These relate to the calculations topic this month. The calculations paper for the GPhC registration assessment allows you to use a calculator but it must be one of the ones specified. Buy one of these models and get used to using it. These questions do not have MCQ options and it is really important you answer in the units specified and round to the nearest whole number unless otherwise indicated.
We know that the only question for estimations of kidney function relates to you putting numbers into Cockcroft and Gault and then relating this to a fairly small number of drugs. Because of this, all these questions are about meropenem you will need the information below for all the questions.
You should probably allow yourself three minutes per question.
The SPC for meropenem IV would be provided in the resource pack in the actual assessment. It can be accessed here https://www.medicines.org.uk/emc/medicine/11215
The Cockcroft and Gault formula for estimating creatinine clearance is provided below:
Cockcroft and Gault formula
Estimated Creatinine Clearance in mL/minute =
(140 – Age) × Weight × Constant
(Age in years
Weight in kilograms; use ideal body-weight
Serum creatinine in micromol/litre
Constant = 1.23 for men; 1.04 for women)
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A 54-year-old man has been diagnosed with bacterial meningitis that is sensitive to meropenem. He weighs 67 kg and has a BMI of 24 kg/m2. He has a serum creatinine of 267 micromol/litre.
What is the recommended total daily dose of meropenem in grams for this man?
A 28-year-old woman has a severe infection just after giving birth. The infection is sensitive to meropenem. She weighs 75 kg. Her serum creatinine is 100 micromol/litre
What is the minimum recommended dose of meropenem in grams that should be administered every eight hours?
A 56-year-old woman has been admitted with febrile neutropenia. It is not yet known whether the infection is sensitive to meropenem but as she is seriously ill, the microbiology advice is to start her with meropenem. She weighs 61 kg and her serum creatinine is 150 micromol/litre
What is the recommended total daily dose of meropenem in grams for this woman?
A 75-year-old man has developed pneumonia that is sensitive to meropenem whilst in ITU. He weighs 70kg and has a serum creatinine of 220 micromol/litre. The decision is made to treat him at the maximum recommended dose of meropenem.
What is the maximum recommended dose of meropenem in grams that should be administered in 24 hours?