QUESTION 1
Calculate their exposure to propranolol in mg/kg.
- 28 tablets × 4 boxes = 112 tablets
- 112 tablets × 40 mg = 4480 mg
- 4480 mg / 70 kg = 64 mg/kg
QUESTION 2
How much glucagon will you need to use to treat this patient on the first day of treatment, assuming they require the higher dose range?
- Loading dose =10 mg
- 150 microgram/kg/hour × 24 hours = 3600 micrograms/kg/day
- 1200 micrograms/kg/day × 70 kg = 252 000 micrograms/day
- 252 000 micrograms/day = 252 mg/day
QUESTION 3
What rate, in ml/hour, will an infusion of 50 mg/50 ml need to run at to provide the upper end of the dose range?
- 150micrograms/kg/hour = 10 500 micrograms/hour
- 10 500 micrograms = 10.5 mg/hour
- 50 mg/50 ml = 1 mg/ml
- 10.5mg/hour / 1mg/ml = 10.5 ml/hour
QUESTION 4
If the treatment lasts for 32 hours in total, with the dose reducing by 50 micrograms/kg/hour after 24 hours, and again at 30 hours, how many 1 mg Glucagen Hypokits (Electronic medicines compendium, 2015) will need to be used (off license) to provide the correct amount of glucagon to fully treat this patient?
- Loading dose =10 mg
- For first 24 hours
- 150 microgram/kg/hour × 24 hours = 3600 micrograms/kg
- 1200 micrograms/kg/day × 70 kg = 252 000 micrograms
- 252 000 micrograms/day = 252 mg
- For subsequent 6 hours (hours 24 to 30)
- 100 micrograms/kg/hour × 6 hours = 600 micrograms/kg
- 600 micrograms/kg × 70 kg = 42 000 micrograms
- 42 000 micrograms = 42 mg
- For final 2 hours (hours 24 to 30)
- 500 micrograms/kg/hour × 2 hours = 100 micrograms/kg
- 100 micrograms/kg × 70 kg = 7000 micrograms
- 7000 micrograms = 7 mg
- Total needed = 10+252+42+7 = 311 mg
- Each kit is 1mg so 311 mg will require 311 hypokits