NZ is a 35 year-old Native American male with weight 185 lbs and height 66 in, who has a history of hypertension, diabetes and chronic kidney disease. The serum creatinine (Scr) is 1.97 mg/dL. NZ is hospitalized with multidrug-resistant Pseudomonas aeruginosa bacteremia. The team wishes to treat this patient with an investigational antibiotic, Drug P. Drug P possesses concentration dependent bactericidal activity. Normal dosing for Drug P is 8 mg/kg/dose intravenously (IV) every 24 hours. Fractional excretion of Drug P is 0.73
1. Using the 4 variable MDRD equation, calculate the eGFR for NZ (round your answer to the nearest whole number).
2. Calculate the dosage adjustment factor for NZ's level of renal dysfunction.
3. Estimate an appropriate dosage regimen for NZ? (Round the dosing interval to the nearest 12 hours and the dose to the nearest 10 mg)
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Equation 27.3.2 IBW for Female Patients
Equation 27.3.3 Creatinine Clearance (Cockcroft-Gault Equation)
Equation 27.3.4 eGFR (MDRD Eqaution)
Equation 27.3.5 Dose Adjustment Factor
Equation 27.3.6 Adjusted Dosing Interval
Equation 27.3.7 Adjusted Dose
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