### Sample Chapter

##### Clinical Calculations With Applications to General and Specialty Areas 7th Edition by Joyce – Sally M. Marshall – Test Bank

Chapter 7: Methods of Calculation for Individualized Drug Dosing

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

1. What is the patient’s body surface area (BSA) (m2)?
2. What is the total dose?
3. How many milliliters should you prepare?

ANS:

1. 500 mg/m2 ´ 1.78 m2 = 890 mg

1. FE: 890 mg/100 mg ´ 5 mL = 44.5 mL

OR

1. 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

1. What is the patient’s BSA (m2)?
2. What is the total dose?
3. How many milliliters should you prepare?

ANS:

b.50 mg ´ 1.83 m2 = 91.5 mg

1. FE: 91.5 mg/100 mg ´ 100 mL = 91.5 mL or 92 mL

OR

For Questions 3 through 18, use the square root method and/or nomogram. Note discrepancies between methods.

1. Give dacarbazine 250 mg/m2/day ´ 5 days.

Patient height: 5 ft 10 in

Patient weight: 173 lb

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

250 mg/m2/day ´ 1.96 m2 = 490 mg/day

1. Height 70 in, weight 173 lb, intersects 2.02 m2

250 mg/m2/day ´ 2.02 m2 = 505  500 mg/day

1. Give 5-fluorouracil 450 mg/m2/wk.

Patient height: 5 ft 6 in

Patient weight: 210 lb

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

450 mg/m2/wk ´ 2.10 m2 = 945 mg/wk

1. Height 66 in, weight 210 lb, intersects 2.04 m2

450 mg/m2/wk ´ 2.04 m2 = 918  920 mg/wk

1. Give leucovorin 200 mg/m2/wk.

Patient height: 5 ft 6 in

Patient weight: 210 lb

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

80 kg x 2.2 = 176 lb

200 mg/m2/wk ´ 2.10 m2 = 420 mg/wk

1. Height 66 in, weight 210 lb, intersects 2.04 m2

200 mg/m2/wk ´ 2.04 m2 = 408.00  400 mg/wk

1. Give cisplatin 30 mg/m2/day ´ 3 days.

Patient height: 70 in

Patient weight: 80 kg

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

1. 80 kg ´ 2.2 = 176 lb

30 mg/m2/day ´ 1.98 m2 = 59.4  59 mg/day

1. Height 70 in, weight 80 kg, intersects 2.08 m2

30 mg/m2/day ´ 2.08 m2 = 62.4  62 mg/day

1. Give cisplatinum 80 mg/m2/wk.

Patient height: 6 ft 2 in

Patient weight: 186 lb

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

80 mg/m2/wk ´ 2.09 m2 = 167.2 mg/wk

1. Height 74 in, weight 186 lb, intersects 2.10 m2

80 mg/m2/wk ´ 2.10 m2 = 168  170 mg/wk

1. Give etoposide 120 mg/m2/wk.

Patient height: 74 in

Patient weight: 70 kg

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

1. 70 kg ´ 2.2 = 154 lb

120 mg/m2/wk ´ 1.90 m2 = 228 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

1. Give Cytoxan 600 mg/m2/wk.

Patient height: 70 in

Patient weight: 85 kg

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

1. 85 kg ´ 2.2 = 187 lb

600 mg/m2/wk ´ 2.04 m2 = 1224 or 1225 mg/wk

1. Height 70 in, weight 85 kg, intersects 2.08 m2

600 mg/m2/wk ´ 2.08 m2 = 1248  1250 mg/wk

Patient height: 70 in

Patient weight: 80 kg

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

1. 80 kg ´ 2.2 = 176 lb

60 mg/m2/wk ´ 1.98 m2 = 118 mg/wk

1. Height 70 in, weight 85 kg, intersects 2.08 m2

60 mg/m2/wk ´ 2.08 m2 = 124.8  125 mg/wk

1. Give vincristine 2 mg/m2/week.

Patient height: 62 in

Patient weight: 75 kg

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

1. 75 kg ´ 2.2 = 165 lb

2 mg/m2/wk ´ 1.80 m2 = 3.6 mg/wk

1. Height 62 in, weight 75 kg, intersects 1.78 m2

2 mg/m2/wk ´ 1.78 m2 = 3.56  3.6 mg/wk

1. Give mitomycin 15 mg/m2/week.

Patient height: 65 in

Patient weight: 64 kg

What is the weekly dose with:

1. square root method?
2. nomogram?

ANS:

1. 64 kg ´ 2.2 = 140.8 or 141 lb

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

1. Height 65 in, weight 64 kg, intersects 1.75 m2

15 mg/m2/wk ´ 1.75 m2 = 26.25  26 mg/wk

1. Give mitoxantrone 12 mg/m2/day ´ 3 days.

Patient height: 5 ft 8 in

Patient weight: 150 lb

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

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

1. Height 68 in, weight 150 lb, intersects 1.85 m2

12 mg/m2/day ´ 1.85 m2 = 22.2  22 mg/day

1. 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:

1. square root method?
2. nomogram?

ANS:

100 mg/m2/day ´ 1.6 m2 = 160 mg/day

1. Height 62 in, weight 130 lb, intersects 1.65 m2

100 mg/m2/day ´ 1.65 m2 = 165 mg/day

1. Give methotrexate 3.3 mg/m2/day ´ 7 days.

Patient height: 72 in

Patient weight: 82 kg

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

1. 82 kg ´ 2.2 = 180.4 lb

3.3 mg/m2/day ´ 2 m2 = 6.6 mg/day

1. Height 72 in, weight 82 kg, intersects 2.10 m2

3.3 mg/m2/day ´ 2.10 m2 = 6.93  6.9 mg/day

1. Give prednisone 60 mg/m2/day ´ 7 days.

Patient height: 72 in

Patient weight: 84 kg

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

1. 84 kg ´ 2.2 = 184.8 or 185 lb

60 mg/m2/day ´ 2.06 m2 = 123.7 or 124 mg/day

1. Height 72 in, weight 84 kg, intersects 2.10 m2

60 mg/m2/day ´ 2.10 m2 = 126 mg/day

1. Give idarubicin hydrochloride 12 mg/m2/day ´ 3 days.

Patient height: 60 in

Patient weight: 60 kg

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

1. 60 kg ´ 2.2 = 132 lb

12 mg/m2/day ´ 1.59 m2 = 19.1 or 19 mg/day

1. Height 60 in, weight 60 kg, intersects 1.60 m2

12 mg/m2/day ´ 1.60 m2 = 19.2  19 mg/day

1. Give cytarabine 100 mg/m2/day ´ 7 days.

Patient height: 64 in

Patient weight: 65 kg

What is the daily dose with:

1. square root method?
2. nomogram?

ANS:

1. 65 kg ´ 2.2 = 143 lb

100 mg/m2/day ´ 1.7 m2 = 170 mg/day

1. Height 64 in, weight 60 kg, intersects 1.69 m2

100 mg/m2/day ´ 1.69 m2 = 169  170 mg/day

1. Order: streptozocin 1000 mg/m2 in 100 mL D5W over 2 hours

Patient’s height and weight: 5 ft 2 in and 210 lb

Drug available: streptozocin 1 g powdered vial, reconstitute with 9.5 mL NS; yields 100 mg/mL

1. What is the patient’s BSA (m2)?
2. What is the total dose?
3. How many milliliters should you prepare?

ANS:

1. 2.04 m2 ´ 1000 mg/m2 = 2040 mg

1. Order: methotrexate 3 mg/m2 PO ´ 2 weekly

Patient’s height and weight: 5 ft 2 in and 130 lb

Drug available: methotrexate tablets 2.5 mg, 5 mg, 7.5 mg

1. What is the patient’s BSA (m2)?
2. What is the total dose?

ANS:

1. 1.6 m2 ´ 3 mg/m2 = 4.80 mg or 5 mg tablet twice a week

1. Order: sargramostim 250 mcg/m2/day, dilute in 50 mL and infuse over 2 hours

Patient’s height and weight: 5 ft 10 in and 215 lb

Drug available: sargramostim 500 mcg/mL

1. What is the patient’s BSA (m2)?
2. What is the total dose?
3. How many milliliters should you prepare?

ANS:

1. 2.52 m2 x 250 mcg/m2 = 630 mcg

1. Order: clofarabine 52 mg/m2 daily and infuse in 250 mL D5W over 2 hours

Patient’s height and weight: 5 ft 4 in and 115 lb

Drug available: 20 mg/20 mL

1. What is the patient’s BSA (m2)?
2. What is the total dose?
3. How many milliliters should you prepare?

ANS:

1. 1.53 m2 ´ 52 mg/m2 = 79.56 mg or 80 mg