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NON-STEADY STATE    -     Dosing By Levels

Patient-Specific Data
Patient:     Location:
dose by levels  
 

Current Levels Data
1st level - Concentration:  mcg/ml    1st level (number hours post dose): hr
2nd level - Concentration: mcg/ml    2nd level (number hours post dose):  hr
3rd level - Concentration: mcg/ml   3rd level (number hours post dose): hr

Current Drug Regimen
Current dose being given:  mg     Current dosing interval: (hours)
Current infusion time (hours):
Desired peak: mcg/ml     Desired trough: mcg/ml
Sample problems
Scenario 1:  (Levels off the first dose)
Regimen:  Tobramycin 140mg (infused over 30 minutes) IVPB q8h. Two post levels are drawn after the first dose.   The first level (level 2 in the figure below) was drawn 2 hours after the 'start' of the infusion, while the second level (level 3) was drawn 6 hours after the 'start' of the infusion.  You will notice a zero was entered for the 1st level concentration and the number of hours post dose. Next, notice that the the number of hours post dose for the 2nd and 3rd level included the infusion period of 30 minutes. It is IMPORTANT not to subtract the infusion time from the number of hours post dose. The program will take care of this for you.
Scenario 2:  (Levels off the second dose)
Regimen:  Tobramycin 140mg (infused over 30 minutes) IVPB q8h. A pre-level was drawn 7 hours after the 'start' of the infusion of the first dose.  Two post levels are drawn after the second dose.   The first level (level 2 in the figure below) was drawn 2 hours after the 'start' of the infusion, while the second level (level 3) was drawn 6 hours after the 'start' of the infusion.  Notice that the the number of hours post dose for the 1st, 2nd and 3rd level included the infusion period of 30 minutes.
It is IMPORTANT not to subtract the infusion time from the number of hours post dose. The program will take care of this for you.

Program HINT: If the pre-level (level 1) was drawn just prior to the infusion of the next dose, the number of hours post dose would be 8 in this example.



pharmacokinetics

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.

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