Answer Happy

Scenario 1 Ewan has been receiving daily supervised methadone from your pharmacy for the last two years. He has been stable on 100 ml of methadone hydrochloride (1 mg/1ml oral solution) for the past year and has a history of alcohol misuse and drinks 15 to 20 Time left 1:59:36 He comes to the pharmacy for his supervised consumption at 8am each morning but missed a dose yesterday and presents for his methadone at 4pm this afternoon. When you ask how he is doing, he admits he's been recently drinking at least 30 units per day after a relationship break down. Question 1 With reference to the pharmacokinetics of methadone and assuming a half-life of 15 hours in this patient, is it safe to dispense and supervise the 100 ml dose today? Include in your answer approximately what proportion of the original concentration (Cmax) is still present in his bloodstream and what factors would influence your decision. Please show all calculations in your answer for marks to be awarded.