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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The aminoglycoside model is not hard-coded into the program.
Drug Intell Clin Pharm. Therefore, it is argued that nomograms based on an assumption of similar kinetics are invalid.
Home Academy Blog About. The second simplified equation may be used at the bedside, which contains coefficients that are easier to memorize.
Assumptions of this level: The persistent low-level exposure of the target organism, as occurs with multiple daily dosing, may markedly reduce the antimicrobial activity of aminoglycosides. When a regimen is calculated, each step in the dosing process is fully enumerated and visible by clicking the “Equations” tab. You may select a specific nomogram by clicking the “Config” icon in the top, right-hand corner of this webpage.
Adjust maintenance dose using the Sawchuk and Zaske method.
Printable Extended-Interval Aminoglycoside Nomograms
After calculating a dose, click on ‘Progress Note’ for a pharmacokinetic template or ‘Equations’ for a step-by-step explanation of the recommended dosing regimen. A meta-analysis of extended-interval dosing versus multiple daily dosing of aminoglycosides.
The Urban-Craig nomogram was developed with an option for Q12h dosing, which is especially useful in younger patients with high aminoglycoside clearance who may have an inappropriately long interval of subtherapeutic drug levels. The following patient populations should be excluded from the high-dose, extended-interval dosing and conventional dosing should be used: 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.
Dose Providing a dose is optional but encouraged This hartfird is used to determine the patient’s true corrected peak value. Drawn min after the start of the infusion.
For more information, read more about IDMS. If the 6 to 16 hour level is undetectable and the infection is not responding, consider changing to a traditional harftord method.
This regimen can be completely empiric, where the dose is harhford on body weight, height, and creatinine clearance, or a regimen may be calculated based on one or more drug levels. Furthermore, extended-interval dosing provides for simpler mathematical calculations and reduced need for drug levels, which may reduce the risk of medication errors.
Utilize the post-antibiotic effect PAEdefined as a recovery period before organisms can resume growth after drug removal. Aminoglycoside Calculator Advanced aminoglycoside pharmacokinetics tool ClinCalc.
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 who may have an inappropriately long interval of subtherapeutic drug levels. The nomogra, criteria are used by this calculator to determine an aminoglycoside dosing weight:.
– Aminoglycoside Dosing Calculator
Once-daily dosing of aminoglycosides. The theoretical benefits of high-dose, extended-interval dosing are to: Regardless, a conservative conclusion is that nomogdam dosing is at least as beneficial and safe, if not better, than conventional dosing. Longer dosing intervals appear to shorten the time required for the MIC to revert to its original value. Press ‘Calculate’ to view calculation results.
Dosed mg IV Q hrs.
The parameters are found in the drug model database and are fully user-editable. Calculate elimination rate hartcord from creatinine clearance. Barnes-Jewish 4 Although the Barnes-Jewish nomogram has not been formally published, it is commonly used as an extended-interval nomogram.
Although definitive evidence is still lacking, animal and human studies strongly suggest that once-daily dosing is less nephrotoxic. Updated November 10,