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Toxicology CALCULATIONS 1- Given a Rx and the signature is: Start 40mg and decrease 5mg everyday until finish. How many days the patient will take to finish this Rx. A) 8 days B) 7 days C) 6 days D) 5 days E) 4 days 1- A 40mg / 5mg tablets = 8 days of treatment 2- Pharmacy manager provides a stock solution of 1:750 and would like you to prepare 60mls of 1:10.000, how much you need to use of the stock solution? A) 2.4mls B) 4.6mls C) 1.3mls D) 46mls E) 0.46mls 2- B 1:750 = 0.13% C1 . V1 = C2 . V2 V= 4.6ml 1:10.000 = 0.01% 0.13 x V1 = 0.01 x 60 0.13V = 0.6

3- At TIPS a clinical trials study was conducted over 2 years for a new drug, resulted 5% of positive study samples. During this study only 3% placebo samples resulted positive study samples. The relative risk reduction resulted with the new drug over the study period is: A) 10% B) 20% C) 30% D) 40% E) 50% 3- D Relative Risk Reduction = Benefit patient Placebo X 100 Benefit Patient RRR = 5 3 / 5 2 / 5 = 0.4 x 100 = 40% 4- At TIPS a clinical trials study was conducted over 3 years for side effect of a drug A, resulted 2.0% of adverse effects. Patient who received a better drug B resulted 1.8% of same adverse effects. Based on these results, what is the minimum number of patients that would have to receive the drug B for 3 years to show this adverse effect in at least one patient. A) 250 patients B) 500 patients C) 750 patients D) 1000 patients D) 100 patients 4- B 2.0% - 1.8% = 0.2% 0.2%--------100% 1patient---- X = 500 patients 5- Using the Hasselbach-Handerson equation, calculate the fraction of aspirin ionized at given pKa is 5.6, and pH 8.6? a) 80% ionized b) 90% ionized c) 99% ionized

d) 99.9% ionized e) 100% ionized 5- D % Drug = 100 = 99.9% ionized 1+10 charge(pH-pKa) 6- Dissociation factor (i) plays an important role in determining the contribution of a substance towards isotonicity. If it is assumed that HCl undergoes 80% dissociation, what will be its dissociation factor? a) 2.3 b) 3.2 c) 6.1 d) 3.6 e) 1.6 6- E Dissociation factor of HCl = H(1) (80%)+ Cl(1) = 2 2----------100% X-----------80% 1.8 7- How many mEq of magnesium sulfate are represented in 1.0 g of anhydrous Magnesium sulfate. A.20 mEq B.1.0 mEq C.16.7 mEq D.10 mEq E.1.5 mEq 7- D 8- Pharmacy manager provided alcohol 95% and asked to prepare 60ml of alcohol 12%. How much of alcohol 95% you should used to make this new concentration of alcohol? a) 4.32ml b) 7.57ml c) 8.64ml d) 6.0ml e) 6.57ml

8- B C1 x V1 = C2 x V2 95 x V1 = 12 x 60 V1 = 7.57ml 9- Pharmacy manager provided you ZnCl2 0.7%, phenilephrine 0.1% and boric acid 1.1% with E values 0.16, 0.32 and 0.5 respectively. This solution will be: a) Isotonic b) Hypertonic c) Hypotonic d) Iso-osmotic e) Isotonicity cannot be finding. 9- C 0.7 x 0.16 + 0.1 x 0.32 + 1.1 x 0.5 = 0.00112 + 0.00032 + 0.0055 100 100 100 = 0.00694 NaCl = 0.9 = 0.009 > 0.00694 = Hypotonic 100 10- A patient brought a prescription with the following signature: Start with double dose of 5ml, than take 2.5mls BID for 7 days. How many ml of amoxicillin suspension should be dispensed to this patient: a) 30mls b) 35mls c) 40mls d) 45mls e) 50mls 10- C 5ml-start dose + (5ml/day x 7days) = 5 + 35 = 40ml 11- Rx; Prednisone 5mg Start 40mg and decrease 5mg everyday until finish. How many tablets should be dispensed? a) 30 tablets b) 35 tablets c) 36 tablets d) 40 tablets e) 12 tablets

11- C 40mg = 8 tablets decrease one tablet every day until finish 12- A metered dose inhaler contains 120 doses. How many days the patient will take to finish the entire inhaler with this signature: Use 2 inhalers in each nostril every morning and at bedtime a) 7 days b) 10 days c) 20 days d) 15 days e) 30 days 12- D Two inhalers in each nostril every morning and at bedtime 2 x 2 nostril x 2 (morning+night) = 8 doses daily 120 doses 8 doses daily = 15 days supply 13- What is the minimum quantity that can be weight on a balance with sensitivity requirements of 15mg of a 5% error is permissible a) 100mg b) 200mg c) 300mg d) 400mg e) 500mg 13- C SR = Weight x Error 15 = weight x 5 = 300mg 100 14- What is the sensitivity of a balance that can weight 120mg of a substance and has a permissible error of 5%? a) 6mg b) 16mg c) 66mg d) 26mg e) 1.6mg 14- A SR = Weight x Error SR = 120mg x 5 = 6mg 100 CORRECT ANSWERS

1- A 40mg / 5mg tablets = 8 days of treatment 2- B 1:750 = 0.13% C1 . V1 = C2 . V2 V= 4.6ml 1:10.000 = 0.01% 0.13 x V1 = 0.01 x 60 0.13V = 0.6 3- D Relative Risk Reduction = Benefit patient Placebo X 100 Benefit Patient RRR = 5 3 / 5 2 / 5 = 0.4 x 100 = 40% 4- B 2.0% - 1.8% = 0.2% 0.2%--------100% 1patient---- X = 500 patients 5- D % Drug = 100 = 99.9% ionized 1+10 charge(pH-pKa) 6- E Dissociation factor of HCl = H(1) (80%)+ Cl(1) = 2 2----------100% X-----------80% 1.8 7- D 8- B C1 x V1 = C2 x V2 95 x V1 = 12 x 60 V1 = 7.57ml 9- C 0.7 x 0.16 + 0.1 x 0.32 + 1.1 x 0.5 = 0.00112 + 0.00032 + 0.0055 100 100 100 = 0.00694 NaCl = 0.9 = 0.009 > 0.00694 = Hypotonic 100 10- C 5ml-start dose + (5ml/day x 7days) = 5 + 35 = 40ml 11- C 40mg = 8 tablets decrease one tablet every day until finish. 12- D Two inhalers in each nostril every morning and at bedtime 2 x 2 nostril x 2 (morning+night) = 8 doses daily

120 doses 8 doses daily = 15 days supply 13- C SR = Weight x Error 15 = weight x 5 = 300mg 100 14- A SR = Weight x Error SR = 120mg x 5 = 6mg 100 PHARMACOKINETIC CALCULATIONS 1- A dose of 240mg was given to a patient, his total body clearance is 3.5L/mim and the drug excreted unchanged in the urine is 80mg. What is his non-renal clearance? a) 240mls b) 2.4L c) 3.3L d) 1.16L e) 1160mls 1- B 240mg-------100% of dose 3.5L------100% Total Clearance 80mg-------- X X-------- 33% Renal Clearance X=33% X=1.16L of Renal Clearance CLhepatic=CLt-CLr CLh=3.5-1.16= 2.4L 2- A dose was given, after 2 hours, the plasma concentration was 64 mg, t1/2=0.7hrs. After 7 hours from the initial dose, what is the drug's concentration? a) 0.0mg b) 1mg c) 2mg d) 3mg e) 4mg 2- A Dose --------After 2 hours-------64mg 64mg-----after t1/2 of 0.7hr-----32mg 32mg-----after t1/2 of 0.7hr-----16mg

16mg-----after t1/2 of 0.7hr-----8mg 8mg-----after t1/2 of 0.7hr-------4mg 4mg-----after t1/2 of 0.7hr-------2mg 2mg-----after t1/2 of 0.7hr-------1mg 2mg-----after t1/2 of 0.7hr-------0.5mg TOTAL: 6.9 hr---Approximately---0.5mg = 0mg 3- What is the absolute bioavailability of tablet A? TABLET A ----------------50mg---------------AUC 40 IV PUSH -------------------10mg---------------AUC 50 a) 80% b) 0.16% c) 16% d) 8% e) 25% 3- C We need to multiply the IV dose by 5 to find the same dosage so: IV Push---------------------50mg---------------AUC 250 Bioaval = AUC Tablet A = 40 = 0.16 X 100 = 16% AUC IV Push 250 4- If the rate of infusion of the drug is 500mg q8hours and clearance is 7.3L/hr. Find steady state concentration a) 85.6mg/L b) 856mg/L c) 8.56g/L d) 8.56mg/L e) 5.86mg/L 4- D Css = Rate of infusion = 500/8 = 8.56mg/L Clearance 7.3 5- A drug was found to have zero order kinetic: 100mg--after 6days--99mg. How long it will take to eliminate the entire drug from the body? a) 100 days

b) 200 days c) 300 days d) 600 days e) 900 days 5- D 1mg--------6days X= 600 days 100mg----- X 6- Ampicilin in 5% dextrose degrades by first order kinetic, at rate constant of 0.026h. What is the shelf life of ampicilin? a) 4hr b) 8hr c) 2hr d) 16hr e) 12hr 6- A T90% = 0.105 = 0.105 = 4hours K 0.026h 7- Approximately 50% of cloxacillin is excreted unchanged in the urine. If the normal dosage schedule for cloxacillin is 125mg q6h, a patient with renal function 20% of normal should receive: a) 25mg q6h b) 31.25mg q6h c) 62.5mg q6h d) 75mg q6h e) 125mg q12h 7- D Patient has 20% of normal renal function, so 50-20=30% 50%-----------125mg q6h 30%-----------X X = 75mg q6h 8- Drug which dose is 1.500mg is given every 24hours. The renal clearance of this drug is 1.2mg/dL. Calculate the clearance in ml/min. a) 88.6 ml/min b) 76.8 ml/min c) 86.8 ml/min

d) 66.8 ml/min e) 43.6 ml/min 8- C 1.2mg/dL--------100ml(dL) 125.000mls--------1.440min (60min x 24hrs) 1500mg---------X X---------------1min X = 125.000mls X = 86.8ml/min 9- If a drug is 50% metabolized. What is the percentage of blood concentration after 4hrs? a) 50% b) 25% c) 12.5% d) 6.25% e) 3.12% 9- D Drug concentration = 100% t1/2 (decrease the drug by half) = 50% 2t1/2 = 25% 3t1/2 = 12.5% 4t1/2 = 6.25% 10- A new antifungal was given at a dose of 5mg/Kg by a single intravenous bolus injection to a 32 years old female who weighted 75Kg. The antifungal has an elimination half-life of 2 hours and apparent volume of distribution of 0.28L/Kg. What is the initial plasma drug concentration in this patient? a) 36mg/L b) 1.8mg/L c) 17.9mg/L d) 1.79mg/L e) 19mg/L 10- C Cp = Do Cp = 5mg/L = 17.8mg/L Vd 0.28L/kg 11- Following the anterior information, calculate the predicted plasma concentration at 8 hours after the dose: a) 15mg/L b) 111mg/L

c) 11.1mg/L d) 1.11mg/L e) 2.64mg/L 11- D Cp initial = 17.9mg/L and elimination t1/2 is 2hours Cp = 17.9 after 2 hours = 8.95 Cp = 8.95 after 2 hours = 4.47 Cp = 4.47 after 2 hours = 2.23 Cp = 2.23 after 2 hours = 1.11 IN 8 HOURS 12-Following the same anterior information, calculate how much drug remains in the patient body, 8 hours after the administrated dose: a) 23mg b) 112mg c) 100mg d) 15.3mg e) 84.4mg 12- A D = 375mg after t/1/2 of 2 hours = 187.5mg after t1/2 of 2 hours = 93.75..Continue the same as the anterior question!!! After 8 hours you will have 23mg 13- Following the anterior information, how long after the dose is exactly 75% eliminated from the patient body? a) 2 hours b) 4 hours c) 6 hours d) 8 hours e) 10 hours 13- B Initial dose = 375mg and elimination t1/2 is 2hours Cp = 375mg after 2 hours = 187.5 50% Cp = 187.5mg after 2 hours = 93.75 25% 4 hours 75% Let us assume the following characteristics of the drug in a 70kg man.

-Therapeutic effective plasma concentration: 2.0mg/L -Biologic half-life: 80minutes -Apparent volume of distribution: 0.70Kg/L 14- What is the recommended rate of infusion for this drug? a) 85mg/min b) 58mg/min c) 0.85mg/min d) 8.5mg/min e) 0.085mg/min 14- C R = K x Vd x Css R = 0.0087 x 49 x 2 = 0.85mg/min K = 0.693/80min = 0.0087 Vd = 0.70 x 70Kg = 49L 15- What is the total body clearance for this patient? a) 33L/min b) 43mls/min c) 43L/min d) 0.43L/min e) 0.43mls/min 15- D ClT = K x Vd ClT = 0.0087 x 49 = 0.43L/min 16- Still following the information of the anterior questions, calculate the corresponding loading dose: a) 98mg b) 160mg c) 48mg d) 24mg e) 100mg 16- A LD = Vd x Css LD = 49 x 2 = 98mg CORRECT ANSWERS 1- B 240mg-------100% of dose 3.5L------100% Total Clearance

80mg-------- X X-------- 33% Renal Clearance X=33% X=1.16L of Renal Clearance CLhepatic=CLt-CLr CLh=3.5-1.16= 2.4L 2- A Dose --------After 2 hours-------64mg 64mg-----after t1/2 of 0.7hr-----32mg 32mg-----after t1/2 of 0.7hr-----16mg 16mg-----after t1/2 of 0.7hr-----8mg 8mg-----after t1/2 of 0.7hr-------4mg 4mg-----after t1/2 of 0.7hr-------2mg 2mg-----after t1/2 of 0.7hr-------1mg 2mg-----after t1/2 of 0.7hr-------0.5mg TOTAL: 6.9 hr---Approximately---0.5mg = 0mg 3- C We need to multiply the IV dose by 5 to find the same dosage so: IV Push---------------------50mg---------------AUC 250 Bioaval = AUC Tablet A = 40 = 0.16 X 100 = 16% AUC IV Push 250 4- D Css = Rate of infusion = 500/8 = 8.56mg/L Clearance 7.3 5- D 1mg--------6days X= 600 days 100mg----- X 6- A T90% = 0.105 = 0.105 = 4hours K 0.026h 7- D Patient has 20% of normal renal function, so 50-20=30% 50%-----------125mg q6h 30%-----------X X = 75mg q6h

8- C 1.2mg/dL--------100ml(dL) 125.000mls--------1.440min (60min x 24hrs) 1500mg---------X X---------------1min X = 125.000mls X = 86.8ml/min 9- D Drug concentration = 100% t1/2 (decrease the drug by half) = 50% 2t1/2 = 25% 3t1/2 = 12.5% 4t1/2 = 6.25% 10- C Cp = Do Cp = 5mg/L = 17.8mg/L Vd 0.28L/kg 11- D Cp initial = 17.9mg/L and elimination t1/2 is 2hours Cp = 17.9 after 2 hours = 8.95 Cp = 8.95 after 2 hours = 4.47 Cp = 4.47 after 2 hours = 2.23 Cp = 2.23 after 2 hours = 1.11 IN 8 HOURS 12- A D = 375mg after t/1/2 of 2 hours = 187.5mg after t1/2 of 2 hours = 93.75..Continue the same as the anterior question!!! After 8 hours you will have 23mg 13- B Initial dose = 375mg and elimination t1/2 is 2hours Cp = 375mg after 2 hours = 187.5 50% Cp = 187.5mg after 2 hours = 93.75 25% 4 hours 75% 14- C R = K x Vd x Css R = 0.0087 x 49 x 2 = 0.85mg/min K = 0.693/80min = 0.0087 Vd = 0.70 x 70Kg = 49L 15- D ClT = K x Vd ClT = 0.0087 x 49 = 0.43L/min 16- A LD = Vd x Css LD = 49 x 2 = 98mg