Detoxicol

SDLS 2008
Medicine for the intoxicated
Subject: Pharmacology Laboratory Topic: Prescription Writing Parenteral Liquids and Others Lecturer: MLDDC, DLP, GAM, RGYA Lecture Date: July 12, 2005 Transcriber(s): JC Tayco No. of pages: 10

Liquid Preparations (Other Liquids, Parenteral, Ophthalmic and Otic Solution) Take this as an Example:
DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Nicky Belardo Silang, Cavite Rx Diclofenac Sodium Solution for Injection 75mg/3ml Dispense no. 1 ampule Label: For Injection. Inject 2ml intramuscularly every 6 hours for 3 doses, as necessary. May 23, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

Note the following in the preceding prescription: 1. The description of the concentration of the drug and/or the amount contained in one ampule following the official name of the drug. 2. The subscritption contains the otal number to be dispensed. 3. The label starts with the phrase For Injection to emphasize the manne of administration followed by the dose per injection as determined by the physician, the route of parenteral administration (subcutaneous, intramuscular, intravenous), the frequency of administration and duration of treatment.

Take this as an Example:

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Nimfa Descalso Gen. Trias, Cavite Rx Ampicillin for Injection 500mg/ml Dispense no. 20 Label: For Injection. Dissolve the contents of 1 bial in 1.5ml distilled water and inject intravenously every six hours round the clock for 5 days. Inject only after a negative skin test. May 23, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

Note the following in the preceding prescriptions: 1. The drug is available as dry, sterile, solid powder for reconstitution. 2. The common vehicle for reconstitution in Distilled water. The amount of diluent is ideally 1.5ml, but may range from 1-2ml.

3. When the drug in solid form produces a solution after reconstitution, the label should start with the word Dissolve to emphasize that the solution is produced. 4. When the drug in solid form produces a suspension after reconstitution, the label should start with the word Suspend to emphasize that a suspension is produced. 5. The instruction Inject only after a negative skin test should generally to place in all drugs to be administered parenterally, most especially when prescribing drugs which are likely to produce hypersensitivity reaction such as antimicrobials. An exception to this rule is when you are prescribing for an emergency or life threatening conditions.

Liquid Preparations (Parenteral, Ophthalmic and Otic Solutions): Practice Exercises 1. A prescription for a patient with severe postoperative pain using Tramadol HCl to be given by slow intravenous injection at a dose of 50mg every 4 hours as necessary not to exceed 3 doses. (Tramadol HCl is available in ampules containing in 100mg/2mL)
Computation: Volume of Preparation per dose: 100 mg = 50 mg 2 mL X

X = 1 mL per dose

Total Volume needed = 1 mL x 3 doses x 1 day = 3 mL Dose day Number of ampules = 3 mL / 2 mL = 1.5 2 ampules Note:

Tramadol is a Regulated Drug and is a Narcotic, DDB Form is needed as well as the S 2 - License The maximum number of ampules that can be dispensed is 3 The patient needs to come back to your clinic for refills Tramadol is closely related to Codeine but Codeine is a derivative of Morphine For injection should be present to emphasize that the drug is for parenteral administration Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) Specify the specific parenteral route of administration in this case intravenously DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Moja Mojako Imus, Cavite Rx Tramadol HCl Injection 100 mg/2 mL Dispense Number:2 Ampules Label: For Injection: Inject one mL intravenously every four hours, not exceeding 3 doses, as necessary. Inject only after a negative skin test July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345 S2 License: 85678

2. A prescription for a 4 year old child with high fever , weighing 23kg using Paracetamol solution to be given intramuscularly at 10mg/kg/dose every 4 hours, as necessary for one day. (Paracetamol is available in ampules containing 300mg/2ml)
Computation: Amount of drug per dose = 10 mg x 23 Kg = 230 mg per dose Kg Volume of Preparation per dose: 300 mg = 230 mg 2 mL X

X = 1.53 mL per dose

Frequency or number of dose per day (based on the 16 waking hour) = 16 hours/4hours = 4 doses per day Total Volume needed = 1.53 mL Dose x 4 doses x 1 day = 6.13 mL day

Number of ampules = 6.13 mL / 2 mL = 3.07 3 ampules (the 0.07 is negligible; Remember 10% difference is allowed) Note: For injection should be present to emphasize that the drug is for parenteral administration

Specify the specific parenteral route of administration in this case intramuscularly

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Moja Mojaru, 4 years old Imus, Cavite Rx Paracetamol Solution for Injection 300 mg/2 mL Dispense Number: 3 Ampules Label: For Injection: Inject 1.53 mL intramuscularly every four hours, as necessary, for one day. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

3. A prescription for a 6 year old girl weighing 30kg suffering from an acute asthmatic attack, using Terbutaline sulfate to be administered subcutaneously at a dose of 0.005mg/kg/dose every 4 hours for 3 doses. (Terbutaline sulfate is available in 0.5mg/mL ampule.)
Computation: Amount of drug per dose = 0.005 mg x 30 Kg = 0.15 mg per dose Kg Volume of Preparation per dose: 0.5 mg = 0.15 mg mL X

X = 0.3 mL per dose

Total Volume needed = 0.3 mL x 3 doses x 1 day = 0.9 mL Dose day Number of ampules = 0.9 mL / mL = 0.9 1 ampule Note: For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case subcutaneously No need for skin test because Terbutaline is used to reverse bronchoconstriction

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Narda Kristala, 6 years old Dasmarias, Cavite Rx Terbutaline Sulfate for Injection 500 mcg/mL Dispense Number: 1 Ampule Label: For Injection: Inject 0.3 mL subcutaneously every four hours for three doses. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

4. A prescription for a 6 year old boy weighing 30kg diagnosed to have acute right periorbital cellulites using Cloxacillin sodium to be administered intravenously at a dose of 50mg/kg/day in 3 divided doses round the clock for 5 days. (Cloxacillin sodium is available in vials containing 250mg and 500mg of the powder.)
Computation: Amount of drug per day = 50 mg x 30 Kg = 1500 mg per day Kg Total amount of drug needed = 1500 mg/day x 5 days = 7500 mg Amount of drug per dose = 1500 mg x 1 day = 500 mg per dose (therefore use the 500 mg preparation) Day 3 doses Number of vials needed = 7500 mg / 500 mg = 15 vials

Note:

In this particular case, the drug is in the powder form (drugs are in powder form for them to be stable because they may be prone to degradation when in solution) Powders in vials when dissolved in distilled water should be consumed within (at most) 24 hours The amount of distilled water to dissolve the contents of the vial may vary from 1 to 2 mL (the resulting solution must not be too thick nor too fluid) REMEMBER: the powder must be COMPLETELY DISSOLVED! For convention, you may use: 1 mL to dissolve 250 mg 1.5 mL to dissolve 500 mg 2 mL to dissolve 1 g Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intravenously

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Doraemon Silva, 6 years old Imus, Cavite Rx Cloxacillin Powder for Injection 500 mg/vial Dispense Number: 15 Vials Label: For Injection: Dissolve the contents of the vial in 1.5 mL of distilled water and inject intravenously every 8 hours, round the clock for 5 days. Inject only after a negative skin test. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

5. A prescription for the treatment of acute gonococcal urethritis in an adult male using Spectinomycin to be administered deep intramuscularly at a single dose of 2 grams in the gluteal area. (Spectinomycin is available in vials containing 2g of the powder.)
Note: In this particular case, the drug is in the powder form (drugs are in powder form for them to be stable because they may be prone to degradation when in solution) Powders in vials when dissolved in distilled water should be consumed within (at most) 24 hours The amount of distilled water to dissolve the contents of the vial may vary from 1 to 2 mL (the resulting solution must not be too thick nor too fluid) REMEMBER: the powder must be COMPLETELY DISSOLVED! For convention, you may use: 1 mL to dissolve 250 mg 1.5 mL to dissolve 500 mg 2 mL to dissolve 1 g Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) How to do a skin test? Prepare a small test solution of the drug, enough to make a wheal On one arm, inject subcutaneously and make a wheal Demarcate the boarders of the wheal using a ball pen Wait for about 10 to 30 minutes If the wheal did not enlarged or no redness bigger than the original wheal border, then the patient is skin test negative If the wheal enlarges or if there is redness bigger than the border of the original wheal mark, then the patient is sensitive (positive skin test) If the wheal enlarged on the border of the marking, prepare another skin test on the other hand but now prepare another wheal which will contain distilled water to act as control For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intramuscularly DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Pedro Penduco Imus, Cavite Rx Spectinomycin Powder for Injection Dispense Number: 1 vial 2 g/vial July 4, 2005

Label: For Injection: Dissolve the contents of the vial in 2 mL of distilled water and inject intramuscularly in the gluteal area. Inject only after a negative skin test.

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

6. A prescription for an adult female with typhoid fever using Ampicillin to be administered intravenously at a dose of 1 gm every 6 hours round the clock for 5 days. (Ampicillin is available in vials containing 250mg, 500mg and 1 g of the powder.)
Computation: Frequency or number of doses per day = 24 hours / 6 hours = 4 doses per day Total amount of drug needed = 1 g x 4 doses x 5 days = 20 g Dose day Number of vials needed = 20 g / 1 g = 20 vials Note:

In this particular case, the drug is in the powder form (drugs are in powder form for them to be stable because they may be prone to degradation when in solution) Powders in vials when dissolved in distilled water should be consumed within (at most) 24 hours The amount of distilled water to dissolve the contents of the vial may vary from 1 to 2 mL (the resulting solution must not be too thick nor too fluid) REMEMBER: the powder must be COMPLETELY DISSOLVED! For convention, you may use: 1 mL to dissolve 250 mg 1.5 mL to dissolve 500 mg 2 mL to dissolve 1 g Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intravenously

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Annie Batongbagal-Dimaunahan Bacoor, Cavite Rx Ampicillin Powder for Injection 1 g/vial Dispense Number: 20 vials Label: For Injection: Dissolve the contents of the vial in 2 mL of distilled water and inject intravenously every 6 hours, round the clock, for 5 days. Inject only after a negative skin test. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

7. A prescription for a 4 year old boy weighing 20kg with severe community acquired pneumonia using CoAmoxiclav to be given intravenously at a dose of 30mg/kg every 8 hours , round the clock for 5 days. (Coamoxiclav is available in vials containing 600mg and 1,200mg of the powder.)
Computation: Amount of drug per dose = 30 mg x 20 Kg = 600 mg per dose (use 600 mg preparation) Kg Frequency or number of doses per day = 24 hours / 8 hours = 3 doses per day Number of vials needed = 1 vial x 3 doses x 5 days = 15 vials Dose day Note:

In this particular case, the drug is in the powder form (drugs are in powder form for them to be stable because they may be prone to degradation when in solution) Powders in vials when dissolved in distilled water should be consumed within (at most) 24 hours The amount of distilled water to dissolve the contents of the vial may vary from 1 to 2 mL (the resulting solution must not be too thick nor too fluid) REMEMBER: the powder must be COMPLETELY DISSOLVED! For convention, you may use: 1 mL to dissolve 250 mg

1.5 mL to dissolve 500 mg 2 mL to dissolve 1 g

Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intravenously

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Harry Potter, 4 years old Bacoor, Cavite Rx Co-amoxiclav Powder for Injection 600 mg/vial Dispense Number: 15 vials Label: For Injection: Dissolve the contents of the vial in 1.5 mL of distilled water and inject intravenously every 8 hours, round the clock, for 5 days. Inject only after a negative skin test. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

8. A prescription for a 20 year old female who was diagnosed to have moderately-advance pulmonary tuberculosis using Streptomycin sulfate at a dose of 1 gm intramuscularly three times a week for 2 months. (Streptomycin sulfate is available in vials containing 1 gm of the powder.)
Computation: Number of vials needed = 1 vial x 3 doses x 8 weeks = 24 vials Dose week Note:

In this particular case, the drug is in the powder form (drugs are in powder form for them to be stable because they may be prone to degradation when in solution) Powders in vials when dissolved in distilled water should be consumed within (at most) 24 hours The amount of distilled water to dissolve the contents of the vial may vary from 1 to 2 mL (the resulting solution must not be too thick nor too fluid) REMEMBER: the powder must be COMPLETELY DISSOLVED! For convention, you may use: 1 mL to dissolve 250 mg 1.5 mL to dissolve 500 mg 2 mL to dissolve 1 g Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intramuscularly

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Annie Shigishigi, 20 years old Imus, Cavite Rx Streptomycin sulfate Powder for Injection 1 g/vial Dispense Number: 24 vials Label: For Injection: Dissolve the contents of the vial in 2 mL of distilled water and inject intramuscularly three times a week for 2 months. Inject only after a negative skin test. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

9. A prescription fro severe anxiety in a 60 year old male, using Diaepam at a dsoe of 5 mg intramuscularly every 12 hours for four doses. (Diazepam is available in 2mL ampules containing 5mg/ml)
Computation: Volume of Preparation per dose: 5 mg = 5 mg mL X

X = 1 mL per dose

Total Volume needed = 1 mL x 4 doses = 4 mL Dose Number of ampules = 4 mL / 2 mL = 2 ampules Note:

Diazepam is a Regulated Drug because it is a Sedative/Hypnotic DDB Form is not needed because Diazepam is a Regulated but Exempted drug S2 License is also needed For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intramuscularly DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Lolo Mojako, 60 years old Imus, Cavite Rx Diazepam Solution for Injection 5 mg/mL Dispense Number:2 Ampules Label: For Injection: Inject one mL intramuscularly every 12 hours for doses. July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345 S2 License: 85678

10. A prescription for a 10 year old child weighing 40kg with Mycoplasma pneumonia, using Erythromycin to be given intravenously at a dose of 50mg/kg/day in four divided doses for five days. (Erythromycin is available in vials containing 500mg of the powder.)
Computation: Amount of drug per day = 50 mg x 40 Kg = 2000 mg per day Kg Total amount of drug needed = 2000 mg/day x 5 days = 10000 mg Amount of drug per dose = 2000 mg x 1 day = 500 mg per dose (therefore use the 500 mg preparation) Day 4 doses Number of vials needed = 10000 mg / 500 mg = 20 vials Note:

In this particular case, the drug is in the powder form (drugs are in powder form for them to be stable because they may be prone to degradation when in solution) Powders in vials when dissolved in distilled water should be consumed within (at most) 24 hours The amount of distilled water to dissolve the contents of the vial may vary from 1 to 2 mL (the resulting solution must not be too thick nor too fluid) REMEMBER: the powder must be COMPLETELY DISSOLVED! For convention, you may use: 1 mL to dissolve 250 mg 1.5 mL to dissolve 500 mg 2 mL to dissolve 1 g Inject only after a negative skin test should be indicated if the drug is known to produce hypersensitivity reactions (REMEMBER: all antibiotics needs a negative skin test before injection) For injection should be present to emphasize that the drug is for parenteral administration Specify the specific parenteral route of administration in this case intravenously

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Baby Mojako, 10 years old Dasmarias, Cavite Rx Erythromycin Powder for Injection 500 mg/vial Dispense Number: 20 vials Label: For Injection: Dissolve the contents of the vial in 1.5 mL of distilled water and inject intravenously every 6 hours for 5 days. Inject only after a negative skin test. July 4, 2005

jctayco
John Carlo L. Tayco, MD

License Number: 87658 PTR Number: 12345

11. A prescription for a 20 year old female diagnosed to have acute herpetic keratitis for on the Left eye, using Ganciclovir Ophthalmic gel at a dose of 1 drop 5 times a day for 14 days, then 1 drop 3 times a day fro 7days. (Ganciclovir is available as 1.5 mg/mL ophthalmic gel in 5mL bottles.)
Computation: Total Number of Drops for the first 14 days = 1 drop x 5 doses x 14 days = 70 drops Dose day Total Number of Drops for the succeeding 7 days = 1 drop x 3 doses x 7 days = 21 drops Dose day Total Number of drops = 70 drops + 21 drops = 91 drops Volume of the drug needed 20 drops = 91 drops 1 mL X

X = 4.55 mL

Number of bottles needed = 4.55 mL / 5 mL = 0.91 1 bottle (5 mL) Note:

20 drops = to 1 mL is just an approximation, the volume of a drop is affected by the viscosity and flow characteristics of the preparation Instill is more appropriate than drop

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Baby Bear, 20 years old Dasmarias, Cavite Rx Ganciclovir Ophthalmic Gel 1.5 mg/mL Dispense Number: 1 Bottle (5 mL) Label: Instill 1 drop to the affected eye 5 times a day or 14 days then 1 drop 3 times a day for 7 days July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

12. A prescription for a 30 year old female diagnosed to have inflammatory ocular condition involving the left eye , using Dexamethasone to be given at a dose of 2 drops every two hours on the first day, then 2 drops every four hours fro the next four days. (Dexamethasone is available as 0.1% Eye drop Solution in 5mL bottles.)
Computation: Number of doses for the first day (based on a 16 waking hours) = 16 hours / 2 hours = 8 doses for the first day Total Number of Drops for the first 14 days = 2 drop x 8 doses x 1 day = 16 drops Dose day Number of doses for maintenance per day (based on a 16 waking hours) = 16 hours / 4 hours = 4 doses for the first day Total Number of Drops for the succeeding 7 days = 2 drop x 4 doses x 4 days = 16 drops Dose day Total Number of drops = 16 drops + 16 drops = 32 drops Volume of the drug needed 20 drops = 32 drops 1 mL X

X = 1.6 mL

Number of bottles needed = 1.6 mL / 5 mL = 0.32 1 bottle (5 mL) Note:

20 drops = to 1 mL is just an approximation, the volume of a drop is affected by the viscosity and flow characteristics of the preparation Instill is more appropriate than drop DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234

Pre Ausan, 30 years old Dasmarias, Cavite Rx

July 4, 2005

Dexamethasone Eye Drop Solution 0.1% Dispense Number: 1 Bottle (5 mL) Label: Instill 2 drops to the affected eye every 2 hours for the first day then 2 drops every 4 hours for the next 4 days.

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

13. A prescription for a 40 year old male diagnosed to have allergic conjunctivitis: Cromolyn sodium ophthalmic Drops at a dose of 1 drop on both eyes five times a day for one week. (Cromolyn sodium is available as 2% Ophthalmic drops in 10mL bottles.)
Computation: Number of Drops needed per eye = 1 drop x 5 doses x 7 days = 35 drops per eye Dose day Total Number of Drops needed = 35 drops/eye x 2 eyes = 70 drops Volume of the drug needed 20 drops = 70 drops 1 mL X

X = 3.5 mL

Number of bottles needed = 3.5 mL / 10 mL = 0.35 1 bottle (10 mL) Note:

20 drops = to 1 mL is just an approximation, the volume of a drop is affected by the viscosity and flow characteristics of the preparation Instill is more appropriate than drop Take note of the eye involved: kasi baka magoyo kayo, bilangin nyo kung ilang mata ang involved! Tandaan ang OPHTHALMIC ay para sa MATA! DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Brother Bear, Jr., 40 years old Dasmarias, Cavite Rx Cromolyn Sodium Ophthalmic Drops 2% Dispense Number: 1 Bottle (10 mL) Label: Instill 1 drop on each eye five times a day for 1 week July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

14. A prescription for a 20 year old male with otitis externa involving the left ear using Chloramphenicol Ear Drops to be given at a dose of 10 drops to the affected ear three times a day fro 7 days. (Chloramphenicol is available in 1.0% Ear drop Solution in 10mL bottles.)
Computation: Number of Drops needed = 10 drop x 3 doses x 7 days = 210 drops Dose day Volume of the drug needed 20 drops = 210 drops 1 mL X

X = 10.5 mL

Number of bottles needed = 10.5 mL / 10 mL = 10.5 1 bottle (10 mL) (remember that 10% difference is acceptable!) Note:

20 drops = to 1 mL is just an approximation, the volume of a drop is affected by the viscosity and flow characteristics of the preparation Instill is more appropriate than drop Take note of the ear involved: kasi baka magoyo kayo, bilangin nyo kung ilang tenga ang involved! Tandaan ang OTIC ay para sa TENGA! DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234

Polar Bear, 20 years old Dasmarias, Cavite Rx

July 4, 2005

Chloramphenicol Ear Drop Solution 1.0% Dispense Number: 1 Bottle (10 mL) Label: Instill 10 drops to the affected ear three times a day for 7 days.

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

15. A prescription fro a 2 year old child with severe nasal congestion due to an upper respiratory infection using Oxymetazoline at a dose of 2 drops in each nostril for two days. (Oxymetazoline is available as 0.025% Nasal Drop Solution in 15mL bottles.)
Computation: Number of Drops needed per nostril = 2 drop x 1 dose x 2 days = 4 drops per nostril Dose day Total Number of Drops needed = 4 drops per nostril x 2 nostrils = 8 drops Volume of the drug needed 20 drops = 8 drops 1 mL X

X = 0.4 mL

Number of bottles needed = 0.4 mL /15 mL = 0.026 1 bottle (15 mL) Note:

20 drops = to 1 mL is just an approximation, the volume of a drop is affected by the viscosity and flow characteristics of the preparation Instill is more appropriate than drop Take note of the nostril involved: kasi baka magoyo kayo, bilangin nyo kung ilang butas ng ilong ang involved! Tandaan ang OTIC ay para sa TENGA!

DE LA SALLE UNIVERSITY MEDICAL CENTER Dasmarias, Cavite Tel No. 417-1234 Papa Bear, 2 years old Dasmarias, Cavite Rx Oxymethazoline Nasal Drop Solution Dispense Number: 1 Bottle (15 mL) Label: Instill 2 drops to each nostrils 2 days. 0.025% July 4, 2005

jctayco
John Carlo L. Tayco, MD License Number: 87658 PTR Number: 12345

---------------------------END OF TRANX------------------------Who makes the rules in a Family?

The female makes the rules. The female is never wrong. The rules are subject to change by the female at any time without prior notification No male can possibly know all the rules. Attempts to document the rules are not permitted

If the female suspects that the male may know some or all of the rules, she has the right to immediately change some or all of the rules. If the female is wrong, it is because of an egregarious misunderstanding which was the direct result of vagrant misunderstanding which was a direct result of something the male said or did wrong. The male must must always apologize immediately for having been the cause of the misunderstanding without any clues from the female as to what he did to have caused the misunderstanding. See above rule. The female may change her mind at any time for any reason or no reason at all The male is never permitted to change his mind or under circumstances without the express written consent of the female which is given only in cases where the female wanted him to change his mind but gave no indication of that wish The female has the right to be angry or upset for any reason, real or imagined, at any time and under any circumstance which in her sole judgement she deems appropriate. The male is not to be given any sign of the root cause of the female's being angry or upset. The female may, however, give false or misleading reasons to see if the male is paying attention The male must remain calm at all times, unless the female wants him to be angry or upset. Under no circumstances may the female give the male any clue or indication whether or why she wants him to be angry or upset The male is expected to read the mind of the female at all times. Failure to do so will result in punishments and penalties imposed at the sole discretion of the female The female may, at any time and for any reason, resurrect any past incident without regard to temporal or spacial distance, and modify, enlarge, embellish, of wholly reconstruct it in order to demonstrate to the male that he is now or has in the past been wrong, insensitive, pig-headed, dense, deceitful, and/or oafish

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The female may use her interpretation of any past occurrence to illustrate the ways in which the male has failed to accord her the consideration, respect, devotion, or material possessions, he has bestowed on other females, domestic pets or barnyard animals, sports teams, automobiles, motorcycles, boats, aircraft, or coworkers. Such illustrations are non-rebuttable If the female is experiencing PMS, Post-PMS, or Pre-PMS, the female is permitted to exhibit any manner of behavior she wishes without regard to logical consistency or accepted norms of human behavior Any act, deed, word, expression, statement, utterance, thought, opinion, or belief by the male is subject to the sole, subjective interpretation of the female, other external factors not-withstanding. Alibis, excuses, explanations, defenses, reasons, extenuations, or rationalizations will not be entertained. Begging the female for mercy and forgiveness are acceptable under some circumstances, especially when accompanied by tangible evidence of contrition. PLEASE NOTE: These rules are subject to change as the female sees fit. All rules are null and void under the PMS Exception Law. New rules apply during different stages of a women's life.

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