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## onlinelibrary.wiley.com

Use these serum concentrations to compute the patient’s own pharmacokinetic parameters for vancomycin and a new dosage schedule that will achieve peak concentrations of 40 μg/mL and trough concentrations of 10 μg/mL. The dosage calculations are similar to those done in the initial dosage section Intermediate Accounting Test 1 Conceptual Questions Ch. 7-9 Flashcards of this chapter, except that the patient’s real pharmacokinetic parameters are used in the equations instead of population pharmacokinetic estimates. Determine the new dosage interval for the desired concentrations. In this example, the patient has a desired peak concentration of 30 μg/mL.

This patient has poor renal function (CrCl loading dose could be prescribed for this patient and given as the first dose. However, in this case, the loading dose is nearly identical to the maintenance dose, so the loading dose would not be given. The prescribed maintenance dose would be 1000 mg every 48 hours.

## Dosing Method

The prescribed maintenance dose would be 1750 mg every 13 days. This loading dose is similar to the suggested maintenance dose, so would not be prescribed. This loading dose is less than the suggested https://online-accounting.net/ maintenance dose, so would not be prescribed. The mechanism of this interaction is unknown, but resulted in a mean 45% increase in prothrombin time over baseline values when warfarin was given alone.

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## Linear Pharmacokinetics Method

While the Matzke nomogram has been shown to provide precise and unbiased dosage recommendations, it does supply relatively large doses because expected peak and trough concentrations are in the middle of their respective therapeutic ranges. Using the pharmacokinetic concepts method or the one-compartment model parameter method produced the same answer of 1250 mg every 12 hours. The Bayesian computer program suggests a longer dosage interval and larger dose because of the population pharmacokinetic parameter influence for volume of distribution on the dosing algorithm. If additional concentrations are input into the program, the effect of the population parameters will diminish and eventually produce the same answer as the other two methods. HY is a 45-year-old, 65-kg female bone marrow transplant recipient who develops methicillin-resistant S.

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- In order to do this, pharmacokineticparameters for the patient will be estimated using mean parameters measured in other individuals with similar disease state and condition profiles.
- A loading dose of 15 mg/kg is suggested by the Moellering nomogram.