Calculate Loading Dose and Initial Maintenance Dose;
Calculate Maintenance Dose from Loading Dose Concentrations;
Calculate Maintenance Dose from Steady State Concentrations!
Exit PkDose and Return to Windows
Introduction
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Welcome to PkDose for Windows
Trial Version 1.0k
PkDose for Windows Version 1.0 by Bruce J. Kiacz, R.Ph. Copyright 1996
The author may be contacted at Compuserve at 102072, 2375 or via the Internet at 102072.2375 @ compuserve.com
CLICK ON THE DESIRED BUTTON WITH YOUR MOUSE OR
PRESS TAB THEN THE SPACEBAR TO SELECT YOUR CHOICE
Press F1 for help with data entry fields@
Press the F1 key if you are not sure what data should be entered into a field.
The potential for induced nephrotoxicity or ototoxicity in patients receiving aminoglycoside therapy requires the clinician to be ever vigilant in monitoring patients in his care. Although nephrotoxicity is usually reversible, ototoxicity is not and the potential for adverse effects increases as the length of exposure to high peak or trough serum concentrations is extended. Serum concentrations in excess of suggested trough levels may indicate tissue accumulation requiring dosage adjustment or discontinuation of the drug.
Laboratory parameters to be monitored include serum creatine, blood urea nitrogen and specific gravity of urine, as well as its examination for proteins, cells or casts suggestive of impending renal damage. Baseline audiometric testing with periodic follow up is suggested to track possible ototoxic effects.
Concurrent use of other nephrotoxic drugs or antibiotics should be avoided, if possible, particularly intravenously administered diuretics such as furosemide, bumetanide and ethacrynic acid.
Peak and trough serum concentrations should be drawn periodically throughout a patient's therapy. Checking these levels once every three days is not excessive even though the patient has achieved "steady state" with respect to his regimen.
In light of the above warnings, it is now appropriate to state that this software is supplied "as is" and without any warranties implied or expressed. Reasonable and prudent testing has been conducted to assure the safety of this program, but due to the diversity of the conditions of its use, as well as the experience of potential users, the author will, in no event, be liable for any damages, incidental or consequential, by said user or any third party, arising from the use of, or inability to use, this software. The user is herewith advised to test the program thoroughly before relying on it.
PkDose for Windows was written to provide clinicians with a worksheet for exploring the potential effects of alternative antibiotic regimens. The program is presented in three parts:
1. Calculation of a loading dose and initial maintenance dose based on an assumed volume of distribution. A "best guess" volume of distribution and calculated creatinine clearance are used to derive the elimination constant. Standard kinetic formulas are then applied to design an estimated regimen. The user may then adjust a suggested regimen by varing dose and interval, as well as go back and change the volume of distribution to view its effects on the suggested regimen.
2. Calculation of maintenance dose from measured loading dose serum concentrations. In some institutions, rapid lab turnaround allows calculation of the maintenance dose from two loading dose serum concentrations, before the first maintenance dose is due. For accuracy, it is suggested that the first concentration be drawn immediately after the loading infusion is completed, with the second draw at least two hours later (longer if renal impairment is suspected). The suggested regimen may then be adjusted to maximize the therapy based on elimination constant and volume of distribution derived from true serum concentration measurements.
3. Calculation of maintenance dose from measured steady state serum concentrations. This is the most familiar method that employs serum concentration data drawn after three to five maintenance doses. Usually this method is most accurate, as the patient is assumed to be at "steady state" with respect to his current regimen. The elimination constant and volume of distribution derived in this method is then used to adjust the suggested regimen, if necessary.
Prior to using PkDose, it is suggested that the clinician review each worksheet, stopping at each data field and pressing the F1 key to view the field help. The loading dose and initial maintenance dose calculations employed by PkDose are generally more agressive than other commonly used systems. It is suggested that the clinician use historical data from his current method to familiarize himself with the PkDose system.
Feel free to copy and share the trial version of PkDose for Windows with your colleagues.
Note, however, the Print and Store functions of the trial edition are not implemented. If, after testing, you are confident that PkDose for Windows will fulfill your needs, click on any Print or Store button to generate an order form.
The full version of PkDose for Windows will allow you to print your consults, just as they appear on the screen, as well as let you save your work in comma-delimited ASCII files that can be imported into almost all popular spreadsheet, database or word processing packages.
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disclaimer
As you examine the trial version of PkDose for Windows, it is suggested that the user press the F1 key at each data entry field.
Most users who have pharmacokinetic experience will find the program to be fairly intuitive. However, each data entry field does have a brief help screen to clarify the nature of the information needed or explain the basis of the calculation performed.
To enter the name of your pharmacy, choose "Change Pharmacy Name" from the File menu of the Main Menu screen.
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