1
A pharmaceutical company have developed a new drug and are in the process of conducting a
phase 3 trial. The trial will include a 3-arm randomized controlled study with an allocation
ratio of 1:2:2
What is the total number of patients required to participate in the study so that there
are at least 50 patients in each arm?
Units = patients
(1 Point)
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2
A stock solution of drug B is available at 20% w/v. You need to dilute this with Syrup, BP in
order to supply a patient with a solution containing 5mg/mL of drug B.
Assuming no volume displacement effects, what quantity of syrup is needed, in mL, for
the preparation of 200mL of the final solution?
Units = mL
(1 Point)
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3
A 39-year-old woman is prescribed Priadel 400mg MR tablets at a dose of ONE tablet at
night. The patient wants to convert from Priadel tablets (lithium carbonate) to liquid (lithium
citrate) at the equivalent dose. Her GP prescribes her one bottle of Priadel liquid. Each dose
should be rounded to the nearest mL for ease of administration.
What quantity of Priadel liquid, in mL, would remain in the bottle after a week of her
new dose?
View resource: https://docs.google.com/document/d/1VBNDIhQF9wojTF4QNVc3Ctrte6-
Gw8ev3leXY8SfNOQ/edit?usp=sharing
Units = mL
(1 Point)
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4
A 55-year-old woman with metastatic breast cancer has experienced a haematological
adverse reaction to erbulin. The oncologist has recommended that the IV dose on days 1 and
8 of the next 21-day cycle are reduced from 1.23mg/m² to 0.97mg/m². The woman weighs
72kg and is 1.67m tall. Erbulin solution for injection contains 440micrograms/mL.
How many mL of erbulin injection 440micrograms/mL should be administered to this
patient per treatment day?
View resource: https://www.england.nhs.uk/wp-content/uploads/2018/04/National-Dose-
Banding-Table-Eribulin-0.44mgmL-v3-August-2020.pdf
Units = mL
(1 Point)
5
A doctor has written a private prescription for doxycycline for the prevention of malaria. The
patient is travelling around South America for 8 weeks. The doctor wants the patient to start 2
days before entering South America and continue for four weeks after leaving. You have a
look at your stock and realise you do not have any 100mg capsules in stock. The patient does
not mind taking two 50mg capsules to make his daily dose of 100mg doxycycline.
How many 50mg capsules will be needed to complete the course?
Units = capsules
(1 Point)
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6
A seven-year-old child, who weighs 19kg, has been admitted to Accident and Emergency
with accidental iron poisoning. The dose of desferrioxamine mesilate infusion for the first 4-6
hours is 15mg/kg/hour.
What is the maximum dose of desferrioxamine mesilate infusion that can be
administered over the first 90 minutes of treatment? Give your answer to two decimal
places.
Units = g
(1 Point)
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7
A 7-month-old child (BSA = 0.4m²) has been admitted to the paediatric ward. She requires
aciclovir 500mg/m² TDS for 5 days.
How many 250mg vials of aciclovir will she require over the period of his treatment,
given that aciclovir must be used immediately after reconstitution?
Units = vials
(1 Point)
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8
A 5-year-old who weighs 18.5kg is prescribed Epidyolex 100mg/mL oral solution for use as
adjunctive therapy of seizures associated with Lennox-Gastaut syndrome. Each mL of oral
solution contains 100mg cannabidiol.
The recommended starting dose of cannabidiol is 2.5mg/kg taken twice daily (5mg/kg/day)
for one week. After one week, the dose should be increased to a maintenance dose of 5mg/kg
twice daily (10mg/kg/day).
What volume of Epidyolex 100mg/mL oral solution, in mL, will the child use in 10 days
when using the 1mL syringe?
Units = mL
(1 Point)
9
A pharmacist mixes 100mL of 15% w/v dextrose, 400mL of 25% w/v dextrose and 2000mL
of water.
What is the final % w/v concentration of dextrose? Give your answer to one decimal
place.
Units = % w/v
(1 Point)
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10
A 15-year-old boy weighing 12 stone 10 pounds is prescribed Solvadi 400mg film-coated
tablets for the treatment of chronic hepatitis C. Each film-coated tablet contains 400mg of
sofosbuvir. The recommended dose is one 400mg tablet, taken orally, once daily with food.
He is also prescribed ribavirin
How many ribavirin 200mg tablets should be prescribed to him as a single dose? [1
stone = 14 pounds]
View resource: https://www.medicines.org.uk/emc/product/12361/smpc
Units = tablets
(1 Point)
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11
A 55-year-old man is prescribed isosorbide dinitrate 6mg per hour for the treatment of
unresponsive left ventricular failure, secondary to acute myocardial infarction. To obtain a
dose of 6mg per hour, 50mL of Isosorbide dinitrate 0.1% should be added to 450mL of a
suitable vehicle, under aseptic conditions. An infusion rate of 60mL per hour (equivalent to
60 paediatric microdrops per minute or 20 standard drops per minute), will deliver the
required dose of 6mg per hour.
What is the final concentration of isosorbide dinitrate in microgram/mL?
Units = microgram/mL
(1 Point)
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12
A 62-year-old woman, weighing 63kg, is prescribed 240micrograms/min of glyceryl trinitrate
5mg/mL to control myocardial ischaemia during and after cardiovascular surgery. Three
10mL ampoules of glyceryl trinitrate 5mg/mL are added to 470mL of Dextrose (5%)
Injection BP to give a final volume of 500mL.
What should the rate be in mL/hour?
Units = mL/hr
(1 Point)
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13
A 1-year-old was initially prescribed phenobarbital 1mg/kg twice daily which was then
increased to 2mg/kg daily. He is now on a maintenance dose of 3mg/kg twice a day and
weighs 9kg. Phenobarbital 0.3% w/v contains 38% v/v ethanol (alcohol).
How many mL of ethanol is he receiving each week from his current dose? Give your
answer to one decimal place.
Units = mL
(1 Point)
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14
You are working as a practice pharmacist and are helping the practice reduce expenditure on
medicines. As a result, you are reviewing the use of tamsulosin tablets which cost more than
tamsulosin capsules at an equivalent dose.
Current costs are shown below:
Tamsulosin 400 microgram tablets: £10.47 per 30 tablets
Tamsulosin 400 microgram capsules: £3.89 per 30 capsules
You have reviewed 36 patients who are prescribed tamsulosin tablets 400 microgram OD and
have identified that 28 of them can potentially switch to tamsulosin capsules 400 microgram
OD. The practice repeat prescribing policy is for 28 days of treatment per prescription.
What is the total saving for the practice for 13 repeats assuming 75% of suitable
patients switch to using tamsulosin capsules? Give your answer to the nearest twenty-
five pounds.
Units = £
(1 Point)
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15
A 54-year-old is prescribed prednisolone as a reducing dose course. She is to take 130mg
OD, reducing by 20mg after 3 days and then by 15mg every three days until a dose of 20mg
is reached. She is then to take 20mg for 5 days, and then 10mg for 5 days, and then 5mg for 5
days, and then stop.
How many 5mg tablets would need to be supplied to her to complete the course?
Units = tablets
(1 Point)
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16
You are a locum working in community pharmacy and the pharmacy uses a formula to
calculate the charge for dispensing private prescription.
Private prescription charge = cost of medicine + 15% + £2 dispensing fee + additional fee of
£2 if a controlled drug + additional fee of £2 if it is a fridge line
NovoMix 30 FlexPen 100units/mL suspension for injection in pre-filled pen, Use as directed
x 10 = total £59.78 cost price
Metformin 500mg tablets 1 BD x 56 = total £1.68 cost price.
Calculate the final price. Give your answer in pounds to the nearest pound.
Units = £
(1 Point)
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17
You are asked to advise on the dose of aminophylline for a one-year-old child who weighs
19.8 pounds. The doctor wants to dilute 250mg aminophylline in 500mL of glucose 5% and
asks you to calculate the infusion rate.
Given that the paediatric dosage of aminophylline is 1mg/kg/hour, what is the correct
infusion rate in mL/hour? [1kg = 2.2lbs]
Units = mL/hr
(1 Point)
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18
A local diabetes nurse independent prescriber would like to convert a patient from insulin
glargine 300units/mL to insulin glargine 100units/mL. The patient currently takes 110units of
insulin glargine 300units/mL daily.
What is an appropriate starting dose of insulin glargine 100 units/mL for the patient
using a U100 syringe in mL? Give your answer to two decimal places.
View resource: https://www.medicines.org.uk/emc/product/6938
Units = mL
(1 Point)
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19
You have been asked to prepare 400mL of a solution of miglustat, which when diluted with
water 1 in 5, produces a 1 in 1,000 solution. You have in stock a 300mL bottle of concentrate,
which contains miglustat 20% w/v.
What volume of concentrate, in mL, is required to complete the order?
Units = mL
(1 Point)
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20
A patient with type 1 diabetes is on a high usage of insulin glargine pre-filled pens Lantus
100units/mL. Her daily usage of insulin pen is 103units in the morning and 89units at night.
Her diabetic nurse reviewed her care plan and advised on switching from Lantus pre-filled
pen to SoloSTAR pen 1.5mL of a higher concentration of insulin glargine, called Toujeo
300units/mL.
The patient is conscious of the need to avoid wasting medicines and has been shown how to
give part doses from Toujeo SoloSTAR pen. This means that the Toujeo SoloSTAR pens will
only be discarded when empty.
How many Toujeo insulin pens you will be supplying for 14 days?
Units = pens
(1 Point)
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21
A 6-year-old child has a gluten-free special diet, she weighs 22kg and she has a percutaneous
endoscopic gastrostomy (PEG) tube in situ. The paediatric dietician recommended using
500mL packs of 1.5kcal/mL Nutrini Peptisorb Energy feeds to be delivered over 11 hours
overnight. The nutritional requirement for a child of her age is 1350kcal per 24 hours from
her enteral feed.
At what rate in mL/hour should this feed be delivered? Give your answer to one
decimal place.
Units = mL/hr
(1 Point)
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22
A 67-year-old, weighing 79 kg has been prescribed 120g of a 1 in 4 dilution of
hydrocortisone butyrate 0.1% ointment. The consultant dermatologist, wants the pharmacy to
prepare the ointment using emulsifying ointment as the diluent.
How many grams of emulsifying ointment are needed to prepare the requested
ointment?
Units = g
(1 Point)
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23
You are discussing fluoride supplements with the local dentist. You stock sodium fluoride
toothpaste in both 2800ppm and 5000ppm.
If the content of sodium fluoride in drinking water is 3ppm, how many mg of sodium
fluoride would be found in 15L of drinking water?
Units = mg
(1 Point)
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24
Drug B has a half-live of 4 hours and is administered once only.
If the initial plasma level of the drug is 6800mg/L, what will its plasma level be after 10
hours?
Units = mg/L
(1 Point)
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25
A patient who weighs 60kg is prescribed Drug D at a concentration of 15% w/v at a dose
of 500mg/kg.
•The infusion is to run as follows:
•0.3mL/kg/hr for 12 minutes
•0.7mL/kg/hr for 24 minutes
•1.3mL/kg/hr for 36 minutes
•2.6mL/kg/hr for 48 minutes
•Then 4mL/kg/hr for the remainder of the infusion.
What volume of drug D, in mL, will be infused after one hour? Give your answer to one
decimal place.
Units = mL
(1 Point)
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26
A 46-year-old man and 45-year-old woman are signed up to your smoking cessation service
and are about to receive the Champix initiation pack via PGD
How many grams of Champix will both patients receive altogether during the 12-week
course? Give your answer to two decimal places.
View resource: https://www.medicines.org.uk/emc/product/13451/smpc
Units = g
(1 Point)
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27
You receive the following request into your hospital manufacturing suite:
Send 300mL benzalkonium chloride solution which when diluted 1 in 40 produces a 1 in 250
solution.
Assuming the only concentrated solution of benzalkonium chloride available contains
25% w/v, what volume of this concentrate, in mL, is needed to fulfil the order?
Units =mL
(1 Point)
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28
What amount of copper sulfate, in grams, is required to make 1250mL of an aqueous
stock solution, such that, when the stock solution is diluted 50 times with water, a final
solution of 0.6% w/v copper sulfate is produced?
Units = g
(1 Point)
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29
You are an independent prescriber undertaking a medication review on a 54-year-old patient
on the 2nd June 2023 at 8am. After discussing with the patient, you decided to issue a one-off
prescription of ramipril, metformin and furosemide to take the patient to the 27th June and
bring everything in line with atorvastatin. You will then issue a 28 day supply of all
medications on 28th June.
Assuming that the patient is fully compliant and has taken no tablets today, how many
metformin 500mg tablets would you prescribe today?
View
resource: https://docs.google.com/document/d/1JJv8psVARo7LbpJ9IGzciUsjwL8DzGjC0T
GHCils15w/edit?usp=sharing
Units = tablets
(1 Point)
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30
A 3-year-old child weighs 12kg and is prescribed 75% of maintenance fluid over 24 hours
(100% maintenance for a 12kg child is 45 mL/hour). The child is presently receiving
medication by continuous infusion at 2mL/hour, 8mL of another medication every 8 hours
and 3mL of a third drug every 6 hours.
What is the amount of feed/milk that this child can receive every hour? Give your
answer to two decimal places.
Units = mL/hr
(1 Point)
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31
A 75-year-old woman is admitted to hospital after suffering from a stroke. She regularly
takes digoxin tablets 62.5micrograms daily but as she cannot swallow tablets her doctor
wants to change her to an equivalent dose of digoxin elixir.
What is the equivalent dose of digoxin in microgram? Give your answer to the nearest
whole number.
[bioavailability of digoxin tablets = 0.7; bioavailability of digoxin elixir = 0.8]
Units = microgram
(1 Point)
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32
A vial contains 500mg of a drug with a displacement volume of 1.5mL/250mg. As part of the
reconstitution process, you add 17mL of sterile water for injection.
What is the concentration, in mg/mL, of the drug in the solution?
Units = mg/mL
(1 Point)
Error! Filename not specified.
33
FluoriGard Daily dental rinse contains 0.05% sodium fluoride.
Instructions for use:
- Use once per day, preferably after brushing teeth.
- Rinse 5-10mL around and between teeth for one minute and then spit out.
- Do not eat, drink or rinse mouth for at least fifteen minutes afterwards.
[Sodium fluoride 2.2mg = 1mg fluoride ion]
How many milligrams of fluoride ions are contained in 5mL of FluoriGard Daily dental
rinse? Give your answer to one decimal place.
Units = mg
(1 Point)
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34
A 52-year-old man weighing 65kg, is receiving a dopamine infusion at a rate of 2.44mL/hour
as an adjunct after open heart surgery. The syringe contains 200mg dopamine in 50mL
normal saline. You are checking to see if this dose is appropriate.
What is the dose in microgram/kg/min? Give your answer to one decimal place.
Units = microgram/kg/min
(1 Point)
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35
A new drug is in the final phase of clinical trials for prostate cancer. It is being compared
against the gold standard. The control event rate was 68% and the experimental event rate
was 36%
What is the number needed to treat for the new drug?
Units = people
(1 Point)
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36
A 56-year-old man is prescribed a Betnovate cream in aqueous cream dilution by the
dermatology department.
Betnovate cream 1 part
Aqueous cream to 4 parts
Prepare 300 g
How many grams of aqueous cream are needed to prepare this?
Units = g
(1 Point)
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37
A 10-year-old girl is prescribed 1.35g of erythromycin intravenously per day for the
prevention and treatment of pertussis.
How many kg does she weigh?
View resource: https://bnfc.nice.org.uk/drugs/erythromycin/
Units = kg
(1 Point)
Error! Filename not specified.
38
An 81-year-old man is prescribed bleomycin 15000 IU Powder for solution for injection/
infusion for testicular tumours. This is to be given once a week at intervals of four weeks via
intramuscular injection. He is 114cm tall and weighs 72kg.
What is his total cumulative dose in units?
[1 x 10³ = 1000]
View resource: https://e-lactancia.org/media/papers/Bleomycin-DS-EMC2018_.pdf
Units = units
(1 Point)
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39
A 36-year-old woman is prescribed a 6-month supply of the combined oral contraceptive pill
Triadene which contains six beige tablets containing 30micrograms ethinylestradiol and
50micrograms gestodene, five dark brown tablets containing 40micrograms ethinylestradiol
and 70micrograms gestodene, and ten white tablets containing 30micrograms ethinylestradiol
and 100micrograms gestodene.
What quantity of ethinylestradiol, in mg will she receive over the 6 months? Give your
answer to two decimal places.
Units = mg
(1 Point)
Error! Filename not specified.
40
A 73-year-old man has been prescribed a vial containing 200mg hydrocortisone sodium
succinate powder for injection for the treatment of shock secondary to adrenocortical
insufficiency. It is to be reconstituted to produce 2mL of injection. The displacement volume
of hydrocortisone sodium succinate is 0.05mL/100mg.
How much water, in mL, should be added to the powder? Give your answer to one
decimal place.
Units = mL
(1 Point)
Error! Filename not specified.
41
