I believe PkDose for Windows 1.0 would be helpful in my practice. Enclosed is $49 (U.S.) for the complete program that will print my results as well as store them in comma delimited ASCII format.+
Enclosed with this form is my check or money order payable to:+
Bruce J. Kiacz, R.Ph.
5434 Whitehouse-Spencer Road
Whitehouse, OH 43571D
Ship To:,
Use this field to enter the patient's name. It is suggested that you be consistent in your entries and always enter your patient's name in the order LAST NAME, FIRST NAME, MIDDLE INITIAL.
PkDose will automatically enter the current date as a default, The user may change this if desired.
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Use this field to record the name of the physician requesting the consult. It is probably a good idea to use the LAST NAME, FIRST NAME, MIDDLE INITIAL format.
PkDose provides a pick list of the most common uses of aminoglycosides or vancomycin. You may type in the diagnosis or use the mouse or arrow keys to scroll down the list of choices and select the disease state that most closely fits your patient.
Sepsis
Pneumonia/Lung Infection
Cellulitis
Wound/Soft Tissue Infection
Urinary Tract Infection
Pyelonephritis
Endocarditis
Meningitis
Peritonitis
Post-Operative
P.I.D.
Empiric Therapy
Use this field to enter the patient's age in years. Unlike the loading dose module, you may safely calculate effective maintenance doses for pediatric patients using measured serum drug concentrations in this, or the other serum concentration-based PkDose module.
0.3937
PkDose employs the method of Devine to calculate ideal body weight. Since this formula requires a minimum height of 60 inches, PkDose will accept a lesser entry but will perform IBW calculations as if the patient were 60 inches tall. Note also that ideal body weight is used in the calculation of creatinine clearance which may be, therefore, overstated in patients less than 60 inches tall.
Use this field to enter the patient's actual weight in pounds.
The only valid entries in this field are M or F. Entering any other letter or number will result in the default choice of F.
Use this field to enter the patient's most recent serum creatinine in mg/dl. PkDose employs the Cockcroft-Gault equation to calculate creatinine clearance.
PkDose uses the Cockcroft-Gault equation to calculate the creatinine clearance of adults 21 years of age, or older. That is, Creatinine Clearance = ((140-Age) * Ideal Body Weight)/(72 * Serum Creatinine). For females, the result is multiplied times 0.85.
For children ages 2 through 12 and females ages 13 to 21, Creatinine Clearance = (0.55 * Height in cm)/Serum Creatinine.
For males ages 13 to 21, Creatinine Clearance = (0.7 * Height in cm)/Serum Creatinine.
For children less than 2 years old, Creatinine Clearance = (0.45 * Height in cm)/Serum Creatinine.
Ideal Body Weight has been calculated for a minimum age of 1 year.
PkDose employs the method of Devine for calculating ideal body weight in adults over the age of 18. For males IBW = 50kg + (2.3kg * each inch height > 60). For females IBW = 45.5kg + (2.3kg * each inch height > 60).
For males that are less than 18 years old but at least 60 inches tall, IBW = 39kg + (2.27kg * each inch height >60). For females less than 18 years old, but at least 60 inches tall, IBW = 42.2kg + (2.27 * each inch height >60).
For all others who are less than 18 years old and less than 60 inches tall, IBW = ((Height in cm)
* 1.65)/1000.
PkDose will calculate an estimated regimen for four different antibiotics. Use the mouse or arrow keys to select your choice.
Gentamicin
Tobramycin
Amikacin
Vancomycin
In this field, enter the length of time, in hours, over which the sample dose was infused.
NOTE: This entry will become the default infusion time for the subsequent estimated maintenance dose. Make it a policy that all aminoglycosides and vancomycin be infused over fixed intervals to minimize dosing errors.
Enter the trough serum concentration in micrograms per milliliter in this field.
Enter the peak serum concentration in micrograms per milliliter in this field.
Many institutions assign a temporary ACCOUNT NUMBER to identify each admission, as well as a permanent MEDICAL RECORD NUMBER that identifies an individual patient. PkDose, therefore, provides both Account Number and Medical Record Number fields for your use. In the event that your institution does not use two identifiers, one may be left blank, or used to record other patient characteristics.
Gentamicin (
Tobramycin (
Amikacin (
PkDose will select a desired trough concentration based on your selection of diagnosis and medication. You may, of course, change this at any time to get a revised estimated loading dose and estimated dosing interval.
Gentamicin
Pneumonia/Lung Infection
Gentamicin (
Tobramycin
Pneumonia/Lung Infection
Tobramycin (
Amikacin
Pneumonia/Lung Infection
Amikacin (
PkDose will select a desired peak serum concentration based on your selection of diagnosis and medication. Tou may, of course, change this at any time to get a revised estimated loading dose and estimated dosing interval.
Many institutions assign a temporary ACCOUNT NUMBER to identify each admission, as well as a permanent MEDICAL RECORD NUMBER that identifies an individual patient. PkDose, therefore, provides both Account Number and Medical Record Number fields for your use. In the event that your institution does not use two identifiers, one may be left blank, or used to record other patient characteristics.
PkDose calculates the patient's individualized volume of distribution, for the selected medication, based on the amount of drug in the body and concentration measured in the plasma.
PkDose calculates the patient's individualized elimination constant using the measured peak and trough serum concentration data.
Use this field to enter a suggested maintenance dose. Select a value that is close to the estimated loading dose, but easily compounded. For instance 80 mg of gentamicin, which is 2 ml, rather than 83 mg which is a difficult to measure 2.075 ml.
Use this field to enter a suggested dosing interval. The user should select a value that is close to the estimated dosing interval, but convient to administer, such as every 8 hours, rather than every 7.5 hours. NOTE: PkDose will select a dose and interval to satisfy the requirements of desired peak and trough serum concentrations. Often, in patients with good renal function, the suggested dosing interval will be less than 8 hours.
IT IS NOT RECOMMENDED THAT AMINOGLYCOSIDE ANTIBIOTICS BE DOSED AT INTERVALS OF LESS THAN 8 HOURS.
MAKE IT A POLICY THAT THE MINIMUM DOSING INTERVAL IS NOT LESS THAN EVERY 8 HOURS!
In this field, PkDose will display the calculated peak serum concentration for the suggested dose and interval entered by the user.
In this field, PkDose will display the calculated trough serum concentration for the suggested dose and interval entered by the user.
Use this field to record the size of the dose in milligrams.
The format for date and time of the dose is 00/00/00 00:00. Use military (24 hour) time and leave a space between the date and time entries.
Enter the date and time of administration of the dose around which the serum concentrations were sampled. If the dose were given at noon on January 1, 1995, the correct format for data entry would be 01/01/95 12:00. Be sure to leave a space between the date and the time or PkDose will not accept your entry. Also, midnight is designated as 00:00 and not 24:00 as is commonly used.
Enter the date and time when the peak serum concentration was drawn. If the sample was taken at noon on January 1, 1995, the correct format for data entry would be 01/01/95 12:00. Be sure to leave a space between the date and the time or PkDose will not accept your entry. Also, midnight is designated as 00:00 and not 24:00 as is commonly used.
Enter the date and time when the trough serum concentration was drawn. If the sample was taken at noon on January 1, 1995, the correct format for data entry would be 01/01/95 12:00. Be sure to leave a space between the date and the time or PkDose will not accept your entry. Also, midnight is designated as 00:00 and not 24:00 as is commonly used.
PkDose calculates the half-life, or the amount of time in hours, required for the plasma concentration of the selected medication to decrease by one-half.
PkDose will generate an estimated maintenance dose based on the the desired peak and trough serum concentrations. This dose and associated dosing interval will usually be an odd number. It is up to the user to enter a suggested dose and interval that will be convenient to manufacture and administer.
PkDose will generate an estimated dosing interval based on the estimated maintenance dose and the desired peak and trough serum concentrations. As with the estimated maintenance dose this interval will usually be an odd number that will fit the peak/trough criteria. It is up to the user to select a more convient dose and interval that will yield acceptable peak and trough serum concentrations.
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Shareware
PkDose provides this field for user comments.
PkDose calculates the clearance of the medication in ml/min for convience in calculating other statistics.
The clinician may find this value helpful when assessing the patient's renal function.
Use this field to enter the location of the patient. PkDose will accept any alphanumeric combination.
PkDose calculates weight in kilograms for convience in calculating other statistics.
PkDose calculates height in centimeters for convience in calculating other statistics.
0.425
0.725
4.2745
10000
PkDose calculates body surface area using the method of DuBois and DuBois for convience in calculating other statistics.
Blood draws for therapeutic serum assay rarely coincide with the time of occurence of true peak serum concentrations. Therefore, to aid the clinician in the decision process, PkDose calculates the true peak serum concentration achieved by the sample dose.
While a True Peak serum concentration may be calculated for a loading dose, since the time of administration of the dose is known, the calculation of the True Trough concentration is impossible as the dosing interval has not yet been selected.
If the loading dose were the only dose given, the True Trough would be zero after seven half-lives.
Consequently, the measured Trough concentration appears in the True Trough field and a calculated Trough Serum Concentration is presented upon the clinician's selection of a suggested regimen.
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