When do you use the Hartford nomogram?
When do you use the Hartford nomogram?
It’s recommended to obtain a random serum level 6 to 14 hours (for Hartford nomogram) and 8 to 12 hours (for Barnes-Jewish nomogram) after the start of the initial infusion. The resultant level is then plotted on the nomogram, in which optimal dosing interval can be determined.
What is Hartford nomogram?
The Hartford Nomogram method utilizes high-dose, once daily dosing to optimize the peak/MIC ratio in most clinical situations by administering a dose of 7mg/kg of either gentamicin or tobramycin.
How is vancomycin calculated?
CLvanco is estimated using a linear relationship to creatinine clearance while normalizing to total body weight:
- CLvanco=(0.695∗CrCl/TotalBW+0.05)∗TotalBW∗0.06.
- CLvanco=(0.698∗CrCl+3.66)∗0.06.
- Vd(liters)=0.17∗Age+0.22∗TotalBW+15Vd(L/kg)=V.
- Cp=Cp0∗e−kt(rewrittentosolvefork)k=ln(Cp0/Cp)/t.
What is conventional dosing?
Traditional/conventional dosing refers to multiple daily doses of aminoglycosides (e.g. tobramycin or gentamicin dosed 80mg every 8 hours or 1.5-2.5 mg/kg every 8 hours). Of the two approaches, EIAD is preferred over traditional dosing in patients that meet EIAD eligibility criteria.
What is extended interval dosing?
Extended-interval aminoglycoside therapy (also known as once-daily aminoglycosides, single daily aminoglycoside dosing, consolidated or high-dose aminoglycoside therapy) utilizes a higher weight-based dose administered at an extended interval (every 24 hours for those with normal renal function and longer for those …
Does vancomycin have linear kinetics?
Remember vancomycin has LINEAR kinetics! Changes in dose should produce proportional changes in serum level, as long as the dosing interval remains constant. So a simple proportion is often all that is required to find your new regimen.
Is vancomycin dosing linear?
How is vancomycin distributed?
The drug is administered intravenously, with a standard infusion time of at least 1 h, to minimize infusion-related adverse effects. In patients with normal creatinine clearance, vancomycin has an α-distribution phase of ∼30 min to 1 h and a β-elimination half-life of 6–12 h.
When should I take gentamicin levels?
Gentamicin levels should be taken 6-14 hours after the start of the infusion. For a daily dose of 5mg/kg/day the Urban-Craig nomogram can be used. Gentamicin levels should be taken 8-12 hours after the dose.
How do you calculate predicted vancomycin concentration?
Clearance
- CLvanco (mL/min/kg) = ([CrCl × 0.0075] + 0.04)
- Vd = 0.47 L/kg. Vd was estimated using an adjusted body weight (ABW).
