Nomograms

Question 1

Nomogram definition

Answer 1

figure or equation consisting of three or more straight or curved lines, each graduated for a different variable - specific mathematical relationship

Question 2

BSA DuBois

Answer 2

S = W^0.425 X H^0.725 X 71.84
w- kg
h- cm
s- Cm^ 2

Question 3

cm to m

Answer 3

100 cm in one m

Question 4

Kest

Answer 4

aminoglycoside dosing, emperic dosing,

0.0024xCrCl + 0.01 hr-1

Question 5

Vest

Answer 5

0.25 L/kg X IBW kg (use ABW if ABW < IBW)

Question 6

average aminoglycoside t 1/2

Answer 6

2

Question 7

how does the drug damaging the kidney effect

Answer 7

decreases clearance and causes toxicity

Question 8

when to use ABW female

Answer 8

ABW if ABW < IBW

Question 9

when to use ABW

Answer 9

use ABW if ABW <25

Question 10

why we use nomograms

Answer 10

maximize efficacy and minimize toxicity

Question 11

MIC

Answer 11

minimum conc in body to kill bacteria but no resistance

Question 12

dose of aminoglycoside

Answer 12

7 mg/L

Question 13

target peak aminoglycoside

Answer 13

20-30 mg/L

Question 14

trough aminoglycoside

Answer 14

trough undetectable

Question 15

peak vs MIC

Answer 15

peak is 10X in MIC

Question 16

why trough negligible

Answer 16

toxicity comes from the trough, accumulation, ODO and renal toxicity

Question 17

drug free interval adjusted

Answer 17

about 6

Question 18

when to take a random

Answer 18

after start of conc, tells what interval pt will be on moving forward

Question 19

adjust the interval when and based on what

Answer 19

adjust interval based on a measured SCr obtained 6-14 hours after dose

Question 20

amino glycoside limitations

Answer 20

• achieve fixed peak and trough
• can’t individualize
• based on average not unique to patients
  (pregnant will have a lot of fluid and peak will be higher than it should be, cause toxicity)

Question 21

aminoglycoside nomogram is used for

Answer 21

tobra and gent, amikacin has a different nomogram

Question 22

what if the dot is on the border

Answer 22

go up a dose

Question 23

what is the time on the nomogram

Answer 23

time from start of infusion and time from sample draw

Question 24

look at two things for 1/ daily amino therapy

Answer 24

1. good crcl

2. pt is obese or not

Question 25

conventional dosing

Answer 25

1 daily amino

Question 26

vancomycin equation

Answer 26

0.17 (age) + 0.22 (TBW in kg) + 15 | average v, 0.5-0.7, less bacteria resistance

Question 27

digoxin vd

Answer 27

V = 3.8 (kg) + 3.1 (ClCr in ml/min)

Question 28

digoxin Cl without HF

Answer 28

0.8 mL/kg/min + (CrCl in ml/min) - use kg actual

Question 29

digoxin Cl with HF

Answer 29

0.33 mL/kg/min + 0.9 (CrCl in ml/min)

Question 30

loading dose

Answer 30

dose/vd = Cdesired

Question 31

Caverage

Answer 31

S x F x dose / Cl x Tau`

Question 32

elderly effect of CrCl

Answer 32

greater than 65 round Scr to 1

Question 33

CrCl in female

Answer 33

multiply by 0.85