4. J.C., a 70 year old male (5'8", 100 kg) is to begin Vancomycin (along with Zosyn and Levaquin) for broad-spectrum coverage for pneumonia (moderate infection with goal AUC 500-600). WBC=13.8, SCr=0.9 mg/dL. Using AUC dosing, please come up with a dosing regimen that is appropriate for JC. a. What is the dosing weight? CrCl ? b. What LD & MD & interval would you recommend? c. When should you order a vancomycin trough for J.C?

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Chapter19: Insurance And Reimbursement
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4. J.C., a 70 year old male (5'8", 100 kg) is to begin Vancomycin (along with Zosyn and Levaquin) for
broad-spectrum coverage for pneumonia (moderate infection with goal AUC 500-600).
WBC=13.8, SCr=0.9 mg/dL. Using AUC dosing, please come up with a dosing regimen that is
appropriate for JC.
a. What is the dosing weight? CrCl ?
b. What LD & MD & interval would you recommend?
c. When should you order a vancomycin trough for J.C?
Now, lets adjust his dose
Assume his initial dose was 1750mg q 12h scheduled at 0900 & 2100. Assume his doses were
given on time. The hospital policy required an infusion time of 2hr. The peak was 45ug/ml
drawn after the 4th dose at 1230, 3.5hr after the start of the infusion. The trough level was
21ug/ml drawn at 2030, 11.5hr after the 4th dose. How would you adjust the dose?
a. Calculate the patient specific k
b. Calculate Cmax & Cmin
c. Calculate the AUC
d. Calculate patient specific Vd
e. Calculate new dosing interval
f. Calculate new dose
g.calculate new AUC
h Confirm
peak+ trough within range
Transcribed Image Text:4. J.C., a 70 year old male (5'8", 100 kg) is to begin Vancomycin (along with Zosyn and Levaquin) for broad-spectrum coverage for pneumonia (moderate infection with goal AUC 500-600). WBC=13.8, SCr=0.9 mg/dL. Using AUC dosing, please come up with a dosing regimen that is appropriate for JC. a. What is the dosing weight? CrCl ? b. What LD & MD & interval would you recommend? c. When should you order a vancomycin trough for J.C? Now, lets adjust his dose Assume his initial dose was 1750mg q 12h scheduled at 0900 & 2100. Assume his doses were given on time. The hospital policy required an infusion time of 2hr. The peak was 45ug/ml drawn after the 4th dose at 1230, 3.5hr after the start of the infusion. The trough level was 21ug/ml drawn at 2030, 11.5hr after the 4th dose. How would you adjust the dose? a. Calculate the patient specific k b. Calculate Cmax & Cmin c. Calculate the AUC d. Calculate patient specific Vd e. Calculate new dosing interval f. Calculate new dose g.calculate new AUC h Confirm peak+ trough within range
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