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Vancomycin – Single Level Analysis – Timing off
Vancomycin – Single Level Analysis – Timing off [Explained]
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Vancomycin - Single Level Analysis
Current dose being given
Current dosing interval
Current infusion time (hrs)
Single level drawn - Trough
Trough level obtained
When was the trough drawn?
Enter number of hours since last dose
: This version was requested because the actual dosing interval may deviate from the medical order (nurse
dose early/late etc). The time below should reflect the number of hours since the last dose was given. If the trough level was drawn 12.5 hours after the last dose, enter 12.5. Note: program will use this as the new dosing interval in order to take into account the extended elimination time. In the
the denominator is calculated by subtracting the dosing interval from the time the trough was drawn.
A new program
was created to determine when to administer the next dose of vancomycin after a supratherapeutic trough is obtained. An estimated elimination rate constant is generated from the creatinine clearance which is then used to determine the timing of the next dose based on the desired target trough concentration.
I also updated our current
to also generate an estimated vancomycin kel value based on the creatinine clearance. Use this program if the vancomcyin level is drawn early and you want to estimate the actual trough just before the next dose to determine if the current regimen is appropriate -
link to new program
Ambrose-Winter's Single Trough Method
A population Vd is used to estimate the [Peak].
This calculated [Peak] and measured [Trough] are then used to calculate an elimination rate constant (kel).
[Peak]=measured [Trough] + Dose/Vd
kel = ln ([Peak]/[Trough])/Tau
Infusion equations are then used to calculate a new Tau and Dose.
: the NewMedicalTerms calculator uses the Vd recommended in Bauer's text: 0.7 L/kg.
if you wish to manipulate this value.
Ambrose PJ, Winter ME. In: Winter ME. Basic clinical pharmacokinetics, 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2004:451-76.
Alternate expression of kel equation
Normally kel = (Ln C1 / C2) / (t2 - t1)
C1= actual or extrapolated Peak; or post peak level
C2= actual or extrapolated trough; or random level
Drawn at least 1.5 x estimated half-life after first level.
(t2 - t1) = Time difference between levels.
Equation 15.5 page 455:
cmax = [cmin + dose (s) (f)] / Vd
Related pharmacokinetic calculators
Allows the user to estimate the actual (extrapolated) trough based on the elimination rate constant and the number of hours the level was drawn before the next scheduled dose. A supratherapeutic level may be actually therapeutic if it was drawn just before the next dose.
Trough drawn early? -Estimation Tool based on entered Kel
This new program can be used to determine when to administer the next dose of vancomycin after a supratherapeutic trough is obtained. An estimated elimination rate constant is generated from the creatinine clearance which is then used to determine the timing of the next dose based on the desired target trough concentration.
Vancomycin -Timing of next dose based on estimated Ke value
Use this program if the vancomcyin level is drawn early and you want to estimate the actual trough just before the next dose to determine if the current regimen is appropriate
Vancomycin  - Predicted Trough-Level drawn early
Dosing by levels
Dosing by levels
Dosing by levels  - pharmacokinetics (quick)
Non-Steady State kinetics
Pharmacokinetics -Multiple Ke (Advanced version)
Pharmacokinetic dosing -aminoglycosides/Vanco Original program
Vancomycin  - Single-level dosing
Vancomycin SINGLE Level-(dosing by levels) Original calc
If you would like to enter the time since the last dose was given, use this version. This new version may be especially useful if the trough was drawn late and thenext dose was delayed. Example: current regimen vanco 1 gram q12h. Trough wasdrawn 12.5 hours after the last dose.
Vancomycin single-level  - dose infused early or late
The NewMedicalTerms vancomycin single-level calculator uses the Vd recommended in Bauer's text: 0.7 L/kg. Use the advanced version if you wish to manipulate this value.
Vancomycin single level  - Advanced version
Vancomycin  - Empiric dosing
Vancomycin Empiric dosing - AUC/MIC