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Vancomycin - Single Level Analysis
Patient:
Location:
Drug
:
Vancomycin
Weight:
Kg
Pounds
Current dose being given
:
mg
Current dosing interval
:
hrs
Current infusion time (hrs)
:
0.25
0.5
1
1.5
2
2.5
3
3.5
4
Single level drawn - Trough
Trough level obtained
:
mcg/ml
When was the trough drawn?
:
Enter number of hours before next dose
:
hrs
[
Hint
: 0.01 = <1 minute before next dose. 0.08 = ~5 minutes before next dose]
Desired peak
:
mcg/ml
Desired trough
:
mcg/ml
Background
Ambrose-Winter’s Single Trough Method
Principles
:
A population Vd is used to estimate the [Peak].
This calculated [Peak] and measured [Trough] are then used to calculate an elimination rate constant (kel).
[Peak]=measured [Trough] + Dose/Vd
kel = ln ([Peak]/[Trough])/Tau
Infusion equations are then used to calculate a new Tau and Dose.
Side note
: the GlobalRPh calculator uses the Vd recommended in Bauer's text: 0.7 L/kg.
Use the
advanced version
if you wish to manipulate this value.
Reference
Ambrose PJ, Winter ME. In: Winter ME. Basic clinical pharmacokinetics, 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2004:451-76.
Alternate expression of kel equation
:
Normally kel = (Ln C1 / C2) / (t2 - t1)
C1= actual or extrapolated Peak; or post peak level
C2= actual or extrapolated trough; or random level
Drawn at least 1.5 x estimated half-life after first level.
(t2 - t1) = Time difference between levels.
Equation 15.5 page 455:
cmax = [cmin + dose (s) (f)] / Vd
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Disclaimer
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.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
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Internal Medicine Section