Pharmacy PEBC Practice Exam

A male patient weighing 165 pounds is brought to the Emergency Room approximately 6 hours after ingestion of an overdose of acetaminophen. Acetylcysteine IV will be administered according to the following dosing regimen: Total IV dose = 300 mg/kg given over 20 hours, as follows: Loading Dose:150 mg/kg in 250 mL D5W IV given over 15 minutes, followed by: First infusion: 50 mg/kg in 500 mL D5W IV given over 4 hours, followed by: Second infusion: 100 mg/kg in 1 L D5W given over 16 hours. Which of the following represents the correct preparation of the three acetylcysteine IV bags needed for this patient?

1. Acetylcysteine 2.25 g in 250 mL D5W; 0.2 g in 500 mL D5W; 1.6 g in 1 L D5W

2. Acetylcysteine 11.25 g in 250 mL D5W; 3.75 g in 500 mL D5W; 7.5 g in 1 L D5W

3. Acetylcysteine 22.5 g in 1 L of D5W

4. Acetylcysteine 24.75 g in 250 mL D5W; 8.25 g in 500 mL D5W; 16.5 g in 1 L D5W

The correct answer is: Acetylcysteine 11.25 g in 250 mL D5W; 3.75 g in 500 mL D5W; 7.5 g in 1 L D5W

Option A is incorrect because it only covers two of the three infusions needed, and the dosages are incorrect. Option C is also incorrect because it only covers one of the three infusions, and the dosage is incorrect. Option D is incorrect because the total dosage for each infusion is too high, and it does not follow the proper dosing regimen. Option B is the correct answer because it covers all three infusions and the dosages are correct according to the specified dosing regimen.