Clinical Pharmacology & Therapeutics Exam – Pediatric
Dosing, Drug Calculations, and Biostatistics Review(PREP)
History of Present Illness: MW is a 3-year-old female. Her mother comes
to the pharmacy to fill a prescription for amoxicillin. The mother also
asks what dose of Tylenol suspension she can give her daughter for
fever.
One month later, the physician calls the pharmacy to ask for the correct
dose of montelukast for MW. Which of the following recommendations
is correct?
A. 4 mg dose of oral granules in the morning
B. 4 mg dose of oral granules in the evening
C. 5 mg chewable tablet once daily in the evening
D. 5 mg chewable tablet taken BID
E. 10 mg tablet once daily in the evening
B. 4 mg dose of oral granules in the evening
Medication Refill History:
Albuterol nebulizer solution 0.083% (2.5 mg/3 mL), 1 nebulizer Q4H PRN
(last filled: 10 days ago)
Augmentin ES 600 mg/5 mL, 12 mL PO BID (last filled: 30 days ago)
Vigamox 1 drop to affected eye TID x 7 days (last filled: 60 days ago)
Ciprodex 4 drops to the affected ear BID x 7 days (last filled: 60 days
ago)
Cefdinir 250 mg/mL, 7.5 mL PO Q24H (last filled: 60 days ago)
Azithromycin ophthalmic solution 1 drop to affected eye BID x 2 days,
then 1 drop to affected eye once daily x 5 days (last filled: 90 days ago)
Which medication has MW received in the past for bacterial
conjunctivitis?
,A. Cefdinir
B. Albuterol
C. Ciprofloxacin
D. Moxifloxacin
E. Amoxicillin
D. Moxifloxacin
Pediatric Visit Discharge Form:
Weight: 26.4 pounds
Diagnosis: otitis media, both ears
Recommendations:
- Amoxicillin suspension 90 mg/kg/day divided Q8H
- Tylenol suspension 10 mg/kg Q8H
The pharmacy has amoxicillin 250 mg/5 mL suspension in stock. The
pharmacist will instruct the mother on how many milliliters of the
suspension to draw up in an oral syringe. How many milliliters should be
administered per dose?
(Answer must be numeric; no units or commas; round the final answer
to the nearest WHOLE number)
7
TBW = 26.4 lb = 12 kg
90 mg/kg/day x 12 kg = 1080 mg/day
1080 mg / 3 doses = 360 mg/dose
5 mL / 250 mg = (X) / 360 mg
X = 7.2 mL → 7 mL
Pediatric Visit Discharge Form:
Weight: 26.4 pounds
,Diagnosis: otitis media, both ears
Recommendations:
- Amoxicillin suspension 90 mg/kg/day divided Q8H
- Tylenol suspension 10 mg/kg Q8H
The pharmacy has a formulation of acetaminophen suspension that
contains 160 mg/5 mL. Select the correct dose, in milligrams, to be given
to MW every 8 hours.
(Answer must be numeric; no units or commas; round the final answer
to the nearest WHOLE number)
120
TBW = 26.4 lb = 12 kg
10 mg/kg x 12 kg = 120 mg
Background: Lowering blood concentrations of LDL cholesterol,
regardless of initial cholesterol concentrations, is associated with a
decreased risk of cardiovascular disease.
Methods: 20,536 adults aged 40-80 years with coronary heart disease,
diabetes, or other occlusive arterial diseases, were randomly assigned
to receive simvastatin 40 mg daily or placebo for 5 years. An intention-
to-treat analysis was performed. The primary outcome was all-cause
mortality. Secondary outcomes included fatal or non-fatal vascular
events.
Results: 10,269 patients received simvastatin and 10,267 patients
received placebo. All-cause mortality occurred in 1,328 patients treated
with simvastatin and 1,507 patients treated with placebo (p = 0.0003).
The risk of death from vascular causes was 5.7% in the simvastatin
group and 6.9% in the placebo group (RR 0.83; 95% CI 0.75-0.91). Death
from non-vascular causes occurred in 5.3% of simvastatin-treated
patients and 5.6% of placebo-treated patients (RR 0.95; CI 0.85-1.07).
There were no significant differences in risk of myopathy, liver damage,
, cancer incidence or hospitalizations for any reason between the two
groups.
Which statistical test would be appropriate to analyze data for the
primary outcome?
A. Mean with standard deviation
B. ANOVA
C. Chi-square test
D. Kruskal-Wallis test
E. Student t-test
C. Chi-square test
Discrete/Categorical Data →
2 groups (Tx & Placebo) →
Chi-square test or Fischer's exact test
Results: 10,269 patients received simvastatin and 10,267 patients
received placebo. All-cause mortality occurred in 1,328 patients treated
with simvastatin and 1,507 patients treated with placebo (p =
0.0003). The risk of death from vascular causes was 5.7% in the
simvastatin group and 6.9% in the placebo group (RR 0.83; 95% CI 0.75-
0.91). Death from non-vascular causes occurred in 5.3% of simvastatin-
treated patients and 5.6% of placebo-treated patients (RR 0.95; CI 0.85-
1.07). There were no significant differences in risk of myopathy, liver
damage, cancer incidence or hospitalizations for any reason between
the two groups.
Based on the results of this trial, how many patients need to be treated
with simvastatin for 5 years to prevent one death due to vascular
causes? (Answer must be numeric; no units or commas.)
84
NNT = 1 / ARR*
* ARR must be in decimals
Dosing, Drug Calculations, and Biostatistics Review(PREP)
History of Present Illness: MW is a 3-year-old female. Her mother comes
to the pharmacy to fill a prescription for amoxicillin. The mother also
asks what dose of Tylenol suspension she can give her daughter for
fever.
One month later, the physician calls the pharmacy to ask for the correct
dose of montelukast for MW. Which of the following recommendations
is correct?
A. 4 mg dose of oral granules in the morning
B. 4 mg dose of oral granules in the evening
C. 5 mg chewable tablet once daily in the evening
D. 5 mg chewable tablet taken BID
E. 10 mg tablet once daily in the evening
B. 4 mg dose of oral granules in the evening
Medication Refill History:
Albuterol nebulizer solution 0.083% (2.5 mg/3 mL), 1 nebulizer Q4H PRN
(last filled: 10 days ago)
Augmentin ES 600 mg/5 mL, 12 mL PO BID (last filled: 30 days ago)
Vigamox 1 drop to affected eye TID x 7 days (last filled: 60 days ago)
Ciprodex 4 drops to the affected ear BID x 7 days (last filled: 60 days
ago)
Cefdinir 250 mg/mL, 7.5 mL PO Q24H (last filled: 60 days ago)
Azithromycin ophthalmic solution 1 drop to affected eye BID x 2 days,
then 1 drop to affected eye once daily x 5 days (last filled: 90 days ago)
Which medication has MW received in the past for bacterial
conjunctivitis?
,A. Cefdinir
B. Albuterol
C. Ciprofloxacin
D. Moxifloxacin
E. Amoxicillin
D. Moxifloxacin
Pediatric Visit Discharge Form:
Weight: 26.4 pounds
Diagnosis: otitis media, both ears
Recommendations:
- Amoxicillin suspension 90 mg/kg/day divided Q8H
- Tylenol suspension 10 mg/kg Q8H
The pharmacy has amoxicillin 250 mg/5 mL suspension in stock. The
pharmacist will instruct the mother on how many milliliters of the
suspension to draw up in an oral syringe. How many milliliters should be
administered per dose?
(Answer must be numeric; no units or commas; round the final answer
to the nearest WHOLE number)
7
TBW = 26.4 lb = 12 kg
90 mg/kg/day x 12 kg = 1080 mg/day
1080 mg / 3 doses = 360 mg/dose
5 mL / 250 mg = (X) / 360 mg
X = 7.2 mL → 7 mL
Pediatric Visit Discharge Form:
Weight: 26.4 pounds
,Diagnosis: otitis media, both ears
Recommendations:
- Amoxicillin suspension 90 mg/kg/day divided Q8H
- Tylenol suspension 10 mg/kg Q8H
The pharmacy has a formulation of acetaminophen suspension that
contains 160 mg/5 mL. Select the correct dose, in milligrams, to be given
to MW every 8 hours.
(Answer must be numeric; no units or commas; round the final answer
to the nearest WHOLE number)
120
TBW = 26.4 lb = 12 kg
10 mg/kg x 12 kg = 120 mg
Background: Lowering blood concentrations of LDL cholesterol,
regardless of initial cholesterol concentrations, is associated with a
decreased risk of cardiovascular disease.
Methods: 20,536 adults aged 40-80 years with coronary heart disease,
diabetes, or other occlusive arterial diseases, were randomly assigned
to receive simvastatin 40 mg daily or placebo for 5 years. An intention-
to-treat analysis was performed. The primary outcome was all-cause
mortality. Secondary outcomes included fatal or non-fatal vascular
events.
Results: 10,269 patients received simvastatin and 10,267 patients
received placebo. All-cause mortality occurred in 1,328 patients treated
with simvastatin and 1,507 patients treated with placebo (p = 0.0003).
The risk of death from vascular causes was 5.7% in the simvastatin
group and 6.9% in the placebo group (RR 0.83; 95% CI 0.75-0.91). Death
from non-vascular causes occurred in 5.3% of simvastatin-treated
patients and 5.6% of placebo-treated patients (RR 0.95; CI 0.85-1.07).
There were no significant differences in risk of myopathy, liver damage,
, cancer incidence or hospitalizations for any reason between the two
groups.
Which statistical test would be appropriate to analyze data for the
primary outcome?
A. Mean with standard deviation
B. ANOVA
C. Chi-square test
D. Kruskal-Wallis test
E. Student t-test
C. Chi-square test
Discrete/Categorical Data →
2 groups (Tx & Placebo) →
Chi-square test or Fischer's exact test
Results: 10,269 patients received simvastatin and 10,267 patients
received placebo. All-cause mortality occurred in 1,328 patients treated
with simvastatin and 1,507 patients treated with placebo (p =
0.0003). The risk of death from vascular causes was 5.7% in the
simvastatin group and 6.9% in the placebo group (RR 0.83; 95% CI 0.75-
0.91). Death from non-vascular causes occurred in 5.3% of simvastatin-
treated patients and 5.6% of placebo-treated patients (RR 0.95; CI 0.85-
1.07). There were no significant differences in risk of myopathy, liver
damage, cancer incidence or hospitalizations for any reason between
the two groups.
Based on the results of this trial, how many patients need to be treated
with simvastatin for 5 years to prevent one death due to vascular
causes? (Answer must be numeric; no units or commas.)
84
NNT = 1 / ARR*
* ARR must be in decimals
