Oral hydromorphone to oral morphine conversion ratio ≈ 1:5.
4 mg Q6H = 16 mg hydromorphone/day
16 mg × 5 = 80 mg morphine/day

Anthracyclines like doxorubicin, daunorubicin, idarubicin, and epirubicin have lifetime dose limits due to risk of cardiotoxicity.

Toxic symptoms include coarse tremor, GI upset, and ataxia at this level. Toxicity at lithium levels > 3mEq/L can result in CNS depression, seizures, irreversible brain damage, coma, arrhythmia.

Prophylaxis for OIs is not recommended until the CD4+ count drops below 200 for PCP and <50 for MAC.

A multi-faceted approach including protocols, education, monitoring, and use of technology like programmable pumps can reduce risks.

A T-score below -2.5 is diagnostic for osteoporosis.

Paul is under 65 but has diabetes, which places him in a high-risk group for pneumococcal disease. Current ACIP guidelines recommend: Pneumococcal vaccination: Patients aged 19–64 with diabetes should receive either: PCV20 alone, or PCV15 followed by PPSV23 (at least 1 year apart, or 8 weeks in immunocompromised).
Annual influenza vaccination: He should receive an inactivated influenza vaccine like Fluvarin. FluMist is not recommended in high-risk patients (e.g., diabetes, chronic conditions). Shingles vaccine (Shingrix) is approved for immunocompetent adults ?50 years or ?19 if immunocompromised, so Peter does not yet qualify based on age alone.

1 gal = 3785 mL --> 3785×0.20 = V2×0.40 --> V2 = 1892.5 mL

All are appropriate due to CNS effects, abuse potential, and safety risks.

Donepezil works as an acetylcholinesterase inhibitor to increase acetylcholine levels in the brain, which is helpful in Alzheimer's disease.