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Features:
Empiric vancomycin dosing that selects a classic equations with the highest probability of success using Naive Bayesian classifiers
Optimizations for AUC or trough targeted dosing, including intermittent or continuous infusion strategies
Redosing methods that support various therapeutic drug monitoring strategies
Side-by-side safety and effectiveness analysis for the top regimens
Instantly generate a clinical note appropriate for use in your electronic chart
Save and load cases for quick redosing as new levels are obtained
Customization of settings to fit your personal preferences or those of your institution
Versatile pharmacokinetics graphing for most common injectible medications
Unit conversion rate calculator for IV drips
Bonus TPN calculators
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YOUR SETTINGS
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Infusion Time 500mg
hr
AUC Method
▼
trapezoidal
primary pk
COLOR CENTER
Red
Green
Blue
- Option to cycle colors automatically or not
- Set default color: serious grey, money green, pleasant purple
check to cycle colors
Stored Colors
▼
id =
class =
(right click
to move me)
CLICK TO RECALCULATE . . .
DELUXE VANCOMYCIN CALCULATOR
YOUR PATIENT
REGIMEN PREDICTIONS
PHARMACOKINETICS
Start by completing this area,
Then select a dosing method
Sex
▼
male
female
Age
years
Height
cm
Weight
kg
SCr
mg/dL
VANCO SPECIFICATIONS
Optimize Calculations For
▼
AUC/MIC
serum levels
AUC
24
/MIC Target
-
Staph aureus MIC
mg/L
Trough Target
-
▼
15-20
10-15
Max Safe Peak
mcg/ml
Advanced...
TRENDING SERUM CREATININE
Estimates clearance when SCr not at steady state
Useful for dosing with empiric method
Earlier SCr
mg/dl
Later SCr
mg/dl
Earlier SCr Time
:
▼
clear times
same day
1 day ago
2 days ago
3 days ago
Later SCr Time
:
Time Between SCr Draws
hr
SCr Half-Life
hr
Renal Clearance
ml/min
Steady State SCr
mg/dL
VD CALCULATOR
From peak after first dose completes infusion
Requires first completing patient characteristics and selecting a dosing method
Record the result and enter manually to improve dosing for remainder of therapy
First Dose
mg
Peak Level
mcg/ml
Calculated Vd
L
GENERAL CALCULATIONS
CrCl
ml/min
IBW
kg
BMI
kg/m
2
BSA
m
2
SELECT DOSING METHOD
EMPIRIC - BAYESIAN
Recalculate and redose if renal function changes
A Bayesian naive classifier selects the published empiric equation that most frequently predicts therapeutic levels in a dataset of similar patients
Equation Chosen
Advanced...
Consider Weight Class
Consider Age Class
Consider Renal Class
Probability Correct
Try Equations
▼
Matzke
Burton (1991)
vanco-calc
Winter
Bauer (2001)
Ambrose
Ambrose 2
Leonard
Leonard 2
Rodvold
Birt (1990)
Crass (2018)
Creighton (1992)
Subpop Count
REDOSING - PEAK AND TROUGH
More accurate closer to steady state, but not required
Draw peak 1-2 hours after infusion completes
Draw trough at least one half-life after peak
Dose Strength
▼
500
750
1000
1250
1500
1750
2000
mg
Peak Level
mcg/ml
Trough Level
mcg/ml
Peak Level Time
:
▼
clear times
same day
1 day ago
2 days ago
3 days ago
Trough Level Time
:
Time Between Levels
hr
REDOSING - TROUGH ONLY
Improved by calculating Vd with initial peak level
Unreliable in the first few days of therapy
Regimen
▼
8
12
24
▼
500
750
1000
1250
1500
1750
2000
mg
hr
Last Dose Time
:
▼
clear times
same day
1 day ago
2 days ago
3 days ago
Trough Time
:
Dose to Trough Time
hr
Trough Result
mcg/ml
Time Adjusted Trough
mcg/ml
REDOSING - SINGLE DOSE
If this is not the first dose, a previous level is required
Previous Level
mcg/ml
Previous Level Time
:
▼
clear times
same day
1 day ago
2 days ago
3 days ago
Single Dose Time
:
Time Passed Since Level
hr
Finds clearance after a single dose then level
Likely inaccurate if used in the first few doses, more useful to salvage erratic dosing later in therapy
Single Dose
mg
Single Dose Time
:
▼
clear times
same day
1 day ago
2 days ago
3 days ago
New Level Time
:
Time Passed Since Dose
hr
New Random Level
mcg/ml
MANUAL CLEARANCE
When clearance is known from previous calculations
If you know Vd as well, enter it in the upper right
Hourly Vanco Clearance
%
CrCl From Bays Equation
ml/min
TEST DOS EQS
Emp Reg
▼
8
12
24
▼
500
750
1000
1250
1500
1750
2000
mg
hr
Then choose and click
a regimen on the chart
Green
predicts a therapeutic steady state
red
predicts in range but safety issue
STANDARD DOSING
peak
trough
auc/mic
Dosing Interval
Dose
in mg
q8h
q12h
q24h
500
750
1000
1250
1500
1750
2000
Loading Dose
mg
Loading Dose Peak
mcg/ml
You may enter any non-standard regimen here
mg
q
h
Finish by examining PK details, then graph it or author a note
Top regimens sorted by nearness to the trough target and showing pharmacokinetic or toxicity issues
Peak Predicted
hr
Trough Predicted
hr
AUC
24
/MIC Predicted
hr
Infusion Time
hr
Hourly Vanco Clearance
%
Vd
L
Half-Life
hr
Steady State After Dose
#
Level Decreases to
hr
DOSING ADVICE
None at present!
REPORT RESULTS
Include loading dose:
Clear and start at steady state:
CONTINUOUS INFUSION
Continuous Infusion Target
(mcg/ml)
-
CI Rate Range
(mg/hr)
-
Choose Rate
mg/hr
CI Loading Dose
mg
CI Steady State Prediction
mcg/ml
CI AUC
24
Prediction
Drug in 24hr 500mL Bag
mg
Final Rate of Infusion
ml/hr
Include loading dose:
CASE FOLDER
Click
Save Case
and record the current case.
Load a case by entering a previously recorded code and then clicking
Load Case
.
After loading a case, if you make changes, click on
Update Case
to update it.
Evergreen Only:
for dataset?
PHARMACOKINETICS GRAPHING
Chart Setup
PK To Use
:
Reset Graph
:
Cl/hr:
Vd:
Start lvl:
Click a calculator regimen,
or enter manually here
Graphing Controls
Simple Graphing
:
Power Graphing
:
Continuous Infusion
:
Dose (mg)
Time (hr)
Dose (mg)
Give dose at
day:
+
time:
:
mg per hr:
Hrs to infuse:
OTHER PHARMACIST TOOLS
DRIP RATE CONVERTER
Current Rate
units
ng
mcg
mg
g
units / kg
ng / kg
mcg / kg
mg / kg
g / kg
mL
L
/
sec
min
hr
day
Desired Rate
units
ng
mcg
mg
g
units / kg
ng / kg
mcg / kg
mg / kg
g / kg
mL
L
/
sec
min
hr
day
Patient Weight
kg
To calculate concentration may use
Mass/Volume
%
or
Ingredient Mass
units
ng
mcg
mg
g
Diluent Volume
mL
L
or just enter manually
Concentration
units / mL
ng / mL
mcg / mL
mg / mL
g / mL
units / L
ng / L
mcg / L
mg / L
g / L
RESULT
TPN CALCULATIONS
TPN Variables...
Custom Lipid Calories
kcal/g
Custom Fluid Needs
mL/kg
Serum Calcium
mg/dL
Serum Albumin
g/dL
Corrected Calcium
mg/dL
Dextrose
g
Amino Acids
g
Lipids
g
Total Kcal
Kcal
Percent Lipids
%
Estimated Fluid Needs
mL
HYPER / HYPONATREMIA
INSTRUCTIONS
↝
Current Serum Sodium
mmol/L
Desired Serum Sodium
mmol/L
Serum Glucose
(optional)
mg/dL
Corrected Sodium
mmol/L
Serum Na Correction Rate
mmol/L/hr
HYPONATREMIA CALCULATOR
Sodium Deficit
mEq
Fluid Type
▼
5% saline (856 mmol/L Na)
3% saline (513 mmol/L Na)
2% saline (341 mmol/L Na)
NS (154 mmol/L Na)
LR (130 mmol/L Na)
Fluid Infusion Rate
ml/hr
Estimated Infusion Duration
hr
HYPERNATREMIA CALCULATOR
Fluid Type
▼
D5W (0 mmol/L Na)
1/4 NS (34 mmol/L Na)
1/2 NS (77 mmol/L Na)
LR (130 mmol/L Na)
PHARMACOKINETICS POWER TOOL
Test results of one-off doses
You do not need to use every field
Hourly Clearance
%
Last Known Level
mcg/ml
Last Level Time
:
▼
clear times
same day
1 day ago
2 days ago
3 days ago
Dose Time
:
Level to Dose Time
hr
Level Before Dose
mcg/ml
Single Dose
mg
Level after Dose
mcg/ml
Level Drops to Target In...
hr