LeFever Kee’s Clinical Calculations 9th Edition | Verified Test Bank

Chapter 07: Methods of Calculation for Individualized Drug Dosing

Kee: Clinical Calculations: With Applications to General and Specialty Areas, 9th Edition

OTHER

Body Surface Area by Square Root

1.      Order: cyclophosphamide 500 mg/m2 in 500 mL of normal saline solution (NSS) over 90 minutes Patient height and weight: 5 ft 10 in, 142 lb

Drug available: cyclophosphamide 100 mg dilute with 5 mL of sterile water; yields 20 mg/mL a. What is the patient’s body surface area (BSA) (m2)?

b.  What is the total dose?

c.   How many milliliters should you prepare?

ANS:

a.   = 1.78m2

b.   500 mg/m2 × 1.78 m2 = 890 mg

c.   FE: 890 mg/100 mg × 5 mL = 44.5 mL

OR

D                        890mg

BF: H × V = 100mg × 5mL = 44.5mL

2.      Order: cisplatin 50 mg/m2 in 500 mL of NSS intravenously over 90 minutes

Patient height and weight: 5 ft 6 in, 160 lb Drug available: cisplatin 100 mg/100 mL a. What is the patient’s BSA (m2)?

b.  What is the total dose?

c.   How many milliliters should you prepare?

ANS:

a.   = 1.84m2

b.   50 mg × 1.84 m2 = 92 mg

c.   FE: 92 mg/100 mg × 100 mL = 92 mL

OR

D                        92mg

BF: H × V = 100mg × 100mL = 92mL

3.

Give dacarbazine 250 mg/m2/day × 5 days.

Patient height: 5 ft 10 in

Patient weight: 173 lb What is the daily dose with a. square root method?

b. nomogram?

ANS:

              a. 3.8677 = 1.97m2

250 mg/m2/day × 1.97 m2 = 493 mg/day

b. Height 70 in, weight 173 lb, intersects 2.02 m2 250 mg/m2/day × 2.02 m2 = 505 ≈ 500 mg/day

4.

Give 5-fluorouracil 450 mg/m2/wk.

Patient height: 5 ft 6 in

Patient weight: 210 lb What is the weekly dose with a. square root method?

b. nomogram?

ANS:

              a. 4.43 = 2.10m2

450 mg/m2/wk × 2.10 m2 = 945 mg/wk

b. Height 66 in, weight 210 lb, intersects 2.04 m2 450 mg/m2/wk × 2.04 m2 = 918 ≈ 920 mg/wk

5.

Give leucovorin 200 mg/m2/wk.

Patient height: 5 ft 6 in

Patient weight: 210 lb What is the weekly dose with a. square root method?

b. nomogram?

ANS:

              a. 4.43 = 2.10m2

200 mg/m2/wk × 2.10 m2 = 420 mg/wk

b. Height 66 in, weight 210 lb, intersects 2.04 m2 200 mg/m2/wk × 2.04 m2 = 408.00 ≈ 400 mg/wk

6.

Give cisplatin 30 mg/m2/day × 3 days.

Patient height: 70 in

Patient weight: 80 kg What is the daily dose with a. square root method?

b. nomogram?

ANS:

a.  80 kg × 2.2 = 176 lb

3.93 = 1.98m2 30 mg/m2/day × 1.98 m2 = 59.4 ≈ 59 mg/day

b.  Height 70 in, weight 80 kg, intersects 2.08 m2 30 mg/m2/day × 2.08 m2 = 62.4 ≈ 62 mg/day

7.

Give cisplatinum 80 mg/m2/wk.

Patient height: 6 ft 2 in

Patient weight: 186 lb What is the weekly dose with a. square root method?

b. nomogram?

ANS:

              a. 4.39 = 2.09m2

80 mg/m2/wk × 2.09 m2 = 167.2 mg/wk

b. Height 74 in, weight 186 lb, intersects 2.10 m2 80 mg/m2/wk × 2.10 m2 = 168 ≈ 170 mg/wk

8.

Give etoposide 120 mg/m2/wk.

Patient height: 74 in

Patient weight: 70 kg What is the weekly dose with a. square root method?

b. nomogram?

ANS:

a. 70 kg × 2.2 = 154 lb

3.639 = 1.91m2

120 mg/m2/wk × 1.91 m2 = 229.2 mg/wk

b. Height 74 in, weight 70 kg, intersects 2.06 m2 120 mg/m2/wk × 2.06 m2 = 247.2 ≈ 250 mg/wk

9.

Give Cytoxan 600 mg/m2/wk. Patient height: 70 in

Patient weight: 85 kg What is the weekly dose with a. square root method?

b. nomogram?

ANS:

a. 85 kg × 2.2 = 187 lb

4.18 = 2.04m2

600 mg/m2/wk × 2.04 m2 = 1224 or 1225 mg/wk b. Height 70 in, weight 85 kg, intersects 2.08 m2 600 mg/m2/wk × 2.08 m2 = 1248 ≈ 1250 mg/wk

 10.

Give Adriamycin 60 mg/m2/wk.

Patient height: 70 in

Patient weight: 80 kg What is the weekly dose with a. square root method?

b. nomogram?

ANS:

a. 80 kg × 2.2 = 176 lb

3.93 = 1.98m2

60 mg/m2/wk × 1.98 m2 = 118.8 mg/wk = 119 mg/wk b. Height 70 in, weight 80 kg, intersects 2.04 m2 60 mg/m2/wk × 2.04 m2 = 122.4 mg/wk

 11. For the following questions, use the square root method and/or nomogram. Note discrepancies between methods.

Give vincristine 2 mg/m2/week.

Patient height: 62 in

Patient weight: 75 kg What is the weekly dose with a. square root method?

b. nomogram?

ANS:

a.  75 kg × 2.2 = 165 lb

3.27 = 1.81m2

2 mg/m2/wk × 1.81 m2 = 3.62 = 3.6 mg/wk

b.  Height 62 in, weight 75 kg, intersects 1.78 m2 2 mg/m2/wk × 1.78 m2 = 3.56 ≈ 3.6 mg/wk

 12.

Give mitomycin 15 mg/m2/week.

Patient height: 65 in

Patient weight: 64 kg What is the weekly dose with a. square root method?

b. nomogram?

ANS:

a. 64 kg × 2.2 = 140.8 or 141 lb

2.93 = 1.71m2

15 mg/m2/wk × 1.71 m2 = 25.6 or 26 mg/wk

b. Height 65 in, weight 64 kg, intersects 1.75 m2 15 mg/m2/wk × 1.75 m2 = 26.25 ≈ 26 mg/wk

 13. For the following questions, use the square root method and/or nomogram. Note discrepancies between methods.

Give mitoxantrone 12 mg/m2/day × 3 days.

Patient height: 5 ft 8 in

Patient weight: 150 lb What is the daily dose with a. square root method?

b. nomogram?

ANS:

a.   3.25 = 1.8m2

12 mg/m2/day × 1.80 m2 = 21.6 or 22 mg/day

b.   Height 68 in, weight 150 lb, intersects 1.85 m2 12 mg/m2/day × 1.85 m2 = 22.2 ≈ 22 mg/day

 14.

Give cytosine arabinoside 100 mg/m2/day × 7 days.

Patient height: 5 ft 2 in

Patient weight: 130 lb What is the weekly dose with a. square root method?

b. nomogram?

ANS:

          a. 2.57 = 1.6m2

100 mg/m2/day × 1.6 m2 = 160 mg/day

b. Height 62 in, weight 130 lb, intersects 1.65 m2 100 mg/m2/day × 1.65 m2 = 165 mg/day

15.     For the following questions, use the square root method and/or nomogram. Note discrepancies between methods.

Give methotrexate 3.3 mg/m2/day × 7 days.

Patient height: 72 in

Patient weight: 82 kg What is the daily dose with a. square root method?

b. nomogram?

ANS:

a. 82 kg × 2.2 = 180.4 lb

4.15 = 2.04m2

3.3 mg/m2/day × 2.04 m2 = 6.7 mg/day

b. Height 72 in, weight 82 kg, intersects 2.10 m2 3.3 mg/m2/day × 2.10 m2 = 6.93 ≈ 6.9 mg/day