Some medications are formulated such that there is a slow release of the active
ID: 123038 • Letter: S
Question
Some medications are formulated such that there is a slow release of the active ingredients. Such formulations known as "extended release." Azithromycin ER is a single-dose, extended release formulation. The recommended dosage for a child 6 months and older who is brought to the Emergency Room with community acquired pneumonia is 60 mg/kg administered orally. Azithromycin (immediate release) has much faster onset of action and acts almost immediately when administered intravenously (by IV). Clinicians exercise clinical judgment when deciding whether or not to treat a pediatric patient with azithromycin intravenously. If therapy is deemed necessary, a dose of 10 mg/kg for those age 6 months to 16 years is considered reasonable. (a) Based on the information above, what would be an appropriate dose of azithromycin ER for a baby weighing 17 lbs such as Amaan? (b) How does the appropriate dose of azithromycin ER for a baby weighing 17 lbs such as Amaan compare with the dose of azithromycin that was given intravenously to Amaan. (c) What would be an appropriate dose of azithromycin (immediate release) administered by IV for a baby weighing 17 lbs such as Amaan? How does your calculated dose compare with that indicated by Dr Loiselle? Dr. Loiselle indicated that the 500 mg dosage administered for Amaan is more typical for an adult and not a 17-pound baby. If a 500 mg of the medication is administered to an adult male of 190 lbs, what would be the dosage (in mg/kg)? If the same amount of medication is administered to an adult female weighing 140 lbs, what would be the dosage (in mg/kg)? Based on your answers to Question 3 above, why do you think that, as a general practice, when antibiotics (including azithromycin) are prescribed to adults, the same dose is usually given, regardless of weight of the patient?Explanation / Answer
3.a. The dose of azithromycin ER is given to be 60mg/kg
Weight of child= 17 lbs = 7.7 kg
Therefore, dose will be 60 X 7.7 = 462 mg
b. Dose of azithromycin given intravenously is 10 mg/kg
Weight of child = 17 lbs = 7.7 kg
Therefore, dose will be 10 X 7.7 = 77 mg
Intravenous dose is 77 mg which is much lesser compared to the oral dose i.e. 462 mg. This is because the drug acts immediately when administered intravenously. So, less dose is required if given intravenously.
c. Dose of azithromycin given intravenously is 10 mg/kg
Weight of child = 17 lbs = 7.7 kg
Therefore, dose will be 10 X 7.7 = 77 mg
According to Dr. Loiselle the dose administered is 500mg which is much more compared to the calculated intravenous dose.
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