A 20-year-old patient weighing 60 kg has to be prescribed an antiepileptic drug (available
as 200 and 400 mg tablets) for generalized tonic-clonic seizures. The pharmacokinetic parameters
and therapeutic plasma concentration of the selected drug are:
Target steady-state plasma concentration (Cpss) – 6 mg/L
Oral bioavailability (F) – 70%
Volume of distribution (V) – 1.4 L/kg
Clearance (CL) – 80 ml/hr/kg
Plasma half life (t½) – 15 hours
What should be the loading dose and the daily maintenance dose of the drug for this patient?
A 20-year-old patient weighing 60 kg has to be prescribed an antiepileptic drug (available
as 200 and 400 mg tablets) for generalized tonic-clonic seizures. The pharmacokinetic parameters
and therapeutic plasma concentration of the selected drug are:
Target steady-state plasma concentration (Cpss) – 6 mg/L
Oral bioavailability (F) – 70%
Volume of distribution (V) – 1.4 L/kg
Clearance (CL) – 80 ml/hr/kg
Plasma half life (t½) – 15 hours
What should be the loading dose and the daily maintenance dose of the drug for this patient?
💡 Explanation
**Core Concept**
The patient requires an antiepileptic drug to treat generalized tonic-clonic seizures. The pharmacokinetic parameters provided will be used to calculate the loading and maintenance doses.
**Why the Correct Answer is Right**
To calculate the loading dose, we use the formula: Loading dose = Desired steady-state plasma concentration (Cpss) x Volume of distribution (V). Given Cpss = 6 mg/L and V = 1.4 L/kg, we first need to convert V to L: 1.4 L/kg x 60 kg = 84 L. Then, the loading dose = 6 mg/L x 84 L = 504 mg.
For the maintenance dose, we use the formula: Maintenance dose = Desired steady-state plasma concentration (Cpss) x Clearance (CL). Given Cpss = 6 mg/L and CL = 80 ml/hr/kg, we first need to convert CL to L/hr: 80 ml/hr/kg x 60 kg = 4800 ml/hr = 4.8 L/hr. Then, the maintenance dose = 6 mg/L x 4.8 L/hr = 28.8 mg/hr. Given the available tablet strengths of 200 and 400 mg, we can round down to 200 mg/hr (or 5.55 mg/kg/hr) to ensure the patient receives the required dose.
**Why Each Wrong Option is Incorrect**
**Option A:** This option would require a calculation, but the given information does not support it.
**Option B:** This option does not use the correct formula to calculate the loading dose.
**Option C:** This option does not correctly apply the formula for the maintenance dose.
**Option D:** This option is incorrect because it does not provide a clear calculation or reasoning.
**Clinical Pearl / High-Yield Fact**
When calculating loading and maintenance doses, ensure to use the correct pharmacokinetic parameters and formulas to avoid dosing errors.
**Correct Answer:** C. 504 mg (loading dose) and 200 mg/hr (maintenance dose)
✓ Correct Answer: A. 720 and 984 mg respectively
📤 Share this MCQ
Share Card Preview
👆 1080x1080 square card — fills the full width in WhatsApp and Telegram