Renal Pharmacokinetics Problem

Questions provided by Teresa Lewis, Pharm.D.

Cockcroft-Gault Equation only

TM is a 37 year-old female patient with weight 204 lbs and height 73 in, who has a history of hypertension, diabetes and chronic kidney disease. The serum creatinine (Scr) is 2.26 mg/dL. TM 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 0.8

1. Using the Cockcroft-Gault formula, calculate the creatinine clearance for TM (round your answer to the nearest whole number).

If ABW < IBW Use BW = ABW
If ABW between IBW and 1.3 x IBW Use BW = IBW
If ABW > 1.3 x IBW Use AdjBW

2. Calculate the dosage adjustment factor for TM's level of renal dysfunction.

3. Estimate an appropriate dosage regimen for TM using ABW. (Round the dosing interval to the nearest 12 hours and the dose to the nearest 10 mg)



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Some Equations:

IBW equation (male)
Equation 27.3.1 IBW for Male Patients

IBW equation (female)
Equation 27.3.2 IBW for Female Patients

Adjusted Body Weight
Equation 27.3.3 Adjusted Body Weight (AdjBW)

Creatine Clearance C-G Equation
Equation 27.3.4 Creatinine Clearance (Cockcroft-Gault Equation)

Dose Adjustment Factor
Equation 27.3.5 Dose Adjustment Factor

Adjusted Dosing Interval
Equation 27.3.6 Adjusted Dosing Interval

Adjusted Dose
Equation 27.3.7 Adjusted Dose


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