A primary healthcare provider has prescribed ertapenem to a 6-year-old child with a urinary tract infection (UTI).
What is the safe dose of medication for this child?

One tablespoon is equal to **14.7867648 milliliters**¹²³⁴. To convert tablespoons to milliliters, you can multiply the value in tablespoons by 14.7867648. For example, 1 tablespoon x 14.7867648 milliliters = 14.7867648 milliliters.

Therefore, to convert 1 tablespoon of mouthwash to milliliters, you can multiply 1 by 14.7867648. The answer is **14.7867648 milliliters**. This is the amount of mouthwash that a patient uses in 1 tablespoon.

This instruction should be given to the patient for the effective management of asthma because the patient is taking an overdose of ipratropium, which may cause serious side effects such as dry mouth, blurred vision, urinary retention, or increased heart rate. The recommended dosage of ipratropium for adults with acute asthma is 0.5 mg (500 mcg) every 20 minutes for three doses, followed by 0.5 mg every two to four hours as needed³. The patient's prescribed dose is 5 mg/kg, which means 300 mg/day for a 60 kg patient. This is 10 times the maximum daily dose of 2 mg (2000 mcg) for ipratropium⁴. Therefore, the patient should halve the dose of medication to 150 mg/day, which is still higher than the usual dosage, but within the range that can be given under medical supervision.

The other options are not appropriate instructions because:

a) Continuing the same dose of medication may worsen the patient's condition and increase the risk of adverse reactions.

b) Changing to alternative medication may not be necessary or effective, as ipratropium is a commonly used bronchodilator for asthma that works by relaxing the airway muscles and improving airflow⁵. The patient may benefit from adjusting the dose or adding other medications, such as corticosteroids or beta-agonists, depending on the severity and frequency of symptoms.

c) Doubling the dose of medication may be dangerous and potentially fatal, as it may cause severe anticholinergic effects, such as dry mouth, blurred vision, urinary retention, increased heart rate, confusion, or coma.