What is the Hartford nomogram?
By Isabella Floyd
What is the Hartford nomogram?
The Hartford Nomogram method utilizes high-dose, once daily dosing to optimize the peak/MIC ratio in most clinical situations by administering a dose of 7mg/kg of either gentamicin or tobramycin.
What is dosing nomogram?
A nomogram is presented for the rapid determination of the dosage adjustment factor for drugs eliminated in part by the kidneys in patients with reduced renal function.
How do you monitor aminoglycosides?
Using a nomogram is a popular method of monitoring aminoglycoside treatment if extended interval dosing is being followed. Commonly used nomograms include the Hartford nomogram and Urban and Craig nomogram. All nomograms are designed for a certain population group with a fixed dose of aminoglycoside.
How do you calculate Ke for gentamicin?
CrCl > 40ml/min at 5mg/kg dose to a maximum of 500mg. CrCl 10-40ml/min at 3mg/kg dose to a maximum of 300mg. CrCl <10ml/min at 1mg/kg dose to a maximum of 120mg….
| Trough level | Interpretation | Action |
|---|---|---|
| >2mg/L | High risk | Stop gentamicin and contact a consultant microbiologist for advice |
When do you use the Hartford nomogram?
It’s recommended to obtain a random serum level 6 to 14 hours (for Hartford nomogram) and 8 to 12 hours (for Barnes-Jewish nomogram) after the start of the initial infusion. The resultant level is then plotted on the nomogram, in which optimal dosing interval can be determined.
When should amikacin levels be drawn?
Both peak and trough concentrations should be monitored. The trough sample is drawn immediately prior to the next dose. Peak samples should be drawn 60 minutes after an IM injection, 30 minutes after the end of a 30-minute IV infusion, or immediately after a 60-minute IV infusion.
What is a major side effect of aminoglycosides?
The major side effects of aminoglycosides are kidney injury, hearing impairment and vestibular toxicity.
What do aminoglycosides treat?
Aminoglycosides are used in the treatment of severe infections of the abdomen and urinary tract, as well as bacteremia and endocarditis. They are also used for prophylaxis, especially against endocarditis.
How do you calculate ideal body weight?
Ideal body weight is computed in men as 50 + (0.91 × [height in centimeters − 152.4]) and in women as 45.5 + (0.91 × [height in centimeters − 152.4]). A simple alternative would be to compute ideal body weight as the weight corresponding to an ideal body mass index of 22 kg/m2.
Why amikacin is given once daily?
For elderly patients a smaller dose of amikacin than the regular daily dose of 15 mg/kg bw, i.e. about 11 mg/kg bw, seems recommendable, when it is given once daily. From the data obtained it is also obvious that once-daily dosing of amikacin does not eliminate the need for checking serum concentrations of the drug.
How long is amikacin used for?
The recommended dose in prematures is 7.5 mg/kg in every 12 hours (see sections 4.4 and 5.2). The usual duration of treatment is 7 to 10 days. The total daily dose by all routes of administration should not exceed 15-20 mg/kg/day.
What is amikacin used to treat?
Amikacin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that surround the brain and spinal cord) and infections of the blood, abdomen (stomach area), lungs, skin, bones, joints, and urinary tract.
