The Hartford nomogram was one of the first published extended-interval Unlike other nomograms, it uses the highest dose of gentamicin/tobramycin (7 mg/kg. Printable extended-interval aminoglycoside nomograms. The Hartford nomogram suggests dividing an amikacin concentration by 2 to plot onto this. Gentamicin is monitored using the Hartford nomogram which relates observ ed concentration to the time post dose within a given concentration range.
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– Aminoglycoside Dosing Calculator
The Hartford nomogram was one of the first published extended-interval nomograms. Aminoglycoside Dosing Calculator This calculator may hratford used to calculate aminoglycoside using either once-daily and conventional dosing strategies dosing.
The bactericidal action of aminoglycosides is concentration dependent, i. These observations may have significant clinical implications. Adjust maintenance dose using the Sawchuk and Zaske method.
Also, serum troughs that are at or near zero may promote tissue drug disposition, shorten tissue exposure, and promote recovery. Once-daily dosing of aminoglycosides. Although the Barnes-Jewish nomogram has not been formally published, it is commonly used as an extended-interval nomogram.
See the Edit drug models section of the help file for further information. Daily dosage of aminoglycosides.
Extended-interval dosing may not be appropriate in certain patient populations that have significantly altered pharmacokinetic parameters or in patients with disease states where very high peak levels are not appropriate. Aminoglycoside Calculator Advanced aminoglycoside pharmacokinetics tool ClinCalc. This calculator uses four extended-interval nomograms. The persistent low-level exposure of the target organism, as occurs with multiple daily dosing, may markedly reduce the antimicrobial activity of aminoglycosides.
The following criteria are used by this calculator to determine an aminoglycoside dosing weight:. Furthermore, some have questioned the validity of all ODA nomograms because they are based on one-compartment parameters derived from studies of traditional dosing methods. Barnes-Jewish 4 Although the Barnes-Jewish nomogram has not been formally published, it is commonly used as an extended-interval nomogram.
There have been numerous clinical trials published attempting to determine whether extended-interval dosing is superior in efficacy or safety to conventional dosing.
The PAE refers to the continued suppression of bacterial growth despite the decline of the antimicrobial concentration to zero. You may select a specific nomogram by clicking the “Config” icon in the top, right-hand corner of this webpage. The aminoglycoside model is not ahrtford into the program. There are a number of proposed benefits to extended-interval dosing compared to conventional dosing: Urban-Craig 6 The Urban-Craig nomogram was developed with an option for Q12h dosing, which is especially useful in younger patients with high aminoglycoside clearance harfford may have an inappropriately long interval of subtherapeutic drug levels.
The theoretical benefits of high-dose, extended-interval dosing are to: Press ‘Calculate’ to view calculation results. The duration of this effect 2 – 8 hours depends on ahrtford factors, chief among them the height of the preceding aminoglycoside peak.
Infusion time of 60 minutes This level represents the first aminoglycoside dose The level is drawn 6 to 14 hours after the start of the aminoglycoside infusion. In vitro studies indicate that more frequent dosing of aminoglycosides tends to reduce their uptake into the bacterial cell of nommogram GNB. Because aminoglycosides are primarily renally eliminated, the elimination constant K el is directly related to the creatinine clearance: If the 6 to 16 hour level is undetectable and the infection is not responding, consider changing to a traditional dosing method.
Determine initial maintenance dose MD i. Comparative in vitro activity of three aminoglycosidic antibiotics: Regardless, a conservative conclusion is that extended-interval dosing is at least as beneficial and safe, if not better, than conventional dosing. The parameters are found in the drug model database and are fully user-editable.
Furthermore, extended-interval dosing provides for simpler mathematical calculations and reduced need for drug levels, which may reduce the risk of medication errors.
The second simplified equation may be used at the bedside, which contains coefficients that are easier to memorize. Calculate elimination rate kel from creatinine clearance. Drawn min after the start of the infusion. Dose Providing a dose is optional but encouraged This dose is used to determine the patient’s true corrected peak value.
Most institutions are hwrtford IDMS by this point, but you should contacting your laboratory if you are unsure of your assay. Home Academy Blog About. You can tailor each drug model to fit your patient population, or you can create your own models.