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.
What is dosing nomogram?
A nomogram is presented for the rapid determination of the dosage adjustment factor for drugs eliminated in part by the kidneys in patients with reduced renal function.
How do you monitor aminoglycosides?
Using a nomogram is a popular method of monitoring aminoglycoside treatment if extended interval dosing is being followed. Commonly used nomograms include the Hartford nomogram and Urban and Craig nomogram. All nomograms are designed for a certain population group with a fixed dose of aminoglycoside.
How do you calculate Ke for gentamicin?
CrCl > 40ml/min at 5mg/kg dose to a maximum of 500mg. CrCl 10-40ml/min at 3mg/kg dose to a maximum of 300mg. CrCl <10ml/min at 1mg/kg dose to a maximum of 120mg….
| Trough level | Interpretation | Action |
|---|---|---|
| >2mg/L | High risk | Stop gentamicin and contact a consultant microbiologist for advice |
When should amikacin levels be drawn?
Serum samples for peak concentrations are collected 60 minutes after the start of intravenous infusion and 60–90 minutes after intramuscular injection. In critically-ill patients, the peak serum levels are drawn after the first dose. Samples for trough concentrations are collected within 30 min of the next dose.
Can amikacin be given IM?
Amikacin sulphate injection may be given intramuscularly or intravenously. Amikacin should not be physically premixed with other drugs, but should be administered separately according to the recommended dose and route. The patient’s pre-treatment bodyweight should be obtained for calculation of correct dosage.
When do you draw aminoglycoside levels?
Draw pre and post levels with the THIRD dose of aminoglycoside (or as per order). Draw “pre” level within 30 minutes prior to the next scheduled drug dose.
How do you calculate ideal body weight?
Ideal body weight is computed in men as 50 + (0.91 × [height in centimeters − 152.4]) and in women as 45.5 + (0.91 × [height in centimeters − 152.4]). A simple alternative would be to compute ideal body weight as the weight corresponding to an ideal body mass index of 22 kg/m2.
How do you calculate adjusted body weight?
Remember that BMI = weight(kg)/height2 (meters squared). Next, we will establish an ‘ideal’ BMI based on values in the standard IBW equations: Male: 60 inches – 50kg – BMI= 21.53. Female: 60 inches – 45.5kg – BMI= 19.59.
What is amikacin used to treat?
Amikacin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that surround the brain and spinal cord) and infections of the blood, abdomen (stomach area), lungs, skin, bones, joints, and urinary tract.
How long is amikacin used for?
The recommended dose in prematures is 7.5 mg/kg in every 12 hours (see sections 4.4 and 5.2). The usual duration of treatment is 7 to 10 days. The total daily dose by all routes of administration should not exceed 15-20 mg/kg/day.
