceryl trinitrate ointment for an anal
fissure. The only strength glyceryl trinitrate ointment that you have available is 0.3% w/w.
Which of the following is the amount of the 0.3% w/w glyceryl trinitrate ointment that you
would need to prepare the required product?
A 40 g
B 50 g
C 30 g
D 20 g
E 15 g
39. Which of the following amounts of white soft paraffin is required to make 250 g of the
product below?
Zinc oxide 12% w/w
Salicylic acid 1% w/w
Starch 15% w/w
White soft paraffin to 100% w/w
A 70 g
B 100 g
C 150 g
D 180 g
E 200 g
40. The formula for Chloral Elixir, Paediatric, BP is:
Chloral hydrate 200 mg
Water 0.1 mL
Blackcurrant syrup 1.0 mL
Syrup to 5.0 mL
You are presented with a prescription, for a 1-year-old child, for 150 mL Chloral Elixir,
Paediatric, BP. You decide to make it up as an extemporaneous preparation. Which of the
following is the amount of chloral hydrate that you would need?
A 0.3 g
B 3.0 g
C 6.0 g
 D 0.6 g
E 10.0 g
41. You are requested to supply 250 g of a 1 in 4 dilution of Eumovate(0.05% w/w clobetasone
butyrate) cream in aqueous cream. Which of the following are the correct amounts of the
two creams that you would need?
A 112.5 g Eumovate plus 112.5 g aqueous cream
B 75 g Eumovate plus 175 g aqueous cream
C 50 g Eumovate plus 200 g aqueous cream
D 100 g Eumovate plus 150 g aqueous cream
E 62.5 g Eumovate plus 187.5 g aqueous cream
42. Which of the following is the amount of Codeine Linctus, BP (codeine phosphate 15 mg/5
mL) required to be added to a suitable diluent to prepare 75 mL Codeine Linctus,
Paediatric, BP (codeine phosphate 3mg/5 mL)?
A 20 mL
B 15 mL
C 10 mL
D 25 mL
E 45 mL
43. The formula for a single capsule filled extemporaneously for use in a clinical trial is:
Estriol 250 micrograms
Estradiol 190 micrograms
Starch 320 mg
Which of the following is the amount of estriol required to produce 50 tablets?
A 12.50 mg
B 1.25 mg
C 125.00 mg
D 250.00 mg
E 25.00 mg
44. Which of the following are the correct amounts of 50 mg/5 mL and 200mg/5 mL phenytoin
sodium suspensions required to prepare 200 mL of an 80 mg/5 mL suspension?
A 80 mL of the 200 mg/5 mL suspension and 120 mL of the 50 mg/5 mL suspension
 B 50 mL of the 200 mg/5 mL suspension and 150 mL of the50 mg/5 mL suspension
C 100 mL of the 200 mg/5 mL suspension and 100 mL of the50 mg/5 mL suspension
D 40 mL of the 200 mg/5 mL suspension and 160 mL of the50 mg/5 mL suspension
E 160 mL of the 200 mg/5 mL suspension and 40 mL of the 50 mg/5 mL suspension
45. Which of the following are the correct amounts (to one decimal place) of clotrimazole 1%
w/w cream and clotrimazole powder required to produce 75 g of 3% w/w clotrimazole
cream?
A 1.5 g of the powder and 73.5 g of the 1% w/w cream
B 73.5 g of the powder and 1.5 g of the 1% w/w cream
C 25 g of the powder and 75 g of the 1% w/w cream
D 75 g of the powder and 25 g of the 1% w/w cream
E 37.5 g of the powder and 37.5 g of the 1% w/w cream
46. You add 90 mL of 4.5% w/v sodium chloride solution to a 500 mL infusion bag of
0.9%w/v sodium chloride solution to obtain the correct level of NaCl for infusion to a
patient. Which of the following is the final concentration of the solution? Assume no
volume displacement effects.
A 1.45% w/v
B 14.50% w/v
C 4.50% w/v
D 4.00% w/v
E 1.00% w/v
47. You are requested to supply 35 g of a cream containing 20% w/w methylaminolevulinate
for use in a photodynamic therapy clinical trial. You have Cetomacrogol Cream, BP in
your hospital pharmacydepartment and can use this as the cream base. What is the formula
foryour methylaminolevulinate cream?
A 10 g methylaminolevulinate and 25 g Cetomacrogol Cream,BP
B 30 g methylaminolevulinate and 5 g Cetomacrogol Cream, BP
C 5 g methylaminolevulinate and 30 g Cetomacrogol Cream, BP
D 7 g methylaminolevulinate and 28 g Cetomacrogol Cream, BP
E 28 g methylaminolevulinate and 7 g Cetomacrogol Cream, BP
48. You have in your pharmacy a cream containing 0.5% w/w hydrocortisone. You have been
requested to use this cream as a base and to add in sufficient calamine such that the final
concentration of calamine in the new cream will be 10.0% w/w. What is the concentration
of hydrocortisone in the new cream?
A 0.3% w/w
B 0.45% w/w
C 0.5% w/w
D 0.05% w/w
E 0.045% w/w
49. A stock solution of drug G is available at 10%w/v. You need to dilute this with Syrup, BP
in order to supply a patient with a solution containing 5 mg/mL of drug G. Assuming no
volume displacement effects, what is your formula for the preparation of 100 mL of the
final solution?
A 10 mL stock solution and 90 mL Syrup, BP
B 80 mL stock solution and 20 mL Syrup, BP
C 20 mL stock solution and 80 mL Syrup, BP
D 95 mL stock solution and 5 mL Syrup, BP
E 5 mL stock solution and 95 mL Syrup, BP
50. A patient is on a continuous intravenous drip of drug B. He needs to be dosed at a rate of
25 mg/h. The drip is set to administer 10 drops of fluid/h, with 4 drops equaling 1 mL in
volume. Which of the following is the concentration of drug B in the intravenous fluid?
A 1 mg/mL
B 10 mg/mL
C 5 mg/mL
D 2.5 mg/mL
E 25 mg/mL
51. A liquid medicine is supplied in a concentration of 10 mg/5 mL. A patient requires 20 mg
orally three times daily for 5 days, then 10 mg three times daily for 5 days, then 10 mg
twice daily for 5 days, then 10 mg once daily for 5 days. Which of the following is the
correct volume of the liquid medicine that will provide the full treatment course?
A 300 mL
 B 200 mL
C 100 mL
D 150 mL
E 250 mL
52. A patient requires an intravenous infusion of 0.9%w/v sodium chloride. In your hospital
pharmacy department you have Water for Injections, BP and 4.5%w/v Sodium Chloride
Solution, BP. Assuming no volume displacement effects, which of the following volumes
of 4.5% w/v Sodium Chloride Solution, BP need to be added aseptically to an expandable
PVC infusion bag containing 100 mL Water for Injections, BP to produce the requisite
sodium chloride concentration?
A 25 mL
B 50 mL
C 100 mL
D 125 mL
E 150 mL
53. A patient needs to use a 1 in 2500 chlorhexidine gluconate solution for wound washing. In
your pharmacy you have a stock solution of 20%w/v chlorhexidine gluconate. Using this
solution you need to prepare an intermediate solution such that the patient will then dilute
this 20-fold to obtain a solution of the requisite concentration. Which of the following is
the correct strength of the intermediate solution?
A 0.5% w/w
B 0.2% w/w
C 1.0% w/w
D 0.4% w/w
E 0.8% w/w
54. According to an official formula for potassium citrate mixture, 300 mL double-strength
chloroform water is required per 1 L mixture. A 2-L bottle of mixture is required. If the
double-strength chloroform wateris prepared from concentrated chloroform water, which of
the following is the correct volume of concentrate required? (Doubles trength chloroform
water is 2 parts concentrate to 38 parts water.)
A 10 mL
 B 20 mL
C 3 mL
D 30 mL
E 15 mL
55. TORISEL (temsirolimus), for use in advanced renal cell carcinoma, is prepared for
infusion by adding 1.8 mL of special diluent to the drug vial resulting in 3 mL of injection
containing 10 mg/mL of temsirolimus. The required quantity is then added to a 250-mL
container of sodium chloride injection for infusion. The recommended dose of
temsirolimus is 25 mg infused over 30 to 60 minutes. The quantity of drug delivered, in
mg/mL, and the rate of infusion, in mL/min, for a 30-minute infusion are:

a. 0.099 mg/mL and 8.42 mL/min

b. 0.099 mg/mL and 8.33 mL/min
c. 1 mg/mL and 8.42 mL/min
d. 1 mg/mL and 8.33 mL/min
e. 0.0099mg/ml and 8.45ml/min
56. CARDENE IV (nicardipine hydrochloride) is administered in the short-term treatment of
hypertension by slow intravenous infusion at a concentration of 0.1 mg/mL. A 10-mL
ampule containing 25 mg of nicardipine hydrochloride should be added to what volume of
D5W to achieve the desired concentration of infusion?
a. 80ml
b. 100ml
c. 240ml
d. 250ml
e. 300ml
57. ORENCIA (abatacept), used to treat intrarheumatoid arthritis, is available in vials, each
containing 250 mg of powdered drug, intended to be reconstituted to 10mg mL with sterile
water for injection. The dose of abatacept depends on a patient’s infubody weight: 60 kg,
500 mg; 60 to 100 kg, 750 mg; and 100 kg, 1 g. The contents of the appropriate number of
vials are aseptically added to a 100ml mL infusion bag or bottle of sodium chloride
injection after the correspondingvolume of sodium chloride injection has been removed.
The concentration ofabatacept in an infusion for a 200-lb patient would be:
a. 5.8 mg/mL
 b. 6.25 mg/mL
c. 6.8 mg/mL
d. 7.5 mg/mL
e. 5.6 mg/ml (1kg = 2.2lb)
58. Efalizumab (RAPTIVA) is available in vials which when reconstituted with 1.3mL of
sterile water for injection yields 1.5 mL of solution containing 100 mg/mL of drug. How
much dry efalizumab is present in the vial?
a. 130 mg
b. 150 mg
c. 0.2 g
d. 15 mg
e. 1.3mg

Directions for the next questions The questions in this section are followed by three responses.
ONE or MORE of the responses is (are) correct. Decide which of the responses is (are) correct.
Then choose:
A If 1, 2 and 3 are correct
B If 1 and 2 only are correct
C If 2 and 3 only are correct
D If 1 only is correct
E If 3 only is correct

59. A 65-kg patient is prescribed sodium nitroprusside for hypertensive crisis by intravenous
infusion. The registrar has requested that the drug is prescribed initially as 1 microgram/kg
per min, and thenincreased in steps of 500 ng/kg per min every 5 min up to a maximum of
8 micrograms/kg per min. If the infusion is commenced at 10.10am:
1. At 10.13am 65 mg sodium nitroprusside will have been administered
2. At 10.17am 0.52 mg sodium nitroprusside will have been administered
3. At 10.21am the patient will be receiving the drug at a rate of 0.00013 g/min
ANSWER: C
60. Calcijex (calcitriol) injection is available as 1 mL ampoules available in two strengths: 1
microgram/mL and 2 micrograms/mL. The injection solution can be given orally.
1. A 1-year-old girl, weighing 10 kg, is prescribed calcitriol orally at a dose of 20
ng/kg once daily for vitamin D-dependent rickets. It is appropriate to give this girl
0.4 mL of the 1 microgram/mL injection solution daily
2. An 18-month-old girl, weighing 2 stone, is prescribed calcitriol orally at a dose of
15 ng/kg daily for hypophosphataemic rickets. It is appropriate to give this girl
0.25 mL of the 2micrograms/mL injection solution daily. (1 stone ≈ 6.35 kg)
3. A 16-year-old boy, weighing 55 kg, is prescribed calcitriol orally at a dose of
0.001 mg daily for persistent hypocalcaemia.It is appropriate for this boy to take
0.5 mL of the 2 micrograms/mL injection solution daily.
ANSWER: E
61. Epoetin beta has been prescribed for a range of indications for the following patients:
1. Mr B, weighing 75 kg, has been prescribed the drug at a dose of 20 units/kg three
times weekly for 4 weeks. Over the 4 weeks Mr B will have taken 18 000 units
epoetin beta
2. Catherine, weighing 60 kg, has recently had her dose increased to 80 units/kg
three times weekly for 4 weeks. Each week Catherine will take 14 400 units
epoetin beta
3. A 2-day-old neonate, weighing 1.25 kg, has been prescribed epoetin beta at a
dose of 250 units/kg three times weekly. Each week this newborn will be given
937.5 units
ANSWER: E
62. The formula for Magnesium Trisilicate Mixture, BP is:
Magnesium trisilicate 50 g
Light magnesium carbonate 50 g
Sodium bicarbonate 50 g
Concentrated peppermint emulsion 25 mL
Double-strength chloroform water 500 mL water to 1000 mL
Which of the following is/are correct?
 1. The concentration of light magnesium carbonate in Magnesium Trisilicate
Mixture, BP is 50 mg/mL
2. 500 mL Magnesium Trisilicate Mixture, BP contains 12.5 Ml concentrated
peppermint emulsion
3. 30 mL of Paediatric Ferrous Sulphate Mixture contains 150 mg sodium
bicarbonate
ANSWER: B
63. The formula for an extemporaneously prepared ointment is:
White soft paraffin 25 g
Betnovate ointment 20 g
Salicylic acid 5 g
Given that Betnovate ointment contains 0.1% w/w betamethasone
valerate, which of the following is/are correct?
1. The concentration of salicylic acid in this extemporaneously prepared ointment is
5% w/w
2. The concentration of betamethasone valerate in this extemporaneously prepared
ointment is 0.02% w/w
3. 75 g of white soft paraffin would be required to prepare 150 g of this
extemporaneously prepared ointment
ANSWER: E
64. You are required to make an intravenous infusion with the following formulae:
Sodium bicarbonate 180 mmol/L
Potassium chloride 150 mmol/L
Sodium chloride 90 mmol/L
The molecular weights are:
Sodium bicarbonate 84
Potassium chloride 74.5
Sodium chloride 58.5
Which of the following is/are correct?
1. 15.4 g potassium chloride is required to prepare 2500 mL of this solution
2. 26.6 g sodium bicarbonate is required to prepare 4 L of this solution
 3. 7.89 g is the combined weight of these three ingredients in 250mL of this
solution
ANSWER: E
65. The formula for 100 tablets is:
Paracetamol 50 g
Codeine hemihydrate 800 mg
Caffeine 3 g
Lactose 20 g
Which of the following is/are correct?
1. 16 tablets contain 0.128 g codeine hemihydrate
2. A patient taking two tablets four times daily for 3 days ingests 4.8 g lactose from
these tablets
3. 32 tablets contain 960 mg caffeine
ANSWER: A
66. Which of the following is/are correct?
1. In order to make 300 g of 2.5% w/w calamine in emulsifying ointment BP, 7.5 g
calamine are required
2. 250 mL of a 1.14% w/v solution of povidone iodine contains of the drug
3. Four 250 mg nitrazepam tablets will be required to make 100 mL of a 50 mg/5
mL nitrazepam suspension
ANSWER: A
67. Diclofenac tablets contain 50 mg diclofenac sodium. (RMM: diclofenac,C14H11Cl2NO2 =
296.1 g/mol; diclofenac sodium, C14H10Cl2NO2.Na =318.1 g/mol.) Which of the following
is/are correct?
1. 28 tablets contain 1.3 g diclofenac
2. 7.5 g diclofenac sodium would be required to prepare 56 tablets
3. 636.2 g diclofenac sodium contains 2 mol sodium ions
ANSWER: D
68. Mepyramine maleate is released from a hydrogel-based delivery system in a zero order
fashion, such that the amount of drug, x, released after time t is given by x = kt, where k is
the zero-order rate constant for this release process. Which of the following is/are correct?
 1. If the zero-order rate constant is 8 mmol/h, then 32 mmol mepyramine maleate
are released after 6 h
2. If 60 mmol are released after 14 h, then the zero-order rate constant is 5.60
mmol/h
3. If the zero-order rate constant is 35 mmol/h, then 280 mmol mepyramine maleate
are released after 8 h
ANSWER: E
69. A pharmacopoeia monograph states that sulfathiazole sodium sesquihydrate should not
contain more than 0.5% sulphonamide-related substances and loses not less than 6.0% and
not more than 10.0% ofits weight when dried to constant weight at 105°C. Which of the
following is/are correct?
1. A 50 kg sample of sulfathiazole sodium sesquihydrate found to contain 250 mg
of sulphonamide-related substances satisfies the requirements of the monograph
2. A sample of sulfathiazole sodium sesquihydrate originally weighing 2 kg is dried
at 105°C to a constant weight of 1.94kg. This does not satisfy the requirements
of the monograph.
3. A sample of sulfathiazole sodium sesquihydrate originally weighing 5 kg is dried
at 105°C to a constant weight of 4 kg.This satisfies the requirements of the
4. monograph
ANSWER: D
70. You receive a prescription to prepare 500 mL of a mixture composed of:
Motilium suspension 1 part
Kolanticon gel 2 parts
Zantac syrup 2 parts
Given that Motilium suspension contains 5 mg/5 mL of domperidone,Kolanticon gel
contains 2.5 mg/5 mL of dicycloverine hydrochloride and Zantac syrup contains
75mg/5mL of ranitidine hydrochloride, which of the following is/are correct?
1. 100 mL of the mixture contains 20 mg domperidone
2. 100 mL of the mixture contains 20 mg dicycloverine hydrochloride
3. 100 mL of the mixture contains 20 mg ranitidine hydrochloride
ANSWER: B
71. You are asked to prepare the following ear-drop formulation under aseptic conditions:
Hydrogen peroxide solution (6% v/v) 25%
Water 75%
Which of the following is/are correct?
1. 1100 mL of the ear-drop formulation contains 25 mL hydrogen peroxide
2. 40 mL of the ear-drop formulation contains 35 mL water
3. 50 mL of the ear-drop formulation contains 12.5 mL hydrogen peroxide
solution
ANSWER: E
PART II: SHORT QUESTIONS ( 80 QUESTIONS)
1. Potassium permanganate solution 1 in 4000 is prepared from a stock of 20 times this
strength. How much potassium permanganate will be needed to make sufficient stock
solution if a patient uses 100 mL of the diluted solution each day for 5 days?
ANSWER: 125mg
1 in 4000 diluted solution = 1 g in 4000 mL diluted solution
Over the 5 days will use 100 mL × 5 = 500 mL
This 500 mL will contain 1/4000 × 500 g = 0.125 g = 125 mg
2. A patient with diabetes uses exenatide as one of his medications. After his recent hospital
review, his dose has been adjusted to 5 micrograms before lunch and 10 micrograms before
his evening dinner. He currently has two unopened 5 microgram per dose prefilled pens at
home and asks you how many days in total these two pens will now last him. (Exenatide
injection is 250 micrograms/mL available as 5 microgram per dose and 10 microgram per
dose prefilled pens, both containing 60 doses).
ANSWER: 40 Days
Dose is now 5 micrograms before lunch and 10 micrograms before his evening
meal, so each day the patient is going to use 15 micrograms

Stock of 2 × 5 microgram/dose, prefilled, 60-dose pens, so between the two pens

has 120 × 5 microgram doses

In a day going to use 15 micrograms = 3 × 5 microgram doses

Number of days = total doses available / number of doses used per day
= 120 × 5 micrograms doses / 3 × 5 micrograms doses
= 40 days.
3. Kajo, a 6-year-old boy (weight 20 kg) with epilepsy, currently takes sodium valproate liquid
200 mg/5 mL at a dose of 7.5 mg/kg twice daily. What volume of the drug will Kajo take
during the month of November (30 days)? You can assume that he is fully compliant and no
spillages or medication loss occur during the month of November.
ANSWER: 225ml
7.5 mg/kg twice daily for 20-kg child equates with (7.5 × 20 × 2) mg daily
= 300 mg daily
The drug is 200 mg/5 mL, so need (300/200) × 5 mL daily =7.5 mL daily
November has 30 days, so in November will use 30 × 7.5 mL = 225 mL.
4. A new respite patient has been admitted into one of the care homes towhich you supply
medication. She has been admitted into the care home for a total of 10 days. The home
requires you to supply 10 days of her liquid medicines to cover her stay. She usually takes
dipyridamole 300mg daily in three divided doses and propranolol 320 mg daily. What
amounts of both liquid medicines will be required for 10 days of therapy?
ANSWER: 320 mL propranolol 50 mg/5 mL oral solution and 300 Ml dipyridamole 50
mg/5 mL solution
Dipyridamole 300 mg daily in three divided doses → 300mg × 10 over 10 days =
3000 mg
Dipyridamole 50 mg/5 mL solution = 1 mg/0.1 mL or 3000 mg in 300 mL
Propranolol 320 mg daily → 320 mg × 10 over 10 days = 3200 mg
Propranolol 50 mg/5 mL oral solution = 1 mg/0.1 mL
3200 mg in 320 mL
5. Potassium permanganate solution 1 in 4000 is prepared from a stock of 20 times this
strength. How much potassium permanganate will be needed to make sufficient stock
solution if a patient uses 100 mL of the diluted solution each day for 5 days?
ANSWER: 125mg
1 in 4000 diluted solution = 1 g in 4000 mL diluted solution
Over the 5 days will use 100 mL × 5 = 500 mL
This 500 mL will contain 1/4000 × 500 g = 0.125 g = 125 mg
6. Ferrous gluconate 300 mg tablets are currently unavailable from manufacturers due to a
supply issue with one of the inactive ingredients. You regularly dispense this tablet for Miss
K at a dose of two twice daily. After a discussion with her prescriber you both agree to
substitute her regular tablet with Sytron elixir at a suitable dose that contains approximately
equivalent iron content. What will be a suitable dose of Sytron elixir for Miss K? (Ferrous
gluconate 300 mg tablets contain 35 mg iron. Sytron elixir contains sodium feredetate 190
mg equivalent to 27.5 mg iron/5 mL)
ANSWER: 25ml/day
Current medication: two ferrous gluconate 300 mg tablets twice daily
= 2 × 35 mg iron twice daily
= 70 mg twice daily = 140 mg daily
So need to calculate an equivalent iron dose in elixir:
Sytron elixir 27.5 mg iron/5 mL, so 5.5 mg in 1 mL
Volume of elixir that will provide 140 mg iron
= 140/5.5 ≈ 25.45 mL
Therefore would change dose to 25 mL/day and appropriate dose from options is
10 mL in the morning and at lunch, and 5 mL at night.
7. Mrs F has haemorrhoids and has been prescribed Ultraproct suppositories. She has to use
the suppositories at a dose of one twice daily for 5 days, then one every other day for a
week. Over the course of the treatment how much fluocortolone caproate will Mrs F have
used? Ultraproct suppository: cinchocaine hydrochloride 1 mg, fluocortolone caproate 630
micrograms, fluocortolone pivalate 610 micrograms.
ANSWER: 8190mg
Days 1–5 one twice daily = total of 10 suppositories
1 week of 7 days at a dose of one every other day = three suppositories
Therefore, total of 13 suppositories used
Each suppository contains 630 mg fluocortolone caproate
Total used = 13 × 630 mg = 8190 mg.
8. A ward registrar requires an intravenous (IV) infusion of 500 mL sodium chloride 0.18%
and glucose 4% to be administered over 100min to an elderly patient. The IV giving set
being used has a flow rate of 5 drops/mL. What will be the suitable drop rate?
ANSWER: 25drops/min
500 mL to be given over 100 min = 500 mL/100 min 5 drops per 1 mL, so rate is
([500 × 5] drops/100 min) = 2500/100drops/min

9. Mwamvita has been given an emergency 4.5 mg dose of drug F by a doctor after presenting
at her local ‘out-of-hours’ clinic. The elimination half-life of drug F is 0.5 h and it follows
first-order kinetics. How much of this drug will remain in her system 2 h after the
administration, assuming that complete absorption and distribution have occurred?
ANSWER: 281.25 × 10–6 g
2 h/0.5 h = 4, so four half-lives have occurred during the 4 h:
4.5 mg → 2.25 mg → 1.125 mg → 0.5625 mg → 0.28125 mg
So, after 2 h the amount of drug F left is 0.28125 mg
0.28125 mg = 2.8125 × 10–4 g = 281.25 × 10–6 g.
10. Ferrous gluconate tablets are out of stock and your patient normally takes two tablets once
daily. The prescriber has prescribed Galfer syrup as an alternative. The patient needs to
receive the same amount of iron. What would be an appropriate dose of Galfer syrup?
(Ferrous gluconate contains 35 mg iron. Galfer syrup contains 45 mg iron/5 mL).
ANSWER: 7.8 ml
Ferrous gluconate tablets each contain 35 mg iron, so two tablets contain 70 mg,
Galfer syrup contains 45 mg iron/5 mL = 9 mg/ml
70/9 = 7.77 ml, which can be rounded to 7.8 ml.
11. What is the concentration of glucose in a solution prepared by mixing 400 mL of 10% w/v
glucose, 100 mL of 20% w/v glucose and 200 mL of 5% w/v glucose.
ANSWER: 10%w/v
First add up all the volumes: 400 mL + 100 mL + 200 mL = 700 mL
Now work out the total amount of glucose:
400 mL of a 10% w/v solution contains 40 g
100 mL of a 20% w/v solution contains 20 g
200 mL of a 5% w/v solution contains 10 g
Adding these amounts we have: 40 g + 20 g + 10 g = 70 g
In the final solution we have 70 g in 700 mL; this equates to 10 g in 100 mL, so
we have a 10% w/v solution of glucose.
12. Mr. Bundala has been started on Cellcept suspension (mycophenolate mofetil 1 g/5 mL
when reconstituted with water) after a heart transplantation. He is taking the medicine at a
dose of 1.5 g twice daily. How many complete days of compliant therapy will each 175 mL
bottle of reconstituted Cellcept suspension provide him?
ANSWER: 11
Each day the patient will use 1.5 g twice daily = 3 g
Suspension strength is 1 g/5 mL, so the patient will use (3 × 5) mL daily
Each bottle contains (175/[3 × 5]) days = 11.66667, i.e. 11 complete days.

13. Drug F has been prescribed for a 5-month-old baby with a body surface area of 0.4 m2. Drug
F should be given as a daily dose of 200micrograms/m2 in two divided doses. Drug F is
available as an oral liquid with a concentration of 0.1 mg/mL. What is an appropriate single
dose for this baby?
ANSWER: 0.4 mL.
Dose: 200 micrograms/m2 daily in two doses, so single dose of 100
micrograms/m2.
For this patient this equates with 100 × 0.4 micrograms = 40 micrograms = 0.04
mg
Drug F liquid concentration is 0.1 mg/mL, so 0.04/0.1 mL = 0.4 ml

14. Vancomycin hydrochloride is to be administered to a 2-year-old patient weighing 30 lb for

the management of antibiotic-associated colitis. The suggested dose to be prescribed is 5
mg/kg four times daily for 7 days. Over the total 7 days how much vancomycin
hydrochloride will the patient have been given? (1 lb = 0.45 kg)
ANSWER: 1.89 g
 Patient weight = 30 lb = 30 × 0.45 kg = 13.5 kg
Dose: 5 mg/kg four times daily for 7 days
Amount taken = (5 × 13.5 × 4 × 7) mg = 1890 mg = 1.89 g.
15. A ward registrar requires an IV infusion of 3 L physiological (normal) saline to be
administered over a 2.5-hour period. The IV giving set being used has a flow rate of 10
drops/mL. Which of the following is a suitable drop rate?
ANSWER: 25 drops/min
500 mL to be given over 100 min = 500 mL/100 min
5 drops per 1 mL, so rate is ([500 × 5] drops/100 min) = 2500/100 drops/min
= 25 drops/min.
16. A patient is to be administered 300 mg fosphenytoin sodium by intravenous infusion. This
drug is available as a 10 mL vial of fosphenytoin sodium at a concentration of 75 mg/mL
(Pro-Epanutin), which is to be diluted to 25 mg/mL strength using glucose 5% before it can
be administered to a patient. How much fosphenytoin sodium and 5% glucose need to be
used to administer the correct dose to this patient?
ANSWER: 12 ml
Vial concentration is 75 mg/mL and 10 ml volume, so each vial contains
750 mg
750 mg/10 mL, so 75 mg in 1 ml, and 300 mg in 4 mL of 75 mg/ml
Needs to be diluted to 25 mg/mL before use, so a 1 in 3 dilution
1 in 3 dilution using 4 mL of original means total volume = 12 ml.
17. A patient is to be administered 75 mg meptazinol hydrochloride intramuscularly every 4
hours when required for severe pain. The nursing staff who will administer this opioid
analgesic are using U100 (100 units) insulin 1 mL syringes with needles. How many units
should be administered to this patient each time of administration, given that meptazinol is
manufactured as 1 mL ampoules of strength 100 mg/mL (as hydrochloride)?
ANSWER: 75 units
100 mg/mL, so 75 mg in 0.75 mL to be administered
U100 syringes, so 100 units/mL, so 0.75 ml delivered from (0.75 × 100)units = 75 units.

18. John weighs 75 kg and requires drug M at a dose of 4 mg/kg per day in three divided doses.
Drug M is available as 20 mg capsules. What is the total daily amount of drug M required
by John, and how many capsules should he take for each dose?
ANSWER: 5 x 20 mg capsules
 Dose: 4 mg/kg per day in three divided doses, so 4 × 75 mg daily in three divided
doses = 300 mg daily in three divided doses
Each dose to be 100 mg = 5 × 20 mg capsules.
19. Nancy is 9 years of age and weighs 27 kg. She has been prescribed a suspension of drug C
of strength 40 mg/5 mL at a dose of 4 mg/kg daily in three divided doses. How much
suspension should Nancy’s mum give her for each dose?
ANSWER: 4.5ml
Dose: 4 mg/kg daily in three divided doses. For this patient this means 4 ×
27 mg daily in three divided doses, so each individual dose is 36 mg
Suspension strength is 40 mg/5 mL; 1 mg in 5/40 mL; 36 mg in (5 × 36/40)
ml = 4.5 ml.
20. A patient weighing 80 kg requires an oral daily dose of 12 mg/kg of drug B for 14 days.
Drug B is available only as a suspension of 30 mg/2 ml. How much suspension will this
person use during this course of treatment? (You can assume that the patient is fully
compliant and no spillage or loss in any other way occurs.)
ANSWER: 896 ml
Oral daily dose: 12 mg/kg for 14 days for 80-kg patient; this is 12 × 80 mg
daily = 960 mg daily
Therefore over 14 days will use 960 × 14 mg = 13 440 mg
Drug B suspension is 30 mg/2 mL, so 1 mg in (2/30) mL and 13 440 mg in (2 × 13
440/30) mL = 896 mL.
21. A nurse asks for your advice about setting up an intravenous infusion of dopexamine
hydrochloride for a male patient, weighing 80 kg, on the cardiac ward. The nurse wishes to
administer the drug at a dose of 500 ng/kg per min. The drug is formulated as a strong 10
mg/mL sterile solution, but needs to be diluted to a concentration of 400 micrograms/mL
with 5% glucose before intravenous administration can occur. What is an appropriate
administration flow rate for you to advise the nurse? (ng = nanogram)
ANSWER: IV rate should be 0.1 mL/min.
Dose: 500 ng/kg per min for an 80-kg patient means 500 × 80 ng/min
= 40 000 ng/min
= 40 micrograms/min
Administered at concentration of 400 micrograms/ml,
so 40 micrograms in 0.1 mL
Therefore, the IV rate should be 0.1 mL/min.
22. A woman weighing 70 kg has been prescribed danaparoid sodium for thromboembolic
disease following the standard directions for patients with a history of heparin-induced
 thrombocytopenia. This standard dose is 2500 units (1250 units if body weight < 55 kg,
3750 units if > 90kg) by IV injection followed by an IV infusion of 400 units/h for 2 h, then
300 units/h for 2 h, then 200 units/h for 5 days. Danaparoid sodium is available as a 1250
units/mL injection distributed in 0.6 mL ampoules. What volume of drug will be
administered to this woman over this complete course of therapy?
ANSWER: 22.32ml
Patient weighs 70 kg, so standard dose to be used.
Treatment course:
2500 units
400 units/ h × 2 h = 800 units
300 units/h × 2 h = 600 units
200 units/h × 5 days = 200 × 24 × 5 units = 24 000 units
Total = 2500 +800 + 600 + 24 000 units = 27 900 units.
Formulated as 1250 units/mL, so will use (27 900/1250) mL = 22.32 ml.
23. A hospitalised male patient weighs 64 kg and requires an infusion of dopamine
hydrochloride. This drug is to be initially given at a dose of 5 micrograms/kg per min. The
hospital pharmacy currently can supply this drug to the ward only in 250 mL containers of
dopamine hydrochloride 1.6 mg/mL in glucose 5%. What is an appropriate flow rate for the
infusion?
ANSWER: 12ml/h
Drug dose: 5 micrograms/kg per min for 64 kg patient means (5 × 64)
micrograms/min = 320 mg/min = 0.32 mg/min
Drug strength: 1.6 mg/mL = 1 mg in (1/1.6) mL, so 0.32 mg in (0.32/1.6) mL =
0.2 mL
Rate, therefore: 0.2 mL/min = (0.2 × 60) mL/h = 12 mL/h
24. A syringe driver contains 15 mL diamorphine hydrochloride 4 mg/mL solution. The length
of the syringe driver is 60 mm. What rate should the syringe driver be set at, so that the
patient receives 5 mg/h of diamorphine hydrochloride?
ANSWER: 5 mm/h.
Solution concentration is 4 mg/mL; 15 mL of this solution contains
4 mg/ml × 15ml = 60 mg
Syringe driver length is 60 mm, so going to deliver 60 mg over length of 60
mm = 1 mg/mm
Rate required is 5 mg/h; this equates to 5 mm/h.
25. A 3-year-old girl has been prescribed ganciclovir (as the sodium salt) as maintenance
therapy at a dose of 6 mg/kg daily on 5 days/week until she has adequate recovery of
 immunity after a transplantation. She weighs 12 kg and has normal renal function. For
administration as an intravenous infusion the ganciclovir (as the sodium salt) powder is
reconstituted with water for injections (500 mg/10 mL), then diluted to a concentration of 5
mg/mL with 0.9% sodium chloride, and the infusion then given over 1 hour. What flow rate
is appropriate for this patient and how much ganciclovir (as the sodium salt) will she have
been administered after 1 week?
ANSWER: 0.24 ml/min
Dose of 6 mg/kg daily for a 12-kg patient – 72 mg daily
Rate of 72 mg/h = 72/60 mg/min = 1.2 mg/min
Strength of 5 mg/mL = 1 mg in 1/5 mL or 0.2 mL, so 1.2 mg is in 1.2 × 0.2 ml/min
= 0.24 mL/min

26. A 6 year old is to be prescribed topiramate as monotherapy for partial seizures. This child
weighs 20 kg and her consultant has decided to prescribe her drug according to a regimen of
0.5 mg/kg at night for 1 week, then increased in steps of 500 micrograms/kg at 1-week
intervals, with the drug given twice daily. Her therapy is started on 1 August. Assuming that
she tolerates her medication and the prescribed regimen is effective, what dose will she be
receiving on 15 August?
ANSWER: 15mg twice daily
1–7 August: 0.5 mg/kg at night
8–14 August: 0.5 mg/kg + 0.5 mg/kg (given twice daily)
15–21 August: 0.5 mg/kg + 1 mg/kg (given twice daily)
Therefore, on 15 August, girl taking 1.5 mg/kg in two divided doses. For a
20-kg patient this is (1.5 × 20)/2 mg twice daily = 15 mg twice daily.
27. A patient receiving palliative care has been recently changed from oral morphine sulphate
solution to intramuscular 4-hourly injections of diamorphine hydrochloride. It has now been
decided to change the analgesia to a 24-hourly subcutaneous infusion of diamorphine
hydrochloride. The prescriber has authorised for any breakthrough pain to be managed by a
subcutaneous injection of diamorphine hydrochloride, equivalent to one-sixth of the total
24-hour subcutaneous infusion dose. Given that the patient was receiving 20 mg
diamorphine hydrochloride intramuscularly every 4 hours, What is the suitable dose of
diamorphine hydrochloride for any breakthrough pain?
ANSWER: 20mg
20 mg every 4 h = 20 mg × 6 = 120 mg daily
Breakthrough dose = 1/6 of 120 mg = 20 mg.
28. A 70-kg adult patient is being treated for iron poisoning. He is administered desferrioxamine
mesilate initially at a dose of 12 mg/kg per h to be reduced by 25% after 6 h. How much
desferrioxamine mesilate will this patient have received after 12 hours of therapy?
ANSWER: 8820 mg
0–6 hours 12 mg/kg per h → 12 × 6 × 70 mg = 5040 mg
6–12 hours 0.75 (12) mg/kg per h → 0.75 × 12 × 6 × 70 mg = 3780 mg
Total received after 12 h = 5040 mg + 3780 mg = 8820 mg.
29. The formula for AURALGAN, an otic solution is
Antipyrine 54mg
Benzocaine 14mg
Glycerin dehydrated ad 1ml
If a dropper delivers 20drops/ml, how many milligrams of benzocaine would be delivered
by 3 drops dose of the solution?
ANSWER: 2.1 mg
Given 20 drops = 1ml then 3 drops = 0.15ml
If 1ml of the preparation contains 4mg of Benzocaine, then 0.15ml (i.e 3 drops)
should contain 0.15 x 14mg = 2.1mg
30. The oral dose of a drug is 2.5 mg. If a solution contains 0.5% w/v of the drug in a dropper
bottle that delivers 12 drops/mL, how many drops would supply the dose?
ANSWER: 6 drops
0.5%w/v = 0.5g/100ml = 500mg/100ml= 5mg/ml
Volume equivalent of 2.5 mg= 2.5mg ÷ 5mg/ml= 0.5ml
Drops equivalent of 0.5ml = 0.5ml x 12drops/ml = 6 drops

31. The recommended maintenance dose of BECLOVENT (beclomethasone diproprionate), an

aerosolized inhalant, is 100 mcg administered twice daily. The commercial inhaler delivers
50 mcg per metered inhalation and contains 200 inhalations. How many inhalers should be
dispensed to a patient if a 60-day supply is prescribed?
ANSWER: 2 inhalers
Monthly requirement = 60 days x 100mcg x 2 = 12000mcg
Total amount supplied by one inhaler = 50mcg x 200inhalations= 10000mcg
 Required number of inhalers = 12000mcg/10000mcg = 1.2 inhalers but we do not
have a fraction of an inhaler therefore 1.2 inhalers should be 2 inhalers.
32. A transdermal patch contains 5 mg of fentanyl and has a drug-release rate of 50mcg/hour.
The patch is worn for 72 hours. Calculate (a) the milligrams of fentanyl delivered daily, (b)
the milligrams of fentanyl maintaining in the patch when it is removed, and (c) the
percentage of drug remaining in the patch when it is removed.
ANSWER: (a) 1.2 mg (b) 1.4 mg (c) 28%
a) 50mcg/hour x 24 hours = 1200mcg = 1.2 mg
b) 5mg – (50mcg/hour x 72 hours) = 1400mcg = 1.4 mg
c) 1.4 mg/5mg x 100 = 28%

33. The content of a vial of penicillin G potassium weighs 600 mg and represents 1 million
units. How many milligrams are needed to prepare 15 g of an ointment that is to contain
15,000 units of penicillin G potassium per gram?
ANSWER: 135 mg penicillin G potassium.
600 mg = 1000,000 units,
Needed units = 15000 units/g x 15g = 225,000 units
Needed milligrams = 225000 units x 600mg / 1000,000 units = 135mg

34. An intravenous infusion contained 20,000 units of heparin sodium in 1000 mL of D5W. The
rate of infusion was set at 1600 units per hour for a 160-lb. patient. Calculate (a) the
concentration of heparin sodium in the infusion, in units/mL; (b) the length of time the
infusion would run, inhours; and (c) the dose of heparin sodium administered to the patient,
on a unit/kg/minute basis.(1kg=2.2lb)
ANSWER: (a) 20 units/ml (b) 12.5 hours and (c) 0.37 units/kg/minute
a) 20000 units /1000 ml = 20 units/ml
b) 20000 units / 1600 units/hour = 12.5 hours
c) 160 lb = 72.7kg
12.5 hours = 750 minutes
20,000 units / 750 minutes = 26. 67 units/minutes
26.67 units/minute / 72.7 kg = 0.37 units/kg/minute
35. If a patient is determined to have a serum cholesterol level of 200 mg/dL, (a) what is the
equivalent value expressed in terms of milligrams percent, and (b) how many milligrams of
cholesterol would be present in a 10-mL sample of the patient’s serum?
a. A male patient weighing 76 kg is placed on heparin therapy for the prevention of
deep vein thrombosis after surgery.
b. How many milliliters of a heparin injection containing 5000 units/mL should be
administered for a loading dose of 80 units/kg? What should be the infusion rate, in
mL/hr, using a solution that contains heparin 25,000 units/500 mL, to administer 18
units/kg/hr?

ANSWER: (a) 200mg% (b) 20mg

a) 200mg/dl = 200mg/100ml = 200mg%
b) 200mg x 10ml / 100ml = 20 mg
36. An intravenous infusion contains 10 mL of a 1:5000 solution of isoproterenol hydrochloride
and 500 mL of a 5% dextrose injection. At what flow rate should the infusion be
administered to provide 5g of isoproterenol hydrochloride per minute, and what time
interval will be necessary for the administration of the entire infusion?
ANSWER: 400 minutes or approximately 6.5 hours

37. Daptomycin (CUBICIN), 4 mg/kg, is recommended for administration over a 30 minute

period by intravenous infusion in 0.9% sodium chloride. How many milliliters of a vial
 containing 500 mg of daptomycin in 5 mL should be added to a 100-mL bag of normal
saline in treating a 165-lb. patient? (1kg=2.2lb).
ANSWER: 3 ml
Required dose in mg = 4mg/kg x (165/2.2) kg
Required dose in ml = 4mg/kg x (165/2.2) kg divide by 500mg/5ml
= 3 ml
38. A pharmacist receives a medication order for 300,000 units of penicillin G potassium to be
added to 500 mL of D5W. The directions on the 1,000,000-unit vial state that if 1.6 mL of
solvent are added, the solution will measure 2 mL. How many milliliters of the solution
must be withdrawn and added to the D5W?
ANSWER: 0.6 ml

39. The biotechnology drug cetuximab (ER- BITUX), used in the treatment of colo rectal
cancer, has a loading dose of 400 mg/m2 administered as an intravenous infusion over a
120-minute period. Using an IV set that delivers 15 drops/mL, calculate (a) the dose for a
patient with a BSA of 1.6m2, and (b) the rate of delivery, in drops/min, for 250 mL of an IV
fluid containing the dose.
ANSWER: a) 640mg b) 31.25 or 31 drops/min
40. A physician orders 35mg of amphotericin B and 25 units of heparin to be administered
intravenously in 1000 mL of D5W over an 8 hour period to a hospitalized patient. In filling
the medication order, the available sources of the additives are a vial containing 50 mg of
amphotericin B in 10 mL and a syringe containing 10 units of heparin per milliliter.
a. How many milliliters of each additive should be used in filling the medication order?
b. How many milliliters of the intravenous fluid per minute should the patient receive
to administer the fluid over the designated interval?
ANSWER: a) 7ml amphotericin B, 2.5 ml heparin b) 2.08ml/min
41. Aminophylline is not to be administered in pediatric patients at a rate greater than 25 mg per
minute to avoid exces- sive peak serum concentrations and pos- sible circulatory failure.
What should be the maximum infusion rate, in milliliters per minute, for a solution
containing 10 mg/mL of aminophylline in 100 mL of D5W?
 ANSWER: 2.5 ml/min
42. An ointment has the following formula:
Sulphur 4 %w/w
Salicylic acid 10 %w/w
Yellow Soft Paraffin, BP to 100 %w/w
What are the amounts of sulphur and salicylic acid required to produce 25 g of this
ointment?
ANSWER: 2.5 g
Sulphur required = 4% of 25 g
= 4/100 × 25 = 1 g
Salicylic acid required = 10% of 25 g = 2.5 g
43. Your hospital pharmacy department has been asked to supply a 20 cm2 bioadhesive patch
containing 50 mg/cm2 of 5-aminolevulinic hydrochloride (ALA) for use in a clinical trial on
a named-patient basis. You know that 30 g aqueous gel containing ALA is required to
prepare a patch of this drug loading 100 cm2 in area. What is the concentration of ALA in
an aqueous gel used to prepare the 20 cm2 patch with an ALA loading of 50 mg/cm2?
ANSWER: 1000 mg ALA in 6 g gel
If the drug loading is 50 mg/cm2 and the patch area is 20 cm2, then 1000 mg ALA
are required
If 30 g gel is required to make a patch 100 cm2 in area, then 6 g gel are required
for a 20 cm2 patch.
44. You have in your pharmacy 400 mg potassium permanganate tablets. You are requested to
prepare 2 L of a potassium permanganate solution such that the patient will dilute this 1 in
10 to obtain a 0.005% solution suitable for wound washing. How many of these tablets
would you dissolve in a small amount of water before making the solution up to a final
volume of 2 L with water?
ANSWER: 2.5 tablets
Final solution has a strength of 0.005% = 0.005 g potassium permanganate/
100 mL
Patient to do a 1 in 10 dilution to produce solution of 0.005% strength
Strength of solution dispensed to patient = 0.05%
0.05% means 0.05 g potassium permanganate/100 mL solution
Need to prepare 2 L of 0.05% solution, so need to calculate the amount of
potassium permanganate in this 2 L
0.05% = 0.05 g per 100 mL = 0.05 × 20 g per 2000 mL = 1 g = 1000 mg
Now need to work how out many 400 mg tablets to be used to give 1 g
 Number of tablets = 1000/400 = 2.5 tablets
45. An ointment has the following formula:
Calamine 5%w/w
Zinc oxide 10%w/w
White Soft Paraffin, BP to 100%w/w
What are the amounts of calamine and zinc oxide required to produce 80 g of this
ointment?
ANSWER:4 g calamine and 8 g zinc oxide
This question can be answered by simple multiplication and division as follows:
(80/100) × 10 = 8
10% of 80 g is, therefore, 8 g
(80/100) × 5 = 4 so 5% of 80 g is 4 g
46. You are asked to prepare and dispense six, 1 g suppositories, each containing 150 mg
bismuth subnitrate. Allowing for a 50% excess (i.e.calculating on the basis that a total of
nine suppositories will be prepared), what are the amounts of suppository base and bismuth
subnitrate required for correct formulation of these suppositories? The displacement value
of bismuth subnitrate is 5.
ANSWER: 8.73 g
A displacement value (DV) of 5 means that 5 g of the drug will displace 1 g
suppository base
Bismuth subnitrate has a DV of 5, i.e. 5 g bismuth subnitrate displaces 1 g
suppository base
Amount of base required = theoretical amount – displaced amount
(Calculating for nine suppositories) = (9 × 1 g) – (amount of drug/DV of drug)
= (9 × 1 g) – (1.35 g/5)
= 9 g – 0.27 g
= 8.73 g
47. You are asked to prepare and dispense six 4 g vaginal pessaries, each containing 500 mg
clotrimazole. Allowing for a 50% excess (i.e. calculating on the basis that a total of nine
pessaries will be prepared), what are the amounts of suppository base and clotrimazole that
will be required for correct formulation of these pessaries? The displacement value of
clotrimazole is 1.5.
ANSWER: 33.0 g
A displacement value (DV) of 1.5 means that 1.5 g of the drug will displace 1 g
pessary base
 Clotrimazole has a DV of 1.5, i.e. 1.5 g clotrimazole displaces 1 g suppository
base
Amount of base required = theoretical amount – displaced amount
= (9 × 4 g) – (amount of drug/DV of drug)
= (9 × 4 g) – (4.5 g/1.5)
= 36.0 g – 3.0 g
= 33.0 g
48. A rectal gel is prepared according to the formulation below:
Lorazepam 80 mg
Methylcellulose 2.5 g
Methylparaben 100 mg
Glycerol 5 g
Water to 100 mL
What is the number of 1 mL ampoules of Ativan injection (lorazepam 4 mg/mL) required
to prepare 25 g of this gel correctly?
ANSWER: 5 vials
If there are 80 mg lorazepam in 100 mL gel, there must be 20 mg in 25 mL
Each vial of Ativan contains 4 mg lorazepam, so five vials are required
49. What volume of Water for Injection, BP is to be added to a vial containing 500 mg
amoxicillin to produce a solution with a volume of 5 mL. The displacement volume of
amoxicillin is 0.1 mL for 125 mg.
ANSWER: 4.6 ml
125 mg amoxicillin displace 0.1 mL, so 500 mg must displace 0.4 Ml
5 mL – 0.4 mL = 4.6 mL water must be added.

50. You are required to compound the following prescription. How many grams of sodium
chloride will you use, given the sodium chloride equivalent of pilocarpine nitrate is 0.23?
Pilocarpine Nitrate 0.3 g
Sodium Chloride q.s.
Purified Water ad 30 mL
Make isoton. sol.
Sig. For the eye.
 ANSWER : 0.201 g
This question is based on isotonicity requirement of parenteral and other
solutions.
Step 1. 0.23 x 0.3 g = 0.069 g of sodium chloride represented by the pilocarpine
nitrate
Step 2. 30 x 0.009 = 0.270 g of sodium chloride in 30 mL of an isotonic sodium
chloride solution
Step 3. 0.270 g (from Step 2) - 0.069 g (from Step 1)
0.201 g of sodium chloride to be used

51. The formula for 1000 g of a cosmetic cream calls for 14.7 g of potassium carbonate (K2CO3
1.5H2O). How many grams of 85% potassium hydroxide (KOH) could be used to replace
the potassium carbonate in formulating the cream?
ANSWER: 11.74 g

52. An ophthalmic solution is labeled to contain the equivalent of 0.3%w/v of ciprofloxacin

base (m.w. 332). How many milligrams of ciprofloxacin hydrochloride (m.w. 386) may be
used to prepare each 5 mL of the solution?
ANSWER: 17.4 mg of ciprofloxacin
0.3 %w/v = 0.3g /100ml = 0.3 x 1000mg/ 100ml = 3mg/ml
3mg/ml x 5ml= 15mg but this is for ciprofloxacin base, for ciprofloxacin
hydrochloride should be;
386/332 x 15mg =17.43 mg
53. Drug S used to treat asthma is 55% bioavailable as 5 mg tablets. If a patient is switched to
the inhalant form of the drug, which is 87% bioavailable, how many metered 500microgram
sprays should the patient administer every 12 hours to receive an equivalent drug dose?
ANSWER: 3.16 or 3 sprays
Total daily dose = 55% x 5 mg = 0.55 x 5 mg = 2.75mg
Need to give this drug 12 hourly, this means a single dose should give
2.75 mg / 2 = 1.375 mg
But this corresponds to 87% of the drug, now 100% should be
100/87 x 1.375 mg = 1.58 mg
Now this corresponds to the following number of sprays 1.58 mg / 500mcg =
1.58 mg / 0.5mg=
= 3.16 sprays approximately 3 sprays

54. A drug is 40% bioavailable by the oral route and 58% bioavailable by the transdermal route.
If a patient is taking a 2.5 mg oral dose twice a day and is switched to the counterpart 2%
ointment, how many grams of the ointment should be administered to provide the equivalent
dose of the drug?
ANSWER: 0.17 g
Effective daily dose by oral route is 40% x 2.5mg x 2 = 0.4 x 2.5 mg x 2 = 2 mg
By using the ointment this should correspond to 58% of the administered drug,
The administered drug should now be 100/58 x 2mg = 3.448 mg
3.448 mg is equivalent to 2% of the ointment, the whole amount of the
administered ointment is then 100/2 x 3.448mg = 172.41 mg = 0.172 g
55. If 5 mL of an elixir containing 2 mg/mL of a drug is bioequivalent to a 15 mg tablet having
a bioavailability factor of 0.60, what is the bioavailability factor (F) of the elixir?
ANSWER: 0.9 or 90%
Effective dose of the tablet which corresponds to the effective dose of the elixir
= 15 mg x 0.6 = 9 mg
Given dose of the elixir in mg = 5ml x 2 mg/ml = 10 mg
 Now bioavailability of the elixir = its effective dose / given dose =
9mg/10mg = 0.9
= 0.9 or 0.9 x 100 = 90%

56. The formula for 1000 g of a cosmetic cream calls for 14.7 g of potassium carbonate (K2CO3
1.5H2O). How many grams of 85% potassium hydroxide (KOH) could be used to replace
the potassium carbonate in formulating the cream?
ANSWER: 11.74 g

57. An ophthalmic solution is labeled to contain the equivalent of 0.3%w/v of ciprofloxacin

base (m.w. 332). How many milligrams of ciprofloxacin hydrochloride (m.w. 386) may be
used to prepare each 5 mL of the solution?
ANSWER: 17.4 mg of ciprofloxacin
0.3 %w/v = 0.3g /100ml = 0.3 x 1000mg/ 100ml = 3mg/ml
3mg/ml x 5ml= 15mg but this is for ciprofloxacin base, for ciprofloxacin
hydrochloride should be;
386/332 x 15mg =17.43 mg

58. Drug S used to treat asthma is 55% bioavailable as 5 mg tablets. If a patient is switched to
the inhalant form of the drug, which is 87% bioavailable, how many metered 500microgram
sprays should the patient administer every 12 hours to receive an equivalent drug dose?
ANSWER: 3.16 or 3 sprays
 Total daily dose = 55% x 5 mg = 0.55 x 5 mg = 2.75mg
Need to give this drug 12 hourly, this means a single dose should give
2.75 mg / 2 = 1.375 mg
But this corresponds to 87% of the drug, now 100% should be
100/87 x 1.375 mg = 1.58 mg
Now this corresponds to the following number of sprays 1.58 mg / 500mcg =
1.58 mg / 0.5mg=
= 3.16 sprays approximately 3 sprays

59. A drug is 40% bioavailable by the oral route and 58% bioavailable by the transdermal route.
If a patient is taking a 2.5 mg oral dose twice a day and is switched to the counterpart 2%
ointment, how many grams of the ointment should be administered to provide the equivalent
dose of the drug?
ANSWER: 0.17 g
Effective daily dose by oral route is 40% x 2.5mg x 2 = 0.4 x 2.5 mg x 2 = 2 mg
By using the ointment this should correspond to 58% of the administered drug,
The administered drug should now be 100/58 x 2mg = 3.448 mg
3.448 mg is equivalent to 2% of the ointment, the whole amount of the
administered ointment is then 100/2 x 3.448mg = 172.41 mg = 0.172 g
60. If 5 mL of an elixir containing 2 mg/mL of a drug is bioequivalent to a 15 mg tablet having
a bioavailability factor of 0.60, what is the bioavailability factor (F) of the elixir?
ANSWER: 0.9 or 90%
Effective dose of the tablet which corresponds to the effective dose of the elixir
= 15 mg x 0.6 = 9 mg
Given dose of the elixir in mg = 5ml x 2 mg/ml = 10 mg
Now bioavailability of the elixir = its effective dose / given dose =
9mg/10mg = 0.9
= 0.9 or 0.9 x 100 = 90%
61. A nurse from Benjamin Mkapa hospital telephones you regarding the proper quantity of an
injection to administer to a pediatric patient from a 1-mL vial containing 0.1 mg of digoxin.
The attending physician has quantity of an injection to administer to a pediatric patient from
 a 1-mL vial containing 0.1 mg of digoxin. The attending physician had prescribed a dose of
25 mcg. How many milliliters should be your response?
Answers
0.1 mg/mL _ 100 mcg/mL
25 mcg*1 mL/100 mcg= 1⁄4 mL or 0.25 mL,

62. A Clinical pharmacist is asked to prepare an intravenous infusion of dopamine. Based on the
patient’s weight, the clinical pharmacist calculates a dose of 500 mcg/min for continuous
infusion. The concentration of a premixed dopamine infusion is 400 mg/250 mL. What is
the concentration of the infusion on a mcg/mL basis? How many milligrams of dopamine is
the patient to receive in the first hour of treatment? How long will the infusion last?
Answers
Concentration of infusion mcg/mL
400mg/250mL=400000mcg/250mL=1600mcg/mL

mg, dopamine, first hour

500mcg/1min*60min/1h*1mh/1000mcg=30mg/h
Infusion duration
400mg*1min/500mcg*1000mcg/1mg=800min=13h, 20min

63. A pharmacist is asked to compound the following formula for the preparation of 100
capsules:
Estriol 200 mg
Estrone 25 mg
Estradiol 25 mg
Methocel E4M 10 g
Lactose 23.75 g
Using a balance that has a sensitivity requirement (SR) of 6 mg, the aliquot method of
weighing, lactose as the diluent, and an error in weighing of 4%, show, by calculations,
how the correct quantity of estrone can be obtained to accurately compound the formula.
Answers
The smallest quantity that should be weighed on the balance:

(100%*6mg)/4%=150mg
Quantity desired (estrone):25mg
Multiple factor selected: 6
Aliquot portion selected: 150mg

Estrone (25*6) 150mg

Lactose 750mg
Aliquot mixture 900mg
Aliquot portion (900mg/6) 150mg of mixture will provide 25mg estrone.
64. Rx
Lactic Acid
Salicylic Acid aa. 1.5 g
Flexible Collodion qs ad 15 mL
Sig: Apply one drop to wart twice a day.
Label: Wart remover. For external us only.
Lactic acid is available as a liquid containing 85 g of the acid in 100 g of solution
(sp.gr. 1.21). Calculate the quantity of this solution, in milliliters, needed to fill the
prescription.
Answers

65. A hospital pharmacist is called to a pediatric nursing station to calculate the quantity of an
injection to administer to a pediatric patient. The daily dose of the injection for the child’s
weight is stated as 15 mg/kg/day, divided into three equal portions. The child weighs 10 kg.
The injection contains 5 mg/mL of the prescribed drug. How many milliliters of injection
should be administered?
Answer
66. An intravenous infusion contained 20,000 units of heparin sodium in 1000 mL of D5W. The
rate of infusion was set at 1600 units per hour for a 160-lb. patient.
Calculate;
(a) The concentration of heparin sodium in the infusion, in units/mL;
(b) The length of time the infusion would run, in hours; and
(c) The dose of heparin sodium administered to the patient, on a unit/kg/minute basis.
Answers
(a) 20,000 units/1000 mL=20 units/mL, and
(b) 20,000 units/1600 units/hour=12.5 hours, and
(c) 160 pounds=72.7 kg
12.5 hours =750 minutes
20,000 units/750 minutes=26.67 units/minute
26.67 units/minute/72.7 kg=0.37 units/kg/minute, answers.

67. A pharmacist received the following prescription:

Rx
Hydrocortisone 0.6%
AQUAPHOR q.s. ad 15 g
Sig. Apply to child’s affected area t.i.d.
The pharmacist has no hydrocortisone powder but does have a hydrocortisone cream,
1%. How many grams each of hydrocortisone cream and Aquaphor should be used in
filling the prescription?
Answer

68. As a pharmacist in the infusion unit, you have received the following order for a patient;

Medication Order: Staphcillin, 750 mg IV every 4 hours

The following product and procedures were followed:
 Product: 6-g vial Staphcillin
Pharmacy Operations: Reconstitute vial with sterile water for injection to yield
Staphcillin 500 mg/mL and further dilute in 100 mL of sodium chloride injection.
Administer: 30-minute IV infusion.
(a) How many milliliters of solution from the reconstituted vial should be used per
infusion?
(b) What should be the infusion rate in milliliters per hour?
(c) With a drop factor of 10 drops per milliliter, calculate the infusion rate in drops per
minute.
Answer

69. You’re working as an industrial pharmacist and you were charged to prepare a
‘‘400%’’extract of cascara sagrada from 100 kg of crude drug.
(a) How many kilograms of the extract would be expected to be prepare?
(b) If the crude drug is assayed to contain 11% hydroxyanthracenes, what would be the
expected percentage strength of the resultant extract?
Answer
70. A pediatrician wishes to prescribe the drug metronidazole (m.w.171) for a pediatric patient
in the oral treatment of amebiasis. The patient is unable to swallow solid dosage forms, and
an oral suspension of the drug would be extremely bitter. An alternative would be for the
pharmacist to compound an oral suspension using metronidazole benzoate (m.w. 275),
which has a low water solubility and thus little taste. If the pediatric dosage range of
metronidazole in the treatment of amebiasis is 35 to 50 mg/kg/day, calculate the dosage
range of metronidazole benzoate.
Answer

71. Rx
MotrinR (Ibuprofen) 600 mg
#21
Sig. I tab tid, pc
Assume that the patient has a stock of AdvilR (ibuprofen 200 mg) at home and he decides
to take them instead of getting the prescription filled by a pharmacist. How many AdvilR
tablets should the patient take in one day?
Answers
1 Motrin 600 mg = 3 AdvilR
Answer: the patient should take 9 AdvilR (3 × 3) every day

72. How many grams of the ointment base (diluent) should be used to make an ointment
containing 5% of boric acid?
 Answer
20 g × 8% = X g × 5%
X=
(20 × 8)/
5
= 32 g, total
Answer: ointment base needed = 32 − 20 = 12 g
73. In what proportion should a 20% coal tar ointment be mixed with white petrolatum (diluent)
to produce a 2% coal tar ointment?
Answer

74. Find the quantity of sodium chloride required in compounding the following prescription.
The sodium chloride equivalent of cocaine HCl is 0.16.

Answers
Step 1: (0.9/100) × 30 = 0.27 g
Step 2: 0.20 × 0.16 = 0.032 g
Step 3: answer: 0.27 − 0.032 = 0.238 or 0.24 g
75. A drug has an elimination half-life of 4 hours. After the administration of a 250 mg dose,
plasma concentration at zero time point4 was found to be 5.65 mcg/mL. What is the volume
of distribution of the drug?
Answer
Vd = D0/C0
D0 = 250 mg = 250,000 mcg
= 250,000 mcg/5.65 mcg/mL = 44,248 mL or 44.3 L
Answer: 44.3 L
76. Product information on LorabidR shows that its usual adult dose is 200–400 mg q12h. What
would be the range of this medication for a patient born on February 9, 2003. How would
you administer the drug from one of the available LorabidR medications? Assume that the
prescription was written on May 2006.
Answer
The patient is a child and would be four years old on the following birthday. Therefore
Cowling’s Equation will be used as follows:
Dose of child =
Age in years at next birthday/
24
× Adult dose
Dose of child =
4 years/
24
× 200
Dose of child = 33.33 mg for the lower drug range
Answer: range of drug for the patient = 33.33 mg to 66.67 mg

77. In juvenile arthritis, AdvilR is required to be given in a dose of 30 mg/kg/ day. How many
milliliters of the AdvilR suspension (100 mg/5 mL) should be given to a child weighing 74
lb?
Answer
74 lb = 74/2.2 = 33.64 kg
In one day, AdvilR required is 30 mg per kg or 30/1 kg = X/33.64 kg
X = 1009 mg
100 mg/5 mL = 1009 mg/X
Therefore, X = milliliters of AdvilR required = 50.5 mL
Answer: 50.5 mL
78. The height of a child is 120 cm and the weight is 130 lb. The usual adult dose of
Amitriptyline HCl is 75 mg/day. What would be the dose for the child based on body
surface area?
Answer
When height and weight of a child are known, surface area may be calculated by using
the formula:
Surface area in m2 = (height × weight) 1/2/60
130 lb = 130/2.2 = 59.1 kg
Surface area in m2 = (120 × 59.1)1/2/60
= 1.40 m2
 Child’s dose =
Surface area of child (m2)/
1.73 m2 × Adult dose in mg/day
Child’s dose =
1.4 (m2)/
1.73 m2 × 75 mg/day
Answer: Child’s dose = 60.7 mg

79. If the recommended dose for meningococcal vaccine is 1 injection of 0.5mL at 0.1 mg/mL,
how many immunizations can a 10-mL multi-use vial yield?
Answer
Strength per injection = 0.1 mg/mL × 0.5 mL = 50 ug Total strength of the vial = 10 mL
× 0.100 mg/mL = 1 mg
Answer: Number of immunizations per vial = 1000 ug/50 ug = 20

80. If every 0.5 mL of tetanus toxoid (TT) contains 5 Lf units and the complete schedule for TT
is 3 IM or SC injections of 0.5 mL administered in 4–8weeks followed by a fourth dose of
0.5 mL in 6 to 12 months, You’re required to calculate how many complete immunization
courses of TT can be administered from a 7.5 mL dosage form of TT.
Answer
Total number of injections required = 4
Total volume injected = 4 × 0.5 mL = 2 mL
7.5 mL / 2.0 mL = 3.75
Answer: Therefore, a total of three complete immunization courses can be administered
per dosage form
PART III: LONG QUESTIONS ( 50 QUESTIONS)
1. Sodium nitroprusside is being prescribed for a 75-kg patient in hypertensive crisis; 50 mg
sodium nitroprusside has been diluted to 1000 mL in a 5% glucose infusion. The drug is to
be administered to the patient at an initial rate of 0.5 microgram/kg per min and then
increased in steps of 500 ng/kg per min at 5-min intervals. Which of the following is the
infusion rate 17 min after treatment is commenced?
ANSWER: 3 mL/min.
Need to define the dose over each 5-min interval:
0–5 min: 0.5 microgram/kg per min
5–10 min: 1 microgram/kg per min (remember 500 ng = 0.5 mg)
10–15 min: 1.5 micrograms/kg per min
15–20 min: 2 micrograms/kg per min
The question asks about the rate of infusion 17 min after treatment is commenced,
so only need to work further with the dose 2 micrograms/kgper min
The patient weighs 75 kg, so dose = 2 × 75 micrograms/min
= 150 micrograms/min
The solution being administered has a strength of 50 mg/1000 mL
= 50 000 micrograms/1000 mL
Need to work out the volume of solution that will contain 150 micrograms and
this will be the volume to be administered every minute:
50 000 micrograms/1000 mL
5000 micrograms/100 mL
500 micrograms/10 mL
50 micrograms/mL
150 micrograms/3 mL
Therefore, rate from 15 min to 20 min = 3 mL/min.

2. A 76-year-old female patient, Mrs Chambers, suffering from dementia has been prescribed
memantine hydrochloride. Her consultant has recommended that her physician initially
prescribes the drug at a dose of half a 10 mg tablet each morning for a week and then
increase the dose by 5 mg/week to a maximum dose of 10 mg twice daily, with daily doses
over 5 mg given in two divided doses. While dispensing a prescription for Ebixa
(memantine hydrochloride 10 mg) tablets for Mrs Chambers on day 17 of her treatment, her
daughter advises you that her mother is having difficulty swallowing the tablets but has been
compliant to date. You decide to contact the prescribing physician and you discuss with her
about changing the formulation to drops. What total daily dose is Mrs Chambers receiving
 on day 17 of treatment and what dose should you advise the physician to prescribe for the
drop formulation for the maximum daily dose? (Ebixa oral drops: memantine hydrochloride
10 mg/g [5 mg ≡ 10 drops of memantine hydrochloride oral drops].)
ANSWER: 20 drops twice daily
Days 1–7: 5 mg morning
Days 8–14: 5 mg morning and night (doses over 5 mg given in two divided doses)
Days 15–21: 10 mg morning and 5 mg night – day 17 total daily dose is 15 mg
Days 22+: 10 mg twice daily, 5 mg = 10 drops, therefore 20 drops twice daily

3. An order for a patient, with a 3-liter daily IV fluid limit, calls for 3 L of D5W with a 100-
mL IV antibiotic to be run-in alone over a 1-hour period and administered every 6 hours.
The administration set is calibrated to deliver 10 drops per milliliter. Calculate:
a. The flow rate of the IVPB antibiotic;
b. The total flow time for the IV antibiotic;
c. The total volume for the IV antibiotic;
d. The total flow time for the D5W;
e. The total volume for the D5W;
f. The flow rate for the D5W.
ANSWER: a) 16.7 or 17 drops per minute b) 4 hours or 240 minutes c) 400 ml d) 20
hours or 1200 minutes e) 2600 ml f)21.6 or 22 drops per minute
4. As a pharmacist at a compounding facility you are required to compound a pediatric
atropine sulphate syrup for Aisha a 2 years old child. In the process you are required to
weigh 4mg and your torsion prescription balance has a sensitivity requirement of 6
milligrams. Explain how you would weigh 4 milligrams of atropine sulfate with an accuracy
of 5%, using lactose as the diluent.
ANSWER: This is a group of problems which are based on the situation when the
required weight or volume to be weighed or measured is too small to be accurately
weighed or measured by the available equipment. The only approach/technique that
remains to help the given individual is the aliquot method which involves measuring a
larger (must be a multiple) portion of the given required small amount of an API that is
mixed with a predetermined large amount of one of its compatible diluents in the
expected formula. The amount of the diluent is established such that it forms a mixture
with the API from which when a portion (of the resulting mixture) is measured it will
represent the required small amount of the API as summarized in the figure below.

This gives the student freedom to choose their multiple factors which will result into
differently established diluent weighed/measured. However in the end the approach must
give the weight or volume needed.
Students explanations should have It three or four main parts of as following;
a) Determination of the minimum weighable/measurable amount by a given balance
which is a product of sensitivity requirement and the maximum tolerable error.
(Sensitivity requirement divided by the maximum tolerable error).In this cases 6 mg
 divided by 5% ie 6mg ÷ 5% = 6 mg ÷ 5/100 = 120 mg. This means a given equipment
can accurately weigh/measure not less than this amount.
b) Selection of the amount of the substance (API) to be weighed/measured and the
corresponding multiple factor. This is governed by ‘part a’ above and also the
formula of the preparation as in the end, the combined API and diluent are going
together into the final drug preparation, so amounts should be selected within the
limits of the preparation which is actually not given in most cases of these questions
however.. That means in this case should be 120mg or above(sensitivity requirement)
and the multiple factor will then be equal to the weighable amount divided by the
needed amount i.e = 120mg/4mg= 25
c) Determination of the amount of the diluent to mixed with the weighed (120mg) API
such that after thorough mixing, when 120mg of the resulting mixture is weighed it
will contain the 4mg of the API. This also presents some options to the student
however the easiest approach is to take the minimum weighable amount multiplied by
the established factor ie. In this case is 120mg x 25 = 3000mg , this should be the
amount of the resulting mixture of the API and the diluent which means the amount of
the diluent to be weighed and mixed with the API is 3000mg – 120mg = 2880mg
d) Weighing a portion of the mixture that contains the needed amount ie. 4 mg in this
case.
if our total mixture, 3000mg contains 120mg of the API then what amount of the
mixture contains 4 mg of the API……………. Cross multiplication gives 120mg of the
mixture…
NB: The student should show this kind of flow of idea and principles but not
necessarily use the same figures… but in the end must convince the examiner on the
feasibility of measurements/weighing using the selected figure.
5. A formula calls for 0.5 milliliter of hydrochloric acid. Using a 10-milliliter graduate
calibrated from 2 to 10 milliliters in 1-milliliter divisions, explain how you would obtain the
desired quantity of hydrochloric acid by the aliquot method.
ANSWER:
 If 4 is chosen as the multiple, and if 2 milliliters is set as the volume of the aliquot,
then:
1. Measure 4 X 0.5 mL, or 2 mL of the acid
2. Dilute with 6 mL of water to make 8 mL of dilution
3. Measure 1⁄4 of dilution, or 2 mL of dilution, which will contain 0.5 mL of
hydrochloric acid.

NB: Maximum tolerable error has not been given in case so no need to establish
the minimum tolerable error first.

6. A prescription calls for 50 milligrams of chlorpheniramine maleate. Using a prescription

balance with a sensitivity requirement of 6 milligrams, explain how you would obtain the
required amount of chlorpheniramine maleate with an error not greater than 5%. Use lactose
as diluent.
ANSWER: Like in the above two questions, the student must use aliquot method
and must show all the necessities to this approach.

7. You are required to compound the following formula;

Sodium citrate 5g
Tartar Emetic 0.015g
Cherr Syrup ad 120ml
Using a balance with a sensitivity of 4 mg, an acceptable weighing error of 5% and
cherry syrup as the solvent for tartar emetic, how could you obtain the correct quantity of
tartar emetic to fill the prescription?
ANSWER: Like in the above questions, the student must use aliquot method and
must show all the necessities to this approach
8. A formula calls for 0.6 milliliter of a color ing solution. Using a 10-milliliter graduate
calibrated from 2 to 10 milliliters in 1-milliliter units, how could you obtain the desired
quantity of the coloring solution by the aliquot method? Use water as the diluent.
ANSWER: Like in the above questions, the student must use aliquot method and
must show all the necessities to this approach

9. Using a 10 milliliter graduated calibrated in 1 milliliter units, explain how you would
measure 1.25 milliliters of a dye solution by the aliquot method. Use water as the diluent.
ANSWER: Like in the above questions, the student must use aliquot method and
must show all the necessities to this approach

10. As a pharmacist at a compounding facility you receive a call for compounding the
prescription below. How many grams of boric acid will you need to compound the
prescription? (Given the sodium chloride equivalents of boric acid, phenacaine
hydrochloride and chlorobutanol are 0.52, 0.20 and 0.24 respectively)
Phenacaine Hydrochloride 1% w/v
Chlorobutanol 0.5% w/v
Boric Acid q.s.
Purified Water ad 60ml
Make isoton. sol.
Sig. One drop in each eye.
ANSWER: 0.669 g
This is also based on isotonicity requirements of parenteral and other solutions.
11. As an industrial pharmacist in the line of parenteral preparations you are required to guide
the preparation of an isotonic dibucaine hydrochloride solution for injection. The
requirement is to prepare vials of 30ml, 1% dibucaine hydrochloride solution with sodium
chloride added for isotonicity. For each vial, how many milligrams each of each, sodium
chloride and dibucaine hydrochloride will you need given that, an isotonic solution freezes
at -0.52 oC and the freezing point depressions of 1% solutions of dibucaine hydrochloride
and sodium chloride are 0.08 oC and 0.58 oC.
ANSWER: 228 mg of Sodium chloride and 300 mg of dibucaine hydrochloride
To make this solution isotonic, the freezing point must be lowered to -0.52.
It is known that a 1% solution of dibucaine hydrochloride has a freezing point
lowering of 0.08 oC.
Thus, sufficient sodium chloride must be added to lower the freezing point an
additional 0.44 (0.52 - 0.08 oC).
Also it is known that a 1% solution of sodium chloride lowers the freezing point
by 0.58oC by proportion:
12. A hospital’s Pharmacy and Therapeutics Committee is determining the most economical of
three drugs considered to be therapeutically equivalent. The least expensive drug, per patient
treatment day, is to be added to the hospital’s drug formulary.
Drug A: 0.5 g/mL, 5-mL vial; dose, 1 mL q6h; cost, $16.50/vial
Drug B: 1 g/mL, 10-mL vial; dose, 0.75 mL q8h; cost, $57.42/vial
Drug C: 1.5 g/mL, 1-mL ampule; dose, 1 mL q12h; cost, $15.94/ampule
Which drug is most economical, per patient treatment day, not taking into consideration
any material or personnel costs?
Answer
13. Show the procedure for Preparing Ammonium chloride mixer 50ml, from the master
formula below.
Ammonium Chloride BP 100 g
Aromatic Ammonia Solution BP 50ml
Liquorice Liquid Extract BP 100ml
Potable water 1000ml
Answers
a) Calculate the quantity of ingredients required to produce the final volume needed.
b) Weigh 5 g Ammonium Chloride BP accurately on a Class II or electronic balance. As
ammonium chloride is soluble 1 part in 2.7 parts of water, the 5 g required for this
product would only dissolve in a minimum initial volume of 13.5mL aqueous vehicle.
Therefore we should choose a convenient volume of vehicle to dissolve the solute, say
15 mL.
c) Measure approximately 15mL potable water and transfer to a beaker.
d) Add the Ammonium Chloride BP to the water in the beaker and stir until dissolved.
e) Transfer to a 50mL conical measure with rinsings.
f) Measure 5mL Liquorice Liquid Extract BP accurately in a 5mL conical measure and
add, with rinsings, to the 50mL measure containing ammonium chloride solution.
g) Measure 2.5mL Aromatic Ammonia Solution BP accurately in a syringe and transfer
to the 50mLmeasure containing the composite solution.
h) Make up to the final volume of 50mL with potable water and stir.
i) Pack into a 50mL amber flat medicine bottle and label.

14. How would you measure 0.025 mL of a concentrate which is to be diluted to 60 mL

following the measurement? You are provided with a 5 mL pipet with marking in units of 1
mL, a measuring cylinder, and a container to dispense the final product.
Answers
Procedure:
Before the actual product is made, it is a good idea to calibrate the final container to the
required volume. In the present case, fill the container with purified water to 60 mL and
mark the level of liquid from outside. Then empty the container. This process is called the
calibration of container.

a. Since 0.025 mL cannot be measured and 1 mL is the minimum measurable quantity,

measure one mL of the drug concentrate using the pipet and transfer this liquid to the
measuring cylinder.
b. In order to make a stock solution, find the volume of water needed by making use of the
multiple factor. The multiple factor in the present case is 1/0.025 = 40. The total amount
of stock solution would be equal to the quantity of measured concentrate multiplied by
 the multiple number, i.e., 1 × 40 = 40. Therefore, the volume of water needed equals 40
− 1 = 39 mL.
c. Add 39 mL of water to the concentrate in the measuring cylinder or make up the total
volume to 40 mL. Mix the solution well. From this solution, withdraw an aliquot which
contains the required 0.025 mL of the concentrate and transfer to the final container.
The aliquot is determined by using the following proportion:
1 mL of the concentrate/
40 mL of stock soln
=
0.025 mL of the concentrate/
X mL of the aliquot
X = 1 mL
d. Place 1 mL of the aliquot in the final container, and add sufficient amount of purified
water to fill to the calibrated mark of 60 mL.

15. Explain how you would make this product.

FD & C dye 0.25 mg
While you’re provided with, purified water qs. and 90 mL and 0.5% w/v of FD & C dye
stock solution.
Answers
Procedure:
a. Calibrate the final container to 90 mL. Determine the amount of stock solution which
contains 0.25 mg of the dye as follows:
500 mg of the dye/
100 mL of the stock soln
=
0.25 mg of the dye/
X mL of stock soln
X = 0.05 mL
b.one can either measure the 0.05 mL by a medicinal dropper or alternatively, the stock
solution can be diluted such that the diluted stock solution would provide a measurable
quantity containing 0.25 mg of the dye. For dilution, measure one mL of the stock
solution and add a sufficient quantity of purified water to obtain 100 mL of diluted stock
solution. The concentration of diluted stock solution is
C1 × V1 = C2 × V2
0.5% × 1 mL = X × 100 mL
X = 0.005%
c. figure out the amount of diluted solution which would provide the required 0.25 mg of
the dye as follows:
5 mg of the dye/
100 mL dil stock soln
=
0.25 mg of the dye/
X mL dil stock soln
X = 5 mL
Measure 5 mL of the diluted stock solution which contains the required
 0.25 mg of the drug.
d. Transfer 5 mL of the diluted stock solution or 0.05 mL of the original stock solution to
the final container and add a sufficient quantity of water to fill up to the calibrated 90-mL
mark.
16. Rx
Gentian violet 0.03 g
Purified water qs ad f ii
Show how you would prepare this prescription using a Class A prescription balance.
Answers
Procedure:
a. Calibrate the final container to 60 mL. Since 0.03 is not weighable on
Class A prescription balance, the aliquot method is required. Weigh 120mg of gentian
violet using the balance.
b. Make a stock solution such that an aliquot of stock solution will provide 0.03 g of
gentian violet. Dissolve 0.12 g of gentian violet in purified water to make 20 mL (this
number is arbitrarily chosen) of the stock solution.
c. From the stock solution, measure an aliquot that contains 0.03 g of the gentian violet.
The aliquot amount is calculated by using the following proportion:
0.12 g of gentian violet/
20 mL of the stock soln
=0.03 g of gentian violet/
X mL of the stock soln
X = 5 mL
d. Transfer 5 mL of the stock solution into the final container, and add a sufficient
quantity of purified water to make up to the calibrated mark of 60 mL.
17. A physician prescribed 25, 4-mg capsules of a drug for a special needs patient, knowing that
the dose prescribed was considered ‘‘subtherapeutic.’’ The lowest strength commercially
available tablets contain 25 mg. The pharmacist decided to select the minimum required
number of 25-mg tablets; reduce them to a powder with a mortar and pestle; weigh the
powder (280 mg); and continue the process using the aliquot method. She called upon her
pharmacy student intern to calculate;
(a) The minimum quantity of lactose (diluent) to use in preparing the crushed tablet-
diluent mixture
(b) The quantity of the mixture to use to fill each capsule. The prescription balance had a
SR of 6mg and a weighing error of 5%wasacceptable.
Show your calculations for (a) and (b), and (c) prove that your answer to (b) is correct by
demonstrating that each capsule would indeed contain 4 mg of drug.
Answers
The smallest quantity that should be weighed on the balance:
18. A 35-year-old male patient weighing 180 lb. and standing 5 ft.8 in. tall has been diagnosed
with AIDS. His physician prescribes lamivudine (EPIVIR) as a component of his treatment
program and knows that the dose of the drug must be adjusted based on the patient’s renal
 function. Laboratory tests indicate that the patient’s serum creatinine is 2.6 mg/dL and has
held at the same level for 5 days.
(a) Calculate the patient’s ideal body weight (IBW) and use in subsequent calculations
if the IBW is lower than the patient’s actual weight.
(b) Calculate the patient’s CrCl by the Cockcroft-Gault equation.
(c) Select the appropriate dose of lamivudine from the dosing schedule:

Creatinine Clearance Initial Dose Maintenance Dose

<5 mL/min 50 mg 25 mg once daily
5–14 mL/min 150 mg 50 mg once daily
15–29 mL/min 150 mg 100 mg once daily
30–49 mL/min 150 mg 150 mg once daily
Answer

19. You’re a pharmacist at a certain District Hospital and you have receive the prescription but
you have notice that you don’t have hydrocortisone powder on hand, instead you have an
injection containing 100 mg of hydrocortisone per milliliter of injection, and you know from
the literature that the injection has a specific gravity of 1.5.
Rx
Hydrocortisone 1.5%
Cold Cream qs 30 g
(a) How many grams of hydrocortisone are needed to fill the prescription?
(b) How many milliliters of the hydrocortisone injection would provide the correct
amount of hydrocortisone?
 (c) How many grams of cold cream are required?
Answer

20. A physician prescribes amiodarone HCl IV for a patient with ventricular fibrillation. The
prescribing information is:
Loading infusions:
Rapid infusion over first 10 minutes: 15 mg/min
Slow infusion over the next 6 hours: 1 mg/min
Maintenance infusion:
Slow infusion over the remaining 18 hours: 0.5 mg/min
Amiodarone HCl IV is available in 3-mL ampuls containing 50 mg/mL.
And you decide to uses a 100-mL bag of D5W for the rapid infusion and 250-mL bottles
of D5W for the slow infusions.
(a) How many milliliters from an amiodarone HCl IV ampule should be placed in the
100-mL bag for the rapid infusion?
(b) What is the drug concentration in the rapid infusion, in mg/mL?
(c) If you added the contents of 3 ampuls to each 250-mL bottle of D5W needed for the
slow infusions, calculate the drug concentration in mg/mL.
(d) What rate of administration, in mL/hr, you would have recommend during the 6-hour
infusion segment?
(e) Calculate the rate of administration in (d) in drops/minute with an administration set
that delivers 15 drops/mL.
(f) Calculate the milligrams of drug administered by slow infusion over the 6-hour
segment.
(g) Make the same calculation as that in (f) but over the 18-hour segment.
Answer
21. A hospital pharmacist fills a medication order calling for an intravenous fluid of dextrose
5% in a 0.9% sodium chloride injection and 40 mEq of potassium chloride in a total volume
of 1000 mL. The intravenous infusion is administered through an IV set that delivers 15
drops per milliliter. The infusion has been running at a rate of 12 drops per minute for 15
hours. During the 15-hour period:
(a) How many mEq of KCl have been administered?
(b) How many grams of KCl have been administered?
(c) How many millimoles of KCl have been administered?
(d) What is the total osmolarity of the intravenous fluid?
Express the answer in millimoles (rounded to the nearest whole number) per 1000mL.
Answer
22. Dr.Duncun has asked you to calculate the dose of clindamycin for a 3-day-old neonate
weighing 3 lb. 7 oz., after a search in literature you learn that the suggested dose is:
 <1200 g: 10 mg/kg/day divided q12h.
<2000 g and 0–7 days old: 10 mg/kg/day divided q12h
<2000 g and >7 days old: 15 mg/kg/day divided q8h
>2000 g and 0–7 days old: 15 mg/kg/day divided q8h
>2000 g and >7 days old: 20 mg/kg/day divided q6h
Each divided dose is to be added to an intravenous infusion at the scheduled hour and
infused over a period of 20 minutes. Clindamycin is available in an IV bag containing
600 mg/50 mL of injectable solution. Calculate how many milliliters of this solution
should be given for each divided dose?
Answer
23. You’re an intern pharmacist at Muhimbili National Hospital, the patient present following
prescription, which requires the correct interpretation of abbreviations prior to engaging in
calculations, compounding, labeling, and dispensing.

Lisinopril
Hydrochlorothiazide aa. 10 mg
Calcium Phosphate 40 mg
Lactose q.s. ad 300 mg
M.ft. cap. i D.T.D. # 30
Sig: cap. i AM a.c.
(a) How many milligrams each of lisinopril and hydrochlorothiazide are required to fill
the prescription?
(b) What is the weight of lactose required?
(c) Translate the label directions to the patient.
Answers

24. A patient with myasthenia gravis has undergone treatment to separate and remove certain
abnormal antibodies and other unwanted elements from the blood (plasmapheresis). The
desired red blood cell component is then returned back to the blood, but the patient has lost
protein and blood volume. The patient’s physician orders 2000 mL of a 5% w/v solution of
albumin in 0.9% w/v sodium chloride injection to replace lost protein and fluid. In filling
the order, the pharmacist decides to use a piece of automated equipment to compound the
mixture. The equipment must be programmed with the specific gravities of the solutions
being mixed. The pharmacist selects to use a 25% w/v albumin solution as the source of the
albumin plus a 0.9% sodium chloride injection. From the literature, the pharmacist finds that
0.9% sodium chloride has a specific gravity of 1.05. Using a precise 25-mL pycnometer
with a tare weight of 28 g, the pharmacist fills it with the 25% w/v albumin solution and
determines the weight of the flask and its content to be 58 g.
(a) What is the specific gravity of the albumin solution?
(b) How many milliliters of the 25% w/v albumin solution are needed to make
2000 mL containing 5% w/v albumin?
(c) What is the weight of the 25% albumin solution needed to fill the order?
(d) If the pharmacist mixed the required number of milliliters of the 25% albumin
solution with a sufficient 0.9% w/v sodium chloride injection to make the required 2000
mL mixture, what would be the specific gravity of the resultant solution?
Answer
25. A physician ordered you to calculate the dose of a cough syrup so that it may be safely
administered dropwise to a child. The cough syrup contains the active ingredient
dextromethorphan HBr, 30 mg/15 mL, in a 120-mL bottle. Based on the child’s weight and
literature references, you had determine the dose of dextromethorphan HBr to be 1.5 mg for
the child. Calculate the dose, in drops, for the child if the calibrated dropper to be dispensed
with medication deliver 20 drops of the cough syrup per 1 mL.
Answer
26. A 7 year patient is being administered enalaprilat every 12 hours by intravenous injection to
manage hypertension and possible heart failure. Based on a dose of 5 mcg/kg, the patient is
receiving 55mcg of enalaprilat per dose.The physician wishes to convert the patient to oral
enalapril at a dosage of 100 mcg/kg as a single daily dose. The standard procedure is to
crush a 2.5-mg tablet of enalapril, mix with sterile water to make 12.5 mL, and administer
the appropriate dose using a calibrated oral dispenser. Calculate the dose, in milliliters, to be
administered to this patient.
Answer
27. You have been asked to calculate the dose of the biotechnology-derived drug epoetin alpha
(EPOGEN, PROCRIT) for a 146.7-lb. patient. The drug is indicated in the treatment of
anemia associated with chronic renal failure at a starting dose of 50 to 100 units/kg. The
patient’s hematocrit (HCT) is taken initially and twice weekly to avoid exceeding or
reaching the target range (HCT 30% to 36%) too rapidly. Once the HCT target is reached,
the dose is reduced to a titrated maintenance dose. The attending physician prescribes an
initial dose of 75 units/kg subcutaneously, three times a week, with the dose reduced by half
when the HCT approaches 33%.The patient’s initial HCT is 29%.The drug is available in 1-
mL vials containing 2000, 3000, 4000, 10,000, and 40,000 units/mL. Calculate the:
(a) Initial dose, in units;
(b) Weekly dose, in units;
(c) Maintenance dose, in units; and
(d) Most convenient vial size and mL to administer for each therapeutic daily dose.
Answer
28. A local ophthalmologist is treating one of his patients for a post-LASIK eye infection that is
not responding to topical ciprofloxacin. These infections, although rare, can occur after laser
in situ keratomileusis (LASIK) surgery for vision correction.Topical amikacin sulfate has
been shown to be effective for the treatment of eye infections due to ciprofloxacin-resistant
Pseudomonas, Burkholderia ambifaria, Mycobacterium chelonae, and Mycobacterium
fortuitum.
The ophthalmologist prescribes 60 mL of a 2.5% amikacin sulfate isotonic solution, 2
drops in the affected eye every 2 hours.
Amikacin sulfate USP (C22H43N5O13.2H2SO2), m.w., 781.76, is an aminoglycoside-
type antibiotic containing 3 ions.
(a) Determine the weight in grams of amikacin sulfate needed to prepare the solution.
(b) Calculate the sodium chloride equivalent (E value) for amikacin sulfate.
(c) Calculate the amount of sodium chloride needed to make the prepared solution
Isotonic.
 (d) How many milliliters of 23.5%sodium chloride injection should be used to obtain the
needed sodium chloride?
Answer

29. A mother asks a pharmacist to help her understand the nutritional content of PEDIASURE
Enteral Formula, which has been recommended for her 12- year-old child. The label
indicates that 1500 mL of the product, taken daily, provides complete nutrition for children
ages 9 to 13 years. The product comes in cans containing 237 mL. If each liter of the
product provides 1000 kcal, 30 g of protein, 132.5 g of carbohydrate, and 39.7 g of lipid,
along with 852 mL of water, calculate the following provided in the recommended dose:
(a) Kilocalories
(b) Grams of protein
(c) Grams of carbohydrate
(d) Percentage of calories derived from fat
(e) Daily water
Answer
30. You were working at the emergency department and the following prescription was
presented; 100 mL of a cefuroxime axetil suspension to contain 300 mg of drug in each 5
mL, in your stock you have 100 mL of a suspension containing 250 mg/5 mL and also has
250-mg scored tablets of the drug. How many tablets should be pulverized and added to the
suspension to achieve the desired strength? Assume no increase in the volume of the
suspension.
A Second Look
You have observed that after adding the pulverized tablets, the suspension measured 102
mL in volume. Calculations revealed that rather than the prescribed drug strength of 300
mg/5 mL, there were 294.1 mg/5 mL. What should you do to bring the suspension to the
desired strength?
Answer
31. A pharmacist received a prescription for the drug allopurinol for a pet parakeet in the
treatment of gout. The veterinarian prescribed 0.5 mg to be administered by oral drops four
times a day. The pharmacist has 100-mg tablets and a dropper that has been calibrated to
deliver 20 drops/mL. The pharmacist decides to crush a tablet, mix it with a sufficient
quantity of water and make a suspension such that the pet’s owner can conveniently
administer the doses to the parakeet.
(a) How many milliliters of suspension should be prepared from the crushed 100- mg
allopurinol tablet?
(b) How many drops should be administered to the parakeet per dose?
Answer

32. Study the following prescription and answer the following questions;
Rx
Clindamycin Phosphate 1.5%
Alcohol (52% v/v) q.s. ad 120 mL
Sig: Apply daily for acne
After studying the prescription you realized that you don’t have clindamycin phosphate
powder but clindamycin Phosphate sterile solution, 150 mg/mL, in vials and from the
label, you learned that the solution is aqueous.
(a) How many milliliters of the clindamycin phosphate sterile solution should you use in
filling the prescription?
(b) How many milliliters of 95% v/v of alcohol are required?
(c) How many milliliters of water should be added to make 120 mL?
Answer
33. Mr.XYZ who is pharmacist receives a telephone call from a pediatrician who has an 8.8-lb.
1-month-old patient with an acid reflux condition. The infant was started on ranitidine
(ZANTAC) syrup, 15 mg/mL, at a dose of 10 mg/kg/day, and has shown improvement.
However, because of the flavor (peppermint) and alcohol content (7.5%), the baby
frequently rejects the medication.
Mr.XYZ suggests preparing a sugar-free and alcohol-free syrup/suspension
With a fruity odor and taste. The physician agrees and prescribes ranitidine syrup/
Suspension, 60 mL, at a dose of 10 mg/kg/day, divided into two 0.5-mL doses.
Mr.XYZ uses finely crushed 75-mg ranitidine tablets as the source of the drug
and ORA-SWEET SF as the vehicle. How many 75-mg ranitidine tablets are required?
Answer
34. A pediatrician telephones you asking that the concentration of an antibiotic suspension be
changed. The pediatrician wants the child-patient to take 200 mg of amoxicillin per
teaspoonful dose. The label for amoxicillin powder for oral suspension indicates that the
addition of 68 mL of purified water will result in a final volume of 100 mL with a
concentration of 250 mg amoxicillin per 5mL of suspension. How many milliliters of water
should you add to the amoxicillin powder to produce a concentration of 200
mg/teaspoonful?
Answer
35. A hospitalized patient has been receiving ranitidine 50 mg by intravenous injection every 8
hours. After discharge, the patient’s physician wishes to continue treatment with a
bioequivalent dose of the oral liquid form of ranitidine. From the literature, the community
pharmacist determines that the oral liquid is 50% bioavailable. The product is available in a
concentration of 75 mg/5 mL, to be taken twice a day. How many milliliters of the oral
liquid should be indicated per dose on the prescription label?
Answer
36. A child weighing 28 lb is to receive 4 mg of phenytoin per kilogram of body weight daily as
an anticonvulsant. How many milliliters of pediatric phenytoin suspension containing 30 mg
per 5 mL should the child receive?
Answers
Step 1. Find the dose for the child.
4 mg/kg or 4 mg/2.2 lb
If the dose is 4 mg/lb, a 28-lb child should receive:
4 mg/
2.2 lb
=
X mg/
28 lb
Answer: X = 50.9 or 51 mg
Step 2. Find how many milliliters would contain that dose. If 30 mg are contained in 5
mL, 51 mg would be contained in:
30 mg/
 5 mL
=
51 mg/
X mL
Answer: X = 8.5 mL

37. A patient is to receive 10 mEq of potassium gluconate four times a day for three days. The
dose is a teaspoonful.
a. How many milligrams of potassium gluconate should be used in compounding the
prescription?
b. What is the volume, in milliliters, to be dispensed to provide the prescribed dosage
regimen?
Answers
Molecular weight of potassium gluconate (C6H11KO7) = 234
10 mEq of C6H11KO7 given 4 times a day for 3 days = 10 × 4× 3 = 120 mEq
Eq. wt. of C6H11KO7 = 234
a. Weight in mg = mEq weight × Number of mEq
= 234 × 120= 28,080 mg = 28.08 g
b. A proportion can be set to calculate the volume, in milliliters, to be dispensed to
provide the prescribed dosage regimen as follows:
10 mEq/
5 mL
=
120 mEq/
X mL
Answer: X = (5 × 120)/10 = 60 mL

38. How would you fill the following prescription? Show all the calculations, procedure, and
the label for the product.
Answers
Tablets available: HCTZ 50 mg and Triamterene 50 mg.
Procedure:
Step 1: The prescription is based upon one capsule and Dr. Huxtable wants ten such
capsules for his patient, Ms. Burns.
Step 2: 20 mg × 10 = 200 mg of hydrochlorthiazide and 40 mg × 10 = 400mg of
triamterene are needed for the ten capsules that are required for the prescription. Since
bulk powders are not provided, the available tablets of hydrochlorthiazide and
triamterene should be used. The number of tablets to be crushed are determined by using
the following proportion:
50 mg of HCTZ/
1 tablet
=
200 mg of HCTZ/
X tablets
X = 4 tablets of HCTZ
50 mg of triamterene/
1 tablet
=
400 mg of triamterene/
X tablets
X = 8 tablets of triamterene
Weigh four tablets of hydrochlorthiazide and eight tablets of triamterene. Assume that the
four tablets of hydrochlorthiazide weigh 800 mg and eight tablets of triamterene weigh
1200 mg. crush the four and eight tablets, respectively. Mix these two powders
geometrically. The total powder now weighs 2000 mg.
Step 3: Determine the capsule size by using the rule of six. Capsule size #3 can hold 3
grains or 195 mg. Weigh 200 mg of the tablet mixture (which is obtained as 2000 mg of
total powder/10 capsules) and try to fill in capsule size #3. If the capsule is not filled or it
is too full, go for the next capsule size, i.e., #2 which holds approximately 4 grains or 260
mg of powder. Verify the appropriateness by filling one or two capsules of size #2. If
appropriate, select this size. For 10 capsules, the total powder should be 2600 mg.
Therefore add 600 mg of lactose in the tablet mixture of 2000 mg by geometric dilution.
Transfer the 2600 mg of powder on a clean paper
or an ointment tile, compress as a cake, and fill all the capsules by a sliding motion.
Step 4: Wipe all the capsules from outside with a clean dry tissue paper, and submit the
capsules in a suitable container with the following label:
i.e. Name of the pharmacy, Address of the pharmacy, Name of the patient, Date of
compounding, Name of the patient,Instrutions to the patient.
39. Show the detailed method of compounding the following prescription along with all the
calculations.

Answers
Powdered ingredients are available.
Procedure:
Step 1: The prescription is based upon twelve capsules, i.e., the ingredient quantities
given (ephedrine sulfate 0.3 g and phenobarbital 0.18 g) are for twelve capsules.
Step 2: Weigh 300 mg of ephedrine sulfate and 180 mg of phenobarbital and mix
thoroughly. The total quantity of the mixture of these two powders is 480 mg. The amount
of ephedrine sulfate needed for one capsule is 25 mg (300 mg of powder/twelve capsules)
and that of phenobarbital is 15 mg (180 mg of powder/twelve capsules). The total amount
of powdered drugs in each capsule is 40 mg. The minimum weight that can be weighed
on a Class A prescription balance with a potential error of not more than 5% is 120 mg.
 Therefore, the weight of powder for each capsule has to be increased to a quantity equal
to or greater than 120 mg.
Step 3: By the rule of six capsule size #4 can hold a total powder quantity of about 130
mg. considering this amount, the total amount of powder for twelve capsules of size #4 is
1560 mg. The amount of lactose that should be added for twelve capsules is 1080 mg
(calculated as 1560 mg − 480mg = 1080 mg). Therefore, weigh 1080 mg of lactose and
add to the drug mixture by geometric dilution. As a confirmation of the size, fill one or
two capsules of size #4 with 130 mg of the mixture and determine the appropriateness. If
the capsule size is correct, punch out the remaining capsules after forming a cake on a
powder paper or an ointment tile.
Step 4: Wipe all the capsules from outside with a clean and dry tissue paper, and submit
in an appropriate container after affixing the following label:

40. Calculate the dose of ValiumR of a thirteen-month-old child by the Young’s method if the
adult dose is 10 mg. ValiumR is available as a 5 mg/5 mL oral solution. How would you
administer this medication to the child?
Answer
Dose of child =
Age in years/
Age in years + 12
× Adult dose
Dose of child =
(13/12)
(13/12) + 12
× 10 mg
Dose of child = 0.83 mg
 5 mg/5 mL = 0.83 mg in 0.83 mL
Answer: Therefore a medicinal dropper will be calibrated to determine the number of
drops which would constitute 0.83 mL and the drug will be administered.

41. Find the quantity of sodium chloride to be used in compounding the following prescription.
The values of sodium chloride equivalent of epinephrine HCl and scopolamine HBr are 0.29
and 0.12, respectively.

Answer
Step 1: Sodium chloride needed to render the prescribed volume isotonic
(0.9/100) × 60 = 0.54 g
Step 2: (a) Epinephrine HCl:
(1/100) × 60 = 0.60
0.60 × 0.29 = 0.174 g
(b) Scopolamine HCl:
(0.5/100) × 60 = 0.30
0.30 × 0.12 = 0.036 g
The total of sum of the weights (in grams) of epinephrine HCl and scopolamine HCl
multiplied by their E values, i.e., the total of (a) + (b)
= 0.174 + 0.036 g = 0.21 g
Step 3: answer: sodium chloride required to make the solution isotonic
0.54 0.21 = 0.33 g

42. Find the quantity of boric acid (in grams) to be used in compounding the following
prescription.
 Answer
Step 1: (0.9/100) × 30 = 0.27 g
Step 2: (1/100) × 30 = 0.3 g
0.3 × 0.13 = 0.039 g
Step 3: 0.27 − 0.039 = 0.231 g
Step 4: From Step 3, 0.231 g of sodium chloride is required to make the preparation
isotonic. But the prescription calls for boric acid as the tonicity agent. Boric acid has an
E value of 0.52. This means that 1% boric acid is osmotically equivalent to 0.52% NaCl
or 1 g of boric acid is equivalent to 0.52 g of NaCl.
1 g/
0.52 g
=
X
0.231 g
where X is grams of boric acid equivalent to 0.231 g of sodium chloride.
Answer: solving for X, we get: (0.231 × 1) /0.52 = 0.444 grams

43. A medication order provided for a one-year-old child weighing 9 kg includes sodium
nitroprusside in a dose of 1.5 mcg/kg/min. The drug available is sodium nitroprusside 25
mg/5 mL. The physician wanted 20 mg of sodium nitroprusside in 200 mL of D5W to be
administered at 20 mL per hour to this child who is in shock. Check for the accuracy of the
dilution order.
Answer
Concentration of the solution in mcg/mL is calculated as follows:
1.5 mcg/kg/min = 1.5 × 9 = 13.5 mcg/min
 Dose per hour = 13.5 × 60 = 810 mcg per hour
Concentration of the solution =
810 mcg/hr
20 mL/hr
Concentration of the solution = 810/20 = 40.5 mcg/mL
The dilution for administration is prepared as follows:
The physician ordered 20 mg/200 mL of the sodium nitroprusside
25 mg/5 mL = 20 mg/X
X = 4 mL of the 25 mg/5 mL available solution should be measured accurately and added
to 200 mL of D5W.
The concentration of the dilution is 20 mg/ (200 + 4) mL = 20 mg/204 mL
= 0.098 mg/mL or 98 mcg/mL
Answer: The concentration of the solution calculated was 40.5 mcg/mL and the dilution
concentration is 98 mcg/mL. Therefore, the dilution order is inaccurate.
44. Upon the administration of 0.27 mg of a therapeutic agent to a normal individual, the
elimination rate constant was found to be 0.0315 hour−1. The normal dosing regimen
included 0.27 mg qid. If the elimination rate constant in renally impaired condition is 80%
of the normal elimination rate constant, how can the dose be adjusted maintaining the same
dosing interval of six hours?
Answer
DOn = 0.27 mg, _n = 6 hours, Keln = 0.0315 hour−1
DOri =? _ri = 6 hours, Kelri = 80% of 0.0315 = 0.0252 hour−1
DOn
_n × Keln
=
DOri
_ri × Kelri
0.27 mg
6 hr × 0.0315 hr−1 =
X
6 hr × 0.0252 hr−1
 X = Dose for the renally impaired condition = 0.216 mg
Answer: 0.216 mg

45. Explain how you would titrate dopamine starting from 4 mcg/kg/min to maintain a mean
systolic pressure between 100–120 mmHg. The patient weighs 165 lb and the IV
preparation is dopamine 200 mg in 125 mL of D5W.
Answer
Titration factor = (mcg/min)/drops/min
= mcg/drop
To calculate micrograms of dopamine per minute,
165 lb = 75 kg
4 mcg/kg/min = 4 × 75 mcg/min for the 75 kg patient= 300 mcg/min
To find the drops per minute, amount in milliliters per hour is required,
200 mg or 200,000 mcg/125 mL = X mcg/1 mL
X = 1600 mcg/mL
Drops/min =300 mcg/min
1600 mcg/mL= 0.1875 mL/min which equals 0.1875 × 60 = 11.25 mL/hour
Note: Whenever microdrop IV set is used, mL/hour = drops/min 11.25 mL/hour = 11.25
drops/min
Titration factor = (mcg/min)/ (drops/min)
= mcg/drop
(300 mcg/min)/
(11.25 drops/min)
= 26.67
Answer: 26.67 mcg/drop

46. Mr. Mboka, a 56 years old man suffering from chronic arthritis is on regular treatment with
a slow release (SR) preparation of diclofenac 100mg once a day. Upon refilling of his
prescription he visits a community pharmacy where you are the superintendent and presents
his prescription to the pharmaceutical dispenser working there. Unfortunately, your
pharmacy do not have such preparation but the desperate dispenser carelessly chooses to
give the conventional diclofenac 50mg tablets to be taken as 2 tablets once a day for a
month. Mr. Mboka is happy that the price is even lower compared to the previous and the
dispenser is proud he managed serving the client regardless of the shortage of the primarily
required medicine. As a pharmacist;
a. What do you understand by (i) conventional tablets and (ii) slow release tablets
b. Explain the therapeutic consequences that Mr. Mboka is likely to face following
such switching; from the slow release tablet to the conventional tablets at the same
dosage regimen.
c. You happen to notice that mistake by the dispenser, what will be your advice to him?
d. Had it been inevitable giving the conventional diclofenac tablets by some reasons
like shortage of the SR tablets in all pharmacies in your city, how could you help this
patient?
15 marks

ANSWER: skeletons
i. Conventional tablets = simple tablets with direct release properties o the
API. Slow release tablets = tablets modified to have special slow rate of
release of the API
ii. Several consequences including toxicity due to rapid absorption of a high
dose of the conventional tablet as well as therapeutic failure due to shorter
effect of the conventional tablet (first order kinetics)
iii. Key advice to the dispenser should constitute education of the understanding
of the two dosage forms and their purposes. Also the consequences of
substituting one for the other without adjustment of dosage regimen.
iv. The remaining approach could be just giving the conventional dosage form
with adjustment of dosage to follow the proper dosage of the conventional
dosage form and not of the slow release product.
 Mostly in this case and assuming proper renal function it could be
diclofenac 50mg tid. However this is could be given for a shorter
duration as the slow release tablet is being secured.

47. Aisha, a 24 years old girl comes to your pharmacy complaining the drug you gave her for
the past three weeks is no showing any significant improvements on her tinea capitis. You
review the case and notice that you gave micronized griseofulvin 500mg tablets once a day
for 30 days. She claims to take the drug with plain drinking water and she normally quickly
chew it first before swallowing since it is too big to pass her throat comfortably. It also
comes to your mind that she is slightly overweight and on weighing her you find she is 91kg
a. What do you think are the reasons for the observed therapeutic failure given the drug
is ideally effective against the strain of her tinea capits?
b. Given no other therapeutic alternatives to tinea capitis in your facility, explain fully
how you will help Aisha by using the same micronized griseofulvin. 10marks
ANSWERS: skeletons
i. A micronized tablet should not be chewed (crushed) in the mouth since it
crushing impairs the special formulation modality to increase absorption
(micronization). Griseofulvin should be taken with food especially fatty foods
(milk) to even increase its absorption. Aisha did the opposite of all these
ii. To help, Aisha must be well instructed on not crushing the tablets and also
take it with food
48. Mzee Kitwe comes to your pharmacy asking for one vial of fortified procaine
penicillin(PPF) powder for injection. In surprise you ask Mzee Kitwe for the indication of
such one vial of PPF and he says is going to apply it on his grandchild’s wound to quicken
its healing.
a. As a pharmacist do you think Mzee Kitwe is right applying the PPF powder on the
wound?
b. Defend your answer above giving reason(s) for it. 5 marks
i. He is not right
ii. He is not right as PPF or any drug works the best when well dissolved in
solution. Applying it directly on the wound in powder form does not
 guarantee any superior effect than loss of the undissolved drug. Stability of
the drug on the body fluids can be a problem.. plus possible irritation of the
drug to the wound due to its direction high concentration.

49. Mariam, a 20 years girl normally uses MEDVEN (betamethasone) cream for cosmetic rather
than therapeutic purpose. She comes to your facility asking for MEDVEN and the dispenser
randomly picks MEDVEN ointment and not the cream as both forms are available and
largely resemble. Mariam rejects it claiming she is not sick to use the drug type of
MEDVEN and she just wants the cream for her cosmetic reasons. Upon interacting with her,
you realize she classifies the ointment as a drug for skin problems and the cream as a
cosmetic for skin bleaching.
a. As a pharmacist what will be your advice to clear Mariam’s misconception?
b. Briefly explain why there may be creams, ointments and gels for the same drug,
concentration and applications. 8 marks

ANSWER: skeleton answers

a) The student is expected to advice the patient that a cream or an ointment are
merely physical forms of the drug and they have nothing to do with classification
of the drug action (A cream is not a bleaching agent)
b) The most genuine reason is to suit different health conditions and skin types..
ointment for dry skin and skin conditions like psoriasis etc and creams and gels
for conditions requiring less occlusion of the skin i.e for oozing conditions and
oily skins

50. Mrs. Manga, a 43 years old woman got an accident and had her left hand mildly injured and
in pain. She is prescribed diclofenac ointment to be rubbed three times a day on the affected
part. You do not have diclofenac ointment in your pharmacy and your desperate dispenser
gives the available diclofenac gel to Mrs. Mwanga making her believe it is the drug she was
prescribed. After three days of application, Mrs. Manga comes back to your pharmacy
reporting she is still experiencing some pain even after applying the drug and to her surprise
she experiences severe dryness and prolonged itching on the parts she applies the drug.
 a. Why is she still experiencing the pain even after application of the drug considering
the fact that her pain is amenable to some topical diclofenac?
b. Why is she experiencing dryness and prolonged itching on the affected parts? 8
marks
ANSWER: skeleton answers
i. An ointment could offer better delivery of the drug into Mrs. Mwanga’s
affected tissues than the given gel(reason for poor analgesia observed)
ii. Mrs. Mwanga’s skin type is probably a dry one which is worsened by the
applied gel. To correct this an ointment could be suitable
51. You are the production manager at G & Siblings Pharmaceutical Plant and your
subordinates produce a batch of phenacaine solution for ophthalimic anesthesia using the
formula below.

Phenacaine Hydrochloride 1%
Chlorobutanol 0.5%
Boric Acid q.s.
Purified Water ad 60L
Make isoton. sol.
Sig. One drop in each eye.
The batch gets into the market and after some days you unexpectedly receive some
complaints your phenacaine is severely irritating the client’s eyes and make them watery
which is however self-limiting upon terminating the drug. Upon reviewing the batch
manufacturing record (BMR) you notice calculation errors on the amount of Boric acid
which resulted into addition of excess amount of it into the mixture.
a. With that observation, what do you think happened to the solution to cause the
reported problems and what is that solution causing to the eyes to cause the reported
problems?
b. As the production manager, which core units of manufacturing do you think did not
do their job properly?
c. What do you think are consequences of such blunder to your manufacturing plant?
d. What will you do to the already distributed product as a responsible production
manager who knows the ethics and regulations? 20 marks
52.
 ANSWER: These are skeleton answers
i. The solution was hypertonic and was causing osmotic imbalance in the eyes
of the clients
ii. In process quality control unit primarily and generally the QA department
iii. Several of them ----- financial losses(wasted materials, refunds), legal issues
by the regulatory authorities, loss of market(trust) etc
iv. Have to inform the whole chain of the consumers and recall all stocked
products at different levels of distribution.
53. At a certain health facility the maximum stock level for all drugs is set at seven months of
stock. The stock on hand of a particular drug present is four months of stock. If the average
monthly consumption of such drug is 150,000 tablets. Calculate the following showing
clearly how you obtain your answers;
a. Maximum stock quantity
b. The order quantity assuming it is ordering time. 10 marks

ANSWER: This does not need specialized quantification formulae it’s a common sense
kind of question.

Stock quantity(amount) = average consumption data x stock level(time)

i. Maximum stock quantity = AMC x maximum stock level
Given AMC = 150,000 tablets/month and maximum stock level = 7 months

= 150,000 tablets/month x 7 months = 1,050,000 tablets

= 1,050,000 tablets

ii. Order quantity = Permitted maximum stock quantity – Available stock

quantity
Permitted maximum stock quantity = 1,050,000 tablets
Available stock quantity = AMC x available stock level
= 150,000 tablets/month x 4 months
= 600,000 tablets
Order quantity = 1050,000 – 600,000 tablets
= 450,000 tablets
54. The following are four different antimalarial drugs(A, B, C and D) 100 tablet packets
dispensed to patients attending a hospital where you are the chief pharmacist for the period
from January to December 2018

a) Draw a pie chart to represent the consumption of all drugs for the whole year of 2018

b) If you are to use this data for decision making and you plan to order only 3 of the four
drugs because of financial reasons, what are the drugs you will probably order for your
hospital? (In order of importance to your hospital)

c) You are required to prepare an order for each drug for the coming three months of
consumption. Using the information in the given table above estimate the amounts of the
drugs (each) to be procured assuming no fluctuations in predicted consumptions.

d) For each drug, what are the actual numbers of tablets that will be procured?

ANSWER: (a)
Drug Fe Marc Jun No
s Jan b h Apr May e July Aug Sept Oct v Dec Total
A 70 23 0 100 18 9 12 0 10 23 0 0 265
B 0 0 0 0 70 15 10 10 0 0 22 0 127
C 25 30 40 40 45 31 10 0 5 5 24 5 260
D 6 4 35 55 45 35 15 15 15 0 12 44 281
 Antimalarials consumed at the hospital from Jan to
December 2018

281 265

127
260

A B C D

1. Antimalarial which will probably be ordered are D> A> C

2. First we have to establish the average monthly consumption (AMC) for each drug
Drug Marc Jun No
s Jan Feb h Apr May e July Aug Sept Oct v Dec Average
A 70 23 0 100 18 9 12 0 10 23 0 0 22.08
B 0 0 0 0 70 15 10 10 0 0 22 0 10.58
C 25 30 40 40 45 31 10 0 5 5 24 5 21.67
D 6 4 35 55 45 35 15 15 15 0 12 44 23.42

Requirement is to establish orders for each drug enough to suit the coming three months

Order for any drug = its AMC x consumption period (In months)
For Drug;
A = 22.08 x 3 = 66.24 approx. 67 packets of 100 tablets
B = 10.58 x 3 = 31.74 approx. 32 packets of 100 tablets
C = 21.67 x 3 = 65.01 approx. 66 packets of 100 tablets
D = 23.42 x 3 = 70.26 approx. 71 packets of 100 tablets

3. Convert the amounts in packets into actual number of tablets by multiplying by 100 as each
packet contains 100 tablets.